경추 퇴행성 질환 환자에서 Cage만을 이용한 2구간 경추 감압술 및 골유합술

이호범,박찬우,유찬종,김우경,이상구,김석민 대한척추신경외과학회 2009 Neurospine Vol.6 No.3

Objective: Anterior cervical discectomy and fusion (ACDF) is a highly successful surgical treatment for nerve root or spinal cord compression caused by disc herniation or spondylosis. Multilevel cervical discectomy usually requires plate and screw fixation for adequate bony fusion and stability. But the use of plate and screw fixation may cause some post-operative complications. So in this study we evaluate the safety and effectiveness of two-level ACDF with carbon or polyetheretherketone (PEEK) cages without cervical plate in cervical degenerative disc disease. Methods: We retrospectively analyzed 18 patients who underwent two-level ACDF with carbon or PEEK cages from February 2002 to August 2008. The mean follow-up period was 31months. Clinical, radiologic and surgical morbidities were assessed in all cases. Outcome assessment was done using Odom’s criteria and visual analogue scale (VAS) score. Radiological assessment was done with bony fusion rate, linear measure of cervical lordosis, cervical lordotic angle and cage subsidence. Results: Radiculopathy was improved in all cases (100%) after surgery, whereas myelopathy was resolved in three of five patients (60%). Radiographic evidence of fusion was found in all patients (100%) at last follow-up. Preoperative mean VAS score was 8.1 compared with a postoperative score 2.5 (p<0.05). The clinical outcome was excellent or good in 16 cases (89%). There were no serious complications such as dislodgement of cages, hardware failure, infection and neurologic deterioration. Linear measure of cervical lordosis at last follow-up was increased from 2.72 ± 1.12 mm to 7.84 ± 1.09 mm. Cervical lordotic angle at last follow-up was increased from 8.9 ± 2.76° to 15.1 ± 2.38°. The mean loss of disc height was 1.40 mm during the follow-up period. However development of subsidence did not influence on clinical outcomes. Conclusion: ACDF in two-level stand-alone cages is a safe and effective procedure in multilevel cervical degenerative diseases. In spite of subsidence, interbody fusion with cages provides load-sharing function and stabilization of the cervical spine by increasing segmental rigidity, thus yielding excellent fusion rates and less graft failure, even in twolevel cervical diseases. Objective: Anterior cervical discectomy and fusion (ACDF) is a highly successful surgical treatment for nerve root or spinal cord compression caused by disc herniation or spondylosis. Multilevel cervical discectomy usually requires plate and screw fixation for adequate bony fusion and stability. But the use of plate and screw fixation may cause some post-operative complications. So in this study we evaluate the safety and effectiveness of two-level ACDF with carbon or polyetheretherketone (PEEK) cages without cervical plate in cervical degenerative disc disease. Methods: We retrospectively analyzed 18 patients who underwent two-level ACDF with carbon or PEEK cages from February 2002 to August 2008. The mean follow-up period was 31months. Clinical, radiologic and surgical morbidities were assessed in all cases. Outcome assessment was done using Odom’s criteria and visual analogue scale (VAS) score. Radiological assessment was done with bony fusion rate, linear measure of cervical lordosis, cervical lordotic angle and cage subsidence. Results: Radiculopathy was improved in all cases (100%) after surgery, whereas myelopathy was resolved in three of five patients (60%). Radiographic evidence of fusion was found in all patients (100%) at last follow-up. Preoperative mean VAS score was 8.1 compared with a postoperative score 2.5 (p<0.05). The clinical outcome was excellent or good in 16 cases (89%). There were no serious complications such as dislodgement of cages, hardware failure, infection and neurologic deterioration. Linear measure of cervical lordosis at last follow-up was increased from 2.72 ± 1.12 mm to 7.84 ± 1.09 mm. Cervical lordotic angle at last follow-up was increased from 8.9 ± 2.76° to 15.1 ± 2.38°. The mean loss of disc height was 1.40 mm during the follow-up period. However development of subsidence did not influence on clinical outcomes. Conclusion: ACDF in two-level stand-alone cages is a safe and effective procedure in multilevel cervical degenerative diseases. In spite of subsidence, interbody fusion with cages provides load-sharing function and stabilization of the cervical spine by increasing segmental rigidity, thus yielding excellent fusion rates and less graft failure, even in twolevel cervical diseases.

