쇄골 중간부 골절후 불유합 및 지연 유합의 원인

윤정로,심재익,김택선,이성종,김영배,김학준,안국환,장재영,홍명표 대한골절학회 2002 대한골절학회지 Vol.15 No.4

쇄골 중간 1/3 부위의 골절은 치료 결과가 양호하여 보존적 치료가 원칙적으로 받아 들어지고 잇으며 불유합에 대한 빈도도 낮은 것으로 되어 있다. 그러나 최근 전위 및 단축의 정도가 심할 경우 높은 불유합의 결과와 불량한 임상 결과를 보고하고 있어 이런 예에 대해선 수술적 치료를 권장하고 있다. 저자들은 단축 및 전위의 정도와 불유합의 연관성을 알아보고자 하였다. 연구 대상 및 방법 : 1993년 2월부터 2002년 1월까지 본원에 내원 했던 성인 중간부 쇄골 골절 환자 194명 중 완전 전위를 보인 78례를 조사하여 이중 63례를 대상으로 분석하여 후 향적 연구를 시행하였다. 4개월 추시 후에도 방사성 사진상 유합 소견이 관찰되지 않으면 불유합의 유의성을 알아보고자 하였다. 결 과 : 63례 중 불유합 및 지연 유합을 소견을 보인 환자는 15(23%)례였다. 골유합을 보인 48례의 단축은 평균 8.6㎜(2㎜-17㎜)였고, 전위는 평균 9.7㎜(2-22㎜)였다 .불유합 및 지연 유합을 보였던 15례에서 단축은 평균 14.5㎜(3㎜-37㎜), 전위는 평균 17.3㎜(4-25㎜)였다. 18㎜이상 단축이 있었던 경우 불유합의 발생과는 통계학적으로 유의성을 나타내었고(Fisher's exact test, p<0.01), Chi-square test상 16㎜ 이상의 전위를 보였던 경우 불유합 발생과 통계학적으로 의미가 있었다(p<0.01). 결 론 : 쇄골 골절 특히 중간 1/3의 골절은 비교적 보존적 치료에 결과가 좋은 것으로 되어 있으나, 전위 및 단축이 심한 경우 불유합에 대한 가능성이 높이 때문에 보다 경과 관찰시 유합의 진행이 없으면 적극적인 치료를 고려해야한다. Purpose : Because the prognosis of the mid 1.3 clavicle fracture is good, the conservative treatment with a figure of 8 bandage is the gold standard and the nonunions are rare. However, recently surgical treatment is recommended when the shortening and displacement is severe because of the high nonunion rate and the poor clinical result. This study was undertaken to evaluate that the shortening and displacement at fracture site are associated with the development of nonunion. Materials and Methods : We analysed the 194 fractures of mid 1/3 clavicle in adults which had been treated conservatively from February 1993 to January 2002 and did the retrospective study. Of these, 78 cases were originally in the middle third of the clavicle and had been completely displaced. We reviewed 63 of these cases. The shortening and displacement at the fracture site was measured on the initial roentgenogram. And the analysis of the patients' chart was done for another predisposing nonunion factors. Nonunion and delayed union are considered to be present when there has been little or no progression of clinical or radiographic healing at a minimum of 4 months after injury. Results : 15 of the 63 cases had developed nonunion.. The average 8.6㎜(2㎜-17㎜) shortening and average 9.7㎜(2-22㎜) in the union patients. The average 14.5㎜(3㎜-37㎜) shortening and average 17.3㎜(4-25㎜) in the nonunion patients. We found that initial shortening ≥18㎜(Fisher's exact test, p<0.01) and initial displacement ≥ 16㎜(Chi-square test. p<0.01)at the fracture site were significantly associated with the development of nonunion. Conclusion : The conservative treatment with figure-80-bandage is the gold standard in the clavicle middle one third fracture. However, the nonunion is commonly occurs in the cases of more of severely shortened and displaced fractures. If there are no signs of callus formation and the patient complains of pain after several week, osteosynthesis should be considered.

횡단형 라구에르 필터를 이용한 비구조화된 시스템의 온-라인 근사화

심재선,김윤상 三陟大學校 1999 論文集 Vol.32 No.1

This paper presents an efficient method which can approximate the systems with unstructured dynamics using Laguerre networks. The proposed method is to approximate a unstructured unknown systems adaptively from only input-output information, which can exclude additional procedure for system identification and thus reduce the required computational burden for real-time approximation. Higher convergence speed is achieved with our manner.

