• Journal of Korean Neurosurgical Society
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• v.49 no.5
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• pp.267-272
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• 2011

Objective : Although iliac crest autograft is the gold standard for lumbar fusion, the morbidity of donor site leads us to find an alternatives to replace autologous bone graft. Ceramic-based synthetic bone grafts such as hydroxyapatite (HA) and b-tricalcium phosphate (b-TCP) provide scaffolds similar to those of autologous bone, are plentiful and inexpensive, and are not associated with donor morbidity. The present report describes the use of Polybone$^{(R)}$ (Kyungwon Medical, Korea), a beta-tricalcium phosphate, for lumbar posterolateral fusion and assesses clinical and radiological efficacy as a graft material. Methods : This study retrospectively analyzed data from 32 patients (11 men, 21 women) who underwent posterolateral fusion (PLF) using PolyBone$^{(R)}$ from January to August, 2008. Back and leg pain were assessed using a Numeric Rating Scale (NRS), and clinical outcome was assessed using the Oswestry Disability Index (ODI). Serial radiological X-ray follow up were done at 1, 3, 6 12 month. A computed tomography (CT) scan was done in 12 month. Radiological fusion was assessed using simple anterior-posterior (AP) X-rays and computed tomography (CT). The changes of radiodensity of fusion mass showed on the X-ray image were analyzed into 4 stages to assess PLF status. Results : The mean NRS scores for leg pain and back pain decreased over 12 months postoperatively, from 8.0 to 1.0 and from 6.7 to 1.7, respectively. The mean ODI score also decreased from 60.5 to 17.7. X-rays and CT showed that 25 cases had stage IV fusion bridges at 12 months postoperatively (83.3% success). The radiodensity of fusion mass on X-ray AP image significantly changed at 1 and 6 months. Conclusion: The present results indicate that the use of a mixture of local autologous bone and PolyBone$^{(R)}$ results in fusion rates comparable to those using autologous bone and has the advantage of reduced morbidity. In addition, the graft radiodensity ratio significantly changed at postoperative 1 and 6 months, possibly reflecting the inflammatory response and stabilization.

• Journal of Korean Neurosurgical Society
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• v.30 no.9
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• pp.1079-1085
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• 2001

Objective : We analysed various surgical approaches and surgical results of 28 middle cranial base tumors for the purpose of selecting optimal surgical approach to the middle cranial base tumor. Methods : In this retrospective review, 28 patients, including 16 meningioma, 6 trigeminal neurinoma, 2 pituitary adenoma, 2 craniopharyngioma, 1 facial neurinoma, and 1 metastatic tumor, underwent surgical treatment using skull base technique. Of theses, 16 tumors were mainly confined to middle cranial fossae, 5 tumors with extension into both anterior and middle fossa, and 7 tumors with extension into both middle and posterior fossa. Tumors that confined to the middle cranial fossa or extended into the anterior cranial fossa were operated with modified pterional, orbitozygomatic or Dolen'c approach, and tumors that extended into the posterior cranial fossa were operated with anterior, posterior or combined transpetrosal approach. Completeness of tumor resection, surgical outcome, postoperative complication, and follow up result were studied. Results : Total tumor removal was achieved in 9 tumors of 10 tumors that did not extended to the cavernous sinus, and was achieved in 7 tumors of 8 tumors that extended to the lateral wall of the cavernous sinus. Of 10 tumors that extended to the venous channel of the cavernous sinus, only 2 were removed totally. Surgical outcome was excellent in 14 patients, good in 10, fair in 2 and poor in 2. There were no death in this series. Dumbell type tumor which extended into both middle and posterior fossae showed tendency of poor prognosis as compared with tumors that confined middle cranial fossa and extended into both anterior and middle cranial fossa. Postoperative dysfunctions were trieminal hypesthesia in 3, oculomotor nerve palsy in 2, abducens nerve palsy in 2, hemiparesis in 2, cerebellar sign in 1, facial palsy in 1 and hearing impairment in 1. Conclusion : Based on our findings and a review of the literature, we conclude that, when selecting the surgical approach to the middle cranial fossa tumors, the most important factors to be considered were exact location of the tumor mass and existence of the cavernous sinus invasion by tumor mass. We recommend modified pterional or orbitozygomatic approach in cases with tumors located anterior and middle cranial base, without cavernous sinus invasion. In cases with tumors invading into cavernous sinus, we recommend Dolen'c or orbitozygomatic approach. And in lateral wall mass and the cavernous sinus, it is preferred to approach the tumor extradurally. For the tumor involing with middle fossa and posterior fossa(dumbell type) a combined petrosal approach is necessary. In cases with cavernous sinus invasion and internal carotid artery encasement, we recommend subtotal resection of the tumor and radiation therapy to prevent permanent postoperative sequele.

