• Journal of Korean Neurosurgical Society
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• v.54 no.1
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• pp.42-46
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• 2013

Objective : Despite several limitations, the Trauma Injury Severity Score (TRISS) is normally used to evaluate trauma systems. The aim of this study was to evaluate the preventable trauma death rate using the TRISS method in severe trauma patients with traumatic brain injury using our emergency department data. Methods : The use of the TRISS formula has been suggested to consider definitively preventable death (DP); the deaths occurred with a probability of survival (Ps) higher than 0.50 and possible preventable death (PP); the deaths occurred with a Ps between 0.50 and 0.25. Deaths in patients with a calculated Ps of less than 0.25 is considered as non-preventable death (NP). A retrospective case review of deaths attributed to mechanical trauma occurring between January 1, 2011 and December 31, 2011 was conducted. Results : A total of 565 consecutive severe trauma patients with ISS>15 or Revised Trauma Score<7 were admitted in our institute. We excluded a total of 24 patients from our analysis : 22 patients younger than 15 years, and 2 patients with burned injury. Of these, 221 patients with head injury were analyzed in the final study. One hundred eighty-two patients were in DP, 13 in PP and 24 in NP. The calculated predicted mortality rates were 11.13%, 59.04%, and 90.09%. The actual mortality rates were 12.64%, 61.547%, and 91.67%, respectively. Conclusion : Although it needs to make some improvements, the present study showed that TRISS performed well in predicting survival of traumatic brain injured patients. Also, TRISS is relatively exact and acceptable compared with actual data, as a simple and time-saving method.

• Sleep Medicine and Psychophysiology
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• v.17 no.2
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• pp.75-84
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• 2010

The cyclic alternating pattern (CAP) is a periodic EEG activity in NREM sleep, characterized by sequences of transient electrocortical events that are distinct from background EEG activities. A CAP cycle consists of two periodic EEG features, phase A and subsequent phase B whose durations are 2-60 s. At least two consecutive CAP cycles are required to define a CAP sequence. The CAP phase A is a phasic EEG event, such as delta bursts, vertex sharp transients, K-complex sequences, polyphasic bursts, K-alpha, intermittent alpha, and arousals. Phase B is repetitive periods of background EEG activity. The absence of CAP more than 60 seconds or an isolated phase A is classified as non-CAP. Phase A activities can be classified into three subtypes (A1, A2, and A3), based on the amounts of high-voltage slow waves (EEG synchrony) and low-amplitude fast rhythms (EEG desynchrony). CAP rate, the percentage of CAP durations in NREM sleep is considered to be a physiologic marker of the NREM sleep instability. In insomnia, the frequent discrepancy between self-reports and polysomnographic findings could be attributed to subtle abnormalities in the sleep tracing, which are overlooked by the conventional scoring methods. The conventional scoring scheme has superiority in analysis of macrostructure of sleep but shows limited power in finding arousals and transient EEG events that are major component of microstructure of sleep. But, it has recently been found that a significant correlation exists between CAP rate and the subjective estimates of the sleep quality in insomniacs and sleep-improving treatments often reduce the amount of CAP. Thus, the extension of conventional sleep measures with the new CAP variables, which appear to be the more sensitive to sleep disturbance, may improve our knowledge on the diagnosis and management of insomnia.

• Molecules and Cells
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• v.39 no.4
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• pp.316-321
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• 2016

The receptor activator of nuclear factor ${\kappa}B$ (RANK) and its ligand RANKL are key regulators of osteoclastogenesis and well-recognized targets in developing treatments for bone disorders associated with excessive bone resorption, such as osteoporosis. Our previous work on the structure of the RANK-RANKL complex revealed that Loop3 of RANK, specifically the non-canonical disulfide bond at the tip, performs a crucial role in specific recognition of RANKL. It also demonstrated that peptide mimics of Loop3 were capable of interfering with the function of RANKL in osteoclastogenesis. Here, we reported the structure-based design of a smaller peptide with enhanced inhibitory efficiency. The kinetic analysis and osteoclast differentiation assay showed that in addition to the sharp turn induced by the disulfide bond, two consecutive arginine residues were also important for binding to RANKL and inhibiting osteoclastogenesis. Docking and molecular dynamics simulations proposed the binding mode of the peptide to the RANKL trimer, showing that the arginine residues provide electrostatic interactions with RANKL and contribute to stabilizing the complex. These findings provided useful information for the rational design of therapeutics for bone diseases associated with RANK/RANKL function.

• Journal of the Korea Computer Graphics Society
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• v.15 no.4
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• pp.31-40
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• 2009

Captured motion data is widely used today in a variety of areas including film production, game development, sports analysis, and medical rehabilitation. The ability of analyzing and processing motion data has increased rapidly for last decades. However, it is still difficult for users to quickly understand the contents of motion data consisting of a series of time-varying poses. One typical approach is to visualize consecutive poses in sequence while adjusting three-dimensional view, which is often time-consuming and laborious especially when users need to repeatedly control time and view in order to search for desired motions. We present a method of visualizing motion data as a sequence of images in comic book layout so that users can rapidly understand the overall flows of motion data, and easily identify their desired motions. The usefulness of our approach is demonstrated by visualizing various kinds of motion data including locomotion, boxing, and interaction with environments.

