• Journal of the Korean Society of Physical Medicine
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• v.7 no.1
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• pp.87-94
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• 2012

Purpose : The purpose of this study was to examine the feasibility and efficiency of balance training program through an interactive video game regimen in people with chronic stroke. Methods : Thirty patients with chronic hemiparetic stroke were recruited. Participants were randomly assigned to either a control group (n=15) or an experimental group (n=15). The control group received the general physical therapy including of strengthening and balance exercise five times a week whereas the experimental group received a program of balance exercise with video game play based on virtual reality as well as the same typical physical therapy. The experimental group received 6 sessions for four weeks. Each session was given 5 minutes. An interactive computer game exercise regimen lasted 30 minutes without rest periods. Outcome measures for weight transfer to paretic side, non-paretic side and sit-squat-speed, sit-squat-length, sit-to-standspeed and sit-to-stand-area for the control group (n=15) and experimental group (n=15) before and after treatment were obtained by using the biorescure. Results: Outcomes demonstrated significant improvement in the experimental group compared with the control group in weight transfer to paretic side, non-paretic side and sit-squat-speed, sit-squat-length, sit-to-stand-speed. No significant training effect was showed in sit-to-stand-area between pretraining and post-training. Conclusion : An interactive computer game exercise based on task oriented approach for balance in chronic stroke were feasible. In other words, This regimen resulted in a greater improvement in dynamic balance for people with chronic stroke.

• Journal of Korean Society of Steel Construction
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• v.18 no.4
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• pp.481-490
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• 2006

The actual performance of a building during an earthquake depends on many factors. The prediction of the seismic performance of a new or existing structure is complex, due not only to the large number of factors that need to be considered and the complexity of the seismic response, but also due to the large inherent uncertainties and randomness associated with making these predictions. A central issue of this research is the proper treatment and incorporation of these uncertainties and randomness in the evaluation of structural capacity and response has been adopted in the seismic performance evaluation of steel tall buildings to account for the uncertainties and randomness in seismic demand and capacities in a consistent manner. The basic framework for reliability-based seismic performance evaluation and the key factors for statistical studies were summarized. A total of 36 target structures that represent typical tall steel buildings based on national building code (KBC-2005) were designed for the statistical studies of demand factor s and capacity factors. The incremental dynamic analysis (IDA) approach was examined through the simple steel moment frame building in determination of global drift capacity.

• Radiation Oncology Journal
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• v.12 no.2
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• pp.159-164
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• 1994

Purpose : To evaluate the role of postoperative radiotherapy in the management of primary or recurrent intracranial meningiomas. Methods and Materials : A retrospective review of 34 intracranial meningioma patients referred to the Yonsei Cancer Center for postoperative radiotherapy between 1981 and 1990 was undertaken. Of the 34 patients, 24 patients received elective postoperative radiotherapy after total or subtotal resection(Group 1), and 10 patients received postoperative radiotherapy as a salvage treatment for recurrent tumors(Group 2). Ten patients received postoperative radiotherapy after total resection, and twenty-four after subtotal resection. Ten patients who had total tumor resection were referred for radiotherapy either because of angioblastic or malignant histologic type(4 patients in Group 1) or because of recurrent disease after initial surgery(6 patients in Group 2). Radiation dose of 50-56 Gy was delivered over a period of 5-5.5 weeks using 4MV LINAC or Co-60 teletherapy unit. Results : Overall actuarial progression free survival(PFS) at 5 years was $80\%$. Survival was most likely affected by histologic subtypes. Five year PFS rate was $52\%$ for benign angioblastic histology as compared with $100\%$ for classic benign histology. For malignant meningiomas, 5 year PFS rate was $44\%$. The recurrence rates of classic, angioblastic, and malignant type were $5\%(1/21),\;80\%(4/5)$, and $50\%(4/8)$, respectively. The duration between salvage post-operative radiotherapy and recurrence was longer than the duration between initial surgery and recurrence in the patients of group 2 with angioblastic or malignant histology. Conclusion . Postoperative radiotherapy of primary or recurrent intracranial meningiomas appears to be effective modality, especially in the patients with classic meningiomas. In angioblastic or malignant histologies, a more effective approach seems to be needed for decreasing recurrence rate.