• The Korean Journal of Nuclear Medicine
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• v.32 no.2
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• pp.151-160
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• 1998

Purpose: Piccolo et al. advocated the usefulness of $^{99m}Tc$-MDP breast scan in differential diagnosis of breast mass with high accuracy. But there are little or no follow-up studies about it as we know. We studied $^{99m}Tc$-MDP uptake pattern and lesion/background ratio in patients complaining palpable breast lesions to evaluate the clinical usefulness of $^{99m}Tc$-MDP scan. Materials and Methods: Total 34 patients were studied with physical examination, mammo-gram and $^{99m}Tc$-MDP scan prospectively. Anteroposterior and both lateral view of breast were obtained 5 minutes after iv injection of 740 MBq $^{99m}Tc$-MDP. Breast uptake pattern of $^{99m}Tc$-MDP was analyzed by a grade system: 0=no uptake, grade 1=bilateral diffuse uptake, grade 2=asymmetric faint uptake, grade 3=focal hot uptake. 20 cases were pathologically confirmed by excision biopsy or aspiration biopsy. 14 cases were normal in physical examination and mammogram. Results: Pathologic results showed 7 carcinomas, 6 benign solid tumors, and 7 fibrocystic changes. Grade 3 pattern of $^{99m}Tc$-MDP uptake was noted in 4/7 carcinomas, 3/6 benign solid tumors, and 1/7 fibrocystic changes. Grade 2 pattern was 217, 0/7, 3/7 respectively. The average L/B ratio was 1.66 in carcinomas, 1.68 in benign solid masses, 1.20 in fibrocystic diseases, 1.05 in normal patients. L/B ratio was higher in carcinoma and benign mass groups than in fibrocystic change and normal control groups(p=0.005). But there was no statistical difference between L/B ratio of malignant mass group and benign mass group. Conclusion: $^{99m}Tc$-MDP scan is not suitable to routine clinical use for breast mass diagnosis. It might be used in limited conditions when whole body bone scan is planned.

• Journal of the Korean Geotechnical Society
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• v.15 no.4
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• pp.207-220
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• 1999

Model tests were performed to investigate the failure modes in embankments on soft ground supported by piles with cap beams. In the model tests, Jumunjin standard sand was placed on simulated cap beams and soft ground. The cap beams are placed perpendicular to the longitudinal axis of the embankment. The colored sand and the Jmniin standard sand were placed one after the other above cap beams and soft ground to make lateral stripes with 3mm thickness in the embarkment. The colored sand was prepared by coating the Jumunjin sand with black lead powder. The photographs illustrate the two characteristic modes of failure in embarkments. One is the soil arching failure and the other is the punching shear failure. The failure mode depends on the height of embankment and the space between cap beams. That is, if the embankment is high enough compared with the space between cap beams, it will fail in arching failure. On the other hand if the embarkment is relatively low or the space between piles is too wide, it will fail in punching shear failure. The soil arching develops in embarkment as a semicylindrical arch with a thickness equal to the width of the cap beam. And the soil wedge developed above the cap beams remains intact during both arching and punching failures. The boundary of punching shear failure of the displaced soil mass can be defined on the basis of observation of the photographs.

