• 기술혁신학회지
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• 제10권4호
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• pp.687-705
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• 2007

본 연구는 특허의 인용정보를 이용하여 비체화 지식의 흐름이라 할 수 있는 기술군간의 파급효과를 측정하는 방법론을 개발하고 실제 사례를 통해 적용 타당성을 제시하고자 하였다. 이를 위해, 기술파급효과에 기존연구를 리뷰하였고, 특허정보의 인용분석과 관련된 지표에 대해 개괄적으로 분석하여 효과적인 특허인용 분석 방법론을 설계하였다. 그리고, KISTI에서 보유하고 있는 미국특허 데이터베이스(USPA)를 이용하여 기술군간 인용관계를 계수하여 기술군간 비체화 지식의 흐름행렬을 도출하였고, 이를 활용하여 기술적 파급효과를 나타낼 수 있는 지수 모형을 연구함과 동시에 네트워크 분석을 통한 기술군간의 파급 유형을 클러스터링하여 기술군간 내생적 속성을 분석하였다. 본 연구의 결과는 어떤 기술군의 타기술군간의 상호 관계에 대해 정량적으로 내생적 속성을 표현하도록 함에 따라 연구개발의 사전기획시 기술적 파급효과에 대한 현안을 제시할 수 있을 뿐만 아니라 기술의 융복합 현상을 이해하는데 기초정보를 제공할 수 있을 것으로 판단된다.

• Clinics in Orthopedic Surgery
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• 제10권4호
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• pp.439-447
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• 2018

Background: Since open Wiltse approach allows limited visualization for foraminal stenosis leading to an incomplete decompression, we report the short-term clinical and radiological results of unilateral biportal endoscopic foraminal decompression using $0^{\circ}$ or $30^{\circ}$ endoscopy with better visualization. Methods: We examined 31 patients that underwent surgery for neurological symptoms due to lumbar foraminal stenosis which was refractory to 6 weeks of conservative treatment. All 31 patients underwent unilateral biportal endoscopic far-lateral decompression (UBEFLD). One portal was used for viewing purpose, and the other was for surgical instruments. Unilateral foraminotomy was performed under guidance of $0^{\circ}$ or $30^{\circ}$ endoscopy. Clinical outcomes were analyzed using the modified Macnab criteria, Oswestry disability index, and visual analogue scale. Plain radiographs obtained preoperatively and 1 year postoperatively were compared to analyze the intervertebral angle (IVA), dynamic IVA, percentage of slip, dynamic percentage of slip (gap between the percentage of slip on flexion and extension views), slip angle, disc height index (DHI), and foraminal height index (FHI). Results: The IVA significantly increased from $6.24^{\circ}{\pm}4.27^{\circ}$ to $6.96^{\circ}{\pm}3.58^{\circ}$ at 1 year postoperatively (p = 0.306). The dynamic IVA slightly decreased from $6.27^{\circ}{\pm}3.12^{\circ}$ to $6.04^{\circ}{\pm}2.41^{\circ}$, but the difference was not statistically significant (p = 0.375). The percentage of slip was $3.41%{\pm}5.24%$ preoperatively and $6.01%{\pm}1.43%$ at 1-year follow-up (p = 0.227), showing no significant difference. The preoperative dynamic percentage of slip was $2.90%{\pm}3.37%$; at 1 year postoperatively, it was $3.13%{\pm}4.11%$ (p = 0.720), showing no significant difference. The DHI changed from $34.78%{\pm}9.54%$ preoperatively to $35.05%{\pm}8.83%$ postoperatively, which was not statistically significant (p = 0.837). In addition, the FHI slightly decreased from $55.15%{\pm}9.45%$ preoperatively to $54.56%{\pm}9.86%$ postoperatively, but the results were not statistically significant (p = 0.705). Conclusions: UBEFLD using endoscopy showed a satisfactory clinical outcome after 1-year follow-up and did not induce postoperative segmental spinal instability. It could be a feasible alternative to conventional open decompression or fusion surgery for lumbar foraminal stenosis.

