• Journal of Trauma and Injury
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• 제26권3호
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• pp.131-138
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• 2013

Purpose: The aim of this study is to present a retrospective review of patients who had a sudden onset of facial palsy after trauma and who underwent facial nerve decompression. Methods: The cases of 25 patients who had traumatic facial palsy were reviewed. Facial nerve function was graded according to the House-Brackmann grading scale. According to facial nerve decompression, patients were categorized into the surgical (decompression) group, with 7 patients in the early decompression subgroup and 2 patients in the late decompression subgroup, and the conservative group(16 patients). Results: The facial nerve decompression group included 8 males and 1 female, aged 2 to 86 years old, with a mean age of 40.8. In early facial nerve decompression subgroup, facial palsy was H-B grade I to III in 6 cases (66.7%); H-B grade IV was observed in 1 case(11.1%). In late facial nerve decompression subgroup, 1 patient (11.1%) had no improvement, and the other patient(11.1%) improved to H-B grade III from H-B grade V. A comparison of patients who underwent surgery within 2 weeks to those who underwent surgery 2 weeks later did not show any significant difference in improvement of H-B grades (p>0.05). The conservative management group included 15 males and 1 female, aged 6 to 66 years old, with a mean age of 36. At the last follow up, 15 patients showed H-B grades of I to III(93.7%), and only 1 patient had an H-B grade of IV(6.3%). Conclusion: Generally, we assume that early facial nerve decompression can lead to some recovery from traumatic facial palsy, but a prospective controlled study should and will be prepared to compare of conservative treatment to late decompression.

• Journal of Trauma and Injury
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• 제26권3호
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• pp.111-124
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• 2013

Purpose: We should prepare proper medical service for disaster control as South Korea is not free from terrorism and war, as we experienced through the two naval battles of the Yeonpyeong, one in 1999 and the other in 2002, the sinking of Cheonan in 2010, and the attack against the border island of Yeonpyeong in 2010. Moreover, North Korea's increasingly bellicose rhetoric and mounting military threats against the world demand instant action to address the issue. The aim of this article is to describe our experience with three patients with combat-related gunshot and explosive injuries to their extremities and to establish useful methods for the management of patients with combat-related injuries. Methods: Three personnel who had been injured by gunshot or explosion during either the second naval battle of the Yeonpyeong in 2002 or the attack against the border island of Yeonpyeong in 2010 were included in our retrospective analysis. There were one case of gunshot injury and two cases of explosive injuries to the extremities, and the injured regions were the left hand, the right foot, and the right humerus. In one case, the patient had accompanying abdominal injuries, and his vital signs were unstable. He recovered after early initial management and appropriate emergency surgery. Results: All patients underwent emergent surgical debridement and temporary fixation surgery in the same military hospital immediately after their evacuations from the combat area. After that, continuous administration of antibiotics and wound care were performed, and definite reconstructions were carried out in a delayed manner. In the two cases in which flap operations for soft tissue coverage were required, one operation was performed 5 weeks after the injury, and the other operation was performed 7 weeks after the injury. Definite procedures for osteosynthesis were performed at 3 months in all cases. Complete union and adequate functional recovery were achieved in all cases. Conclusion: The patient should be stabilized and any life-threatening injuries must first be evaluated and treated with damage control surgery. Staged treatment and strict adherence to traditional principles for open fractures are recommended for combat-related gunshot and explosive injuries to the extremities.

• 동의생리병리학회지
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• 제22권3호
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• pp.562-568
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• 2008

