• Archives of Plastic Surgery
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• 제36권5호
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• pp.617-622
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• 2009

Purpose: Endoscopic transnasal correction of the blowout fractures has many advantages over other techniques. But after removal of packing material, there were some patients with recurrence of preoperative symptoms. Authors tried to make a quantitative anterograde analysis of orbital volume change over whole perioperative period which might be related with recurrence of preoperative symptoms. Methods: 10 patients with pure medial wall fracture(Group I) and 10 patients with medial wall fracture combined with fracture of orbital floor(Group II) were selected to evaluate the final orbital volume change, who took 3 CT scans, pre-, postoperative and 4 months after packing removal. By multiplying cross - section area of orbit in coronal view with section thickness, orbital volume were calculated. Then, mean orbital volume increment after trauma, mean orbital volume decrement after endoscopic correction and volume increment after packing removal were found out. And we tried to find correlations between type of fracture, initial correction rate and final correction rate. Results: The mean orbital volume increment of the fractured orbits were 7.23% in group I and 13.69% in group II. After endoscopic surgery, mean orbital volume decrement were 11.0% in group I and 12.46% in group II. Mean volume increment after packing removal showed 3.10% in group I and 6.50% in group II. The initial correction rate(%) showed linear correlation with final correction rate(%) after packing removal. And there were negative linear correlation between increment percentage of orbital volume by fracture and final correction rate(%). Conclusion: Orbital volume was proved to be increasing after removal of packing or foley catheter and it was dependent upon type of fracture. Overcorrection should be done to improve the final result of orbital blowout fracture especially when there are severe fracture is present.

• 터널과지하공간
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• 제16권3호
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• pp.259-276
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• 2006

큰 초기응력을 받는 암반에서의 파괴 과정은 굴착경계에 평행하게 발생하는 응력 유도 균열에 의해 지배된다. 특히 지압의 절대크기가 암반 강도의 일정 비율 이상이 되면 응력 집중에 의한 암반의 취성 파괴를 유발하고, 이러한 현상은 터널 굴착 시 발생하는 파괴음과, 굴착면에 평행한 형태로 암편이 탈락하는 취성파괴 현상을 동반한다. Mohr-Coulomb과 같은 기존의 구성 모델은 일반적으로 마찰각과 점착력을 일정한 값으로 가정하므로, 점진적인 암반의 취성파괴 현상을 모사하기 어렵다. 본 논문에서는 일반적인 수치해석 코드에서 취성파괴를 잘 모의할 수 있는 것으로 알려진 CW-FS 모델을 사용하여 유류 저장공동 주변 암반에 대한 수치해석을 실시하고, 그 결과를 선형 Mohr-Coulomb 모델의 결과와 비교하였다. 또한 마찰각과 점착력 성분의 전단 소성변형률 한계를 변화시키면서 해석을 실시하여, 유류 저장공동에서 관찰된 취성파괴와 비슷한 양상을 보이는 해석 결과를 찾아보았다. 결과적으로 CW-FS 모델은 견고한 암반에서의 취성파괴를 모의하는데 있어 적절한 해석방법이라는 것을 알 수 있었다.

• Journal of Chest Surgery
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• 제32권3호
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• pp.270-275
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• 1999

배경: 저자들은 흉부 손상환자에서 심손상이 예상되는 경우 심전도, 혈중내 CK, CK-MB분획 변화를 선별하여 이상이 있는 경우 이면성 심초음파검사를 실시하여 이상유무로 심타박상 및 심좌상으로 분류하여 임상적 고찰을 해보기로 하였다. 대상 및 방법: 1997년 1월부터 1998년 3월까지 15개월간 심손상이 의심되어 본교실에 입원치료한 24명을 대상으로 병력, 내원당시 심전도 및 혈중내 CK, CK-MB 분획을 연속적 선별검사를 실시하여 이상이 있는 경우 심초음파검사를 하였다. 결과: 연령분포는 20∼40대가 58.3%로 가장 많았으며, 남여비는 3 : 1 이었다. 원인은 교통사고가 15례(62.5%)로 가장 많았다. 동반손상의 경우 다발성 늑골골절, 흉골골절 순이었다. 심전도 검사상 심타박상의 경우 정상이 가장 많았으며, 심좌상에서는 ST-T변화가 가장 많았다. CK-MB분획은 심좌상에서 높았으며, 내원 당일은 통계학적 유의성은 없었으나 내원 1, 2, 3일에는 통계학적 유의성이 있었다. 재원기간은 심타박상에서 평균 9.22일이었고, 심좌상에서 26.18일이었다(p=0.0075). 합병증은 급성폐부전이 7례로 가장 많았으며, 이중 5례에서는 인공호흡기 치료를 하였으며 사망한 경우는 없었다. 결론: 저자들은 흉부손상환자에서 심손상이 의심되는 경우 심전도, CK, CK-MB분획을 연속 선별검사하여 이상이 있는 경우 심초음파를 실시하여 심좌상의 유무를 진단하는 것이 좋을 것으로 사료된다.