• 대한원격탐사학회지
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• 제39권2호
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• pp.223-232
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• 2023

고해상도의 위성 영상을 이용하여 지표를 모니터링하기 위한 방법으로 분석 대상 객체의 색상을 이용하여 영상을 분류하는 방법이 널리 사용된다. 고해상도 위성영상에서는 도심 지역의 경우 건물, 도로 등과 같은 주요 객체들 이외에도 수목 등과 같은 식생 객체들도 빈번하게 나타난다. 도심 지역에 나타나는 식생 객체들의 색상은 건물, 도로, 그림자 등의 객체와 유사한 경우가 많으며, 이는 색상 정보에 기초하여 객체를 분류할 경우에 분류 성능이 저하되는 요인이 된다. 본 연구에서는 건물 등과 같은 다양한 색상을 가지는 객체뿐만 아니라 식생 객체도 정확하게 분류할 수 있는 기법을 제안한다. 제안하는 방법은 식생 객체 검출에 유용한 정규식생지수 영상을 RGB 영상과 함께 사용하고 객체 클래스를 서브 클래스로 세분화하여 분류한다. 서브 클래스 분류 결과를 융합한 후에 영상 분할 결과와 결합하여 최종 분류 결과를 생성한다. 차세대중형위성1호 영상을 이용한 실험에서 정규식생지수를 사용하지 않은 서브채널 분류 기법과 서브클래스 분류 기법의 overall accuracy가 각각 73.18%, 81.79%의 결과를 보인 반면, 정규식생지수와 서브클래스 분류를 함께 적용하여 제안한 방법은 overall accuracy가 87.42%의 우수한 성능을 보였다.

• 간호행정학회지
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• 제7권2호
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• pp.265-284
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• 2001

The case management has been applied to improve the quality of care and the cost-effectiveness in the most health care institutions. In a way of case management, the critical pathway(CP) has been executed in many acute care settings, focused on the diagnoses with high cost, high volume, and high risk. This study was conducted to develop a case management program using CP as an intervention of patients with lumbar spinal stenosis for the surgery of posterolateral fusion, and to find out the effects of the critical pathway on the quality of nursing care, patient satisfaction as an outcome of care, length of stay and medical charge, and nurses' job satisfaction. At the same time, patients' functional states were checked with the Oswestry Low Back Pain Index, to show that the CP would not decrease the patients' function compared to the control group. The subjects were 25 control patients with a usual operation of lumbar fusion and 25 experimental patients with CP. They were all female, aged $50s{\sim}70s$, admitted in the Orthopedic surgery ward of a university hospital. Also nurses on the floor using CP were asked to respond to measurement tool of job satisfaction before and after the application of CP, and compared with other nurses on the different wards. Data were analyzed with t-test for continuous variables and chi-square for non-parametric variables in addition to the reliability test of the measurement tools. The results of this study were as followings: 1. Patients' functional states The differences in Oswestry scores of the experimental and control groups assessed at preoperation and at discharge were not statistically significant. The change in scores of the experimental group measured at preoperation and at discharge was larger than that of the control group, however the difference was not statistically significant. The results indicate that the CP did not decrease the patients' functional status. 2. The quality of nursing care The total of quality of nursing care given to the experimental group was better than that of the control group(P=.000). In addition, the experimental group showed better scores of quality of every item of care than the control group(P=.000 -.004). 3. Patient satisfaction Patients of the experimental group were not more satisfied with general care than the control group. But they were more satisfied with discharge care of 'explanation about medication, body posture, and brace application' and 'explanation about the adjustment of daily living and exercise during recovery'(P= .047, P=.028). 4. Nurses' job satisfaction Nurses working with the CP showed more job satisfaction than before the CP introduction(P=.048). But the control group of nurses on a different floor showed no change in job satisfaction at the same period of time. 5. Length of stay and medical charge The mean length of stay of the experimental group was shorter than that of the control group without statistical significance. The charge of medication and treatment of the experimental group were smaller than that of the control group(P=.011, P=.000). The results of the study support that the case management using critical pathway enables to improve the quality of care and job satisfaction, to reduce the medical charge, and consequently to increase satisfaction with care. However, the case management should be instituted focusing on the quality improvement of nursing and the client satisfaction, not just for the purpose of cost-effectiveness of health care facilities.