Theosteoporosis, which is occurred after menopause, is a kind of metabolic bone disorder. It develops when the bone mass begins to decrease radically and its main symptoms are the bone fracture and the height-shortening. This thesis aims at what effects the Phlomis umbrosa will have for the prevention of the osteoporosis in the SD-rat that is caused by the ovariectomy. The 24 female white rats, after their ovaries are removed, were divided into the Normals, the Control group, Phlomis umbrosa Administrated group. After then, for 8 weeks, D.W to the normals and the control, and the Phlomis umbrosa(46 mg/100 g) to the Phlomis umbrosa group were given in the mouths of them. After 8 weeks the rats were sacrificed. And the weight, albumin, AST, ALT, total-cholesterol, triglyceride, P, Ca, T4, estradiol, the weight of the femur, the amount of tibia ash, the area of trabecular bone, the thickness of trabecular bone were measured. The serum analysis shows that the total cholesterol of the Phlomis umbrosa Administrated group reduced remarkably, compared to that of the control group. AST, ALT, ALP, T4 of Phlomis umbrosa group were decreased, but not in distinct measure. Estradiol of Phlomis umbrosa group increased substantially compared to that of the control group, but albumin, triglyceride, Phosphorous, calcium of the group showed the tendency to increase, but not so remarkably. The histological observation shows that the area and the thickness of (trabecular bone), the number of osteoclast of the Phlomis umbrosa groups increased significantly compared to those of the control group. Conclusions: The above experiment shows that Phlomis umbrosa has the prevention effect by supplying estradiol.

• 대한유전성대사질환학회지
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• 제16권3호
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• pp.148-154
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• 2016

요소 회로 대사 이상은 요소 합성에 관련된 효소의 결핍으로 인해 발생하는 질환으로, ornithine과 carbamylphosphate로부터 citrulline을 생성하는 과정에 관여하는 효소인 OTC 결핍증이 가장 흔하다. OTC 결핍증은 ammonia, glutamate, glutamine, alanine 등의 축적되면서 고암모니아 혈증 및 고글루타민 혈증으로 인한 신경학적 증상이 나타나게 되며, 근긴장 저하, 호흡 부전, 경련, 기면, 혼수로 진행하여 사망에 이르게 된다. 저자들은 생후 4일 경부터 구토와 함께 의식의 저하를 보인 환자에서 직열 질량 분석법을 통해 OTC 결핍증을 진단하였고, 증상 발생 31시간 만인 생후 118시간 째에 지속적 정정맥 혈액여과(continuous venovenous hemofiltration, CVVH)을 적용하여 고암모니아 혈증을 치료하였다. 또한 직접염기서열분석법을 통해 780번과 781번 염기 사이에 CAGGCAGTGT가 삽입되는 변이(c.780_781insCAGGCAGTGT (p.Ile261Glnfs*35))를 발견하였다. 환자는 4일 간의 CVVH 이후 혈중 암모니아 농도와 의식이 호전되어 생후 53일 째 퇴원하였으나, 생후 12개월 경 좌측 대퇴골의 골절과 골수염이 발생하였고, 이후 패혈증 쇼크, 고혈당, 다발성 장기부전으로 사망하였다. 이에 저자들은 OTC 결핍증 환자에서 CVVH 치료 및 패혈증과 당뇨를 경험하였고, 유전자 검사에서 이전에 보고된 바 없는 새로운 변이를 확인하였기에 증례를 보고하는 바이다.

• 터널과지하공간
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• 제18권5호
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• pp.343-354
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• 2008

시추공을 이용한 초기응력 측정을 위한 새로운 방법을 제안하였다. 이 새로운 개념의 측정법은 기본적으로 응력 해방과 파쇄 기술을 결합한 방법이다. 액화질소와 같은 극저온 액체를 이용하여 시추공 주변의 인장 열응력을 유도하여 시추공 주변의 응력을 해방시킬 수 있다. 종국에는 시추공 주변의 인장 강도가 암반의 인장 강도에 초기 지압으로 존재하는 압축 응력의 합을 초과할 때 시추공벽에 균열을 발생시킨다. 이와 같은 개념을 인장 응력으로부터 초기 응력 수준을 평가하는데 적용하기 위한 이론적 분석을 수행하였다. 또한, 제안한 방법의 유효성을 검토하기 위해 FLAC3D를 이용한 열-역학 상호작용 연속체 해석을 수행하였다. 사전 이론적 검토 및 수치해석으로부터 저온 열균열 발생 현상을 이용한 초기 응력 측정법이 시추공벽에서의 인장 균열 형성을 감시하고 시추공벽에서의 균열 개시 시점의 온도를 기록함으로써 초기 응력을 정밀하게 측정할 수 있음을 확인하였다.