소면적 작물 오미자(Schisandra chinensis)에 대한 농약의 안전사용기준 설정

이호범,이영철,최세정,김은제,김현왕,김예진,조연수,조서연,김용석 한국농약과학회 2021 한국농약과학회 학술발표대회 논문집 Vol.2021 No.5

구조물에 대한 진동 및 진동제어 방법에 관한 해석

이호범 한국공기청정협회 1996 空氣淸淨技術 Vol.9 No.2

반도체 정밀 생산기기 방$\cdot$제진을 위한 미진동 Design Guide Line 해석

이호범 한국공기청정협회 1999 空氣淸淨技術 Vol.12 No.1

하천 수질의 오염도평가 방법의 비교 연구

이호범,이중기,신대윤,Lee, Ho-Beom,Lee, Jung-Ki,Shin, Dae-Yewn 한국환경보건학회 2005 한국환경보건학회지 Vol.31 No.5

This study is undertaken to find the optimal method to make the decision on the degree of water pollution by comparison of K-WQI, KOE-WQI that is made for index with the water quality index and water quality environment standard of the Frame Act on Environment Policy as the result of survey for water quality reality on the major point of the Yeongsan river from 2002 to 2004. The water quality of major rivers has some differences depending on seasons. however, under the water quality standard by the $BOD_5$ density, most of rivers displayed the water quality level of $II{\sim}III$ grading, and on K-WQI that is classified by indexing for 10 categories of pH, DO, $BOD_5,\;COD,\;SS,\;T-N,\;NH_3-N,\;NO_{3^-}$ N, T-P, and E-Coli and classified into 5 groups from 100 points to 40 points, they displayed the score distribution of the first grade in water quality for $85{\sim}100$ points to the second grade in water quality for $70{\sim}84$ points. On KOE-WQI that is classified by indexing for 5 categories of pH, DO, $BOD_5$, COD and T-coli and classified into 5 groups from 90 points or above for outstanding and 29 points or below for very bad, and the water quality distribution is made ranged from the first grade in water quality for 90 points or more to the third grade in water quality for $69{\sim}50$ points. In addition, for the contribution of the water quality decline, the Environmental standard has significant dependency on the $BOD_5$ density, with K-WQI contributing in various water quality decline depending on the environment around the river area of $BOD_5,\;T-N,\;NH_3-N,\;NO_3-N,\;T-P$, and E-Coli, and KOE-WQI acting os the factor contributing to lower the water quality decline by $BOD_5$, COD, and T-coli. As such, the current water quality environment standard has high dependency on $BOD_5$ and KOE-WQI excludes some nitrogen and phosphorus that considers the river environment that the grade in water quality is set by some category, and K-WQI reflected well of the ecology environment of rivers with the diversity of the assessment factor as well as to have the low dependency of specific factor to be objective.