• 한국측량학회지
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• 제37권6호
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• pp.499-506
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• 2019

정규수치표면모델(NDSM: Normalized Digital Surface Model)은 원격탐사데이터의 상세 분석을 위한 핵심 적인 자료로 사용된다. 지상기준높이인 정규수치표면모델을 생성하기 위한 가장 간단한 방법은 수치표면모델(DSM: Digital Surface Model)에서 수치지형모델(DTM: Digital Terrain Model)을 차분하는 것이지만, 무인항공기 데이터의 경우 높은 해상도의 특성상 식생, 도심 구조물 등 많은 수의 복잡한 지형지물을 포함하고 있어 정확한 수치지형모델을 추출하기 어렵다. 본 연구에서는 무인항공기 데이터의 고해상도 특성을 잘 살리고 비용효율적인 수치지형모델 생성이 가능하도록 RGB 기반 식생 지수인 ExG (Excess Green)를 이용하여 낮은 ExG 값을 갖는 영역 확장법의 초기 시드점을 선정하였다. 이때 국소적으로 낮은 식생지수 값을 갖는 초기 시드점이 잘못 추출되는 문제를 해결하기 위하여 지역적 윈도우 분석을 적용하였다. 이후, 해당 위치의 수치표면모델값을 바탕으로 영역 확장법을 적용하여 이웃하는 지면 화소들을 병합하였다. 영역 확장법 적용을 위해 경사도 파라미터가 사용되었으며 최종적으로 병합된 세그먼트의 크기가 0.25㎡ 초과일 경우 초기 시드점을 지면점으로 결정하였다. 다양한 경사도 파라미터 값을 설정하여 무인항공기 데이터 기반 정규수치표면모델 생성의 최적 경사도 기준값을 도출하고자 하였다. 최종적으로 추출된 지면점들에 대한 정확도 평가를 수행하였으며 지면점들에 보간법을 적용하여 정규수치표면모델을 생성하고 제안 기법을 농업지역에 적용하여 농작물의 지상기준높이 추출 및 농업 모니터링 가능성을 검증하였다.

• Journal of Korean Neurosurgical Society
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• 제43권5호
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• pp.221-226
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• 2008

Objective : The aim of the present study was to assess the safety and efficacy of the dynamic stabilization system in the treatment of degenerative spinal diseases. Methods : The study population included 20 consecutive patients (13 females, 7 males) with a mean age of $61{\pm}6.98$ years (range 46-70) who underwent decompression and dynamic stabilization with the Dynesys system between January 2005 and August 2006. The diagnoses included spinal stenosis with degenerative spondylolisthesis (9/20, 45%), degenerative spinal stenosis (5/20, 25%), adjacent segmental disease after fusion (3/20, 15%), spinal stenosis with degenerative scoliosis (2/20, 10%) and recurrent intervertebral lumbar disc herniation (1/20, 5%). All of the patients completed the visual analogue scale (VAS) and the Korean version of the Oswestry Disability Index (ODI). The following radiologic parameters were measured in all patients : global lordotic angles and segmental lordotic angles (stabilized segments, above and below adjacent segments). The range of motion (ROM) was then calculated. Results : The mean follow-up period was $27.25{\pm}5.16$ months (range 16-35 months), and 19 patients (95%) were available for follow-up. One patient had to have the implant removed. There were 30 stabilized segments in 19 patients. Monosegmental stabilization was performed in 9 patients (47.3%), 9 patients (47.3%) underwent two segmental stabilizations and one patient (5.3%) underwent three segmental stabilizations. The most frequently treated segment was L4-5 (15/30, 50%), followed by L3-4 (12/30, 40%) and L5-S1 (3/30, 10%). The VAS decreased from $8.55{\pm}1.21$ to $2.20{\pm}1.70$ (p<0.001), and the patients' mean score on the Korean version of the ODI improved from $79.58%{\pm}15.93%$ to $22.17%{\pm}17.24%$ (p<0.001). No statistically significant changes were seen on the ROM at the stabilized segments (p=0.502) and adjacent segments (above segments, p=0.453, below segments, p=0.062). There were no patients with implant failure. Conclusion : The results of this study show that the Dynesys system could preserve the motion of stabilized segments and provide clinical improvement in patients with degenerative spinal stenosis with instability. Thus, dynamic stabilization systems with adequate decompression may be an alternative surgical option to conventional fusion in selected patients.

