• Journal of Korean Neurosurgical Society
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• 제54권3호
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• pp.225-231
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• 2013

Objective : Spinal dysraphism defects span wide spectrum. Wound dehiscence is a common postoperative complication, and is a challenge in the current management of cerebrospinal fluid (CSF) leaks and wound healing. The purpose of this study is to evaluate the risks of CSF-related morbidity in the surgical treatment of spinal dysraphism. Methods : Ten patients with spinal dysraphism were included in this retrospective study. The median age of the cohort was 4.8 months. To assess the risk of CSF morbidity, we measured the skin lesion area and the percentage of the skin lesion area relative to the back surface for each patient. We then analyzed the relationship between morbidity and the measured skin lesion area or related factors. Results : The overall median skin lesion area was 36.2 $cm^2$ (n=10). The percentage of the skin lesion area relative to the back surface ranged from 0.6% to 18.1%. During surgical reconstruction, 4 patients required subsequent operations to repair CSF morbidity. The comparison of the mean area of skin lesions between the CSF morbidity group and the non-CSF morbidity group was statistically significant (average volume skin lesion of $64.4{\pm}32.5cm^2$ versus $27.7{\pm}27.8cm^2$, p<0.05). CSF morbidity tended to occur either when the skin lesion area was up to 44.2 $cm^2$ or there was preexisting fibrosis before revision with an accompanying broad-based dural defect. Conclusion : Measuring the lesion area, including the skin, dura, and related surgical parameters, offers useful information for predicting wound challenges and selecting appropriate reconstructive surgery methods.

• The Journal of Advanced Prosthodontics
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• 제6권6호
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• pp.539-546
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• 2014

PURPOSE. Silk fibroin (SF) is a new degradable barrier membrane for guided bone regeneration (GBR) that can reduce the risk of pathogen transmission and the high costs associated with the use of collagen membranes. This study compared the efficacy of SF membranes on GBR with collagen membranes (Bio-$Gide^{(R)}$) using a rat calvarial defect model. MATERIALS AND METHODS. Thirty-six male Sprague Dawley rats with two 5 mm-sized circular defects in the calvarial bone were prepared (n=72). The study groups were divided into a control group (no membrane) and two experimental groups (SF membrane and Bio-$Gide^{(R)}$). Each group of 24 samples was subdivided at 2, 4, and 8 weeks after implantation. New bone formation was evaluated using microcomputerized tomography and histological examination. RESULTS. Bone regeneration was observed in the SF and Bio-$Gide^{(R)}$-treated groups to a greater extent than in the control group (mean volume of new bone was $5.49{\pm}1.48mm^3$ at 8 weeks). There were different patterns of bone regeneration between the SF membrane and the Bio-$Gide^{(R)}$ samples. However, the absolute volume of new bone in the SF membrane-treated group was not significantly different from that in the collagen membrane-treated group at 8 weeks ($8.75{\pm}0.80$ vs. $8.47{\pm}0.75mm^3$, respectively, P=.592). CONCLUSION. SF membranes successfully enhanced comparable volumes of bone regeneration in calvarial bone defects compared with collagen membranes. Considering the lower cost and lesser risk of infectious transmission from animal tissue, SF membranes are a viable alternative to collagen membranes for GBR.

• Journal of Chest Surgery
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• 제52권2호
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• pp.70-77
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• 2019

Background: Extracorporeal life support (ECLS) is used as a bridge to revascularization in high-risk patients with ischemic heart disease. We reviewed our experiences of coronary artery bypass grafting (CABG) after ECLS in patients with cardiac arrest or refractory cardiogenic shock. Methods: We retrospectively reviewed 4,616 patients who underwent CABG at our institution between May 2006 and February 2017. We identified patients who underwent CABG following ECLS for cardiogenic shock or cardiac arrest. Twenty-three patients (0.5% of all CABG cases) were enrolled in the analysis. Their median age was 65 years (Q1-Q3, 58-77 years). Nine patients (39.1%) were diagnosed with ST-elevation myocardial infarction. Mechanical complications after acute myocardial infarction, including acute mitral regurgitation, left ventricular rupture, and ventricular septal defect, occurred in 9 patients (39.1%). Results: The median time from cardiopulmonary resuscitation to ECLS initiation was 25 minutes (Q1-Q3, 18.5-28.5 minutes). Conventional CABG was performed in 10 patients (43.5%) who underwent concomitant intracardiac procedures. Postoperative ECLS was required in 16 patients (69.5%). The rate of successful ECLS weaning was 91.3% (n=21). There were 6 early mortalities (26.1%). Conclusion: CABG after ECLS was very rare in real-world circumstances. Although the early mortality rate was high, the risk of mortality may be acceptable under such devastating circumstances.

