• Journal of Trauma and Injury
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• 제24권1호
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• pp.56-59
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• 2011

Abdominal compartment syndrome (ACS) is a life-threatening disorder caused by rapidly increasing intra-abdominal pressure. ACS can result in multiorgan failure and carries a mortality of 60~70%. The treatment of choice in ACS is surgical decompression. There are very few reports of ACS and experience in Korea. We report 12-year-old male patient who developed an abdominal compartment syndrome due to traffic-accident-induced retroperitoneal hematomas, Which was successfully treated by performing a bedside emergency surgical decompression with open linea alba fasciotomy with intact peritoneum. When patients do not respond to medical therapy, a decompressive laparotomy is the last surgical resort. In patients with severe abdominal compartment syndrome, the use of a linea alba fasciotomy is an effective intervention to lower intra-abdominal hypertension (IAH) without the morbidity of a laparotomy. Use of a linea alba fasciotomy as a first-line intervention before committing to full abdominal decompression in patients with abdominal compartment syndrome improves physiological variables without mortality. Consideration for a linea alba fasciotomy as a bridge before full abdominal decompression needs further evaluation in patients with polytrauma abdominal compartment syndrome.

• Journal of Chest Surgery
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• 제21권3호
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• pp.497-509
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• 1988

Current therapy of aortic dissections remains unstandardized because of the relative rarity of these catastrophic events and conflicting reported results of various therapeutic strategies. Hence, we reviewed our current results and planned to purify our method of interpretation of results and so, to standardize therapeutic managements. This study comprised unselected, consecutive 27 patients with aortic dissections who were operated at Seoul National University Hospital from Jan 1983 to March 1988. The results from analysis of their preoperative, operative and postoperative finding were as follows: 1] 7 patients had acute type A, 14 had chronic type A, 4 had acute type B, and 2 had chronic type B. 2] The causes of dissections were unclear, but 8 patients had Marfan`s syndromes, 2 had previous operative histories on cardiovascular systems and 2 had congenital heart diseases. 3] Multiple preoperative variables were found to correlate significantly with operative mortality and complications. The prevalences of such preoperative major complicating factors were significantly more frequent in acute than chronic [P < 0.05] and type A than type B [P < 0.01]. 4] Operations were performed according to the type of the dissections and whether it was acute or chronic. Usually dacron tube graft replacements were performed[25/26]. Intraluminal sutureless graft replacement was performed in 11 patients. Of the 14 patients with combined aortic regurgitation, concomitant aortic valve resuspension in 4, seperative aortic valve replacement in 1, and aortic valve replacement with coronary reimplantation were performed in 9 patients. 2 patients had concomitant arch vessel managements. 5] Over-all operative mortality rate was 33% and 54% for acute type A, 25% for acute type B, 29% for chronic type A, 0% for chronic type B respectively. The main causes of operative mortality were cardiovascular complications [mainly CPB-weaning failure] in acute cases and hemorrhagic complications in chronic cases.

• Journal of Chest Surgery
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• 제30권10호
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• pp.1040-1043
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• 1997

식도암 .수술후 발생한 bronchiolitis obliterans organizing pneumonia환자 1례를 보고하고자 한다. 이 환자는 수술후 4일째부터 미열, 마른기침, 경미한 호흡곤란을 호소하였다 이때 촬영한 단순 흉부 사진과 흉부 컴퓨터 촬영상 폐양측에 반성(Patchy)침습소견이 나타났다. 고식적 치료에도 불구하고 경도의 백혈구 증다증과 함께 호흡기 증상은 더욱 악화되어 호흡부전의 소견을 보였다. 개흉적 폐생검을 실시하였으며, 병리조직검사 상 BOOP라는 진단을 얻었다. 수주간에 걸친 부신피질호르몬치료후 임상적, 생리학적, 그리고 방사선검사에서 많은 호전을 보였다. 이에 우리는 개흉술후 발생될 수 있는 급성호흡부전증에서 BOOP도 그 원인이 될 수 있음을 알았다. 이 경우 부신피질호르몬치료로 좋은 효과를 얻을 수 있으므로 개흉술후 발생되는 급성호 흡부전의 경우 가능한 조속히 조직검사를 시행할 팔요가 있음을 알 수 있었다.