• 한국측량학회지
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• 제38권4호
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• pp.295-304
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• 2020

IPCC는 기상이변의 예방 대책의 중요성을 권고하였으며 폭염은 주요 예방대책수립 주제 중 하나이다. 일반적으로 예방대책수립을 위한 기존 연구는 지형적 특성과 사회적 특성을 따로 구분하여 폭염취약지역을 도출하였으나 본 연구에서는 공간, 지형적 특성뿐만 아니라 사회적 특성을 함께 고려하여 폭염취약지역을 분석하고자 하였다. 에너지 사용량, 인구밀도, 정규식생지수, 수변이격거리, 태양복사량, 도로분포를 변수로 하여 점검하고, 여러 회귀모형 중 가장 적합한 모형인 Spatial Lag Model을 선택하여 사용가능한 변수를 추출하였다. 그리고 Fuzzy 이론에 기초하여 각 변수에 대한 폭염 취약정도를 분석하고, 6개의 변수를 중첩분석하여 최종적으로 폭염취약지역을 도출하였다. 연구 대상지는 폭염의 영향이 큰 대구광역시를 선정하였으며, 취약지역의 경우 기존 도심지이며 수변 및 식생에 영향을 적게 받은 대구 서구, 남구, 달서구에 주로 분포되어있음을 확인하였다. 이를 통해 대구광역시의 폭염 저감을 위한 정책적 지원에 있어 공간적, 사회적 특성을 모두 고려해야 함을 확인하였다.

• Archives of Plastic Surgery
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• 제37권4호
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• pp.481-484
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• 2010

Purpose: Congenital dermoid cysts develop during the fusion of the embryo when the ectodermal tissue gets trapped in the line of fusion. Dermoid cysts of the head are rare lesions comprised of epidermal and mesodermal elements. Furthermore, dermoid cysts in the occipital area are extremely rare. Only a few cases of dermoid cysts in the posterior scalp have been reported. Especially, A bilateral, synchronous presentation in this location has not been reported previously in the literature. Methods: All 5 cases had a gradually enlarging mass of the posterior aspect of the scalp. The cysts were mobile, noncompressible, and non-tender, without evidence of an associated sinus tract, skin dimpling, discoloration, or communication with adjacent structures. The CT scan displayed a hypodense cystic lesions about -87 to +24 HU (Housefield units, average +3.2 HU) with hypodense capsule and no postcontrast enhancement. All tumors were found just under the skin, and were well encapsulated, so they were completely removed the mass with adjacent periosteum. Results: On gross findings, all tumors were oval-or round-shaped, and when the cystic tumor was cut open it presented a greasy and caseous substance. Histologically, all specimens contain desquamated squamous epithelium and keratin in the lumen and are encapsulated and lined by keratinized stratified squamous epithelium. And, all cases of posterior mass are the presence of adnexal structures. Conclusion: Appropriate diagnosis requires not only an index of suspicion for this rare tumor a very careful history and search for skin changes. Especially, CT can reveal the exact location of the cyst, its relationship with the adjacent structures. We think that occipital dermoids divide into superficial and deep type. In our cases, because they did not have intra-cranial involvement or fistula formation, they are superficial type. This report describes the clinical and operative aspects of the superficial dermoid cysts and provides a review of the literatures.