• Journal of the Korean Society for Aeronautical & Space Sciences
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• v.36 no.2
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• pp.163-170
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• 2008

The aeroelastic stability analysis of a soft-in-plane, composite hingeless rotor blade in hover and in forward flight has been performed by combining the mixed beam method and the aeroelastic analysis system that is based on a moderate deflection beam approach. The aerodynamic forces and moments acting on the blade are obtained using the Leishman-Beddoes unsteady aerodynamic model. Hamilton's principle is used to derive the governing equations of composite helicopter blades undergoing extension, lag and flap bending, and torsion deflections. The influence of key structural modeling issues on the aeroelastic stability behavior of helicopter blades is studied. The issues include the shell wall thickness, elastic couplings and the correct treatment of constitutive assumptions in the section wall of the blade. It is found that the structural modeling effects are largely dependent on the layup geometries adopted in the section of the blade and these affect on the stability behavior in a large scale.

• Archives of Plastic Surgery
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• v.33 no.5
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• pp.637-642
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• 2006

Purpose: Incidence of chronic osteomyelitis in femur is lower than that of tibia due to abundantsurrounding soft tissue like muscles and subcutaneous fat. However, if the femur is infected, surgical approach would be very difficult because of surrounding soft tissue and bony defects would be getting larger due to the late detection. Chronic osteomyelitis of femur is an intractable disease with frequent recurrence and remained bone instability in spite of multiple classical operations. Methods: From August 1998 to October 2005, we had 7 cases of fibular osteocutaneous free flap to reconstruct the femur. Those were followed-up for 23 months. All 7 cases were male. 4 cases were in midshaft and the others are distal part of femur. Results: The 7 cases that had not been healed in spite of average 9.1 times previous operations were reconstructed successfully without the recurrence of chronic osteomyelitis. Continuous rehabilitation therapy and brace were very helpful for the ambulation. It took 5.6 months for complete union of bone, and 9.8 months for the ambulation. Conclusion: After wide resection, reconstruction of the femur using fibular osteocutaneous free flap guaranteed bone stability and prevented recurrence of osteomyelitis through rich blood supplying fibula and muscle. Double barrel graft of fibula would be needed in case of the sufficient strength and thickness of femur. We report the successful results of reconstruction of femur with fibular osteocutaneous free flap for chronic osteomyelitis of femur.

• Archives of Plastic Surgery
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• v.35 no.5
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• pp.615-618
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• 2008

Purpose: Pyoderma gangrenosum is a rare cutaneous ulcerative disease. First described in 1930, the condition is characterized by progressive ulceration with deeply undermined purple-red edge. The lower extremities are most commonly affected but other parts of the skin and mucous membranes may also be involved. Although medical treatments with topical wound therapy are commonly used, surgical intervention is still controversial. In this paper, we report an atypical case of pyoderma gangrenosum which was characterized by extensive soft tissue breakdown. Methods: A 27-year-old male patient was referred to our institution with a $7{\times}8cm$ sized deeply undermined ulceration with pus-like discharge and fever. Incision and drainage was performed at another clinic 3 days prior to admission to our institution. After a thorough physical examination and the MRI review, a diagnosis of necrotizing faciitis was made. Accordingly, fasciotomy and debridement was performed. However, the wound enlarged progressively and the patient remained highly febrile for 9 days after the treatment. Septic screening did not reveal any occult infection. After a secondary review of the case, the initial diagnosis of necrotizing fasciitis was rejected and changed to pyoderma gangrenosum. With the use of dexamethasone intravenously, the wound improved dramatically and the fever was eliminated. Steroid mediation was tapered with duration of 1 month. The wound was stabilized and subsequently covered with split-thickness skin graft. Results: Split-thickness skin grafting with 1 : 1.5 mesh was successfully taken. Conclusion: Initial clinical features of pyoderma gangrenosum are very similar to that of necrotizing fasciitis. High fever and progressive ulceration with severe pain could invite earlier surgical approach. The advancing wound margins (the well defined violaceous, undermined border and necrotic ulcer base) and lack of isolation of pathogenic organism was used to make the correct diagnosis of pyoderma gangrenosum. We achieved a good result with proper medication and split-thickness skin graft.

• Journal of Chest Surgery
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• v.31 no.8
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• pp.787-791
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• 1998

Materials and methods: Between 1979 and 1996, 27 patients with primary cardiac tumor underwent surgery at Catholic University Medical College. Mean age of patient was 45.1${\pm}$3.03 ranging from 21 to 67 years old. Twenty-four cases were myxomas, 2 cases were chondrosarcoma, and remained case was angiosarcoma. Diagnosis was confirmed by echocardiography, cardiac angiography, CT scan, and MRI. The most common site of tumor origin was fossa ovalis limbus area(17cases:63%). A biatrial operative approach was commonly used in 15 cases and the tumor was removed through left atriotomy site. Complete excision of the tumor with a cuff of normal tissue was performed. All heart chambers were carefully explored for evidence of multicentric myxomas or other tumor debris. Most of the patients were improved on postoperative period compared to preoperative NYHA functional class. Results: There was one operative death due to low cardiac output syndrome. Follow up period was 3 months to 17 years. There was 2 late deaths due to local recurrences. Conclusion: complete surgical excion is important for increasing cure rate. Malignancy cannot be ruled out even though preoperative echocardiography suggests benign nature. Chest CT or MRI is effective for further evalution in addition to echocardiography. In suspicious of malignancy, more extensive resection is essential and postoperative chemotheraphy or radiotherapy is useful.