• 한국화재소방학회논문지
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• 제30권3호
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• pp.31-40
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• 2016

최근 초고층 건물 외벽에는 유리 커튼월 시스템이 많이 적용되고 있으며, 이러한 초고층 건물은 화재 발생 시 연돌효과 및 외부 기류에 따라 수직으로 화재가 급격하게 확산되는 특성을 가지고 있다. 기존에 사용되고 있는 스프링클러헤드는 상층부로의 화재 확산을 효과적으로 방지 할 수 없기 때문에 화재시 막대한 재산 및 인명피해를 초래한다. 따라서 본 연구에서는 보다 넓은 유리커튼월 면적을 방호할 수 있는 수막을 형성하고 층간 화재 확산을 방지 할 수 있는 수막 헤드를 개발하였다. 수막 헤드의 성능을 검증하기 위하여 살수 실험 장치를 구성하고 이를 활용하여 기존 스프링클러 헤드와 살수 패턴을 비교, 분석하였다. 상층부로의 화재 전파 차단 성능을 검토하기 위하여 2층 유리커튼월로 구성되어 있는 실험 장치를 활용하여 화재 실험을 수행하였다. 이를 통해 본 연구에서 제시한 수막 헤드가 기존 스프링클러헤드 보다 효과적으로 화염을 차단하는 것을 확인하였고 수치해석을 통해 최초 크랙 위치 및 파단 임계 온도를 분석하였다.

• 지질공학
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• 제16권3호
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• pp.245-254
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• 2006

부산시 좌천동의 단열암반층에서 자연구배 추적자시험으로 브롬이온농도를 관측하여 심도별 단열발달 상태에 따른 수리분산특성을 비교하였으며, 단열암반층의 유효공극율과 종분산지수를 추정하였다. 수직적인 수리분산특성의 차이는 브롬이온의 농도이력곡선, 관측심도별 브롬이온농도와 시간에 대한 선형회귀분석 및 관측지점별 수리단열특성을 이용하여 규명되었다. 관측공 내 지표면하 18 m(RQD 13%, 평균절리간격 2 cm, TCR 100%) 지점이 주입지점에서의 이격거리가 짧고 단열이 더욱 발달되어 있었기 때문에 25 m(RQD 41%, 평균절리간격 7 cm, TCR 100%) 지점보다 추적자가 빨리 도달하였으며, 초기농도와 최고농도가 더 높게 나타났다. 최고농도도달 전후의 농도변화에 의하면 추적자가 최고농도도달시까지는 주로 1차 단열을 통해 이송되었고, 최고농도도달 이후에는 2차 단열을 통해 이송되거나 기질확산에 의한 수리 분산이 진행되었다. 선형회귀분석에 의한 지표면하 18 m 지점에서 브롬이온농도의 증가/감소 기울기는 3.46/-1.57이며 지표면하 25 m 지점에서는 3.19/-0.47로서 파쇄가 더 심한 지표면하 18 m 지점에서의 용질이송이 빠르게 진행됨을 알 수 있었다. 농도이력곡선에서 브롬이온의 농도증가 형태는 가우시안함수로 나타나고, 농도감소 형태는 기질확산에 의한 꼬리효과(tailing effect)로 인해 지수함수로 나타났다. CATTI 코드를 이용하여 추정한 단열암반층의 유효공극율은 10.5%, 종분산지수는 0.85 m이었다.

• Archives of Reconstructive Microsurgery
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• 제16권2호
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• pp.113-118
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• 2007

