• Journal of Korean Neurosurgical Society
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• 제61권1호
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• pp.42-50
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• 2018

Objective : Massive intracerebral hemorrhage (ICH) and major infarction (MI) are devastating cerebral vascular diseases. Decompression craniectomy (DC) is a common treatment approach for these diseases and acceptable clinical results have been reported. Author experienced the postoperative intracranaial pressure (ICP) trend is somewhat different between the ICH and MI patients. In this study, we compare the ICP trend following DC and evaluate the clinical significance. Methods : One hundred forty-three patients who underwent DC following massive ICH (81 cases) or MI (62 cases) were analyzed retrospectively. The mean age was $56.3{\pm}14.3$ (median=57, male : female=89 : 54). DC was applied using consistent criteria in both diseases patients; Glasgow coma scale (GCS) score less than 8 and a midline shift more than 6 mm on brain computed tomography. In all patients, ventricular puncture was done before the DC and ICP trends were monitored during and after the surgery. Outcome comparisons included the ictus to operation time (OP-time), postoperative ICP trend, favorable outcomes and mortality. Results : Initial GCS (p=0.364) and initial ventricular ICP (p=0.783) were similar among the ICH and MI patients. The postoperative ICP of ICH patients were drop rapidly and maintained within physiological range if greater than 80% of the hematoma was removed. While in MI patients, the postoperative ICP were not drop rapidly and maintained above the physiologic range (MI=18.8 vs. ICH=13.6 mmHg, p=0.000). The OP-times were faster in ICH patients (ICH=7.3 vs. MI=40.9 hours, p=0.000) and the mortality rate was higher in MI patients (MI=37.1% vs. ICH=17.3%, p=0.007). Conclusion : The results of this study suggest that if greater than 80% of the hematoma was removed in ICH patients, the postoperative ICP rarely over the physiologic range. But in MI patients, the postoperative ICP was above the physiologic range for several days after the DC. Authors propose that DC is no need for the massive ICH patient if a significant portion of their hematoma is removed. But DC might be essential to improve the MI patients' outcome and timely treatment decision.

• Journal of Korean Neurosurgical Society
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• 제55권6호
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• pp.307-312
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• 2014

Objective : We investigated the expression of hippocampal heat shock protein 70 (HSP-70) infarction volume after different durations of experimental ischemic stroke in mice. Methods : Focal cerebral ischemia was induced in mice by occluding the middle cerebral artery with the modified intraluminal filament technique. Twenty-four hours after ischemia induction, both hippocampi were extracted for HSP-70 protein analyses. Slices from each hemisphere were stained with 2,3,5-triphenyltetrazolium chloride (2%), and infarction volumes were calculated. HSP-70 levels were evaluated using western blot and enzyme-linked immunosorbent assay (ELISA). HSP-70 subtype (hsp70.1, hspa1a, hspa1b) mRNA levels in the hippocampus were measured using reverse transcription-polymerase chain reaction (RT-PCR). Results : Cerebral infarctions were found ipsilateral to the occlusion in 10 mice exposed to transient ischemia (5 each in the 30-min and 60-min occlusion groups), whereas no focal infarctions were noted in any of the sham mice. The average infarct volumes of the 2 ischemic groups were $22.28{\pm}7.31mm^3$ [30-min group${\times}$standard deviation (SD)] and $38.06{\pm}9.53mm^3$ (60-min group${\times}$SD). Western blot analyses and ELISA showed that HSP-70 in hippocampal tissues increased in the infarction groups than in the sham group. However, differences in HSP-70 levels between the 2 infarction groups were statistically insignificant. Moreover, RT-PCR results demonstrated no relationship between the mRNA expression of HSP-70 subtypes and occlusion time or infarction volume. Conclusion : Our results indicated no significant difference in HSP-70 expression between the 30- and 60-min occlusion groups despite the statistical difference in infarction volumes. Furthermore, HSP-70 subtype mRNA expression was independent of both occlusion duration and cerebral infarction volume.