• International Journal of Industrial Entomology and Biomaterials
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• 제32권2호
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• pp.80-89
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• 2016

The effects of Cudrania tricuspidata (CT) extract on markers of osteoporosis were examined in ovariectomized rats. We classified 26 rats into five groups and provided a pellet chow diet and tap water throughout the 27-wk experimental period. During the last 15 wk, we added oral injections to each group as follows: sham-operated (SHAM, n=4) and ovariectomized-control (OVX, n=5) with distilled water, alendronate with 10 mg/kg/d of alendronate sodium (ALEN, n=5), CT (CT100, n=6) with 100 mg/kg/d of CT, and CT (CT300, n=6) with 300 mg/kg/d of CT. After the experimental period, blood, urine, and micro-CT images were assessed. The CT100 and OVX groups did not show any significant differences in urinary n-terminal telopeptide (NTx) (p<0.05 ), but with increases in CT concentration, the NTx level was slightly reduced. Serum osteocalcin was significantly higher in the CT groups than in all other groups (p<0.05 ). Notably, the serum calcium levels of all groups were within the normal range, but urinary calcium levels in the CT groups were significantly lower than the OVX group (p<0.05 ). In addition, the CT groups exhibited higher trabecular BMD than the OVX groups while showing similar BMD to the ALEN group (p<0.05 ). The Tb.Th of the ALEN group was lower than all other groups. Based on the overall analysis of results, CT prevented bone loss by inhibiting bone resorption and enhancing bone formation. Although alendronate showed a similar effect in preventing bone loss, it did so by solely inhibiting bone resorption, and its long-term use reportedly causes paradoxical effects such as hip fractures. Thus, for osteoporosis induced by ovariectomy, we conclude that CT extract is an effective natural treatment without severe side effects.

• Radiation Oncology Journal
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• 제38권2호
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• pp.109-118
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• 2020

Purpose: Hypofractionated radiotherapy (RT) is becoming a new standard in postoperative treatment of patients with early stage breast cancer after breast conservation surgery. However, data on hypofractionation in patients with advanced stage disease who undergo mastectomy followed by local and regional nodal irradiation (RNI) is lacking. In this retrospective study, we report late-term effects of 3 weeks post-mastectomy hypofractionated local and RNI with two-dimensional (2D) technique in patients with stage II and III breast cancer. Methods: Between January 1990 and December 2007, 1,770 women with breast cancer who were given radical treatment with mastectomy, systemic therapy and RT at least 10 years ago were included. RT dose was 35 Gy/15 fractions/3 weeks to chest wall by two tangential fields and 40 Gy in same fractions to supraclavicular fossa (SCF) and internal mammary nodes (IMNs). SCF and IMNs dose was prescribed at d_max and 3 cm depth, respectively. Chemotherapy and hormonal therapy was given in 64% and 74% patients, respectively. Late-term toxicities were assessed with the Radiation Therapy Oncology Group (RTOG) scores and LENT-SOMA scales (the Late Effects Normal Tissue Task Force-Subjective, Objective, Management, Analytic scales). Results: Mean age was 48 years (range, 19 to 75 years). Median follow-up was 12 years (range, 10 to 27 years). Moderate/marked arm/shoulder pain was reported by 254 (14.3%) patients. Moderate/marked shoulder stiffness was reported by 219 (12.3%) patients. Moderate/marked arm edema was seen in 131 (7.4%) patients. Brachial plexopathy was not seen in any patient. Rib fractures were noted in 6 (0.3%) patients. Late cardiac and lung toxicity was seen in 29 (1.6%) and 23 (1.3%) patients, respectively. Second malignancy developed in 105 (5.9%) patients. Conclusion: RNI with 40 Gy/15 fractions/3 weeks hypofractionation with 2D technique seems safe and comparable to historical data of conventional fractionation (ClinicalTrial.gov Registration No. NCT04175821).

