척추경 나사못 기기술을 사용한 요추부 척추관 협착증의 수술적 치료

조재림,이광현,윤원구,이창우 대한척추외과학회 1994 대한척추외과학회지 Vol.1 No.2

The purpose of this study is to report our results for pedicle screw fixation in 161 cases of lumbar spinal stenosis from August,1987 to July,1993. The operation was performed for degenerative spinal stenosis in 72 cases, for stenosis by isth- mic defect in 51 cases, for stenosis combined with herniated lumbar disc in 30 cases, and for iatrogenic stenosis in 8 cases. The age at the time of operation was from 17 to 76, the mean age was 47.1 years. Contrel-Dubousset instrument was applied in 99 cases, compact C-D in 26 cases, Diapason in 30 cases, TSRH in 4 cases, and Steffee and P.W.B. in 1 case respectively. Decompression for 1 segment was carried out in 45 cases, 2 segments in 56 cases, 3 seg- ments in 41 cases, over 4 segments in 19 cases. Wide decompression including facetectomies were necessary to obtain complete decompression. The clinical results were that among the 161 cases followed over 1 year, 151 cases(94%) were good to excellent, 9 cases were fair and I case was poor according to the criteria of Kirkaldy-Willis. We could anticipate the good result in patients who had preoperative symptom duration for less than two years. But, the degree of compression of dural sac in myelogram is not correlated with the good result. Complications were multiple, hematoma(45 cases), meralgia paresthetica(13 ases), treatsient neurologic deficit(16 cases), dural tear(5 cases), urinary tract infection(2 cases), superficial infection(3 cases), screw breakage(5 cases), malposition of screw(1 case), prenetration of anteri- or cortex(2 cases), and dissociation of screw and rod(1 case). But no permanent neurologic deficit, or deep infection was observed and no reoperation was done. To obtain excellent results, complete decompression, firm internal fixation preferably by pedicle screws, and sufficient autogenous bone grafr were necessary.

정형외과영역에서의 Cefpiramide sodium (Sepatren^(�))의 임상 연구

조재림,박영봉,최태열 최신의학사 1987 最新醫學 Vol.30 No.4

Effect modification of the association between long-term exposure to particulate matter and brain cortical thickness by low-grade systemic inflammation

조재림,손정우,노주환,김우진,장희선,노영,김선영,김창수 환경독성보건학회 2020 한국독성학회 심포지움 및 학술발표회 Vol.2020 No.9

Mechanisms linking particulate matter exposures and cognitive impairment: epidemiological evidence

조재림,장희선,박현지,노영,손정우,고상백,이승구,김선영,김창수 환경독성보건학회 2022 한국독성학회 심포지움 및 학술발표회 Vol.2022 No.10

Joint Effect of Inflammatory Dietary Patterns and Physical Activity on the Risk of Depressive Symptoms: A Nation-Wide Cross-Sectional Study

조재림,Kim Thai Thien Nguyen,고주연 연세대학교의과대학 2025 Yonsei medical journal Vol.66 No.7

Purpose: Depression is a major global public health concern. Diet and physical activity are major modifiable lifestyle factors associated with depression; however, their joint effects have not been fully addressed. This cross-sectional study aimed to quantitatively examine the interaction between physical activity and inflammatory nutrients in depression and utilized Bayesian kernel machine regression (BKMR) models to compare the effects of inflammatory nutrients on depression in individuals with and without physical activity. Materials and Methods: The inflammatory diet was assessed using the dietary inflammatory index (DII), while physical activity levels were measured using the Global Physical Activity Questionnaire, with sufficient physical activity defined as achieving 600 metabolic equivalent task minutes per week. Depression was defined as a 9-item Patient Health Questionnaire score of ≥10. We used multiple logistic regression and BKMR models to investigate the associations between the DII and depression, with all models adjusted for covariates. Results: A total of 4110 participants from the 2020 Korea National Health and Nutrition Examination Survey were included in this study. Notably, participants with higher total DII scores were more likely to have depressive symptoms, and the additive interaction between insufficient physical activity and inflammatory nutrients was attributed to a 36% risk of depression. Moreover, BKMR analyses showed that individuals with insufficient physical activity exhibited a greater risk of depression posed by pro-inflammatory dietary patterns and did not benefit from anti-inflammatory dietary patterns with regard to the risk of depression. Conclusion: Comprehensive plans for diet control and increased physical activity are essential to help prevent depression.

