우리나라의 핵융합에너지 개발 정책

김창우,Kim, Chang-U 한국원자력산업회의 2006 원자력산업 Vol.26 No.11

신생아 경련의 임상적 양상 및 예후에 관한 고찰

김창우,장창환,김행미,최병호,권순학,Kim, Chang Wu,Jang, Chang Hwan,Kim, Heng Mi,Choe, Byung Ho,Kwon, Soon Hak 대한소아청소년과학회 2003 Clinical and Experimental Pediatrics (CEP) Vol.46 No.12

목 적 : 신생아 경련은 일반적으로 임상적 양상이 소아나 성인과는 크게 다르며 그 빈도도 드물지 않다. 그러나 국내에서는 이에 대한 연구 및 자료가 부족하여 저자들은 신생아 경련으로 입원한 환자를 대상으로 이들의 임상양상, 치료 및 예후에 관해 알아보고자 본 연구를 시행하였다. 방 법 : 2000년 1월부터 2003년 4월까지 경북대학교병원 소아과에서 신생아 경련으로 치료받았던 41명(남 24, 여 17, 재태연령 $38.4{\pm}3.6$주)을 대상으로 후향적 연구를 시행하였으며 이들의 병력상에 나타난 위험인자, 신경학적 진찰소견, 검사실 소견, 뇌 영상소견, 뇌파소견, 경련의 양상, 치료에 대한 반응 및 예후를 비교하였다. 결 과 : 경련시작 당시의 나이는 $6.1{\pm}4.6$일이었고 경련의 양상은 다발성 간대가 17례(42%), 비정형적 발작이 10례(24%)로 가장 많았다. 병력상 위험인자로서는 비정상적 분만력 및 신생아 가사가 11례(27%), 전해질 이상이 11례(27%), 경련의 가족력이 3례(7%), 뇌의 구조적 이상이 3례(7%), 기타 저혈압 2례(5%) 핵황달, 청색형 선천성 심장병으로 인한 저산소증, 선천성대사이상 등이 3례(7%)였으며 나머지 8례(20%)에서는 위험인자가 발견되지 않았다. 뇌영상 촬영상 21례(51%)에서 비정상적인 소견을 보였으며 이중 뇌출혈이 9례(22%)였으며 뇌백질연화증이 2례(5%), 뇌경색이 2례(5%)였고 그 외 선천성 수두증, cortical dysplasia, dural sinus thrombosis, 시상부위 음영증가 등의 소견을 보였다. 뇌파는 전체 41례 중 33례에서 시행되었고 17례(52%)에서 이상소견을 보였다. 치료는 저혈당이나 전해질이상이 동반된 경우 이를 교정해 주었으며 항경련제로는 phenobarbital을 1차 약제로 사용하였고 반응이 없는 경우 phenytoin을 추가하였다. 경련이 재발하거나 나쁜 예후를 보인 환아들은 많은 수에서 신생아 가사에 의한 뇌손상이나 뇌의 선천성 기형이 있었으며 뇌파상에 비정상적인 배경파나 뇌영상소견상 이상을 보이는 경우가 많았다. 결 론 : 신생아 경련의 많은 경우가 비정상적인 출산력과 미숙아, 기타 전해질이상과 관련된 문제가 많았고 전반적으로 약물에 대한 반응이 좋았으며 경련 발생 당시의 임상적 소견이나 검사소견 특히 뇌파나 뇌영상 촬영 소견상 큰 이상이 없었던 경우에는 예후가 좋았다. 따라서 신생아 경련의 위험요소를 잘 이해하고 분만 및 경련발생 시 적절한 대처를 해주는 것이 환아의 예후에 중요한 요인으로 작용하는 것 같다. Backgroud : Seizures in the neonate are relatively common and their clinical features are different from those in children and adults. The study aimed to provide the clinical profiles of neonatal seizure in our hospital. Methods : A total of 41 newborns with seizures were enrolled in this study over a period of three years. They were evaluated with special reference to risk factors, neurologic examinations, laboratory data, neuroimaging studies, EEG findings, seizure types, response to treatment, and prognosis, etc. Results : The average age at onset of seizures was $6.1{\pm}4.6days$ and the majority of patients(42%) had multifocal clonic seizure and 24% had subtle seizure. Factors that are known to increase risk of neonatal seizures include abnormal delivery history, birth asphyxia, and electrolyte imbalance, etc. However, they remain obscure in about 20% of cases. More than 50 percent showed abnormal lesions on neuroimaging studies such as brain hemorrhage, periventricular leukomalacia, brain infarction, cortical dysplasia, hydrocephalus, etc. and 17 out of 32 patients showed abnormal electroencephalographic patterns. Phenobarbital was tried as a first line antiepileptic drug and phenytoin was added if it failed to control seizures. The treatments were terminated in the majority of patients during the hospital stay. The overall prognosis was relatively good except for those with abnormal EEG background or congenital central nervous system malformations. Conclusion : Neonatal seizures may permanently disrupt brain development. Better understanding of their clinical profiles and appropriate management may lead to a reduction in neurological disability in later childhood.

