• Journal of Korean Neurosurgical Society
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• 제37권6호
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• pp.405-409
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• 2005

Objective: The purpose of this study is to assess the factors related to the outcome of 84 patients who underwent surgery for anterior communicating Artery(ACoA) aneurysms. Methods: The authors review 84 patients who were undertaken from January 1998 to May 2004. In the management of ACoA aneurysms, the outcome was based on several factors: Clinical condition, Distribution of hemorrhage, Time between aneurysmal rupture and surgery, Direction and shape of the aneurysm. Results: The incidence rate of the ACoA aneurysm was 35%. Seventy four patients were classified as those having a good recovery, but 5 patients suffered from some morbidity and 5 patients died. The rate of good outcome for the patients with Hunt and Hess grade was as follows 100% in grade I, 95% in grade II, 80% in grade III, IV and V. The rate of good outcome for the patients with Fisher grade was as follows 98% in grade I, II and 81% in grade III, IV. Nineteen of 22 patients who underwent early surgery were rated as good, while twenty six of 30 patients for whom surgery was delayed showed a favorable result. The unfavorable outcomes were also attributed by vasospasm or other medical problems. Conclusion: For further improvement of the overall surgical outcome: First, early surgical intervention is recommended for good grade patients. Second, active management of poor grade patients should be scrutinized with early surgery. Third, it is also important to step up the effort to minimize the risk of medical complications to enhance surgical results on top of the mainstay of prevention efforts for vasospasm and rebleeding.

• 한국습지학회지
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• 제7권2호
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• pp.89-104
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• 2005

우리나라 서 남해안에 위치한 59개 갯벌의 다모류 출현 양상을 바탕으로 갯벌의 생태등급을 평가하였다. 갯벌의 생태등급 평가는 다모류의 분포밀도, 다양성, 풍부성, 자원적 가치, 종 위험도 등의 생물학적인 자료와 해안선의 자연성, 훼손 가능성, 지형경관 등의 인문지리학적인 면을 평가기준으로 하였다. 조사지역에서 출현한 다모류는 총 14목 37과 181종이었으며, 각 조사지역의 생태등급은 다음과 같다. I 등급 4개 지역(충남 학암포, 전남 우이도와 거문도, 경남 비진도와 매물도), II 등급 30개 지역, III 등급 19개 지역, IV 등급 4개 지역이었다. 이번 조사 결과 생태등급 기준에 대한 보다 면밀한 검토가 필요할 것으로 생각되며, 선정된 각 해역의 생태등급에 따른 정기적인 생물 조사 및 생태계 위협요인의 제거와 같은 실질적인 관리 방안을 마련하여야 할 것으로 판단된다. 특히 생물상 및 자연성이 높은 생태등급 지역의 경우 보다 적극적인 보전 노력이 요구된다.

• Radiation Oncology Journal
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• 제29권3호
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• pp.181-190
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• 2011

Purpose: Thoracic radiotherapy is a major treatment modality of stage III non-small cell lung cancer. The normal lung tissue is sensitive to radiation and radiation pneumonitis is the most important dose-limiting complication of thoracic radiation therapy. This study was performed to identify the clinical and dosimetric parameters related to the risk of radiation pneumonitis after definitive radiotherapy in stage III non-small cell cancer patients. Materials and Methods: The medical records were reviewed for 49 patients who completed definitive radiation therapy for locally advanced non-small cell lung cancer from August 2000 to February 2010. Radiation therapy was delivered with the daily dose of 1.8 Gy to 2.0 Gy and the total radiation dose ranged from 50.0 Gy to 70.2 Gy (median, 61.2 Gy). Elective nodal irradiation was delivered at a dose of 45.0 Gy to 50.0 Gy. Seven patients (14.3%) were treated with radiation therapy alone and forty two patients (85.7%) were treated with chemotherapy either sequentially or concurrently. Results: Twenty-five cases (51.0%) out of 49 cases experienced radiation pneumonitis. According to the radiation pneumonitis grade, 10 (20.4%) were grade 1, 9 (18.4%) were grade 2, 4 (8.2%) were grade 3, and 2 (4.1%) were grade 4. In the univariate analyses, no clinical factors including age, sex, performance status, smoking history, underlying lung disease, tumor location, total radiation dose and chemotherapy were associated with grade ${\geq}2$ radiation pneumonitis. In the subgroup analysis of the chemotherapy group, concurrent rather than sequential chemotherapy was significantly related to grade ${\geq}2$ radiation pneumonitis comparing sequential chemotherapy. In the univariate analysis with dosimetric factors, mean lung dose (MLD), $V_{20}$, $V_{30}$, $V_{40}$, MLDipsi, $V_{20}$ipsi, $V_{30}$ipsi, and $V_{40}$ipsi were associated with grade ${\geq}2$ radiation pneumonitis. In addition, multivariate analysis showed that MLD and V30 were independent predicting factors for grade ${\geq}2$ radiation pneumonitis. Conclusion: Concurrent chemotherapy, MLD and $V_{30}$ were statistically significant predictors of grade ${\geq}2$ radiation pneumonitis in patients with stage III non-small cell lung cancer undergoing definitive radiotherapy. The cutoff values for MLD and $V_{30}$ were 16 Gy and 18%, respectively.