인공 해수분위기에서 저탄소강의 부식특성에 미치는 합금원소 Cr, Co 및 W의 효과

심재주,유승재,최윤석,김정구,유장용 대한금속재료학회 2003 대한금속·재료학회지 Vol.41 No.12

The aqueous corrosion characteristics of 1% Cr-steel alloyed with small amounts of Co and W, in synthetic seawater was studied by using immersion weight-loss tests, electrochemical corrosion tests (potentiodynamic test and electrochemical impedance spectroscopy (EIS) measurements) and analytical techniques. 1% Cr steels containing Co or W from 0.2 to 0.4 wt.% showed higher corrosion resistance than the 1% Cr steel in the immersion and potentiodynamic tests. EIS measurements showed that the Nyquist plot presented one time constant. Furthermore, the Co- and W-bearing steels present higher Rp values than the 1% Cr steel through all the test period. The better corrosion resistance of the Co-and W-bearing steels is attributed to protectiveness of the surface layer. The corrosion products were examined using electron probe microanalysis (EPMA) and X-ray photoelectron spectroscopy (XPS). The results of EPMA indicated that Cr was concentrated in the inner region of the rust layer, while Co and W were distributed all over the rust layer. XPS results showed that Co existed as a trivalent oxide in the rust layer and W in the rust appeared in the form of a WO₄ compound.

프로농구 관중의 관람유형과 경기장 유인 요인과의 관계

심재영,이창민,김태동,윤석민 한국스포츠리서치 2003 한국 스포츠 리서치 Vol.20 No.1

This study was to investigate the relationship between consuming behaviors and the enticing factors of sports arena. The independent variables of the study was royalty. The dependent variables were enticing factors including performance, status of reputation, facilities, and marketing factors. The subjects of the study were 470 randomly selected spectators who were present at 3 games, held in Wonju, Seoul, and Anyang among pro-basketball season games. The apparatus to collect data was 'the enticing factors of sports arena' and 'consuming behaviors' questionnaires(Cho Kwan-Hyung, 2000) which were revised and complemented based on four areas in spectator orientation(Marcum & Greenstein, 1985) and enticing factors of sports arena(Cronin & Taylor, 1992). Chi-square and One-way ANOVA were used to analyze the data by SPSS 10.0 for Windows(P<.05). The results of analyzing the relationship between royalty and the enticing factors of sports arena led to following conclusions. First, A companion type has a difference in accordance with a region, gender, age, presence of marriage, level of income, and occupation in statistics. A trait of buying a ticket has a difference according to a region, gender, and occupation in statistics. A trait of motivation to inspect has a difference in proportion to a region, gender, age, presence of marriage in statistics. Second, facilities factor was significantly different depended on companion orientation, which was one of the spectator orientation. There were not significant difference in inciting factors of sports arena according to method of ticket purchase and spectator motives.

인간의 청각특성을 이용한 잡음 혼입시의 음성인식에 관한 연구

심재성,윤태성 國立 昌原大學校 産業技術硏究所 1992 産技硏論文集 Vol.6 No.-

In this study, computational model for peripheral auditory system is constructed and recognition experiments for 5 Korean vowels and 10 Korean digits, which are added with Gaussian white noise quantitatively, are executed in order to investigate the adaptibility of human auditory system in noise. Also, for the purpose of objective comparison, the recognition tests are performed by extracting LPC cepstrum coefficients for the same speech data.

프로농구 관중의 충성도와 경기장 유인 요인과의 관계

심재영,이창민,윤석민 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.2

This study was to investigate the relationship between consuming behaviors and the enticing factors of sports arena. The independent variables of the study was royalty. The dependent variables were enticing factors including performance, status of reputation, facilities, and marketing factors. The subjects of the study were 470 randomly selected spectators who were present at 3 games, held in Wonju. Seoul, and Anyang among pro-basketball season games. The apparatus to collect data was 'the enticing factors of sports arena' and 'consuming behaviors' questionnaires(Cho Kwan-Hyung, 2000) which were revised and complemented based on four areas in spectator orientation(Marcum & Greenstein. 1985) and enticing factors of sports arena(Cronin & Taylor, 1992). Chi-square and One-way ANOVA were used to analyze the data by SPSS 10.0 fur Windows(p<.05). The results of analyzing the relationship between royalty and the enticing factors of sports arena led to following conclusions. Performance, status of reputation and facilities according to cheering team orientation, that was one of the elements in devoting level, were significantly different Furthermore, there was significant difference in status of reputation factor depended on cheering athlete orientation. However, enticing factors of sports arena according to membership and out cheering were not significantly different.