• Journal of Korean Neurosurgical Society
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• 제64권5호
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• pp.799-807
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• 2021

Objective : Cerebrospinal fluid leakage related complications (CLC) occasionally occur after intradural spinal surgery. We sought to investigate the effectiveness of early ambulation after intradural spinal surgery and analyze the risk factors for CLC. Methods : For this retrospective cohort study, we enrolled 314 patients who underwent intradural spinal surgery at a single institution. The early group contained 79 patients who started ambulation after 1 day of bedrest without position restrictions, while the late group consisted of 235 patients who started ambulation after at least 3 days of bed rest and were limited to the prone position after surgery. In the early group, Prolene 6-0 was used as the dura suture material, while black silk 5-0 was used as the dura suture material in the late group. Results : The overall incidence rate of CLC was 10.8%. Significant differences between the early and late groups were identified in the rate of CLC (2.5% vs. 13.6%), surgical repair required (1.3% vs. 7.7%), and length of hospital stay (2.99 vs. 9.29 days) (p<0.05). Logistic regression analysis revealed that CLC was associated with practices specific to the late group (p=0.011) and the revision surgery (p=0.022). Conclusion : Using Prolene 6-0 as a dura suture material for intradural spinal surgery resulted in lower CLC rates compared to black silk 5-0 sutures despite a shorter bed rest period. Our findings revealed that suture - needle ratio related to dura defect was the most critical factor for CLC. One-day ambulation after primary dura closure using Prolene 6-0 sutures appears to be a costeffective and safe strategy for intradural spinal surgery.

• Journal of Chest Surgery
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• 제55권2호
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• pp.151-157
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• 2022

Background: We investigated surgical outcomes after the surgical repair of cor triatriatum sinister (CTS). Methods: Thirty-two consecutive patients who underwent surgical repair of CTS from 1993 through 2020 were included in this study. The morphological characteristics, clinical features, and surgical outcomes were described and analyzed. Results: The median age and body weight at operation were 9 months (interquartile range [IQR], 3-238 months) and 7.5 kg (IQR, 5.8-49.6 kg), respectively. There were 16 males (50%). According to the modified Lucas classification, type IA (classical CTS) was most common (n=20, 62.5%). Atrial septal defect was associated in 22 patients (68.8%) and anomalous pulmonary venous return in 8 patients (25%). Pulmonary hypertension was preoperatively suspected with a high probability in 18 patients (56.3%). There was 1 early death (3.1%) after emergent membrane excision and hybrid palliation in a high-risk hypoplastic left heart syndrome patient. There were no late deaths. The overall survival rate was 96.9% at 15 years post-repair. No early survivors required reoperation during follow-up. Most survivors (31 of 32 patients, 96.9%) were in New York Heart Association functional class I at a median follow-up of 74 months (IQR, 39-195 months). At the latest echocardiography performed at a median of 42 months (IQR, 6-112 months) after repair, no residual lesion was observed except in 1 patient who had moderate pulmonary hypertension (mean pulmonary arterial pressure of 36 mm Hg). Conclusion: Surgical repair of cor triatriatum could be performed safely and effectively with an extremely low risk of recurrence.

• Korean Journal of Radiology
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• 제21권9호
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• pp.1095-1103
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• 2020

Objective: The present study aimed to investigate whether quantitative dual-energy computed tomography (DECT) parameters offer an incremental risk stratification benefit over the CT ventricular diameter ratio in patients with acute pulmonary embolism (PE) by using propensity score analysis. Materials and Methods: This study was conducted on 480 patients with acute PE who underwent CT pulmonary angiography (CTPA) or DECT pulmonary angiography (DE CT-PA). This propensity-matched study population included 240 patients with acute PE each in the CTPA and DECT groups. Altogether, 260 (54.1%) patients were men, and the mean age was 64.9 years (64.9 ± 13.5 years). The primary endpoint was all-cause death within 30 days. The Cox proportional hazards regression model was used to identify associations between CT parameters and outcomes and to identify potential predictors. Concordance (C) statistics were used to compare the prognoses between the two groups. Results: In both CTPA and DECT groups, right to left ventricle diameter ratio ≥ 1 was associated with an increased risk of all-cause death within 30 days (hazard ratio: 3.707, p < 0.001 and 5.573, p < 0.001, respectively). However, C-statistics showed no statistically significant difference between the CTPA and DECT groups for predicting death within 30 days (C-statistics: 0.759 vs. 0.819, p = 0.117). Conclusion: Quantitative measurement of lung perfusion defect volume by DECT had no added benefit over CT ventricular diameter ratio for predicting all-cause death within 30 days.