• Investigative Magnetic Resonance Imaging
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• 제22권3호
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• pp.150-157
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• 2018

Purpose: To assess associations between morphological characteristics of intracranial arteries in time-of-flight MR angiography (TOF-MRA) and atherosclerotic risk factors. Materials and Methods: From January 2014 to October 2015, a total of 129 patients (65 men and 64 women) without intracranial arterial stenosis > 50% were included in this study. All MRIs were performed using a 3T machine with 3D TOF-MRA sequences. We evaluated irregularity, tortuosity, and dilatation of intracranial arteries in maximal intensity projection (MIP) of TOF-MRA. Subjects' risk factors for atherosclerosis including history of hypertension and diabetes were collected by reviewing their medical records. Associations between morphological characteristics and each known atherosclerosis risk factor were examined using univariate regression analysis. Multivariate regression models were built to determine combined association between those risk factors and morphologic changes of intracranial arteries. Results: In multivariate analysis, hypertension (coefficient [95% CI]: 0.162 [0.036, 0.289], P = 0.012) and absence of diabetes (coefficient [95% CI]: -0.159 [-0.296, -0.023], P = 0.022) were associated with large diameter of intracranial arteries. Males (coefficient [95% CI]: 0.11 [-0.006, 0.23], P = 0.062) and higher age (coefficient [95% CI]: 0.003 [-0.001, 0.008], P = 0.138) had marginal association with increased diameter. Tortuosity was associated with old age (OR: 1.04 [1.02, 1.07], P < 0.001). Irregular contour of intracranial arteries was significantly associated with old age (OR: 1.05 [1.02, 1.09], P = 0.004), presence of diabetes (OR: 2.88 [1.36, 6.15], P = 0.0058), and previous ischemic stroke (OR: 3.91 [1.41, 11.16], P = 0.0092). Conclusion: Morphological characteristics (irregularity, tortuosity, dilatation) of intracranial arteries seen in TOF-MRA might be associated with atherosclerotic risk factors in subjects with no or mild stenosis.

• 한국콘텐츠학회논문지
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• 제11권3호
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• pp.281-292
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• 2011

본 연구는 PNF 중 스프린터 패턴 적용 시 하지의 근 활성도가 균형 능력에 미치는 영향을 알아보고자 다음과 같이 실시하였다. 편마비 환자 24명을 대조군과 실험군으로 나누어 실험군에 주 3회, 6주 동안 PNF의 상 하지 패턴의 결합인 스프린터 패턴(Sprinter pattern)을 실시하였다. 하지 근활성도는 내 외측광근, 내 외측슬괵근, 외측비복근의 활동전위의 실효치 값을 분석하였다. 균형 능력 검사는 FICSIT-4, FSST, MTD-Balance system 이용하여 측정하였다. 운동 적용 방법에 따른 측정 시점에 대한 대조군과 실험군의 유의성 검정은 Two-way repeated measure ANOVA를 실시하였고, 각 측정 항목들 간의 상관관계를 알아보기 위하여 Pearson correlation으로 분석하였다. 그 결과, 스프린터 패턴의 적용은 마비측 하지의 근 활성도를 증가시켜 정적 및 동적 균형능력을 향상시키는데 효과가 있었음을 확인할 수 있었다. 따라서 마비측 하지의 효율적 근동원을 위한 치료적 중재프로그램으로 적극적인 활용과 함께 다양한 운동 패턴들과 결합시켜 새로운 중재를 개발할 필요가 있을 것으로 생각된다.

• 생명과학회지
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• 제26권12호
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• pp.1367-1375
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• 2016

Cilostazol은 phosphodiesterase III의 선택적 저해제로 알려져 있으며, 뇌졸중 치료에 일반적으로 사용되고 있다. Cilostazol을 처리한 경우, 국소 뇌허혈이 발생한 후에 혈관신생을 통해서 혈관형성이 향상된다는 것을 본 연구자들이 발표하였다. 혈관신생은 조직의 허혈상태를 극복하기 위해서 혈관재생을 촉진하는 중요한 과정으로써, 혈관내피세포의 증식, 이동, 모세관구조 형성의 다단계 과정으로 구성되어 있다. 이에 본 연구에서는 인간 뇌혈관내피세포를 이용하여 cilostazol이 혈관신생의 각 단계들에 어떤 영향을 미치는지 조사하였다. Cilostazol은 농도의존적으로 뇌혈관내피세포의 이동성을 촉진하였으나, 뇌혈관내피세포의 증식과 모세관구조 형성에는 영향을 미치지 않았다. Cilostazol이 세포이동을 조절하는 기전을 분석하기 위해서 cDNA microarray를 수행하였고, 세포이동에 관련성이 있는 5종의 후보 유전자들을 선택하여 real-time PCR을 통해 해당 유전자의 발현을 검증하였다. Cilostazol에 의해서 발현양이 조절되는 유전자들로써, phosphoserine aminotransferase 1 (PSAT1)와 CCAAT/enhancer binding protein ${\beta}$ ($C/EBP{\beta}$)은 발현이 증가하였고, tissue factor pathway inhibitor 2 (TFPI2), retinoic acid receptor responder 1 (RARRES1), RARRES3는 발현이 감소하였다. 이상의 결과를 통해서 cilostazol이 혈관내피세포의 이동을 촉진하여 혈관신생을 향상시킬 수 있음을 제안할 수 있으며, 뇌혈관내피세포에 대한 cilostazol의 조절기전에 대해서 더욱 상세히 규명을 한다면 혈관형성을 통하여 허혈성 질환을 치료할 수 있는 유용한 정보가 될 것으로 기대한다.