자기공명영상의 image scale 재설정에 따른 최적의 영상신호 표준화

이호범,최관우,손순룡 한국콘텐츠학회 2017 한국콘텐츠학회논문지 Vol.17 No.12

In this study, we tried to improve the reproducibility of signal intensity by applying DOTS method. The study was conducted on 30 patients who had undergone hepatic screening because of poor reproducibility and decreased signal intensity. The images were acquired before and after injection of contrast media and then post - processed by DOTS methods. Signal intensity was compared and evaluated. The results showed that the signal intensity of the images was 183.3% (1038.0 ± 70.7 before application, 2940.7 ± 179.6 after application) and 1118.4% (444.1 ± 92.4, 5410.5 ± 168.4 after application). This is a significant improvement in the fact that the reproducibility of MRI) was changed by the DOTS method, which is a post-processing method. 본 연구는 자기공명검사 시 재현성이 달라져 신호강도가 저하되는 문제점을 후처리 기법인 DOTS 기법을 적용함으로써 개선하고자 하였다. 연구방법은 재현성이 떨어져 신호강도 저하가 가장 빈번하게 발생하는 간 검사를 시행한 30명을 대상으로 하였으며, 조영제 주입 전․후 영상을 획득한 다음 DOTS 기법으로 영상을 후처리하여 적용 여부에 따른 영상의 신호강도를 비교 평가하였다. 연구결과 영상의 신호강도는 DOTS 기법을 적용한 경우가 적용하지 않은 경우보다 조영제 주입 전에는 183.3%(적용 전 1038.0±70.7, 적용 후 2940.7±179.6), 주입 후에는 1118.4%(444.1±92.4, 적용 후 5410.5±168.4) 유의하게 증가하였다. 이는 후처리 기법인 DOTS 기법을 통해 영상척도의 기준을 재설정하여 개선한 것으로써 자기공명검사 시 재현성이 달라져 신호강도가 저하되는 문제를 근본적으로 해결하였다는 데 의의가 있다.

해상송전철탑 구조물의 주기점검을 통한 경년열화 변화특성

이호범,장일영 한국구조물진단유지관리공학회 2012 한국구조물진단유지관리공학회 논문집 Vol.16 No.4

해상송전철탑 구조물에 있어서 구조 및 재료 손상에 대해 주기적으로 안전점검을 실시하고, 그 결과를 이용한 수명관리(life management)의 시행은 적극 추천되는 일이다. 본 연구에서는 영흥도 시화호 내에 있는 총 6개의 해상송전철탑에 대해서 강재부재에 대해 3가지, 콘크리트 기초에 대해 5가지, 해수 중 강관파일 및 해수 자체에 대해 4가지 형태의 열화점검을 각각 수행하였다. 강재에 대한 점검 항목들은 외관조사, 부재두께, 도막상태 등에 대한 것이고, 콘크리트 기초에 있어서는 균열형상, 압축강도, 중성화깊이, 염화물 함유량 등에 대한 항목, 그리고 해중 강관파일에 있어서의 전위 및 양극조사에 따른 부식정도, 동영상 촬영 및 해수의 수질환경성 평가 등에 대한 항목이다. 이와 같은 정기적 열화점검은 연속 3년 동안 매년 10월경에 동일위치에 대해 평가하였다. 결과적으로 본 연구에서는 이러한 자료를 체계적으로 활용함으로써 해상송전철탑 안전성 유지관리에 유익하게 적용될 수 있는 새로운 열화지표를 개발하였다. In electric power transmission tower structures on offshore, implementation of life management using the event data of regular safety inspections for structural and material damages is strongly recommended. In this study, six tower structures in Sihwa Lake around Yeoungheung island were target bodies for the safety inspections. safety inspections for deterioration about each of six towers were performed about three items for steel member, five items for concrete foundation, and four items for steel-pipe pile in seawater and seawater itself. Safety inspections for steel members included the visual observations of surface appearances, the measurements of member thicknesses, and the checks of painting states. Also safety inspections for concrete foundations comprised the estimation of crack features, the evaluation of non-destructive compression strengths, and the measurements of neutralization depths and chlorides contents. For steel-pipe piles in seawater the inspections comprised the surveys of corrosion states in accordance with potential levels tests and anode tests, the analyses of photos taken on surfaces of the piles as well as the evaluation of seawater quality. A set of deterioration inspections was performed at the same positions around october of each year for three consecutive years. As a result in this study, Newly developed deterioration indexes have been applied profitably to maintain structural safety for electric power transmission towers by utilizing these event data systematically.