• Proceedings of the Korean Institute Of Construction Engineering and Management
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• 2008.11a
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• pp.93-98
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• 2008

Haeundae Doosan We've The Zenith project is adjacent to Suyoung-bay, now it is in the process of excavation and foundation work. The main use of the tower is residence which height is 300m and 80 floor, the highest residential reinforced concrete building through the Orient. It is comprised of 3 high- rised buildings and 1 low-rised building, the basement is 230m wide and 200m length sized mass structure. The lateral resistance system is acted effectively against the lateral load and satisfactorily against the wind vibration by the 4 direction extension of the center core wall($700{\sim}800mm$ thickness) and reinforced concrete column set around the slab. Flat-plate slab system(250mm thickness) is adjusted for the slab system and it enables effective work process and shortening the working term by minimizing the ceiling height and not needing to install perimeter beam and drop panel. The strength and serviceability of the structure is able to be monitored and estimated constantly through the health monitoring system during the construction and after the construction.

• The Journal of Engineering Geology
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• v.11 no.1
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• pp.1-11
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• 2001

The geological characteristics of Korea are that we can encounter the rock layer only after 10m of excavation, methods to presume the rock pressure distribution of the rock layer is urgently needed. When using the existing empiric science of Terzaghi-Peck, Tschebotarioff to measure the rock pressure of the rock layer, underestimate the real strength because of the cohesion is ignored. Therefore calculating the horizontal sliding force of wedge block, which includes the dips and shear strength of discontinuities and surcharge load etc., think to be to getting a closer rock stress of the real rock pressure acting upon the earth structure in rock mass. This research use Coulomb soil pressure theory assuming that the backfill soil will yield wedge failure when it has cohesion, applying Prakash-Saran(l963), and then it uses equilibrium of force and shear strength $\tau$=c+$\sigma$tan $\Phi$ of the cliscontinuities. Analyzing shear strength and dips of cliscontinuities using calculated theory according to the status of discontinuities aperture, we were able to find out that because the cohesion and friction angle of the rock layer itself is large enough, how the dip directions and dips facing the excavation face is the only factor deciding whether or not the rock stress is applied. The evaluated theory of this research should be strictly estimated, so that the many parameters such as c, $\Phi$value, types and structures of rock class, excessive lateral pressure, dynamic load, earthquake, needed later when calculating shear strength of discontinuities and especially the ground water effect acting on rock layer should be coumpted with many measuring data achieve at the insite to study the application.

• Archives of Plastic Surgery
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• v.37 no.5
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• pp.681-686
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• 2010

Purpose: Obese proportion is increasing universally, estimating more than a billion. So reducing the weight became one of the topic in medical market. Not only diet, exercise, medication, but also many surgical procedures are being developed, such as sleeve gastrectomy, gastric bypass surgery. After massive weight loss, skin excess and laxity occurs, leading to unsatisfying body contour. Body contouring surgery including abdominoplasty, breast reduction is performed when skin excess is present in abdomen and breast. When skin excess is present circumferentially, belt dermolipectomy is the treatment of choice. Methods: A 23-year-old man had weight gain since he was 12 of age. A year before visiting to our department, his height was 168 cm, weight was 150 kg and body mass index (BMI) was 53.15 kg/$m^2$. The patient lost 55 kg of his weight through exercise and diet control. When he visited again, his weight was 95 kg and BMI was 33.66 kg/$m^2$. In physical examination, skin excess and laxity was seen in both breast and abdomen circumferentially and lateral folds were seen in the back. Abdominal contour deformity (Pitman classification type 6) and pseudogynecomastia (grade 3) were present in both breast. Belt dermolipectomy of abdomen, both breast and lateral folds was performed, resecting 6,400 g of tissue and additive 1,200 g through revisional operation. Results: The patient lost 6,500g of his weight and BMI reduced by 2.3 kg/$m^2$. The patient's hospital course was uneventful during 5 weeks of hospitalization and he was satisfied with his final body contour. Conclusion: Body contouring with belt dermolipectomy in patient who has circumferential skin excess and laxity after massive weight loss can be a treatment of choice.