인공 수돗물 분위기에서 저탄소강의 부식특성에 미치는 합금원소(Cr, Co, W, Cu, Ni, Ca)의 영향에 관한 연구

심재주,최윤석,김정구 대한금속재료학회 2003 대한금속·재료학회지 Vol.41 No.9

This paper presents the corrosion behavior of the low alloy steel contained alloying elements such as Cr, Co, W, Cu, Ni and Ca in synthetic tap water using potentiodynamic polarization tests, electrochemical impedance spectroscopy (EIS), XPS and EPMA. Potentiodynamic poalrization curves indicated that all the specimens had active corrosion behavior. Corrosion rate tended to reduce as the result of the alloying. Also, EIS test results showed that the more the content of element, the larger the polarization resistance. It can be seen that these results were caused from the formation of a coherent, protective film contained alloying elements. Actually, XPS results showed that Cr, Cu, and Ca were formed as protective metal oxides at the surface of rust film under the stagnant condition. The results of EPMA indicated that Cr, Cu, and Ca were distributed densely at the inner layer of the rust film, while Co, W, and Ni were distributed at the whole layer under the flow condition. Consequently, alloying elements improved corrosion resistance of low alloy steel in synthetic tap water. Especially, Cr, Cu, Ni, and Ca-containing specimen had the lowest corrosion rate due to the inner rust film formation during the initial stage of corrosion, which suggested a potential substitute for carbon steel in potable water system.

분산형 전원의 계통 연계에 따른 영향 및 시뮬레이션

심재선,박지웅,윤창대,임창민,장 현 三陟大學校 2006 論文集 Vol.39 No.-

As EG(Embedded Generation: photo- voltaic, wind, combined heat and power, fuel cell, small hydro etc.) grows fast in adopting to peak load reducing at the middle or the end of distribution system, there much has been interested in interconnection of EG. This paper discusses the various issue of a embedded generator to power system and shows the simulation of its various situation that could happen(focusing on load-flow by EG) by using a commercial software CYME(PSAF) for load-flow. With a result of above simulation, this paper shows a way of possible solution briefly.

정신분열병 환자의 우울증에서 Paroxetine과 삼환계 항우울제 병용치료

심주철,공보금,박정환,윤영란,신재국,김정익,안동성,김용관,차인준,김영훈 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.4

