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신상익,승영호 한국해양학회 1993 韓國海洋學會誌 Vol.28 No.2
The tidal front forming in the Mid-Yellow Sea off Korea, near Tae-An peninsular, is calculated using a 3-D general circulation model(Semtner, 1974) and the concept of mixing rate, an extension of the concept of mixing efficiency proposed by simpson & Hunter(1974). Along the north and south open boundaries, simple radiation conditions are applied. The model is run with the initial state which represents the winter condition. With imposed uniform heating by solar radiation and spatially-different vertical mixing, the model then generated the tidal front comparable to the observed one.
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Usefulness of Prone Cross-Table Lateral Radiographs in Vertebral Compression Fractures
조재환,신상익,이재협,염진섭,장봉순,이춘기 대한정형외과학회 2013 Clinics in Orthopedic Surgery Vol.5 No.3
Background: Dynamic radiographs are recommended to investigate non-healing evidence such as the dynamic mobility or intravertebral clefts in osteoporotic vertebral compression fractures (VCFs). However, it is difficult to examine standing flexion and extension lateral radiographs due to severe pain. The use of prone cross-table lateral radiographs (PrLRs) as a diagnostic tool has never been proposed to our knowledge. The purpose of this study is to clarify the usefulness of PrLRs in diagnosis and treatment of VCFs. Methods: We reviewed 62 VCF patients examined with PrLRs between January 1, 2008 and June 30, 2011. To compare the degree of pain provoked between standing extension lateral radiographs (StLRs) and PrLRs, numeric rating scale (NRS) scores were assessed and compared by a paired t-test. Vertebroplasty was done for 40 patients and kyphoplasty was done for 9 patients with routine manners. To assess the degree of postural reduction, vertebral wedge angles (VWA) and vertebral height ratios (VHR) were calculated by using preoperative StLRs, PrLRs, and postoperative lateral radiographs. Two variables derived from changes in VWA and VHR between preoperative and postoperative radiographs were compared by a paired t-test. Results: The average NRS scores were 6.23 ± 1.67 in StLRs and 5.18 ± 1.47 in PrLRs. The degree of pain provocation was lower in using PrLRs than StLRs (p < 0.001). The average changes of VWA between preoperative and postoperative status were 5.24° ± 6.16° with PrLRs and 3.46° ± 3.47° with StLRs. The average changes of VHR were 0.248 ± 0.178 with PrLRs and 0.148 ± 0.161 with StLRs. The comparisons by two variables showed significant differences for both parameters (p = 0.021 and p < 0.001, respectively). The postoperative radiological status was reflected more precisely when using PrLRs than StLRs. Conclusions: In comparison with StLR, the PrLR was more accurate in predicting the degree of restoration of postoperative vertebral heights and wedge angles, and provoked less pain during examination. The PrLR could be a useful diagnostic tool to detect intravertebral cleft or intravertebral dynamic instability.