• The Korean Journal of Pain
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• 제18권2호
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• pp.271-274
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• 2005

Cervical radicular pain has been recognized as a common cause of neck, shoulder and arm pain. The initial recommended therapy is based on the medical treatment by anti-inflammatory, analgesic agents, rest, traction and physical therapy. In the case of failure with these therapies, the classical alternative is a surgical discectomy, but this is associated with numerous risks inherent to invasive procedures. As a result, a number of percutaneous intradiscal therapies have developed over the last 3 decades, which have specifically focused on the pathology of the disc. However, these treatments have considerable limitations and success rates, and none allow for the extraction of a quantifiable amount of nucleus pulposus via a 17 gauge introducer using fluoroscopic guidance alone. Herein, we describe our experience using a $Dekompressor^{(R)}$ on a 52 year-old female patient with a cervical disc herniation. Percutaneous decompression in the treatment of cervical disc herniation was successfully performed, with a good outcome.

• Journal of Korean Neurosurgical Society
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• 제43권4호
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• pp.186-189
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• 2008

Objective : We assessed the surgical results of percutaneous balloon compression in 50 patients with idiopathic trigeminal neuralgia. Methods : Fifty patients with follow-up period of more than 12 months were retrospectively analyzed. The mean follow-up period was 42 months (range, 12-82). The mean age was 65.8 years (range, 27-83). Seventeen patients (34%) had other previous surgical procedures. The balloon was inflated by injecting radio-contrast media under brief general anesthesia according to Mullan’s technique. The mean inflating time was 88 seconds (range, 60-120). The whole procedure took about 20 minutes. Results : We reported excellent and good results in 70% of the cases, poor in 6% as annoying dysesthesia, recurrence in 16%, and 8% failure due to technical deficiencies. Forty-six patients (92%) were initially relieved of their pain. There were permanent motor weakness of the masseter muscle in 4% of patients and transitory diplopia in 8%. Neither anesthesia dolorosa nor keratitis occurred. Almost all patients (92%) were discharged postoperatively within two days. Conclusion : These results indicate that balloon compression would be an effective method with acceptable morbidity, technically, It can be performed rapidly and simply in the treatment of idiopathic trigeminal neuralgia.

• International Journal of Contents
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• 제12권1호
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• pp.25-43
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• 2016

An agent-centric event planning method is proposed for providing pedagogical experiences in an immersed environment. Two-level planning is required at in a macro-level (i.e., inter-event level) and an intra-event level to provide realistic experiences with the objective of learning declarative knowledge. The inter-event (horizontal) planning is based on search, while intra-event (vertical) planning is based on hierarchical decomposition. The horizontal search is dictated by several realistic types of association between events besides the conventional causality. The resulting schematic plan is further augmented by conditions associated with those agents cast into the roles of the events identified in the plan. Rather than following a main story plot, all the events potentially relevant to accomplishing an initial goal are derived in the final result of our planning. These derived events may progress concurrently or digress toward a new main goal replacing the current goal or event, and the plan could be merged or fragmented according to their respective lead agents' intentions and other conditions. The macro-level coherence across interconnected events is established via their common background world existing a priori. As the pivotal source of event concurrency and intricacy, agents are modeled to not only be autonomous but also independent, i.e., entities with their own beliefs and goals (and subsequent plans) in their respective parts of the world. Additional problems our method addresses for augmenting pedagogical experiences include casting of agents into roles based on their availability, subcontracting of subsidiary events, and failure of multi-agent event entailing fragmentation of a plan. The described planning method was demonstrated by monitoring implementation.

• Journal of Korean Neurosurgical Society
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• 제48권4호
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• pp.335-341
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• 2010

Objective : Anterior cervical corpectomy with fusion (ACF) or laminoplasty may be associated with substantial number of complications for treating multilevel cervical ossification of the posterior longitudinal ligament (OPLL) with significant cord compression. For more safe decompression and stabilization in multilevel cervical OPLL with prominent cord compression, we propose circumferential cervical surgery (selective ACF and laminoplasty) based on our favorable experience. Methods : Twelve patients with cervical myelopathy underwent circumferential cervical surgery and all patients showed multilevel OPLL with Signal change of the spinal cord on magnetic resonance imaging (MRI). A retrospective review of clinical, radiological. and surgical data was conducted. Results : There were 9 men and 3 women with mean age of 56.7 years and a mean follow up period of 15.6 months. The average corpectomy level was 1.16 and laminoplasty level was 4.58. The average Japanese Orthopedic Association score for recovery was 5.1 points and good clinical results were obtained in 11 patients (92%) (p < 0.05). The average space available for the cord improved from 58.2% to 87.9% and the average Cobb's angle changed from 7.63 to 12.27 at 6 months after operation without failure of fusion (p < 0.05). Average operation time was 8.36 hours, with an estimated blood loss of 760 mL and duration of bed rest of 2.0 days. There were no incidences of significant surgical complications, including wound infection. Conclusion : Although the current study examined a small sample with relatively short-term follow-up periods, our study results demonstrate that circumferential cervical surgery is considered favorable for safety and effectiveness in multilevel OPLL with prominent cord compression.

