멀티패스 레이저 클래딩에 있어서 중첩률의 기준에 따른 클래드 층의 특성 비교

김종도(Jong-Do Kim),이은진(Eun-Jin Lee),황준구(Jun-Gu Whang) 한국마린엔지니어링학회 2016 한국마린엔지니어링학회지 Vol.40 No.9

Birmingham 고관절 표면치환술 - 최소 5년 추시 결과 -

김원유 ( Weon Yoo Kim ),지종훈 ( Jong Hun Ji ),박상은 ( Sang Eun Park ),김영율 ( Young Yul Kim ),도정훈 ( Jung Hoon Do ) 대한고관절학회 2007 Hip and Pelvis Vol.19 No.2

목적: 고관절 병변의 치료를 위하여 Birmingham 표면치환술로 시행한 인공 고관절 치환술의 최소 5년 이상의 추시결과를 보고한다. 대상 및 방법: 2001년 8월부터 2002년 4월까지 Birmingham 표면 치환술을 이용하여 고관절 전치환술을 시행하였던 17명(남자 8명, 여자 9명)의 20예를 대상으로 하였고 모든 환자는 추시가 가능하였다. 질병분류를 보게 되면 대퇴 골두 무혈성 괴사가 11예, 골성 관절염이 7예, 강직성 척추염이 2예이었다. 수술시 연령은 평균 35.9세(범위;22~65세)이다. 임상적으로는 Harris Hip score를 이용하여 평가하였고 추적 방사선 촬영을 이용하여 골 용해, 비구 컵 및 주대의 이동, 대퇴골 경부의 골절, 인공관절 주위의 골음영 변화 등을 관찰하였다. 결과: 임상적으로 Harris hip score는 술전 38점에서 최종 추시 시 94점으로 현저한 증가가 있었으며 합병증으로는 대퇴 골두 무혈성 괴사 환자에서 시행한 경우 대퇴 경부골절이 발생하여 기존의 무시멘트 대퇴 스템으로 재치환하여 재수술을 한 경우가 2예, 최종 추시에도 완전히 회복되지 않은 좌골 신경 불완전마비가 1예 있었다. 방사선적으로는 골용해, 비구 컵과 주대의 이동은 없었으며 전례에서 차이는 있으나 비구컵 주위에서 이차적으로 적응되면서 재배치되는 것으로 생각되는 골소주의 변화 및 골다공증이 관찰되었다. 결론: Birmingham 표면치환술을 이용한 인공 고관절 전치환술은 대퇴골두 무혈성괴사에서 시행할 시는 후일 경부골절이 합병될 위험이 있으며 기존의 인공 관절 치환술과는 달리 대퇴 골두를 보존하면서 수술하게 되므로 수술 시야가 협소해 지므로 좌골신경의 과다한 견인으로 인한 마비를 주의하여야 할 것을 유념하여야 한다. Purpose: We wanted to evaluate more than 5 years of the clinical follow-up results of Birmingham hip joint resurfacing arthroplasty. Materials and Methods: 20 cases of Birmingham resurfacing arthroplasties were performed in 17 patients (8males and 9 females) between August 2001 and April 2002. Eleven patients had avascular necrosis of the femoral head, nine had osteoarthritis and two had ankylosing spondylitis. All the patients could be followed-up and the mean age at the time of operation was 35.9 (range: 22~65) years. Clinical evaluation was done with using the Harrris hip score; the osteolysis, migration of the femoral component and acetabular cup, the presence of femoral neck fracture and the secondary changes around the components were evaluated according to the radiological follow up findings. Results: The mean preoperative Harris hip score of 38 points was improved to 94 points at the time of the final follow-up. Complications developed in the avascular necrosis patients, in the two cases of femoral neck fracture and in one case of incomplete sciatic nerve palsy. There was no osteolysis or movement of the femoral cap, peg and acetabular cup on the radiological evaluation. Some degree of periacetabular osteoporosis and some change of the trabecular pattern were found in all cases due to the secondary change from mechanical stress. Conclusion: Birmingham resurfacing hip arthroplasty provided excellent clinical and radiological results, and especially in the osteoarthritis patients. Special concern might be needed for the patients with avascular necrosis of the femoral head and for protecting the sciatic nerve.