대학병원 직원들의 부검에 대한 인식도

이호범,곽정식,Lee, Ho-Beom,Kwak, Jyung-Sik 대한수사과학회 2007 대한수사과학회지 Vol.2 No.2

부검은 검안만으로 사인 또는 사망의 종류를 확인할 수 없는 경우 시체를 해부하여 이를 확인하는 검시(檢屍)방법이다. 본 연구자는 대학병원 직원들의 부검에 대한 인식도를 알아보기 위해 설문지를 이용하여 2007년 4월 2일부터 5월 4일까지 1개월간 대구광역시 영남대학교의료원의 직원들을 대상으로 설문조사를 실시하였다. 전체 286 명 중 남자가 121 명(42.3%), 여자가 165 명(57.7%)이었으며, 의사 57 명(19.9%), 간호사 71 명(24.8%), 의료기술직 83 명(29.0%), 행정사무직 58 명(20.3%), 기타 직종 17 명(5.9%)이었다.대상자들의 설문조사를 살펴보면 부검에 대한 교육정도에서 의사는 2회 이상이 61.4%인데, 간호사는 1.4%, 의료기술직은 15.7%, 행정사무직은 1.7%, 기타 직종은 5.9%로 의사들에 비해 교육정도가 많이 부족하였다. 본인이나 가족이 갑자기 쓰러져 사망했을 때 부검을 의뢰하겠는가라는 질문에 의사는 의뢰한다가 59.6%로 높았으나, 간호사는 22.5%, 의료기술직은 39.8%, 행정사무직은 41.4%, 기타 직종은 35.3%로 낮게 나타났다. 직장 동료가 근무 중 갑자기 쓰러져 사망한 경우 부검을 해야 한다고 생각하는가라는 질문에서도 의사는 그렇다가 66.7%로 높았으나, 간호사는 33.8%, 의료기술직은 39.8%, 행정사무직은 43.1%, 기타 직종은 17.6%로 낮게 나타났다. 병원내 환자가 병사했을 때 부검을 해야 한다고 생각하는가라는 질문에서도 의사는 그렇다가 50.9%, 간호사는 8.5%, 의료기술직은 19.3%, 행정사무직은 24.1%, 기타 직종은 17.6%로 낮게 나타났다. 부검은 어떤 곳에서 해야 하는가라는 질문에 의사는 의과대학 법의학교실이 73.7%로 가장 높았고, 다른 직종에서는 국립과학수사연구소가 가장 높게 나타났는데, 간호사는 62.0% 의료기술직은 59.0%, 행정사무직은 46.6%, 기타 직종은 58.8%이었다. 부검의 주체는 모든 직종에서 대부분의 대상자들이 전문 법의병리의사가 되어야 한다고 생각하는 것으로 나타났는데, 의사는 98.2%, 간호사는 94.4%, 의료 기술직은 96.4%, 행정사무직은 89.7%, 기타 직종은 88.2%이었다. 평소 부검의 필요성은 의사는 73.7%, 간호사는 23.9%, 의료기술직은 47.0%, 행정사무직은 34.5%, 기타 직종은 23.5%로 의사들이 평소 부검의 필요성을 많이 느끼는 것으로 나타났다. 사후 본인의 사체를 의과대학이나 연구기관 등에 기증할 용의가 있는가라는 질문에 의사는 22.8%, 간호사는 11.3%, 의료기술직은 24.1%, 행정사무직은 22.4%, 기타 직종은 23.5%만이 있다라고 답했다. 대상자들의 설문조사를 분석한 결과, 의사들에 비해 다른 직종의 대상자들이 부검에 대한 교육정도나 거부감이 더 큰 것으로 나타났다. 부검에 대한 부정적 의식의 개선을 위해 전문 인력의 양성과 관련 법률을 정비하여 우리나라 실정에 맞는 올바른 검시제도의 정착과 국민들에 대한 체계적인 법의학교육에 힘써야 할 것이다. An autopsy is a postmortem assessment or examination of a body to determine cause of death or manner of death. The author had surveyed Personnel's perception toward conducting an autopsy in general hospital with autopsy at YeungNam University Medical Center, Daegu, Korea from April, to May, 2007. The total number of 286 personnel consisted of 121 men(42.3%), 165 women(57.7%). There were 57 doctors(19.9%), 71 nurses(24.8%), 83 medical technicians (29.0%), 58 office workers(20.3%), and 17 others(5.9%). 61.4% of doctors had an experience of education for autopsy more than 2 times, but nurses(1.4%), medical technicians(15.7%), office workers(1.7%), and others(5.9%) had little experience. Response of conducting an autopsy for sudden death of respondent or respondent's family member was 59.6% of doctors, 22.5% of nurses, 39.8% of medical technicians, 41.4% of office workers, and 35.3% of others. Response of conducting an autopsy for sudden death of respondent's companion was 66.7% of doctors, 33.8% of nurses, 39.8% of medical technicians, 43.1% of office workers, and 17.6% of others. Response of conducting an autopsy for sudden death of patients in general hospital was 50.9% of doctors, 8.5% of nurses, 19.3% of medical technicians, 24.1% of office workers, and 17.6% of others. Survey about a proper institution for autopsy showed 73.7% of doctors for department of forensic medicine in medical school, and 62.0% of nurses, 59.0% of medical technicians, 46.6% of office workers, and 58.8% of others for National Institute of Scientific Investigation. Most of the respondents agreed with the forensic pathologist as the director of autopsy:98.2% of doctors, 94.4% of nurses, 96.4% of medical technicians, 89.7% of office workers, and 88.2% of others. Survey for necessity for autopsy showed responsiveness of doctors, 23.9% of nurses, 47.0% of medical technicians, 34.5% of office workers, and 23.5% of others. Survey for donation of him- or herself after death to the medical school or institution for the death investigation revealed responsiveness of 22.8% of doctors, 11.3% of nurses, 24.1% of medical technicians, 22.4% of office workers, and 23.5% of others. The result of the survey questionnaire showed more negative awareness for autopsy in nurses, medical technicians, office workers, others and than doctors. To improve the negative awareness for autopsy and settle proper postmortem inspection system, education of professional manpower for forensic medicine and inaction of law which is adequate for the actual circumstance of Korea should be considered.