요추부 질환에서 시행한 단분절 유합과 장분절 유합간의 임상 결과에 대한 비교

조재림,윤원구,권오재 대한척추외과학회 1995 대한척추외과학회지 Vol.2 No.1

In some of the lumbar sinal disorders, fusion is the method of choice for relieving spinal pain and usually one or two segments fusion is sufficient but somtimes as in degenerative spinal stenosis it is necessary to carry out three or more segments fusion. The purpose of this study is to compare the clinical results between these short and long segment fusion groups. From August 1987 to December 1992, 138 lumbar spinal disorders were operated on and followed for more than one year, the average follow up period was 2 years and 5 months. One or two segments fusion was carried out in 111 patients and three or more segments fusion in 27 patients. 49 patients were male and 89 patients were female. Most prevalent age was from 41 to 60 in both groups. Degenerative spinal stenosis was the most common etiology for operation in both groups. In all cases, pedicle screws were female. Most prevalent age was from 41 to 60 in both groups. Average operation time was 4.75 hours in short segment fusion group and 6.25 hours in long segment fusion group. Under the hypotensive anesthesia, the amount of blood loss during operation was 1520 ㎕ and 2000㎕ respectively, and the amount of postoperative suction drainage was 450㎕ and 730㎕ respectively. On clinical results, 96.4% of good to excellent results were obtained in short segment fusion group while in long segment fusion group is was 85.2% but overall clinical results had no statistical significance between these two groups. In complications, hematoma was the most frequent complication in both groups but it was more frequent in long segment fusion group. Dural tear occured in 5 patients and it was more frequent in long segment fusion group and this was the only statistically significant complication. In this series, we had no deep would infection, no nonunion and no permanant neurologic deficit.

요추부에서의 재수술

조재림,박예수,임광민 대한척추외과학회 1996 대한척추외과학회지 Vol.3 No.2

The failed back syndrome refers to unsuccessful back surgery, which means back surgery without improvement. Thus it naturally implies the incorrect or inadequate operation. But in many instances, as in the newly developed herniated nucleus pulposus in a adjacent disk, reoperation is necessary after a long period of complete recovery from the initial symptom by successful initial operation. In this case it ti unfair to call it the failed back syndrome. Thus the term 'repeat surgery' is being used by many authors and we also used this terminology in this report. We analyzed 20 cases of repeat surgery, 15 cases of which were operated initially at the other hospital and the results are as follow : 1. The main cause of repeat surgery was a incomplete decompression(47.6%) of the neural tissue in the initial operation and the next one was degenerative changes in the adjacent disks which occured several years after initial operation with fusion. 2. By precise diagnosis and complete removal of offering reasons as well as by solid fusion with firm internal fixation in a repenat surgery overall 80% or more of good to excellent results could be obtained.

Physical Activity-Induced Modification of the Association of Long-Term Air Pollution Exposure with the Risk of Depression in Older Adults

조재림,박웅비,장희선,고주연,손정우,노영,김선영,고상백,김창수 연세대학교의과대학 2024 Yonsei medical journal Vol.65 No.4