• Childhood Kidney Diseases
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• 제12권2호
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• pp.178-185
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• 2008

목 적 : 최근 I, II 등급 방광 요관 역류의 임상적 중요성이 적어지면서 요로감염 영아 모두에게 침습적인 VCUG를 시행하여야 하는지에 대한 의문이 제기되어 있다. 요로감염이 있는 3개월 미만의 영아를 대상으로 III 등급 이상의 중증 방광 요관 역류에 대한 예측인자를 알아보고 VCUG의 시행 여부에 대한 임상적인 근거를 제시하고자 하였다. 방 법: 2004년 1월부터 2007년 9월까지 가천의과대학교 병원에 입원해서 요로감염으로 치료받은 3개월 미만의 환아 중 초음파 검사와 VCUG를 시행받은 환아를 대상으로 하였다. 후향적인 의무기록의 검토를 통하여 I 군(III-V 등급의 방광 요관 역류)과 II 군 (정상 혹은 I, II 등급의 방광 요관 역류) 간의 임상적 지표와 영상 검사 결과를 비교 검토하였다. 초음파의 민감도와 특이도 및 양성예측도와 음성예측도, 그리고 위험도와 우도비를 구하여 중증 방광 요관 역류에 대한 진단적 가치를 알아보았다. 결 과: 총 54명(남아 41명, 여아 13명) 의 대상아 중에서 I군이 14명, II군이 40명이였다. I 군에서 CRP가 높았고(6.11$\pm$5.18와 3.27$\pm$3.45, P=0.025) 비정상적인 초음파 소견이 많았지만(71.4%와 22.5%, P=0.002) 관련 인자를 보정한 후에는 초음파만이 통계적인 유의성이 있었다(P=0.002). 원인균, 균혈증 및 DMSA 이상소견은 두 군간에 유의한 차이가 없었다. 중증 방광 요관 역류에 대한 초음파의 민감도는 71.4%(41.9-91.4), 특이도는 77.5%(61.5-89.1), 위험도는 6.9(1.58-30.41)이었고 음성예측도는 88.6%(73.2-96.7), 음성우도비는 0.37(0.16-0.86)을 나타내었으나($\alpha$=0.05, 검정력 94%) III 등급의 방광 요관 역류4명은(28.6%)은 정상적인 초음파 소견을 보였다. 결 론 : 3개월 미만의 요로감염이 있는 영아에서 중증 방광 요관 역류 에 대해 VCUG를 대체할만한 예측인자를 규명하지 못했다. 따라서 모든 요로감염 영아(3개월 미만)에서 VCUG의 시행이 필요할 것으로 생각된다.