• Journal of Korean Neurosurgical Society
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• v.39 no.6
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• pp.427-431
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• 2006

Objective : The purpose of this study is to assess the usefulness of three-dimensional computed tomography angiography [3D-CTA] as a postoperative follow-up examination after intracranial aneurysms have been clipped. Methods : Between January 2002 and June 2005, 522 consecutive patients received treatment for intracranial aneurysms. A retrospective analysis of 310 patients with postoperative 3D-CTAs was performed to evaluate aneurysmal remnants and de novo aneurysms. This study was conducted in 271 patients with at least immediate and 6-month routine 3D-CT As for postoperative clipped aneurysm and 39 patients with 3D-CTAs for clipped aneurysm before 2002 when there was no 3D-CTA in our hospital. Results : Eight patients had abnormal CT angiographic findings. Aneurysm remnants were revealed in 4 patients and de novo aneurysms were discovered in 5 patients. Two patients were found at the postoperative 6-month 3D-CTA performed routinely. In 1 patient, the aneurysm was demonstrated on the way to the examination of syncope. In 2 patients, the author recommended 3D-CTA although there was no symptom because the patients had visited our institute long time ago [5.1, 4.5 years]. Of the 8 patients, 2 remnants and 1 de novo aneurysm were treated by endovascular treatment. Three de novo aneurysms at the middle cerebral artery and 1 pericallosal artery aneurysm were treated by direct clipping because these aneurysms were not suitable for the endovascular treatment in point of anatomical configuration. One patient with both remnant and de novo aneurysm was treated conservatively. Conclusion : 3D-CTA is an available, non-invasive diagnostic tool for the postoperative follow-up examination of aneurysmal state in patients after clipping.

• The Korean Journal of Pain
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• v.32 no.4
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• pp.292-300
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• 2019

Background: The aim of this study was to investigate the clinical characteristics of complex regional pain syndrome (CRPS) in young male patients in South Korea, especially focusing on the association with military service. Methods: From January 2007 to May 2017, we investigated the electronic medical records of 430 consecutive patients, aged 18 to 30 years, who visited Seoul National University Hospital Pain Center, with a suspected diagnosis of CRPS at the initial visit. The following patient details were available for analysis: demographic and disease-related variables, relevance to military service, medications, and the treatment modalities received. Results: Out of 430 patients, 245 (57.0%) were diagnosed with CRPS, of which, 200 were male patients and 45 were female patients. Of the male patients, 95 (47.5%) developed CRPS during military service. CRPS during military service was more likely to result from sprain/strain, and the incidence of CRPS was significantly higher in the lower extremities in patients from the military service group than in those from the non-military service group. During the follow-up period, 37.9% of male CRPS patients (n = 61/161) were treated successfully. Patients with moderate to severe initial pain intensity, and diagnosed during their military service, showed better outcomes. Conclusions: Our results demonstrated that manifestation of CRPS in the young Korean population was more common in male and among those male CRPS patients, about half the cases developed during the military service period.

• The Journal of Advanced Prosthodontics
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• v.11 no.5
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• pp.280-285
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• 2019

PURPOSE. The present study was designed to examine the clinical fit of fixed dental prosthesis fabricated by the milling-sintering method using a presintered cobalt-chromium alloy. MATERIALS AND METHODS. Two single metal-ceramic crowns were fabricated via milling-sintering method and casting method in each of the twelve consecutive patients who required an implant-supported fixed prosthesis. In the milling-sintering method, the prosthetic coping was designed in computer software, and the design was converted to a non-precious alloy coping using milling and post-sintering process. In the casting method, the conventional manual fabrication process was applied. The absolute marginal discrepancy of the prostheses was evaluated intraorally using the triple-scan technique. Statistical analysis was conducted using Mann-Whitney U test (${\alpha}=.05$). RESULTS. Eight patients (66.7%) showed a lower marginal discrepancy of the prostheses made using the milling-sintering method than that of the prosthesis made by the casting method. Statistically, the misfit of the prosthesis fabricated using the milling-sintering method was not significantly different from that fabricated using the casting method (P=.782). There was no tendency between the amount of marginal discrepancy and the measurement point. CONCLUSION. The overall marginal fit of prosthesis fabricated by milling-sintering using a presintered alloy was comparable to that of the prosthesis fabricated by the conventional casting method in clinical use.