• Physical Therapy Rehabilitation Science
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• 제6권2호
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• pp.90-95
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• 2017

Objective: The purpose of this study was to investigate the physical therapists' perception of the use of gait measures, the frequency of the gait measures used, and also to identify the barriers that limit the use of these assessment tools. Design: Cross-sectional study. Methods: Physical therapists from the Seoul, Gyeonggi area from March to July 2016 were included in the study. Over the course of 18 weeks, a cross-sectional study was conducted with a self-report questionnaire. A total of 700 questionnaires were distributed and 350 questionnaires (50%) were collected, however with the exclusion of 140 questionnaires due to non-consent, a total of 210 questionnaires (30%) were analysed. Results: Out of the 10 standardized assessment tools, the therapists showed the highest perception for the timed up and go test (TUG [n=153, 72.9%]) and they also had high perception for the 10 meters walk test (10MWT [n=149, 71.0%]), and 6-minute walk test (6MWT [n=123, 58.6%]). The respondents answered that the TUG (n=116, 55.2%), 10MWT (n=100, 47.6%), and 6MWT (n=51, 24.3%) was used the most often. On the contrary, only four (1.9%) therapists have used the Chedoke-McMaster stroke assessment and the Rivermead Mobility Index. The lack of time was considered as the most important barrier to the use of assessment tools in clinical practice. Conclusions: Through this study, it has been shown that the domestic physical therapists used the TUG and the 10MWT mainly due to high recognition and evaluation status; however, the lack of time was the greatest impediment to the clinical application of the gait assessment tools.

• 생명과학회지
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• 제19권11호
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• pp.1568-1574
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• 2009

본 연구는 고혈압전단계자들에 대한 지속적인 건 스트레치시 시간에 따른 생리학적 반응을 분석하여 정상혈압자와 고혈압전단계자에 대한 EPR의 한 요소인 기계적 수용기가 혈압 및 혈역학 반응에 어떠한 영향을 주는지를 검토하였다. 그 결과, 안정 시와 시간에 따른 혈압 반응은 고혈압전단계자에 있어 SBP, MAP가 평균 20sec에서 통계적으로 가장 높은 경향을 보였으며(p<0.05), 정상혈압자에서는 SBP, DBP, MAP가 평균 45sec에서 가장 높은 경향을 보였다(p<0.05). 이는 고혈압 전단계자의 지속적인 수동적 건 스트레치 시 정상혈압자에 비해 Group III mechanoreceptors의 역기능에 따른 상승된 혈압 반응이 초기에 나타내었다고 사료된다. 또한 혈역학 반응에서 안정 시와 비교하여 지속적인 수동적건 스트레치 시 고혈압전단계자에서의 HR, SV, CO, TPR 모두 유의한 차이를 보이지 않았으나 정상혈압자에서 SV, CO가 통계적으로 유의한 차이를 보였다(p<0.05). 이는 CO, SV, HR, TPR이 정상혈압자에 비해 고혈압전단계자에 있어 높은 경향을 나타내었지만, 혈역학 반응은 본 연구를 통해 차이를 보이지 않아 앞으로 연구가 필요할 것으로 사료된다.