• 한국간담췌외과학회지
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• 제26권2호
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• pp.190-198
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• 2022

Backgrounds/Aims: Traumatic pancreatic injury (TPI) is rare as an isolated injury. There is a trend to perform conservative treatment even in patients with complete duct dissection and successful treatment. This study reviewed our 20 years of experience in the management of TPI and assessed patient outcomes according to age group and treatment strategy. Methods: A retrospective analysis of patients diagnosed and treated with TPI at a level-I trauma center from 2000-2019. Patients were divided into two groups: adults and pediatrics. Conservative treatment cases were subjected to subgroup analysis. Level of evidence: IV. Results: Of a total of 77 patients, the mean age was 24.89 ± 15.88 years. Fifty-six (72.7%) patients had blunt trauma with motor vehicle accident. Blunt trauma was the predominant mechanism in 42 (54.5%) patients. Overall, 38 (49.4%) cases had grade I or II injury, 24 (31.2%) had grade III injury, and 15 (19.5%) had grade IV injury. A total of 30 cases had non-operative management (NOM). Successful NOM was observed in 16 (20.8%) cases, including eight (32.0%) pediatric cases and eight (15.4%) adult cases. Higher American association for the surgery of trauma (AAST) grade of injury was associated with NOM failure (16.7% for grade I/II, 100% for grade III, and 66.7% for grade IV injury; p = 0.001). An independent factor for NOM failure was female sex (69.2% in females vs. 29.4% in males; p = 0.03). Conclusions: High AAST grade TPI is associated with a high rate of NOM failure in both pediatric and adults.

• 한국자원식물학회지
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• 제20권5호
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• pp.424-436
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• 2007

여기에서는 제주도에 분포하는 임목유전자원에 대하여 앞으로의 개발과 보존전략 수립의 기초 자료로 활용하기 위하여 수행하였다. 제주도에 분포하는 목본식물은 62과 136속 279종 28변종 13품종으로 계 320 분류군이었다. 그 중 침엽수인 나자식물은 3과 5속 7종으로 전체의 2.2%였으며, 나머지인 59과 131속 272종 28변종 13품종 계 313 분류군이 활엽수였다. 활엽수 중 상록수는 31과 45속 72종 7변종 5품종으로 84 분류군으로 활엽수종의 26.8%이며, 낙엽수는 42과 93속 200종 21변종 8품종 계 229 분류군으로 73.2%였다. 이들은 교목 122 분류군(38.1%), 관목 177 분류군(55.1%), 만경 21 분류군(6.8%)으로 구성되어 있었다. 또한 휴면형, 번식형, 산포기관형 및 생육형에 의한 스펙트럼이 분석되었다. 제주도에 분포하는 목본식물 320 분류군 중 17과 21속 14종 16변종 30 분류군이 한국특산이었으며, 그 중 22 분류군은 제주특산이었다. 제주도에 분포하는 목본식물 중 식물구계학적 특정식물 종은 V 등급 10 분류군, IV 등급 24 분류군, III 등급 53 분류군이었다. 이 결과는 V 등급은 전국의 12%, IV 등급은 7.6%, III 등급은 17.2%에 해당하는 것이다.

• Journal of Chest Surgery
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• 제26권3호
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• pp.191-195
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• 1993

Among 25 consecutive cases having undergone mitral valve surgery between March 1991 and June 1992 in Gill General Hospital, 11 patients[44%] who had undergone mitral valve reconstruction using prosthetic rings is evaluated and presented. Patients` mean age is 43 + 19 years[range:16-72], and they are consisted with 4 males and 7 females. Mitral valve insufficiency is due to degenerative disease in 6 cases[55%] and rheumatic disease in 5 patients[45%]. Carpentier`s functional classification I is 2 cases, II is 6 cases, and III is 2 cases. Surgical techniques include prosthetic ring annuloplasty[11 patients, 100%], chorda shortening[6, 55%], leaflet mobilization[4,36%], new chorda formation[2, 18%], chorda transposition[1, 9%] commissurotomy[3, 27%], and papillary muscle splitting[3, 27%]. Average number of mitral anatomic lesions per patient are 2.7 and we used average 2.8 procedures upon mitral valve apparatus per patient. There were no surgical mortality and no late valve related admission during the mean follow up period of 17 months. The mean functional class[NYHA] is 2.81 preoperatively and improved to 1.10 postoperatively. Doppler echocardiography showed much improvement from grade II MR [1 case], grade III MR [1 case] and 9 cases of grade IV MR to 6 cases of patients showed no MR, only trace MR in 4 cases, and grade I MR was found only in one patient with NYHA functional class II postoperatively. The postoperative mean mitral valve area is $2.10+0.28cm^2$. We conclude that mitral reconstruction is a predictable and stable operation.