Purpose: The purpose of this work was to describe the results of treatment for motor vehiclerelated crushing injuries among children and adolescents under sixteen years in Korea. Materials and Methods: A retrospective analysis was conducted of data from children who were under sixteen year and injured foot by motor vehicles. Cases were documented 1) age at the time of injury, 2) injured site, 3) the area of accident, 4) the kind of vehicle, 5) associated injuries, 6) methods of treatment for soft tissue reconstruction and 7) complications. The relationships between the area of accident and associated injuries, and the kind of vehicle and associated injuries were analyzed using Chi-square test and Fisher exact test. Results: There were 97 children who were 15 year and younger. The mean age was 7.4 years, and 65% were boys. The left foot was more dominant side of injury (57%). Seasonal variation was seen with the number of injuries peaking during the summer (43%, p<0.05). Among the vehicles, 78.3% were the large vehicles (bus, truck or van). The where of accident was more frequent at an alley or less than two lanes of traffic. But, the relationships between the place of accident and associated injury or the kind of vehicles and associated injury were not statistically significant. The associated injury were fracture or dislocation (23 cases, 35.9%), injury of tendon (21 cases, 32.8%). There were amputation or disarticulation of foot in 8 cases (8.2%) and post-traumatic deformities such as flatfoot, hindfoot varus or valus deformities by tendon injury in 7 cases (7.2%). Conclusion: More than 50% of crushing or degloving injuries of child's foot by traffic accidents happened in boys between 5 to 9 years old. The associated injury was unrelated with size of vehicles or accident place at the time of accident. But, even though foot injury happened in an alley or one lane by small vehicles, child who hurt feet by car need thorough investigation about associated injury. If a surgeon keep in mind and treat child to associated injury necessarily, can minimize complication. Microsurgical reconstruction for soft tissue defect was prior to other methods.

• 보건행정학회지
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• 제30권2호
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• pp.231-244
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• 2020

Background: As the population is aging, chronic diseases and depression are becoming the main problems in a country's healthcare system. In this study, we aimed to explore the associations between chronic diseases and depression among the elderly in South Korea. Methods: We analyzed 9,975 (men, 4,147; women, 5,828) respondents obtained from the 2014 National Survey of Living Conditions and Welfare Needs of Korean Older Persons. Our dependent variable was either 1 or 0 according to whether a respondent had depression or not, where depression was defined when the Short Form of Geriatric Depression Scale score was 8 or more points. Variables of interest were 24 types of chronic diseases and covariates included various socio-demographic and health behavior characteristics. We performed Rao-Scott chi-square tests and hierarchal logistic regression analyses by gender, reflecting the characteristics of the survey. Results: A significant difference was found in the proportion of having depression between genders (men 18.9% vs. women 23.4%). According to fully adjusted, multivariable analyses, for elderly men, relative to those without any chronic disease, the odds ratio of depression was 1.56 (95% confidence interval [CI], 1.10-2.22) in the stroke patients group and 1.82 (95% CI, 1.01-3.25) in the osteoporosis patients group. For elderly women, the odds ratio was 1.96 (95% CI, 1.28-3.00) in the fracture/dislocation and aftereffects patients group and 1.30 (95% CI, 1.03-1.64) in the group of patients with other diseases. Conclusion: Even after being adjusted for diverse characteristics, some chronic diseases were significantly associated with depression in the elderly and the association differed between genders. Therefore, public health and medical interventions are needed to manage such chronic diseases together with curing depression symptoms.

• 한국구조물진단유지관리공학회 논문집
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• 제15권5호
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• pp.178-189
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• 2011

본 연구에서는 CFRP 표면부착 공법의 대안으로 최근에 관심을 끌고 있는 NSM(Near Surface Mounted)기법으로 전단 보강된 RC 부재의 전단강도를 평가하기 위한 실험과 해석을 수행하였다. 전단철근이 없는 7개의 실험체에 대해 4점 휨실험을 실시하였다. 실험변수로는 CFRP 스트립의 경사($45^{\circ}$, $90^{\circ}$)와 스트립의 간격(250mm, 200mm, 150mm, 100mm)이 고려되었다. 실험적 연구를 통해 NSM공법으로 전단 보강된 RC 부재의 전단강도와 파괴모드에 대한 각 실험변수의 영향을 평가하였다. 실험결과는 $45^{\circ}$ 경사로 스트립을 보강한 실험체들은 스트립의 파단으로 파괴된 반면, 수직으로 스트립을 보강한 실험체들은 스트립의 슬립으로 파괴됨을 보였다. 또한, $45^{\circ}$ 경사 스트립이 수직 스트립보다 전단저항력 증가시킬뿐만 아니라 파괴시의 처짐을 크게 증가시키는 것으로 나타났다. 추가적으로 RBSN 해석은 NSM기법으로 전단 보강된 RC 부재의 균열형상 및 하중-처짐관계를 적절하게 예측하였다.