흉요추부 골다공성 압박 골절과 동반된 천골 기능부전 골절 - 동반 빈도와 고위험 인자에 대해-

이호범,유찬종,이상구,김우경,박찬우,홍지명 대한척추신경외과학회 2009 Neurospine Vol.6 No.2

Objective: The sacral insufficiency fractures (SIFs) are not uncommon and usually occur in osteoporotic bone with minimal or unremembered trauma. Especially, if they are accompanied by osteoporotic compression fracture of the thoracolumbar spine, SIFs can be usually overlooked due to subtle clinical symptoms and signs coupled with radiographic findings. The review aims to be raising awareness of the incidence & risk factors of the SIFs. Methods: We retrospectively reviewed the 252 patients who were admitted at our hospital due to osteoporotic compression fracture of the thoracolumbar spine with minimal or unremembered trauma for 5 years. We assessed the incidence of the SIF being accompanied by osteoporotic compression fracture of the thoracolumbar spine and the effects according to sex, age, probable risk factors (diabetes mellitus & arterial hypertension), the location of fracture and the severity of osteoporosis. Results: 252 patients, including 36 men (14.3%) and 216 women (85.7%) were involved in this study and the osteoporotic compression fractures were located at thoracic (36 cases), thoracolumbar junction (180 cases), lumbar spine (36 cases). There are 18 cases (the incidence: 7.1%), including 2 men (5.5%) and 16 women (7.4%) in which the SIF was accompanied by osteoporotic compression fracture of the thoracolumbar spine. The effects according to sex, age, probable risk factors, the location of fracture and the severity of osteoporosis were not statistically different in both groups (group with SIF and group without SIF). Conclusion: The clinicians need to consider the possibility of SIF in patients of osteoporotic compression fracture of the thoracolumbar spine. Objective: The sacral insufficiency fractures (SIFs) are not uncommon and usually occur in osteoporotic bone with minimal or unremembered trauma. Especially, if they are accompanied by osteoporotic compression fracture of the thoracolumbar spine, SIFs can be usually overlooked due to subtle clinical symptoms and signs coupled with radiographic findings. The review aims to be raising awareness of the incidence & risk factors of the SIFs. Methods: We retrospectively reviewed the 252 patients who were admitted at our hospital due to osteoporotic compression fracture of the thoracolumbar spine with minimal or unremembered trauma for 5 years. We assessed the incidence of the SIF being accompanied by osteoporotic compression fracture of the thoracolumbar spine and the effects according to sex, age, probable risk factors (diabetes mellitus & arterial hypertension), the location of fracture and the severity of osteoporosis. Results: 252 patients, including 36 men (14.3%) and 216 women (85.7%) were involved in this study and the osteoporotic compression fractures were located at thoracic (36 cases), thoracolumbar junction (180 cases), lumbar spine (36 cases). There are 18 cases (the incidence: 7.1%), including 2 men (5.5%) and 16 women (7.4%) in which the SIF was accompanied by osteoporotic compression fracture of the thoracolumbar spine. The effects according to sex, age, probable risk factors, the location of fracture and the severity of osteoporosis were not statistically different in both groups (group with SIF and group without SIF). Conclusion: The clinicians need to consider the possibility of SIF in patients of osteoporotic compression fracture of the thoracolumbar spine.