복수가 동반된 간경변증을 가진 말기 신부전 환자에서 복막투석의 안정성

김정인 ( Jung In Kim ),이정은 ( Jung Eun Lee ),백현정 ( Hyun Jeong Baek ),최성철 ( Sung Chul Choi ),도정호 ( Jung Ho Do ),허우성 ( Woo Seong Huh ),김윤구 ( Yoon Goo Kim ),김대중 ( Dae Joong Kim ),오하영 ( Ha Young Oh ) 대한신장학회 2007 Kidney Research and Clinical Practice Vol.26 No.3

Purpose : When liver cirrhosis patients accompanying ascites need renal replacement therapy because of chronic renal failure (CRF), peritoneal dialysis (PD) can allow direct removal of ascites and prevent anticoagulants use. However, since PD might aggravate hypoalbuminemia and increase chances of peritonitis, clinicians tend to hesitate to apply it to those patients. The aim of the present study is to assess the outcome and stability of PD for the treatment of CRF patient with cirrhosis accompanying ascites. Methods : A retrospective study based on the clinical records was performed in cirrhotic patients with ascites in whom PD was performed for the treatment of CRF and who were followed up at Samsung Medical Center unit, between January 1995 and July 2005. Results : In our study, 15 patients were enrolled. Child-pugh class was worse in non-survival group than survival group (p<0.01). One-year patient survival was 40% in Class C and 75% in Class B, and patient survival differed between Class C and Class B (p=0.0014). Causes of death were terminal liver failure (n=6) and sepsis due to pneumonia (n=1). Total 27 episodes of peritonitis occurred, and the peritonitis rates were 0.91 episodes/patients-year. Conclusion : Although the peritonitis rates turned out somewhat high, the use of PD for the treatment of CRF in patients with liver cirrhosis accompanying ascites seems to be safe and effective. Main cause of death in our study seems to be related to liver disease.

건강한 한국인 성인 남자에서 성호르몬과 대사증후군과의 연관성

김석 ( Seok Kim ),이은정 ( Eun Jung Rhee ),석효선 ( Hyo Sun Seok ),최영길 ( Young Gil Choi ),정원길 ( Won Gil Chung ),이도영 ( Do Young Lee ),김세연 ( Se Yeon Kim ),정찬희 ( Chan Hee Jung ),박철영 ( Cheol Young Park ),이원영 ( Wo 대한내과학회 2007 대한내과학회지 Vol.73 No.6

목적: 여러 연구에서 남성호르몬의 감소가 제2형 당뇨병, 인슐린저항성, 고인슐린 혈증, 이상지질혈증, 대사증후군과 관련이 있다고 보고되었다. 그러나 아직까지 국내에서는 남성호르몬과 심혈관계에 위험인자로 알려진 이상지질혈증, 인슐린저항성과 대사증후군 등에 대한 연구가 부족한 실정이다. 본 연구는 한국인 성인 남성에서 성호르몬 농도와 대사증후의 연관성에 대해 알아보기 위해 시행되었다. 방법: 2003년 6월부터 2003년 7월까지 강북삼성병원검진센터에서 건강 검진을 받은 289명의 성인 남성을 대상으로 하였다. 연구는 검진센터에서 기록된 자료를 기초로 하였고, 수정된 국제 콜레스테롤 교육 프로그램 성인치료 패널 III 기준에 근거하여 대사증후군을 정의하였다. 혈중 총 테스토스테론 농도는 방사면역 측정법을 이용해서 측정하였고, 혈중 성호르몬 결합글로불린은 면역방사계측정법을 이용해서 측정하였다. 결과: 총 대상군에서 대사증후군의 유병율은 15.6%였고, 건강한 남성에서 연령과 체질량지수를 보정한 후에 총 테스토스테론의 농도는 고밀도 지단백 콜레스테롤, 공복 인슐린, 요산과 상관관계를 보였으며, 성호르몬 결합글로불린은 이완기 혈압, 요산, 중성지방, 공복 인슐린, 인슐린저항성 지표와 상관관계를 보였다. 나이, 흡연력, 음주력과의 상호작용을 통제한 후에도 총 테스토스테론과 성호르몬 결합글로불린의 감소와 에스트라디올의 증가는 대사증후군의 유병율과 유의한 상관관계를 보였다. 결론: 건강한 한국인 성인 남성에서의 성호르몬 결합글로불린의 감소와 에스트라디올의 증가는 대사증후군에 유병율에 유의한 영향을 미쳤고 이상지질혈증에도 관련이 있었다. 앞으로 테스토스테론 보충 요법 후의 여러 대사 지표들의 변화에 대한 연구도 흥미로울 것으로 생각된다. Background: Recent studies report an association of decreased testosterone levels with type 2 diabetes mellitus, insulin resistance, hyperinsulinemia, dyslipidemia and metabolic syndrome. However, studies on correlations of testosterone with dyslipidemia, insulin resistance and metabolic syndrome in Koreans are scarce. We analyzed the relationship between levels of sex hormones and metabolic syndrome, lipid profiles and insulin resistance in Korean adult males. Methods: A total of 289 males were selected among the participants in a medical health check-up from June to July 2003 at Kangbuk Samsung Hospital Health Promotion Center. Metabolic syndrome was defined according to the Modified National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATP) III. The serum total testosterone level was measured using a radioimmunoassay and sex hormone binding globulin (SHBG) was measured using a radioimmunometric assay. Results: The prevalence of metabolic syndrome was 15.6% and the total testosterone level showed a significant correlation with the levels of high-density lipoprotein cholesterol, fasting insulin, and uric acid even after adjustment for age and body mass index (BMI). Serum SHBG showed a significant correlation with diastolic blood pressure, uric acid, triglyceride, fasting insulin and insulin resistance indices. In logistic regression analysis in which age, drinking history, and smoking status were adjusted, decreased total testosterone and SHBG levels as well as increased estradiol levels showed significant correlations with an increased prevalence of metabolic syndrome. Conclusion: This study shows that decreased total testosterone and SHBG levels and an increased estradiol level were significantly correlated with increased metabolic syndrome prevalence and dyslipidemia in healthy Korean male adults. Further studies are suggested for the association of sex hormone replacement and the changes in the metabolic status. (Korean J Med 73:565-574, 2007)