Usefulness of the Attic Reconstruction Using the Tragal Cartilage and Perichondrium for Prevention of a Retraction Pocket

김창우,Moon Il Park,Sun-Min Park,Jong Joo Lee,Hyeon-Seong Kim 대한청각학회 2011 Journal of Audiology & Otology Vol.15 No.3

Introduction Canal wall up mastoidectomy surgery is performed to preserve the external auditory canal posterior wall in patients who have a destroyed epitympanum due to middle ear disease or other surgical procedures. One adverse side effect of this surgery is the possibility of formation of a retraction pocket in the tympanic membrane. The degree of Eustachian tube disability that may occur due to attic retraction after middle ear surgery is also an important consideration. A number of factors including defects in the external auditory canal, such as attic destruction, are major causes of retraction pockets.1) The occurrence of a retraction pocket in the attic can induce ossicle erosion, thereby causing conductive hearing loss and progression to repetitive otorrhea or cholesteatoma as the retraction pocket worsens. Therefore, an appropriate treatment is necessary to prevent bone loss in the epitympanum and the formation of a postoperative retraction pocket. The tympanic attic is typically reconstructed using bone fragments2) or cavum conchae cartilage,3,4) or defects are treated with tragal cartilage5) or artificial implants.6) However, if maintenance of the normal structure of the attic fails after reconstruction, then canal down mastoidectomy surgery should be performed, which involves removal of the posterior external auditory canal posterior wall. Therefore, the choice of the appropriate method is important in handling bone defects of the epitympanum during the initial surgery. In this study, the epitympanum was reconstructed using tragal cartilage and perichondrium in patients with attic destruction due to cholesteatoma. The effectiveness at preventing the formation of a retraction pocket was evaluated by observing and analyzing these patients postoperatively for more than a year. The findings reported here will help in the choice of an appropriate treatment method for attic destruction during the initial surgery. Subjects and Methods Subjects Attic reconstruction was performed using tragal cartilage from January 2005 to January 2009. Patients' medical records and surgical findings were reviewed retrospectively for 46 patients who were available for follow-up for more than one year. The patients were 27 men and 19 women aged 12 to 72 years old (average age 43.1 years). Attic reconstruction was only performed when bone destruction by the attic cholesteatoma was confined to the epitympanum. Exclusion criteria included cases of adhesion or retraction pocket in the pars tensa of the tympanic membrane, cholesteatoma in the middle ear, perforation or reoperation, Eustachian tube dysfunction, or unidentified pnuematization in the middle ear [such as sclerotic pneumatization in the mastoid from temporal bone computed tomography (CT)]. Operation (Fig. 1)A posterior auricular skin incision was made and a musculoperiosteal flap (an anterior based flap) was formed. An external auditory canal skin incision was made in the direction of 5 o'clock to 10 o'clock for the right ear (2 o'clock to 7 o'clock direction for the left ear) at a distance of about 3 mm from tympanic ring. This incision was designed to pass the lateral portion of the bone destruction in the epitympanum area. A tympanomeatal flap was made to separate the tympanic membrane from the manubrium and to expose the destroyed bone area of the epitympanum. Mastoidectomy surgery and posterior tympanotomy was performed, and both cholesteatoma and granulation tissues were removed by removing the incus and malleus head, depending on the state of the cholesteatoma erosion. Cartilage was harvested from the ipsilateral tragus together with perichondrium. The harvested tissue was trimmed so that the perichondrium extended 2 mm beyond the cartilage border on one side, when designing cartilage to fit the size of the destroyed epitympanum. This tissue was placed between the bony portion of the external auditory canal and the temporalis fascia, for tympanic membrane inserti... Background and Objectives: Bone defect of the attic wall is a critical cause of the postoperative retraction pocket after canal wall up mastoidectomy. So, proper treatment of the attic defect is important and attic reconstruction is an acceptable procedure but it is controversial when the attic is reconstructed or not. The aim of this study is to analyze the usefulness of the attic reconstruction using tragal cartilage and perichondrium for prevention of retraction pocket and propose the indication to perform the attic reconstruction. Subjects and Methods: We retrospectively reviewed the medical records of 46 consecutive patients who underwent tympanomastoidectomy and attic reconstruction using tragal cartilage between January 2005 and January 2009. The follow-up period varied from 12 to 65 months, with the average period of 34 months. We analyzed postoperative status of the scutum and the tympanic membrane, and development of the residual or recurrent cholesteatomas and evaluate development of the retraction pocket according to the preoperative size of the bony defect of the scutum and status of the ossicular chain. Results: Retraction pocket was developed in the 13% of the operations and most of the cases had large attic destruction more than 3 mm and destructed ossicular chain. Conclusions: Attic reconstruction using tragal cartilage is a simple method to repair the bony defect of the external ear canal and effective in preventing postoperative retraction pocket if the size of destructed scutum is less than 3 mm.