• 한국임상수의학회지
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• 제30권2호
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• pp.119-122
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• 2013

암컷, 9개월, 2.2 kg의 단모종 고양이가 2주간의 심한 변비 증상을 주증으로 내원하였다. 보호자 보고에서 증상 발생 4개월 전 골반 골절이 있었음을 확인 하였다. 신체 검사에서 이급후중 및 오른쪽 고관절의 운동 제한을 확인 하였고, 직장 검사에서 양측 관골구의 내측 돌출과 치골의 배측 변위를 동반한 골반 강 협착을 확인할 수 있었다. 방사선 검사에서 확장 된 대장과 골반 강의 비정상적 구조를 동반한 골반 강 협착을 확인 하였다. 배변 유연제와 관장을 이용한 보존적 치료를 실시하였으나 심한 변비 증상이 개선 되지 않았다. 장골, 좌골, 치골, 관골구의 부분 절골술을 실시 하였다. 수술 후 방사선 검사와 직장검사에서 확장 된 골반 강을 확인 할 수 있었다. 수술 후 배변 유연제(5 ml, PO, q12h; Duphalac$^{(R)}$)를 2주간 투약 하였고 그 후 2주간은 2.5 ml 용량으로 투여 하였다. 수술 후 따뜻한 물을 이용한 관장을 2회 실시 하였다. 수술 후 14일 째 검사에서 배변과 보행에 문제가 없음을 확인 하였고 5개월 째 검사에서 심한 배변과 오른쪽 뒷다리 파행 증상이 관찰 되지 않았다.

• 터널과지하공간
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• 제20권5호
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• pp.344-351
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• 2010

닫힌 균열을 따라 발생하는 전단거동을 Mode II 크랙의 시작과 진행으로 묘사할 수 있다. 파괴역학 이론에서는 순수 Mode II 재하에서 일반적으로 고유물성으로 인식되는 에너지 방출율(GII, Engergy Release Rate)이 한계점($G_{IIC}$)에 도달했을 때 전단거동이 시작된다고 예측한다. 지난 몇 년간 퍼듀대학의 암반공학그룹은 한계 에너지 방출률($G_{IIC}$)의 구속응력(normal stress)과 닫힌 균열의 거칠기에 대한 관계를 실험적으로 접근해왔다. 먼저 많은 실험들이 아크릴 재료를 대상으로 실행되었는데, 이는 광탄성(Photoelastic) 방법을 이용한 균열 끝(fracture tip)의 응력 집중 영역을 시각화하는 것을 가능케 해 주었다. 그 다음 실험 연구는 비교적 낮은 압축강도를 지닌 균질한 석고에 시행되었고, 최근에는 더 높은 압축강도를 지닌 재료를 대상으로 실험연구를 수행하였다. 그 예로 시멘트로 만든 시료 불록에 직접 전단 실험을 하였는데, 이전의 실험들과 마찬가지로 불연속면의 최대마찰각(Peak Friction Angle)이 잔류 마찰각(Residual Friction angle)과 비슷할 때만이 $G_{IIC}$가 재료의 고유물성으로 간주 될 수 있다는 점을 확인할 수 있었다. 그렇지 않은 경우에 한계 에너지 방출율($G_{IIC}$)은 구속응력과 함께 증가한다.

• 대한핵의학회지
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• 제24권1호
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• pp.124-132
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• 1990

It has been reported that hematoma is one of the most crucial factors in fracture healing since callus formation is disturbed by washing out the hematoma near a fracture site. However, it is not clear why the hamatoma is important and how it plays a role during the fracture healing. In order to investigate the role of hematoma in the process of fracture healing, the osteogenic potential by subperiosteal transplantation have been studied. Experimental fractures by operation were made at the mid-shaft of the tibia in New Zealand white rabbits. Removal of hematoma at the fracture site was done after 2 and 3 days from experimental fracture, and the removed hematoma was transplanted into the subperiosteal area at the mid-shaft of the ulna of each rabbit. As control groups, we have performed 3 different procedures 1) the hematoma was transplanted into the muscular layers at the thigh and forearm; 2) autologous blood clots were transplanted into the subperiosteal area of the ulna; and 3) sham operation without a transplantation into the subperiosteal area. After transplantation, serial bone scintigraphy and simple radiography were performed at 4 days, 1 week, and 2 weeks to detect an abnormality. The results of bone scintigraphy were positive in 5 of 6 experimental group. However, all in three control groups were negative. Histological observation of the positive bone revealed new bone formation with trabeculation. These results suggest the hematoma in fracture site has osteogenic potential in the subperiosteal area which can be demonstrable by bone scintigraphy and histologic findings. Therefore, it is considered that hematoma of the fracture site plays an important role in the process of fracture healing. Further biochemical investigation using various experimental models is mandatory to apply this preliminary result to the treatment of clinical delayed union or nonunion.