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하부 흉추부의 굴곡-신연 손상으로 인한 척수 손상 후에 발생한 아급성 지연성 상행성 척수병증 - 증례 보고 -
박상재,조재환,신상익,이춘기,장봉순 대한척추외과학회 2013 대한척추외과학회지 Vol.20 No.3
Study Design: A case report. Objectives: To report a rare case of subacute delayed ascending myelopathy. Summary of Literature Review: After low spinal cord injury, the cord injury may proceed to a proximal level and lead to subacute delayed ascending myelopathy. The patient suffered from orthostatic hypotension, weakness and sensory loss in the upper extremities and dyspnea. MRI showed more proximal progression of the spinal cord injury. There is no prevention or treatment for this condition. Materials and Methods: A 62-year-old man fell from heights and had 11th thoracic spine flexion-distraction injury. Upon arrival at the hospital, he was found to suffer from lower extremity weakness and sensory loss, but showed no neurologic symptom in his upper extremities. Two days later, we performed posterior instrumentation with fusion, and no postoperative neurologic symptom change was detected. One week after the fall, he suffered from dyspnea, upper extremity weakness and sensory loss. MRI was taken and we discovered that his spinal cord injury had proceeded to the 2nd cervical spine level. Results: Three months later, he showed little improvement in his upper extremity motor power, but not to the extent of the previous low spinal injury. Conclusion: Physicians should pay attention to the upper extremity and respiratory function of the patient with low spinal cord injury,because the level of spinal cord injury may proceed to a proximal level. 연구 계획: 증례 보고. 목적: 드문 척수 손상 중의 하나인 아급성 지연성 상행성 척수병증 환자를 1례 경험하였기에 보고하고자 한다. 선행 문헌의 요약: 하부 척수의 손상 후 손상 부위보다 근위부로 척수 손상이 진행되는 경우가 드물게 보고되며 이를 아급성 지연성 상행성 척수병증(subacute delayed ascending myelopathy)이라고 한다. 기립성 저혈압, 상지의 근력 및 감각 저하, 호흡 곤란 등의 증상과 동반하여 자기공명영상에서수상 당시보다 더 근위부로 척수 손상이 진행한 양상을 확인함으로써 진단할 수 있다. 대상 및 방법: 62세 남자 환자가 3층 높이에서 낙상하여 제 11번 흉추부의 굴곡-신연 손상으로 인한 척수 손상을 받았다. 내원 당시 하지 마비가 있었으나 상지의 신경학적 이상은 없었다. 수상 2일 후 후방 유합술 및 기기 고정술 시행하였으며 수술 전후로 신경학적 증상의 변화는 없었다. 수상 1주 후 호흡 곤란, 상지의 감각 이상 및 위약감을 호소하여 자기공명영상을 촬영하였고 제 2번 경추 이하 부위의 척수까지 손상이 진행된 것이 관찰되었다. 결과: 수상 후 3개월까지 경과 관찰하여 호흡 곤란 및 상지의 감각 이상, 위약감이 조금 호전되었으나 초기의 하부 흉추 손상시의 수준까지 회복되지는못하였다. 결론: 하흉추부 척수 손상이 있더라도 상지의 신경 기능이나 호흡 기능 평가에 대해 세심한 주의를 기울여야 할 것으로 사료된다.
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원위 대퇴골 골연골종으로 인한 대퇴 정맥 혈전증 - 증례 보고 -
오주한,김재윤,공현식,김우성,신상익,Oh, Joo-Han,Kim, Jae-Yoon,Gong, Hyun-Sik,Kim, Woo-Sung,Shin, Sang-Ik 대한근골격종양학회 2006 대한골관절종양학회지 Vol.12 No.1
골연골종은 가장 흔한 양성 골 종양으로, 주변 골단판 연골의 골막하 전위에 의한 과증식성 골 병변이며, 대개 골단판이 닫히면서 성장이 끝나는 것으로 알려져 있다. 이러한 골연골종이 혈관계 합병증을 유발하는 경우는 드물지만, 종괴 효과로 주변의 동맥이나 정맥을 눌러 허혈이나 정맥염이 생기거나, 연골모가 골화되면서 생기는 날카로운 말단에 의해 동맥벽의 천공이 생길 수 있다. 이러한 혈관계 합병증은 대부분 젊은 남자의 동맥에서 발생하며, 정맥에 생기는 경우는 드문 것으로 알려져 있다. 저자들은 원위 대퇴골 골연골종으로 인해 심부 정맥 혈전증이 발생한 21세 남자 환자에서 골연골종의 제거 후 정맥 절제술 및 복재 정맥 이식술로 치료한 경험을 보고하고자 한다. Osteochondroma is a hyperplasic bony lesion caused by subperiosteal displacement of physeal cartilages, and the most common benign bone tumor. Osteochondromas rarely cause vascular complications, but when encountered, acute ischemia, phlebitis, and arterial puncture are the most common. They are caused by the mass effect or by the sharp end of the tumor. Deep vein thrombosis may be caused by impaired venous blood flow or a hypercoagulable blood state, but sometimes no predisposing cause can be found. We experienced a patient with deep vein thrombosis caused by the mass effect of an asymptomatic osteochondroma, and treated him successfully by excising the osteochondroma and performing a saphenous vein graft after resecting obstructed vein.
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