경정맥을 통한 간생검의 유용성과 안전성

김도하(Do Ha Kim),김홍자(Hong Ja Kim),박능화(Neung Hwa Park),이근찬(Geun Chan Lee),정영화(Young Wha Chung),이영상(Young Sang Lee),구동억(Dong Erk Goo),윤현기(Hyeon Ki Yoon),성규보(Kyu Bo Sung),유은실(Eun Sil Yu),서동진(Dong Jin Suh) 대한내과학회 1998 대한내과학회지 Vol.54 No.2

N/A Objectives : Liver biopsy is an essential tool to confirm suspected diagnosis and to guide specific therapy in patients with liver disease. But, the standard percutaneous needle biopsy is contraindicated in patients with coagulopathy and large amount of ascites. The transjugular approach has been developed for these problem cases, but its efficacy and safety has not been adequately tested in Korea. Methods : We retrospectively analysed 21 transjugular liver biopsy cases, and the success rate of procedure, the adequacy of obtained specimen for diagnosis and procedure related complications were reviewed. Results : The major reasons for trasjugular liver biopsy were coagulopathy(71%) and massive ascites(19%). Liver tissue was obtained successfully in 20 of 21 cases. The mean number of specimens was 3.4±1.1 per case and the mean size of specimen was 1.8±0.7mm Pathologists reviewed and judged as adequate for diagnosis in 13 cases(65%), helpful in 6 cases(30%), and inadequate in 1 case. Minor complications such as neck pain, hematoma at puncture site, or transient fever occurred in 5 cases (23.8%) but there was no major complication or procedure-related mortality. Conclusion: Transjugular liver biopsy is a safe and valuable technique that provides adequate diagnostic informations in about two thirds of patients for whom conventional percutaneous biopsy is contraindicated.

흥분독성 소뇌손상 백서모델에서 운동기술학습이 균형 및 협응력에 미치는 영향

김기도 ( Gi Do Kim ),민경옥 ( Kyung Ok Min ),심재환 ( Jae Hwan Shim ),정재영 ( Jae Young Jeong ),김용억 ( Young Eok Kim ),김경윤 ( Kyung Yoon Kim ),김계엽 ( Gye Yeop Kim ),심기철 ( Ki Cheol Sim ),김은정 ( Eun Jung Kim ),남기원 ( K 대한물리의학회 2010 대한물리의학회지 Vol.5 No.3

Purpose:This study is intended to examine the motor skill learning on balance and coordination in the cerebellar injured rats by 3AP. Methods:This study selected 60 Sprague-Dawley rats of 8 weeks. Experiment groups were divided into four groups and assigned 15 rats to each group. Group Ⅰ was a normal control group(induced by saline); Group Ⅱ was a experimental control group(cerebellar injured by 3AP); Group Ⅲ was a group of motor skill learning after cerebellar injured by 3AP; Group Ⅳ was a group of treadmill exercise after cerebellar injured by 3AP. In each group, motor performance test, histologic observations, synaptophysin expression and electron microscopy observation were analyzed. Results:In motor performance test, the outcome of group Ⅱ was significantly lower than the group Ⅲ, Ⅳ (especially group Ⅲ)(p<.001). In histological finding, the experimental groups were destroy of dendrities and nucleus of cerebellar neurons. Group Ⅲ, Ⅳ were decreased in degeneration of cerebellar neurons(especially group Ⅲ). In immunohistochemistric response of synaptophysin in cerebellar cortex, experimental groups were decreased than group Ⅰ. Group Ⅲ`s expression of synaptophysin was more increased than group Ⅱ, Ⅳ. In electron microscopy finding, the experimental groups were degenerated of Purkinje cell. Conclusion:These result suggest that improved motor performance by motor skill learning after harmaline induced is associated with dynamically altered expression of synaptophysin in cerebellar cortex and that is related with synaptic plasticity.