• Journal of Korean Neurosurgical Society
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• 제60권5호
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• pp.584-590
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• 2017

Objective : Traumatic brain injury (TBI) in children under age 24 months has characteristic features because the brain at this age is rapidly growing and sutures are opened. Moreover, children this age are completely dependent on their parents. We analyzed the demographic data and risk factors for outcomes in TBI patients in this age group to elucidate their clinical characteristics. Methods : We retrospectively reviewed the medical records and radiological films of children under 24 months who were admitted to Kyungpook National University Hospital from January 2004 to December 2013 for TBI. Specifically, we analyzed age, cause of injury, initial Glasgow coma scale (GCS) score, radiological diagnosis, seizure, hydrocephalus, subdural hygroma, and Glasgow outcome scale (GOS) score, and we divided outcomes into good (GOS 4-5) or poor (GOS 1-3). We identified the risk factors for post-traumatic seizure (PTS) and outcomes using univariate and multivariate analyses. Results : The total number of patients was 60, 39 males and 21 females. Most common age group was between 0 to 5 months, and the median age was 6 months. Falls were the most common cause of injury (n=29, 48.3%); among them, 15 were falls from household furniture such as beds and chairs. Ten patients (16.7%) developed PTS, nine in one week; thirty-seven patients (61.7%) had skull fractures. Forty-eight patients had initial GCS scores of 13-15, 8 had scores of 12-8, and 4 had scored 3-7. The diagnoses were as follows : 26 acute subdural hematomas, 8 acute epidural hematomas, 7 focal contusional hemorrhages, 13 subdural hygromas, and 4 traumatic intracerebral hematomas larger than 2 cm in diameter. Among them, two patients underwent craniotomy for hematoma removal. Four patients were victims of child abuse, and all of them had PTS. Fifty-five patients improved to good-to-moderate disability. Child abuse, acute subdural hematoma, and subdural hygroma were risk factors for PTS in univariate analyses. Multivariate analysis found that the salient risk factor for a poor outcome was initial GCS on admission. Conclusion : The most common cause of traumatic head injury in individuals aged less than 24 months was falls, especially from household furniture. Child abuse, moderate to severe TBI, acute subdural hematoma, and subdural hygroma were risk factors for PTS. Most of the patients recovered with good outcomes, and the risk factor for a poor outcome was initial mental status.

• 시큐리티연구
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• 제57호
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• pp.85-110
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• 2018

경호원은 경호 대상자의 신변을 외부의 우발상황과 위협에 대비하고 대처하기 위해 기본적인 체력훈련과 경호무도를 지속적으로 수련하고 있으며, 현재 경호전공 대학생들은 보편적으로 상대를 잡고 메치고 제압하는 기술을 유용하게 사용할 수 있는 경호무도 중 하나인 유도 수업을 의무적으로 실시하고 있다. 따라서 본 연구는 10주간의 유도수련 운동프로그램을 통해 체계적인 훈련이 경호무도전공 남자대학생들의 신체구성, 행동체력, 성장 호르몬 및 IGF-1에 어떠한 영향을 미치는지 파악하여 경호무도로써 유도의 가치를 제고할 수 있는 객관적 자료를 제공하는데 의의를 두었으며, 그 결과 다음과 같은 결론을 얻었다. 10주간의 유도수련 후 근육량은 유의하게 증가하는 것으로 나타났으며, 체지방률과 BMI 등은 유의하게 감소하는 것으로 나타났다. 행동체력의 근력과 순발력은 유의하게 증가하는 것으로 나타났으며, 성장호르몬은 유의하게 증가하는 것으로 나타났다. 이상의 결과를 종합해 볼 때, 유도수련 대학생들은 전반적으로 신체구성은 긍정적으로 개선되었고 행동체력의 근력과 순발력은 향상되었으며, 성장호르몬을 증가 시켰다. 따라서 유도수련을 통한 근력과 성장호르몬의 증가는 신체의 근육의 발달로 인해 지방 분해를 촉진시키고 척추의 골밀도를 높여서 골절의 위험을 줄여 수련자들의 부상을 방지해 줄 것이다. 또한 비만 예방, 심혈관질환, 대사성질환을 방지하여 경호업무기능을 높여 주고 경호원으로서의 수명을 연장하는 계기가 될 것으로 사료된다.