• Journal of Korean Neurosurgical Society
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• v.30 no.4
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• pp.472-478
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• 2001

Objectives : The authors present a retrospective analysis of 100 consecutive adult patients harboring craniopharyngiomas who underwent microsurgical resection between 1981 and 1999 to assess the long-term outcome of surgical treatment and to determine the most optimal management strategy. Methods : The extent of surgical removal was divided into four categories ; GTR(gross total removal), RSTR(radical subtotal removal), STR(subtotal removal),and PR(partial removal). The median follow-up period was 50 months(4-198). CT scan and/or MR imaging and hormonal status were evaluated to the last follow-up. Results : Visual disturbance was the most common presentation, which was improved in 42 cases and aggravated in 19 cases following the operation. Hypopituitarism was detected in 56 patients preoperatively, 82 during the immediate postoperative period, and 76 at the last follow-up. Improvement of pituitary function was not observed in any of these patients. Twenty of 100 patients showed recurrence at the mean of 27 months(3 to 196). The median progression-free survival(PFS) time of all patients was 145 months and 5-year PFS rate was 74%. Five-year PFS rate of GTR or RSTR group(71%) was significantly higher than that of STR or PR group(30%)(p=0.01). Postoperative radiation therapy significantly prolonged the PFS from 94 months in non-radiation group to 182 months(p=0.002). However, there was no statistical difference in number of patients who required hormonal replacement therapy between radiation and non-radiation group. Conclusion : Visual disturbance can be improved by early diagnosis and surgical decompression. GTR or RSTR in selected patients is considered a proper surgical strategy. Post-operative radiation therapy for residual tumors must be considered, although the ideal timing of radiation therapy is to be determined.

• Journal of Korean Neurosurgical Society
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• v.29 no.6
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• pp.786-793
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• 2000

Objectives : A clinical analysis was performed to provide management strategy and to improve management outcome of elderly patients with intracranial aneurysm. Patients and Methods : We reviewed medical records of 746 consecutive patients with intracranial aneurysm who were admitted from July 1991 to December 1996. They were divided into two age groups : elderly(120 patients aged 65 years or older) and non-elderly(626 patients aged 64 years or younger). We investigated the differences between the two groups in clinical characteristics, management outcome and surgical results. Results : Female(80.0%), internal carotid artery aneurysm(48.9%), poor clinical grade(Hunt and Hess Grade IV, V : 39.8%), postoperative subdural fluid collection(38.2%), and postoperative hydrocephalus(39.7%) were more frequent in the elderly patients. There were no significant differences in the incidence of hypertension, multiple aneurysm, unruptured aneurysm, rebleeding, delayed ischemic neurological deficits, postoperative hemorrhage, and low density on the postoperative brain CT scan. In some cases, surgical clipping of ruptured aneurysm could not be performed due to moribund state or refusal of surgery by the elderly patient's family. Both management outcome and surgical results in elderly aneurysm patients at 3 months after rupture were worse than those of the non-elderly group. The most common reason of unfavorable outcome was poor clinical grade in both groups, while serious medical illness causing unfavorable outcome was more common in the elderly group. Conclusion : Surgical treatment of a ruptured aneurysm should not be avoided in elderly patient solely on the basis of advanced age. If the patients are in good clinical grade, early aneurysm surgery followed by early ambulation should be recommended. Further improvements in outcome may be achieved by thorough knowledge of poor resilience of brain, CSF flow dynamics, and diminished cardiopulmonary reserve in elderly patients with intracranial aneurysm.

• Pediatric Infection and Vaccine
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• v.24 no.1
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• pp.44-53
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• 2017

Purpose: The aim of this study was to investigate the risk factors for posttransplant lymphoproliferative disorder (PTLD) and to evaluate the association between Epstein-Barr viral load and the development of PTLD in pediatric heart transplant recipients. Methods: We reviewed children aged <18 years who underwent heart transplantation and quantitative analysis of blood Epstein-Barr virus (EBV) viremia at our institute from January 2006 to March 2015. Clinical characteristics and EBV viral loads were compared according to the presence of PTLD. Results: Over 9 consecutive years, a total of 40 heart transplant recipients, were included. Among 28 children with available EBV viral load measurements, seven patients (25%) had EBV viremia only defined as at least one time of ${\geq}457copies/mL$. PTLD occurred in three recipients (7.5%) 4.3, 6.3, and 17.0 months after transplant and all PTLD cases had preceding EBV viremia. The median age at transplant was 5.3 years (range, 0.5 to 6.0 years) in the PTLD group, compared with 11.9 years (range, 0.3 to 17.8 years) in the non-PTLD group (P=0.021). The median values of the peak EBV levels in the PTLD group were 3,452,170 copies/mL (range, 46,750 to 7,622,910 copies/mL); the peak EBV levels in the non-PTLD group were 3,112 copies/mL (range, 2,250 to 103,000 copies/mL). Conclusions: Younger age at transplant and presence of EBV viremia were associated with the development of PTLD in pediatric heart transplant recipients. A prospective study will be required to determine the blood EBV load for predicting the development of PTLD in these patients.