추간반 및 후관절의 퇴행 정도를 이용한 요추 불안정 판단의 임상적 유용성

이호범,박찬우,이상구,김우경,유찬종 대한척추신경외과학회 2009 Neurospine Vol.6 No.3

Objective: Treatment for symptomatic lumbar stenosis is usually surgical decompression and additional global fusion is recommended for patients with segmental instability. The aim of this article is to evaluate that degeneration degree of the disc and facet joint could be the indicator of judgment for segmental instability. Methods: We retrospectively reviewed 84 patients who underwent surgical treatment for lumbar spinal stenosis. Patients in Group 1 (30 patients) with radiological instability underwent decompression with global fusion, patients in Group 2 (54 patients) without radiological instability underwent decompression with global fusion or decompression only according to the existence and nonexistence of clinical instability. Magnetic resonance images were used to assess the disc degeneration from Grade I (normal) to Grade V (advanced) and the facet joints degeneration from Grade 0 (normal) to Grade 3 (advanced). All patients were checked with the simple X-ray stress view and evaluated. Results: Severity of the disc degeneration had no significant association with the segmental instability, and no correlation with the facet joint degeneration. Severity of facet joint degeneration had significant correlation with the radiological instability. The segmental instability was increased with increasing severity of facet joint degeneration, especially translation. There was a significant association between facet joint degeneration and clinical instability. The facet joint degeneration was increased in patients with clinical instability. Conclusion: Our results suggest that the facet joint degeneration may be the useful indicator of judgment for segmental instability Objective: Treatment for symptomatic lumbar stenosis is usually surgical decompression and additional global fusion is recommended for patients with segmental instability. The aim of this article is to evaluate that degeneration degree of the disc and facet joint could be the indicator of judgment for segmental instability. Methods: We retrospectively reviewed 84 patients who underwent surgical treatment for lumbar spinal stenosis. Patients in Group 1 (30 patients) with radiological instability underwent decompression with global fusion, patients in Group 2 (54 patients) without radiological instability underwent decompression with global fusion or decompression only according to the existence and nonexistence of clinical instability. Magnetic resonance images were used to assess the disc degeneration from Grade I (normal) to Grade V (advanced) and the facet joints degeneration from Grade 0 (normal) to Grade 3 (advanced). All patients were checked with the simple X-ray stress view and evaluated. Results: Severity of the disc degeneration had no significant association with the segmental instability, and no correlation with the facet joint degeneration. Severity of facet joint degeneration had significant correlation with the radiological instability. The segmental instability was increased with increasing severity of facet joint degeneration, especially translation. There was a significant association between facet joint degeneration and clinical instability. The facet joint degeneration was increased in patients with clinical instability. Conclusion: Our results suggest that the facet joint degeneration may be the useful indicator of judgment for segmental instability