• Journal of Korean Neurosurgical Society
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• v.63 no.5
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• pp.614-622
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• 2020

Objective : The method of approach during transforaminal endoscopic lumbar discectomy (TELD) has been the subject of repeated study. However, the ideal entry point during TELD has not been studied in detail. Therefore, this study investigated the ideal entry point for avoiding complications using computed tomography (CT) scans obtained from patients in the prone position. Methods : Using CT scans obtained from patients in the prone position, we checked for retroperitoneal or visceral violations and measured the angles of approach with five conventional approach lines drawn on axial CT scans at each disc space level (L2-3, L3-4, and L4-5). We also determined the ideal entry point distance and approach angles for avoiding retroperitoneal or visceral violations. Correlation analysis was performed to identify the patient characteristics related to the ideal entry point properties. Results : We found that the far lateral approach at the L2-3 level resulted in high rates of visceral violation. However, rates of visceral violation at the L3-4 and L4-5 levels were remarkably low or absent. The ideal angles of approach decreased moving caudally along the spine, and the ideal entry point distances increased moving caudally along the spine. Weight, body mass index (BMI), and the depth of the posterior vertebral line from the skin were positively associated with the distance of the ideal entry point from the midline. Conclusion : We reviewed the risk of the extreme lateral approach by analyzing rates of retroperitoneal and visceral violations during well-known methods of approach. We suggested an ideal entry point at each level of the lumbar spine and found a positive correlation between the distance of the entry point to the midline and patient characteristics such as BMI, weight, and the depth of the posterior vertebral line from the skin.

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.4
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• pp.651-657
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• 2007

Odontomas are the common type of odontogenic tumors and generally are asymptomatic and frequently lead to impaction or delayed eruption of permanent teeth. They are composed of enamel, dentin, cementum and pulp tissue and are divided into compound and complex according to the morphology of the hard tissues. Compound odontomas consist of varying numbers of small toothlike structure and have a predilection for the maxillary anterior regions. Complex odontomas consist of an unorganized mass of odontogenic tissues and comprise approximately 25 percent of all odontomas and have a predilection for the mandibular posterior regions. The etiology of odontomas is uncertain but hypothesized to involve local trauma, infection and genetic factors. Treatment of odontoma is conservative surgical removal and are little probability of recurrence. These two cases were about the patients with delayed eruption of mandibular first molar and mandibular lateral incisor. We surgically removed odontoma, exposed impacted tooth and guided impacted tooth into normal position by orthodontic traction. At the completion of traction, the mandibular first molar and mandibular lateral incisor was positioned fairly within the arch and complications such as root resorption were not observed.

• Korean Journal of Clinical Laboratory Science
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• v.52 no.1
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• pp.18-27
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• 2020

The correct distinction of carbapenem-resistant Enterobacteriaceae (CRE) and ccarbapenemase producing Enterobacteriaceae (CPE) and the rapid detection of CPE are important for instituting the correct treatment and management of clinical infections. Screening protocols are mainly based on cultures of rectal swab specimens on selective media followed by phenotypic tests to confirm a carbapenem-hydrolyzing activity, the rapid carbapenem inactivation method, lateral flow immunoassay, the matrix-assisted laser desorption ionization-time-of-flight test and molecular methods. The CPE is accurate for detection, and is essential for the clinical treatment and prevention of infections. A variety of phenotypic methods and gene-based methods are available for the rapid detection of carbapenemases, and these are expected to be routinely used in clinical microbiology laboratories. Therefore, to control the spread of carbapenemase, many laboratories around the world will need to use reliable, fast, high efficiency, simple and low cost methods. Optimal effects in patient applications would require rapid testing of CRE to provide reproducible support for antimicrobial management interventions or the treatment by various types of clinicians. For the optimal test method, it is necessary to combine complementary test methods to discriminate between various resistant bacterial species and to discover the genetic diversity of various types of carbapenemase for arriving at the best infection control strategy.