• Journal of Chest Surgery
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• v.29 no.1
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• pp.107-111
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• 1996

Persistent bronchopleural fistula (BPF) still presents a troublesome therapeutic challenge and demands an aggressive approach when conventional measures fail. A 50-year-old man had a rigtlt pneumonectomy for far-advanced pulmonary tuberculosis with the development of postopneumonectomy empyema and BPF 1 month postoperatively in October 1 81. The condition was managed with BPF closure and the Clagett procedure, which failed with the recurrence of BPF and empyema, followed by a spontaneous open window at about 1 year port:operatively. The BPF, which had been aggravated to a large size, was managed by the closure and obliteration of the empyema cavity using a Pectoralis-skin pedicled flap 13 years postoper atively on Jul, 1994. The BPF was controlled by the procedure, and the patient, with improved respiratory symptom, was discharged 43 days postoperatively. We conclude that the use of myocutaneous flap Is an effective procedure for the closure of a large BPF. The surgical technique of the pedicled flap operation is described and the case is reported.

• Journal of Chest Surgery
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• v.53 no.6
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• pp.325-331
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• 2020

Background: We evaluated the association between tricuspid annular dilatation and the development of moderate or severe tricuspid regurgitation (TR). Additionally, we determined the optimal tricuspid annular dilatation threshold to use as an indicator for tricuspid annuloplasty in patients with less-than-moderate functional TR (FTR). Methods: Between August 2007 and December 2014, 227 patients with less-than-moderate TR underwent mitral valve surgery without a tricuspid valve (TV) procedure. The TV annular diameter was measured via transthoracic echocardiography. The TV annular index (TVAI) was calculated as the TV annular diameter divided by the body surface area. The mean duration of echocardiographic follow-up was 42.0 months (interquartile range, 9.3-66.6 months). Results: Eight patients (3.5%) developed moderate or severe TR. The rate of freedom from development of moderate or severe TR at 5 years was 96.2%. TV annular diameter, left atrial diameter, preoperative atrial fibrillation, and TVAI were found to be associated with the development of moderate or severe TR in the univariate analysis. A cut-off TVAI value of 19.8 mm/㎡ was found to predict the development of moderate or severe TR, and a significant difference was observed in the development of TR of this severity based on this cut-off (p<0.001). Conclusion: The progression of TR was not infrequent in patients with untreated lessthan-moderate FTR. An aggressive treatment approach can be helpful to prevent the progression of FTR for patients with risk factors, especially TVAI greater than 19.8 mm/㎡.

• The Korean Journal of Pain
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• v.18 no.2
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• pp.192-197
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• 2005

Background: Radicular pain, associated with herniated intervertebral disc, has been treated with either conservative treatments or a traditional surgical discectomy. Several modalities for minimally invasive percutaneous procedures have been developed as alternatives to a surgical discectomy. Percutaneous decompression using a $Dekompressor^{(R)}$ probe has been recently introduced. Herein, we report the outcome of percutaneous decompression with a $Dekompressor^{(R)}$ for the treatment of a herniated intervertebral disc. Methods: Between August 2004 and April 2005, percutaneous decompression was performed using a $Dekompressor^{(R)}$, 1.5-mm percutaneous lumbar discectomy probe in 17 patients with a herniated lumbar intervertebral disc resistant to conservative treatments, with the results reviewed retrospectively. The procedure was performed under fluoroscopic guidance after local anesthesia. Disc access was gained with a posterolateral approach on the symptomatic side and intradiscal placement of the discectomy probe in the herniated disc confirmed from the anteroposterior and lateral views on the fluoroscopy. Results: We obtained satisfactory clinical results in 14 patients with a decrease in the initial Visual analogue scale (VAS) of more than 55% and the elimination or reduction of analgesic medication, with a follow-up of 3 to 11 months. Conclusion: We concluded that a percutaneous discectomy with a $Dekompressor^{(R)}$ probe might be an effective alternative for the treatments of painful disc herniations resistant to conservative managements when performed under proper selection criteria.