혈관조영상 잠재혈관기형에 대한 선형가속기형 정위방사선수술의 임상경험

김대용(Dae Yong Kim),안용찬(Yong Chan Ahn),이정일(Jung Il Lee),남도현(Do-Hyun Nam),임도훈(Do Hoon Lim),이정은(Jeong Eun Lee),여인환(Inhwan J Yeo),허승재(Seung Jae Huh),노영주(Young Joo Noh),신성수(Seong Soo Shin),홍승철(Seung-Chyul H 대한방사선종양학회 2001 Radiation Oncology Journal Vol.19 No.1

목 적 :혈관조영상 잠재혈관기형(angiographically occult vascular malformation, AOVM)의 치료에 정위방사선수술을 적용하여 병변의 영상학적 반응과 임상 경과, 치료에 대한 부작용을 분석하여 AOVM의 치료 시 정위방사선수술의 역할을 정립하고자 한다. 대상 및 방법 : 1995년 2월부터 1999년 12월까지 AOVM으로 진단 받은 11명(12병변)의 환자에 대하여 선형가속기를 이용한 정위방사선수술을 시행하였다. 모든 병변은 자기공명영상에서 병변의 중심부에는 이질적인 고신호를 보이며, 저신호의 테두리로 둘러 쌓여 경계가 분명한 혈관기형 소견을 보였다. 정위방사선수술 시 처방선량은 회전중심점 선량 기준으로 67∼80% (중앙값 80%) 등선량곡면에 13∼25 Gy (중앙값 16 Gy)이었으며, 모두 단일 회전중심점을 이용하였고, 8∼20 mm (중앙값 14 mm) 크기의 원형 콜리메이터를 사용하였다. 결 과 :추적관찰 기간은 12∼56개월(중앙값 42개월)이었다. 재출혈이 일어난 경우는 3예로 치료 후 5, 6, 12개월 때 각 1차례씩 발생하였고 이후 추가적인 재출혈은 없었다. 정위방사선수술로 인한 조직괴사는 2예에서 발생하였으며, 모두 영구적인 신경학적 후유증을 초래하였다. 임상증세를 동반하지 않은 채 T2 강조영상에서 병변 주위의 부종이 관찰된 경우도 1예 발생하였다. 결 론 :정위방사선수술을 이용한 AOVM의 치료는 재출혈을 효과적으로 방지할 수 있는 치료방법으로 생각된다. 그러나 동정맥기형에 비하여 신경학적 후유증이 발생할 확률이 높기 때문에 치료 환자의 선택과 처방선량의 결정 시에는 보다 신중한 고려가 필요하다 Purpose :To establish the role of stereotactic radiosurgery (SRS) for the treatment of patients with angiographically occult vascular malformation (AOVM). Materials and Methods : Eleven patients (12 lesions) with AOVM were treated with linear acceleratorbased SRS between February 1995 and December 1999. A magnetic resonance imaging of each patients showed well- circumscribed vascula r lesion with reticulated core of heterogeneous signal intensity and peripheral rim of low signal intensity. SRS were performed with the median peripheral dose of 16 Gy (range 13∼25). A single isocenter was used with median collimator size of 14 mm (range 8∼20) diameter. Results :With a median follow- up period of 42 months (range 12∼56), rebleeding occurred in 3 AOVMs at 5, 6 and 12 months after SRS but no further bleeding did. Two patients experienced radiation- induced necrosis associated with permanent neurologic deficit and one patient showed transient edema of increased T2 signal intensity. Conclusion : SRS may be effective for the prevention of rebleeding in AOVM located in surgically inaccessible region of the brain. Careful consideration should be needed in the decision of case selection and dose prescription because the incidence of radiation- induced complications is too high to be accepted.

스마트 콘텐츠를 위한 UX/UI 기술 동향

김시정(Si-Jung Kim),조도은(Do-Eun Cho) 한국콘텐츠학회 2016 한국콘텐츠학회지 Vol.14 No.1

한방병원에 입원한 뇌졸중환자의 역학적 동향에 대한 임상적 관찰

김승은(Seung-Eun Kim),김도형(Do-Hyung Kim),고창남(Chang-Nam Ko),김용석(Yong-Suk Kim),박동원(Dong-Won Park),이경섭(Kyung-Sub Lee) 대한한의학회 2000 대한한의학회지 Vol.21 No.4

IOT(Internet of Things) 보안 기술 동향

김시정(Si-Jung Kim),조도은(Do-Eun Cho) 한국콘텐츠학회 2015 한국콘텐츠학회지 Vol.13 No.1