저자들은 마산동서병원에 입원중인 우울증이 동반된 정신분열증 환자 10명을 대상으로 사용중인 항정신병약물에 paroxetine과 저용량의 삼환계 항우울제를 6주간 병용투여한 후 우울증상에 대한 효과와 치료의 안전성 및 약물상호작용을 알아보았다. Paroxetine은 고정량의 항정신병약물과 삼환계 항우울제에 부가하여 일일 20㎎을 6주간 병용하게 하였으며, 임상상태는 HDRS, HARS, UKU Side Effect Rating Scale등의 평가척도를 사용하여 평가하였다. 또한 약동학적 약물상호작용은 삼환계 항우울제들의 혈장농도를 HPLC로 측정하여 분석하였다. 결과는 다음과 같다. 1) 10명의 전체 대상환자에서의 HDRS 평균점수는 TCA와 paroxetine 병용투여 6주후에 통계적으로 유의하게 감소되었다. 이중 40%의 환자에서는 병용투여 6주후에 HDRS 점수상 50% 이상의 감소를 보여, 일부의 환자들에서는 정신분열병에 동반된 우울증상의 치료에 소량의 삼환계 항우울제와 paroxetine의 병용치료가 효과가 있음을 확인하였다. 2) 두 명의 환자에게서 심각한 약물독성이 발생하였다. 이중 한 명은 삼환계 항우울제의 높은 혈중농도로 인한 항콜린성 위기(anticholinergic crisis) 소견을 보였으며, 다른 한 명은 인지기능 및 의식수준은 명료하였으나 망상과 환각증상이 약화되는 소견을 보였다. 따라서 본 연구에서 시도된 복합적 약물치료의 경우, 삼환계 항우울제의 혈중농도의 측정을 포함한 세심한 임상적 추적이 필요하다고 생각된다. 3) 기저치의 amitriptyline과 그 대사물인 nortriptyline의 농도합. imipramine과 대사물인 desipramine의 농도합은 각각 47.8-226.5ng/㎖. 80.5-395.6ng/㎖였으며 일반적으로 이들 약물들의 단독사용시에 문헌에 보고된 혈중농도를 훨씬 상회하고 있었다. 이는 병용투여된 항정신병 약물 약시 강력한 CYP2D6 효소억제제로서 기저치의 삼환계 항우울제들의 혈장농도를 이미 상당히 증가시켰던 것으로 판단되며, 그러한 결과로 인해 본 연구에서는 paroxetine이 이전의 문헌보고들과는 달리 뚜렷하게 삼환계 항우울제들의 혈장농도를 증가시키지 못하였다. 본 연구는 SSRI와 삼환계 항우울제의 병합 투여가 우울증의 개선 효과를 빠르게 하고, 치료역을 넓히고, 약물상호작용의 결과 paroxetine이 삼환계 항우울제의 혈중농도를 증가시킨다는 기존의 연구결과를 이용하여 정신분열병 우울증상의 치료에 parotextine과 소량의 삼환계 항우울제를 병용하는 방법을 시도해 본 연구이다. 저자들은 이러한 약물치료가 일부의 환자들에게서 효과가 있음을 관찰하였으나, 항정신병약물과 삼환계 항우울제를 병용투여 할 경우는 물론 이에 paroxetine과 같은 선택적 세로토닌 재흡수 억제제를 병용할 경우 복합약물상호작용의 결과로 약물독성의 위험성이 크며 세심한 주의가 필요함을 경험하였다. Depression is well-known to comorbid with several psychiatric disorders. Many schizophrenics also suffer from depression in the course of their illness. Combined therapy of SSRI and tricyclic antidepressants were reported to have benefits in some depressed patients. Paroxetine, a potent CYP2D6 inhibitor, increases the blood levels of tricyclic antidepressant markedly. Using paroxetine, we tried this combined therapy in the treatment of depressive symptoms in 10 chronic schizophrenic inpatients and evaluated its efficacy and drug interactions between paroxetine and tricyclic antidepressants. The following results were obtained : 1) The mean score of Hamilton's Depression Rating Scale(HDRS) was reduced significantly after 6 weeks-trials of this combined therapy for the mild depressive symptoms in 10 chronic schizophrenics. In four patients, 50% or more reductions in the scores of HDRS were noticed at final evaluation. 2) Two among our 10 subjects experienced severe toxic behavioral problems. Anticholinergic crisis with toxic confusion due to high blood levels of tricyclics was found in one patient and the other showed rapid clinical deterioration in his psychotic symptoms such as delusion and hallucination without any consciousness alternation. 3) Baseline plasma levels of tricyclics before adding paroxetine were higher than expected in our chronic schizophrenic subjects maintained with their antipsychotic medications. Several antipsychotics were also known as a potent CYP2D6 inhibitors and to increase the blood levels of tricyclics. Because the blood levels of tricyclics had already increased significantly by the use of antipsychotics, adding paroxetine to antipsychotics and tricyclic antidepressant in our subjects could increase the blood levels of tricyclics not so much as previously reported in the literatures.

수돗물에서 동 배관의 부식특성에 관한 연구

심재주,신동호,최윤석,김정구,유승재 대한금속재료학회 2003 대한금속·재료학회지 Vol.41 No.12

The corrosion behavior of copper in neutral aerated synthetic tap water was investigated using electrochemical methods, SEM and XPS. All potentiodynamic polarization curves showed active corrosion behavior, and the corrosion rate was more sensitive to flow velocity than Cl^(-) ion concentration and temperature. The result of potentiostatic test indicated that the current density decreased with increasing time regardless of Cl^(-) ion concentration and temperature in stagnant condition because copper compounds were formed uniformly on the surface. The EIS plot was changed from two time constants to three time constants with the formation of Cu₂O, and the charge transfer resistance (R_(ct)) was very large and increased with increasing immersion time. From all results, copper had good corrosion resistance in this potable water system.