• 대한전기학회논문지:전력기술부문A
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• 제53권1호
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• pp.22-30
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• 2004

As an information-oriented society comes, many people use PC and depend on database that network server has. However, the online data can be missed when a blackout happens and also a power failure effects on standard of judgment on Power Quality. Thus, it is reason of a trend using interruption-free live-line work when a trouble happens to power system. However, the 83％ among the number of people who receive an electric shock experience when a laborer is doing interruption-free live-line works. In interruption-free method, the education and the training problem has been issued. However, we have a few instructors for that training. Furthermore, the trainees have short training period, just 4 weeks. In this paper, to develope the method that has no restriction of a time and place and reduce the wasteful materials, immersion type virtual reality(or environment) technology is used. The users of a 3D immersion type VR training system can interact with the system by doing same action in the real safe environment. Thus, it can be valuable to apply this training system to a dangerous work like as "Interruption-free live-line work exchanging COS(Cut-Out-Switch)". In this program, the user works with a instruction on the window and speaker and can't work other tasks until each part of the task completed. The workers using this system can use their hands and viewpoint movement as he is in a real environment but the trainee can't use all parts and senses of a real body with the current VR technology. Despite of this weak point, when we consider the trends of improvement in electrical devices and communication technology, we can say that 3D graphic VR application has a high potentiality.

• Journal of Trauma and Injury
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• 제28권4호
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• pp.284-291
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• 2015

The aim of this study is to present a nonoperative treatment for abdominal injuries in patients with multiple traumas and to discuss the role of metropolitan tertiary hospital, non-regional trauma centers. We collected data from patients with multiple traumas including abdominal injuries from 2009 to 2014. Patient characteristics, associated injuries, short-term outcomes and departments that managed the patients overall were analyzed. Based on treatment modalities for abdominal injury, patients were divided into two groups: the operative treatment group and the nonoperative treatment group. We compared differences in patient characteristics, injury mechanisms, initial vital signs, detailed injury types, lengths of hospital and ICU stays. Of the 167 patients with multiple traumas, abdominal injuries were found in 57 patients. The injury mechanism for 44 patients (77.2%) was traffic accidents, and associated extra-abdominal injuries were shown in 45 patients (78.9%). The mean lengths of hospital and ICU stays for the 57 patients were 36.4 days and 8.3 days, respectively. The in-hospital mortality rate was 8.8%. Ten patients (17.5%) were treated operatively, and 47 patients (82.5%) were treated nonoperatively. Among the 47 patients in the nonoperative treatment group, 17 patients received embolization, and 3 patients underwent a percutaneous drainage procedure. Operative treatments were used more in patients with injuries to the pancreas and bowel. No patient required additional surgery or died due to the failure of nonoperative treatment. No differences in the clinical characteristics except for the detailed injury type were observed between the two groups. In appropriately selected patients with multiple traumas including abdominal injuries, nonoperative treatment is a safe and feasible. For rapid and accurate managements of these patients, well-trained trauma surgeons who can manage problems with the various systems in the human body and who can decide whether nonoperative treatment is appropriate or not are required.

• 대한교통학회지
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• 제26권5호
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• pp.195-204
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• 2008

운전자가 도로를 주행하면서 안내표지판을 인지하고 원하는 목적지로 잘 도착할 수 있도록 하기 위해서는 인적요소, 표지판의 요소, 기하구조 등 여러 가지 원인이 잘 조화되어 운전자를 이끌어야 한다. 본 연구의 목적은 운전자가 표지판을 정확하게 인지하고 다음 목적지로 갔는지를 알아보기 위해서 성공여부(성공0, 실패1)의 개념을 사용하여 도로표지의 지명 판독과정에서 영향을 미치는 인자를 규명하는 것이다. 운전자의 인적요소, 표지판 요소 등을 고려하였으며, 도로주행시뮬레이터(driving simulator)를 이용하여 도로표지의 지명 판독과정에서 안전운행에 영향을 미치는 인자에 대한 통계 분석을 실시하였다. 통계적 분석은 선정된 변수를 토대로 Logistic Model을 이용하여 성공여부에 대한 확률식을 제시하였다. 본 연구의 결과는 도로표지 설계 및 설치에 있어서 도로 이용자에게 보다 좋은 시설이 될 수 있도록 하는데 기초자료로 활용될 수 있을 것이다.