• 한국조경학회지
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• 제31권5호
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• pp.31-42
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• 2003

This study looked at worked on remaining landscapes in terms of landscape ecology. It presented some ways to conserve and to activate remaining landscapes with examples of agricultural lands in Hwa-won Gun, Ok-po Myun. The results are as follows: We investigated 20 remaining landscape types and 90 remaining landscapes, and classified them in terms of forest and water zones. To evaluate the investigated remaining landscapes, we produced a grading system using 8 criteria such as vitality, stability, field suitability, type of inner scenery formation, connection, recreation, and culture/tradition. Our evaluation of the vitality found that Grade I had the mast remaining landscapes; Grade II had 28, Grade III had 16, Grade V had four, and Grade IV had none. We evaluated the outer landscape influence using 3 criteria such as divisibility, vitality, and indication. We found from evaluating the type of inner scenery formation that most of the landscapes superior to Grade III were adjacent to water zones and that linear landscapes evaluated as Grade I, and II played an important role in this connection. We evaluated the recreation probability using marks, frequencies, and emergencies of peculiar types. Based on the results, we proposed some ways to conserve and to activate the remaining landscapes classified by grades using the results of the last evaluation. Additionally, we proposed some ways to activate the restoration of the linear axis of the green space function the formation of a buffer green space around matric space, the improvement of the axis of the green space center, and the formation of additional green tracts of land to play the role of stepping stones. We proposed the possibility of improving uniformed farm land structures. This study did not consider the weighting values of the evaluation index. Therefore a more objective study will be needed with an expert-survey in the future.

• 한국환경복원기술학회지
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• 제17권1호
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• pp.65-79
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• 2014

This study selected Nakdong River basin zone in Daegu as an example area to conduct landscapetope classification and aesthetic value assessment of landscape according to the classified landscapetope. The main result of this research can be summed up as following. First, the result of landscapetope type classification showed 28 types of landscapetope including complex residential area (AA), natural stream type with copious vegetation (BA), forest type centered on mixed forest of soft and hardwood (EB) along with 129 types of imputed specific landscapetope. The result of the total first assessment using B-VAT showed the first grade 10 types, II grade 4 types, III grade6 types, IV grade 3 types, 5 types for V grade with the lowest value. The second assessment conducted toward the landscapetope types with the grade higher than the average (including III grade) in the result of the first assessment showed that there are 66 spaces for the sites (1a, 1b) with special meaning for aesthetic landscape evaluation. And also, there were 69 spaces for those (2a, 2b, 2c) with meaning for aesthetic landscape evaluation. The design model of this research is largely divided into improvement goal and specific execution plan. First, the improvement goal is divided into 6 categories including conservation area, complementary area, and restoration area, and the specific execution plan is divided into 14 categories including special landscape management area, general landscape management area, conservation of hill areas with optically good condition. A comprehensive master plan was suggested by directly applying the set landscape planning model to the subject place of this research.

• 한국환경과학회지
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• 제29권12호
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• pp.1185-1198
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• 2020

This study aimed to suggest a framework for biotope classification and evaluation based on habitat values to rationally establish management areas of national parks. The factors and indicators related to the biotope classification and evaluation were established based on integration from those of previous studies. The decision tree evaluation process was applied to the classification and evaluation of the biotope type level. The evaluation of the biotope group level was carried out to determine the weight and the AUEM (Adding Up Estimation Matrix) was applied for the final grades. As a result, the biotope type of Seolaksan National Park was classified into 43 types and Odaesan National Park was classified into 41 types. Bukhansan National Park, which is located in a metropolitan city, was classified into 49 types. In terms of biotope evaluation, grade III had a ratio of 50.6%, the highest in Seolaksan national park. The ratios of grade I and grade II, which have great ecological-value, were respectively 12.0% and 36.5%. Grade II was 48.2%, the highest ratio in Odaesan National Park. The ratios of grades I and II were 10.8% and 37.9%, respectively. Grade III was 54.8%, the highest ratio in Bukhansan national park, and the ratios of grade I and grade II, which have great ecological-value were, respectively, 11.4% and 25.7%. The biotope values of major national parks were evaluated according to the type focusing on the actual vegetation. This framework can be considered for application to the spatial management of other types of protected areas.