• 혜화의학회지
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• 제14권1호
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• pp.43-49
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• 2005

One case of patient with urinary retention was reported in this clinical study. After the study, the results were as follows: 1. Anulesis belongs to l$\acute{o}$ng-bi(癃閉) in oriental medicine and the patient of this case belongs to chronic anulesis. 2. The patient of this case was thought as broke out anuresis by vesical nerve palsy of diabetic bladder pathy and sequela of stroke, and ischuria of long lie down 3. The patient of this case changeable process is supposed to urinary frequency, 'bi(閉)', 'l$\acute{o}$ong(癃)', urinary incontinence and urinary frequency. 4. First time of drug treatment is GAMIPHALJENG-SAN(ji$\bar{a}$-w$\grave{e}$i-b$\bar{a}$-h$\bar{e}$ng-s$\check{a}$n) by oral administration that action of alleviate a fever, water utilization and metaphase, convalescence time of drug treatment is PHALMIWANGAMI (b$\bar{a}$-w$\grave{e}$i-w$\acute{a}$n-ji$\bar{a}$-w$\grave{e}$i), YIKLUENG-TANG(yi-ling-t$\bar{a}$ng), CHUKYOO-TANG(s$\grave{u}$-ni$\grave{a}$o-t$\bar{a}$ng) that action of recreation. 5. Accupuncture treatment is s$\bar{a}$n-x$\bar{i}$ng-xuw$\acute{e}$, zw$\acute{u}$-s$\bar{a}$n-li, qi-h$\check{a}$i, gu$\bar{a}$n-yu$\acute{a}$n, zh$\bar{o}$ng-ji by mild supplementing and reducing manipulation of needle and heat accupuncture is qi-h$\check{a}$i, gu$\bar{a}$n-yu$\acute{a}$n, zh$\bar{o}$ng-ji-xu$\acute{e}$. 6. The other treatment is a sitz bath that prevent of urinary tract infection, and relieve of initial acute auresis by using of urethral catheterization.

• 한국가스학회지
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• 제19권6호
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• pp.15-21
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• 2015

천연가스 연료는 매장량과 경제성 측면에서 미래 가치가 매우 높기 때문에 여러 가지 이용 기술 개발이 활발하게 이루어지고 있으며 내연기관을 이용한 발전 분야에서도 그 중요성이 점점 증가하고 있는 실정이다. 천연가스 연료를 이용하는 MW급 발전용 대형 왕복엔진의 경우 연료공급시스템의 고도화 개발이 필요한데 그 중에서도 천연가스 분사기의 개발은 실질적인 천연가스 연료 이용을 위한 핵심이다. 본 연구에서는 천연가스 분사기를 상부에 위치한 솔레노이드의 전자기력에 의해 구동되고 하부의 밸브 바디부 전기자와 이동판이 상하로 움직이는 구조의 분사밸브 형태로 고안 및 설계하였으며 이 시작품의 동특성을 엔진 흡기 모사 조건에서 실험하였다. 전기자의 변위와 지름을 변경해 가면서 실험을 수행하였는데, 그 결과 유량의 선형성이 잘 보장되고 1bar 의 차압에서 2ms 이내의 응답성으로 분사밸브가 열리는 결과를 얻었다. 가스 유량 또한 100Liter/min(@2Hz) 이상으로 충분하기 때문에 본 연구에서 고안한 천연가스 분사밸브는 요구되는 동특성 성능실험을 만족하였기 때문에 MW급 발전용 천연가스 엔진 연료공급시스템에 적합할 것으로 판단된다.

• 대한한방내과학회지
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• 제40권2호
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• pp.220-227
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• 2019

Objectives: Parkinson's disease is the neurodegenerative disease that affects both motor and non-motor function, including postural instability. Camptocormia is an abnormal condition in which the thoracolumbar spine bends forward during walking or standing. However, the treatment options are limited and often not effective. The purpose of this study was to report on the Korean medical treatment of a Parkinson's disease patient with postural instability who presented with camptocormia. Methods: We used Korean medical treatment including herbal medicine (Jemageopung-tang), acupuncture and pharmacopuncture therapy to the patient who was admitted to the hospital for 21 days. The clinical symptoms were assessed with the Unified Parkinson's Disease Rating Scale (UPDRS) and walking time without assistance. Results: After treatment, the UPDRS Parts 2 and 3 scores were decreased from 5 to 3 and 20 to 9, respectively. Also, the walking time without assistance was improved. Conclusion: This study suggested that Korean medical treatment could be an effective option for treating Parkinson's disease with postural instability.