• 한국재난정보학회 논문집
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• 제8권4호
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• pp.362-375
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• 2012

관광호텔은 숙박과 음식점, 운동, 휴양 등의 부대시설을 함께 갖춘 불특정 이용객과 투숙객 이 많은 복합시설로서 화재발생에 따른 인명피해와 재산손실에 매우 취약한 위험이 상존하는 시설이다. 본 연구에서는 관광호텔의 화재발생 현황에 대한 2001년부터 2010년까지 10 년간의 화재통계분석과 대형 호텔화재사례 15건을 분석하였다. 화재발생 장소는 호텔 객실 (33.2%)과 음식점 주방(11.8%)가 주요 발생장소이며 주요 화재원인인 전기화재(40.8%), 담배화재(14.5%), 용접 등 화기작업(9.2%) 등으로 나타났다. 또한 화재사례연구에서는 방화구획설치 및 관리 불량, 가연내장재 사용 등이 연구기간 동안 반복적으로 모든 사례에서 나타나서 주요 화재위험으로 분석되었다. 관광호텔은 이러한 화재위험의 특성에 따라 적합한 방화위험관리의 개발과 현장 운영이 필요하다. 예방점검, 사용자 교육 및 훈련, 투숙객의 화재예방안내 등의 적극적 예방관리가 필요하다. 또한 화재의 연소확대를 차단하기 위한 방화구획의 관리, 스프링클러 등의 자동소화설비를 설치가 필요하며, 가연성 물질의 사용 을 자제하여야 하고, 투숙객 피난 안전에 대한 신속한 조치, 비상절차 등과 관련된 비상대응규정의 운용이 매우 중요하다.

• 한국ITS학회 논문지
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• 제20권1호
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• pp.174-192
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• 2021

카메라나 레이더에 비해 높은 인지 성능을 제공하는 라이다 센서는 높은 가격으로 의해 ADAS나 자율주행에 적용되기 어려웠으나, 최근 가격이 빠르게 낮아지고 있어 라이다를 활용한 기존 자율주행 기능 개선에 관한 기대가 높아지고 있다. 레벨3 자율주행자동차의 경우, 센서의 결함 또는 한계 등 인지시스템에 위험한 상황이 발생했을 때 운전자에게 수동모드로의 제어권 전환을 요청하며, 만약 이러한 요청에도 운전자가 반응하지 않을 경우 MRM 즉 최소위험기동을 구현하여야 한다. 본 연구에서는 이러한 배경을 바탕으로 인지 시스템에서 생기는 위험으로 인해 LKS의 정상작동이 힘든 경우에 대한, 라이다 기반의 MRM 알고리즘을 개발하였다. 본 논문의 LKS MRM 기술은 라이다에서 수집된 포인트 클라우드 데이터를 기반으로 객체 군집화를 통해 전방에 있는 차량의 이동 경로를 생성하고, 이를 자차량의 목표 경로점으로 변환하여, 카메라 기반의 LKS가 정상 작동을 할 수 없는 경우 라이다 기반의 경로 추종제어를 통해 최소위험기동을 수행한다. 제안된 알고리즘의 성능을 검증하기 위하여 HAZOP 기법을 사용하여 위험원을 식별하였고 이를 바탕으로 검증용 시나리오 3가지를 도출하여, 뵨 연구에서 구축한 시뮬레이션 환경에서 알고리즘 검증을 수행하였다. 그 결과 본 연구에서 제안한 라이다 기반 LKS MRM 알고리즘이 여러 가능한 인지시스템의 위험 상황에 대해 차선이탈을 방지하고 이를 통해 교통사고를 방지하는 것을 확인할 수 있었다.