우리나라 원자력산업과 방사선이용의 전망

김창우,Kim, Chang-U 한국동위원소협회 2000 동위원소회보 Vol.15 No.2

독자적인 우주개발 능력을 확보한다

김창우,Kim, Chang-U 한국과학기술단체총연합회 2007 과학과 기술 Vol.40 No.10

재발된 유두 갑상선암으로 완결갑상선절제술을 시행한 환자의 임상양상 및 수술합병증

김창우,이소희,유행랑,이강영,강상욱,정종주,남기현,장항석,정웅윤,박정수,Chang Woo Kim,So Hee Lee,Haeng Rang Ryu,Kang Young Rhee,Sang-Wook Kang,Jong Joo Jung,Kee-Hyun Nam,Hang Seok Chang,Woong Youn Chung,and Cheong Soo Park 대한갑상선-내분비외과학회 2009 The Koreran journal of Endocrine Surgery Vol.9 No.3

방사선/방사성동위원소 이용과 안전정책

김창우,Kim, Chang-U 한국동위원소협회 2000 동위원소회보 Vol.15 No.3

국가기본도의 하천정보 고도화 추진계획

김창우,Kim, Chang-U 한국수자원학회 2022 물과 미래(한국수자원학회지) Vol.55 No.6

신형상의 데크플레이트를 이용한 합성슬래브의 구조적 거동에 관한 연구

김창우,최성모,강도안,김동규,Kim, Chang Woo,Choi, Sung Mo,Kang, Do An,Kim, Dong Kyu 한국강구조학회 1997 韓國鋼構造學會 論文集 Vol.9 No.4

냉간성형된 데크플레이트는 건물의 바닥슬래브에 콘크리트 타설시 거푸집용으로만 주로 사용되었으나, 콘크리트와의 일체성을 높임으로써 주인장재 역할을 할 수 있는 합성용 데크가 등장하고 있다. 본 논문은 새로 개발된 합성용 데크의 구조성능 평가를 위한 연구의 결과를 제시하고 있다. 신형상의 데크는 콘크리트와 데크사이의 합성효과를 개선하기 위하여 locking rib와 dove tail 및 강력한 엠보싱이 추가되었다. 콘크리트와 데크플레이트사이의 합성효과를 규명하기 위하여 28개의 실험체가 실험되어 졌다. 본 연구의 중요, 변수는 스팬, 데크플레이트 두께, 지지조건, 지지점에 전단연결재의 유무등이다. Cold-formed deck sections are used in many composite floor slab applications wherein the steel deck serves not only as the form for the concrete during construction but also as the principal tensile reinforcement for the bottom fiber of the composite slab. This paper provides the results of an experimental study performed for the composite slabs with the new shaped deck plates with the locking ribs, the dove tails, and the powerful embossment, which are the mechanical means to improve positive interlocking effect between the deck and the concrete. A total of 28 specimens are tested to investigate the composite effects between the concrete and metal deck plate. Important parameters in this are the span length, the thickness of the deck plate, support condition, and whether shear studs are placed at each support or not. The test results are summarized for the maximum load and failure behavior for the specimens.

과학기술부의 RI정책방향

김창우,Kim, Chang-U 한국동위원소협회 2000 동위원소회보 Vol.15 No.1