• Journal of Korean Neurosurgical Society
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• 제65권1호
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• pp.96-106
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• 2022

Objective : The most common complication of anterior cervical discectomy and fusion (ACDF) is cage subsidence and maintenance of disc height affects postoperative clinical outcomes. We considered cage subsidence as an inappropriate indicator for evaluating preservation of disc height. Thus, this study aimed to consider patients with complications such as reduced total disc height compared to that before surgery and evaluate the relevance of several factors before ACDF. Methods : We retrospectively reviewed the medical records of 40 patients who underwent stand-alone single-level ACDF using a polyetheretherketone (PEEK) cage at our institution between January 2012 and December 2018. Our study population comprised 19 male and 21 female patients aged 24-70 years. The minimum follow-up period was 1 year. Twenty-seven patients had preoperative bone mineral density (BMD) data on dual-energy X-ray absorptiometry. Clinical parameters included sex, age, body mass index, smoking history, and prior medical history. Radiologic parameters included the C2-7 cobb angle, segmental angle, sagittal vertical axis, disc height, and total intervertebral height (TIH) at the preoperative and postoperative periods. Cage decrement was defined as the reduction in TIH at the 6-month follow-up compared to preoperative TIH. To evaluate the bone quality, Hounsfield unit (HU) value was calculated in the axial and sagittal images of conventional computed tomography. Results : Lumbar BMD values and cervical HU values were significantly correlated (r=0.733, p<0.001). We divided the patients into two groups based on cage decrement, and 47.5% of the total patients were regarded as cage decrement. There were statistically significant differences in the parameters of measuring the HU value of the vertebra and intraoperative distraction between the two groups. Using these identified factors, we performed a receiver operating characteristic (ROC) curve analysis. Based on the ROC curve, the cut-off point was 530 at the HU value of the upper cortical and cancellous vertebrae (p=0.014; area under the curve [AUC], 0.727; sensitivity, 94.7%; specificity, 42.9%) and 22.41 at intraoperative distraction (p=0.017; AUC, 0.722; sensitivity, 85.7%; specificity, 57.9%). Using this value, we converted these parameters into a bifurcated variable and assessed the multinomial regression analysis to evaluate the risk factors for cage decrement in ACDF. Intraoperative distraction and HU value of the upper vertebral body were independent factors of postoperative subsidence. Conclusion : Insufficient intraoperative distraction and low HU value showed a strong relationship with postoperative intervertebral height reduction following single stand-alone PEEK cage ACDF.

• 대한정형외과학회지
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• 제52권1호
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• pp.65-72
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• 2017

목적: 후관절 근접 낭종이 동반된 퇴행성 요추부 질환으로 수술 받은 23명의 환자를 대상으로 방사선적 특징과 임상적 결과를 분석하고자 한다. 대상 및 방법: 23명의 환자를 대상으로 척추관 협착증 동반 여부, 불안정성, 척추 전방 전위증 동반 여부, 낭종의 위치 및 방향, 후관절의 퇴행성 변화 정도, 후관절 각도, 추간판 퇴행 정도를 확인하였다. 모든 환자에게 광범위 감압술 및 기기고정 유합술을 시행하였다. 임상적 결과를 Oswestry low back pain disability questionnaire 및 visual analogue scale을 이용하여 평가하였다. 결과: 23예 중 19예(82.6%)에서 척추관 협착증이 동반되었고, 4예(17.4%)에서는 후관절 낭종이 독립적으로 존재하였다. 이 중 7예(30.4%)에서 불안정성과 전방 전위가 동반되었다. 낭종의 발생은 제4-5 요추간(69.6%)이 가장 많았으며 이환된 병변측의 후관절이 반대측에 비하여 심한 퇴행성 변화를 보였다. 후관절 각도는 좌 우측에 유의한 차이가 없었으며 해당 분절의 추간판은 17예(69.6%)에서 퇴행성 변화를 보였다. 임상적 결과는 수술 후 2년 추시 양호하였다. 결론: 낭종의 발생과 퇴행성 변화는 유의한 상관관계가 있었으며 후관절 낭종과 동반된 퇴행성 요추부 질환에서 광범위 감압술 및 유합술이 좋은 임상적 결과을 얻어 유용한 술식으로 생각된다.