• Journal of Periodontal and Implant Science
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• 제33권3호
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• pp.457-474
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• 2003

The ultimate objective of periodontal treatment is to get rid of an on-going periodontal disease and further regenerate the supporting tissue, which is already destroyed, functionally. Currently, the bone grafting operation using various kinds of bone grafting materials and the operation for induced regeneration of periodontal tissue using the blocking membrane are performed for regeneration of the destroyed periodontal tissue. However, there are respective limitations Galenical preparations, which are used for regeneration of periodontal of tissue, has less risk of rejective reaction or toxicity that may be incidental to degradation and their effect is sustainable. Thus, in case they are applicable to a clinic, they can he used economically. Chitosan has such compatibility, biological actions including antibacterial activity, acceleration of wound treatment, etc., and excellent mechanical characteristics, which has recently aroused more interest in it. Also, it has been reported that it promotes osteogenesis directly or indirectly by functioning as a matrix to promote migration and differentiation of a specific precussor cell (for example, osteoblast) and further inhibiting the function of such a cell as fibroblast to prevent osteogenesis. In this study, the pure chitosan solution, which was obtained by purifying chitosan, was used. However, since this chitosan is of a liquiform, it is difficult to sustain it in a defective region. It is, therefore, essential to use a carrier for delivering chitosan to, and sustaining it gradually in the defective region. In the calvarial defect model of the Sprague-Dawley rat, it is relatively easy to maintain a space. Therefore, in this study, the chitosan solution with which ACS was wetted was grafted onto the defective region, For an experimental model, a calvarial defect of rat m s selected, and a critical size of the defective region was a circular defect with a diameter of 8 mm. A group in which no treatment was conducted for the calvarial defect was set as a negative control group. Another group in which treatment was conducted with ACS only was set as a positive control group (ACS group). And another group in which treatment was conducted was conducted with by grafting the pure chitosan solution onto the defective region through ACS which was wetted with the chitosan solution was set an experimental group (Chitosan/ACS group). Chitosan was applied to the Sprague-Dawley rat's calvarial bone by applying ACS which was wetted with the chitosan solution, and each Sprague-Dawley rat was sacrificed respectively 2 weeks and 8 weeks after the operation for such application. Then, the treatment results were compared and observed histologically and his tometrically. Thereby, the following conclusions were obtained. 1. In the experimental group, a pattern was shown that from 2 weeks after the operation, vascular proliferation proceeded and osteogenesis proceeded through osteoblast infiltration, and at 8 week after the operation, ACS was almost absorbed, the amount of osteogensis was increased and many osteoid tissue layers were observed. 2. At 2 weeks after the operation, each amount of osteogenesis appeared to be 8.70.8 %, 13.62.3 % and 4.80.7 % respectively in the experimental group, the positive control group and the negative control group. Accordingly, it appeared to be higher in the Experimental group and the positive control group than in the negative control group, but there was no significant difference statistically (p<0.01). 3. At 8 weeks after the operation, each amount of osteogenesis appeared to be 62.26.1%, 17.42.5 % and 8.21.4 % respectively in the experimental group, the positive control group and the negative control group. Accordingly, it appeared to be substantially higher in the experimental group than in the positive control group and the negative control group, and there was a significant difference statistically (p<0.01). As a result of conducting the experiment, when ACS was used as a carrier for chitosan, chitosan showed effective osteogenesis in the perforated defective region of the Sprague-Dawley rat's calvarial bone.

• 조명전기설비학회논문지
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• 제29권1호
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• pp.57-63
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• 2015

The incidence of fires caused by electrical factors has increased with the growth in domestic electrical consumption. According to the national fire data system of national emergency management agency, electrical fires accounted for 20% of all domestic fires in the last 10 years. Electrical fires are mainly caused by short circuit, leakage current, defect in an electrical equipment, over load, utility fault, etc. The fault current can be several times larger than the nominal current, thereby exceeding the rated current of cable. Consequently, the cable conductor, typically copper wire, heats up to a temperature that ignites surrounding combustibles. This paper describes the transient characteristics of the 0.6/1kV, TFR-8 cable have been investigated, and analyzed under the over current conditions for reduce the risk of electrical fire by experimental and FEM analysis. The experimental and FEM(Finite Element Method) analysis results of temperature and resistance variation according to the over current in copper wires were analyzed. The experimental results coincide well with the FEM analysis.