Purpose: Evidence suggests that long-term air pollution exposures may induce depression; however, the influence of physical ac tivity on this effect is unclear. We investigated modification of the associations between air pollution exposures and depression by the intensity of physical activity. Materials and Methods: This cross-sectional study included 1454 Korean adults. Depression was defined as a Geriatric Depres sion Scale score ≥8. Concentrations of particulate matter (PM10 and PM2.5: diameter ≤10 μm and ≤2.5 μm, respectively) and nitro gen dioxide (NO2) level at each participant’s residential address were estimated. Based on metabolic equivalents, physical activity intensity was categorized as inactive, minimally active, or health-enhancing physical activity (HEPA). Results: Each 1-part per billion (ppb) NO2 concentration increase was significantly associated with a 6% [95% confidence interval (CI), 4%–8%] increase in depression risk. In older adults (≥65 years), a 1-ppb NO2 increase was associated (95% CI) with a 4% (1%–7%), 9% (5%–13%), and 21% (9%–33%) increase in depression risk in the inactive, minimally active, and HEPA groups, re spectively. Compared with the inactive group, the minimally active (p=0.039) and HEPA groups (p=0.004) had higher NO2 expo sure-associated depression risk. Associations of PM10 and PM2.5 with depression did not significantly differ by the intensity of physical activity. Conclusion: We suggest that older adults who vigorously exercise outdoors may be susceptible to air pollution-related depression.

Polycyclic Aromatic Hydrocarbons Mediate the Association between Tobacco Smoking and Alcohol Use Disorder

조재림,이동규,배문주,김미지,오성수,박기수,이찬주,박성하,이승구,고상백,정선재,김창수 연세대학교의과대학 2024 Yonsei medical journal Vol.65 No.12

Purpose: Smoking is causally related to alcohol use disorder. Although polycyclic aromatic hydrocarbons (PAHs) are major neurotoxic pollutants in tobacco smoke, evidence is lacking on the role of PAHs in the relationship between smoking and alcohol use disorder. This study investigated the types of PAHs associated with smoking and whether exposure to those PAHs mediated the effect of smoking on alcohol use disorder. Materials and Methods: A total of 968 male firefighters were analyzed. Smoking history and cumulative pack-years were obtained using self-reported questionnaires. Alcohol use disorder was defined using the Alcohol Use Disorder Identification Test. PAH exposure was assessed by urinary metabolites. Regression analyses were performed between exposure (smoking), outcome (alcohol use disorder), and mediator (PAH metabolites) variables. A mediation analysis was performed to test the indirect effect of PAH metabolites on the association between smoking and alcohol use disorder. All analyses were repeated for 770 participants who were followed up after 2 years, while alcohol use disorder was redefined from follow-up data ensuring the temporal sequence of the variables. Results: Both 2-naphthol [β=0.78, 95% confidence interval (CI): 0.59–0.98] and 2-hydroxyfluorene (β=0.69, 95% CI: 0.56–0.82) were associated with smoking history. Furthermore, 2-naphthol and 2-hydroxyfluorene mediated the associations of smoking history (proportion mediated: 14.2%, 23.6% respectively) or cumulative pack-years (proportion mediated: 14.4%, 25.4% respectively) with alcohol use disorder. The results were consistent in longitudinal settings. Conclusion: Exposure to PAHs mediated the association between tobacco smoking and alcohol use disorder. PAH exposure from tobacco may increase the risk of addictive disorders.

OpenAI의 GPT 아키텍처를 활용한 NCS기반 진로교육과정 설계 시스템 개발 연구

조재림,이보람,정진수,이정훈 한국인적자원관리학회 2024 인적자원관리연구 Vol.31 No.1

This study aimed to develop a customized curriculum design system for career education by utilizing OpenAI's GPT architecture. The integration of AI in modern educational environments is essential for the development of learner-centered educational methodologies, and this study aims to respond to this need. The GPT architecture's language processing and generation capabilities and the possibility of integrating the curriculum based on the National Occupational Competency Standards (NCS) were explored to lay the foundation for the system, and the research was conducted through a multi-disciplinary expert review. The experts who participated in the review consisted of doctoral and master's degree holders working in the fields of computer science, educational engineering, career education, and university academic support teams, and their feedback was used to design and improve the system. The outcome of the research was a storyboard for the development of a system with an innovative approach to education through the convergence of AI technology and career education. The system, using GPT architecture, showed that it can play an important role in providing students with personalized career education. This study is meaningful for the advancement of educational technology and the development of learner-centered personalized education methodologies, and provides important insights into the future direction of educational technology development. The study focused on exploring the possibilities of curriculum design using AI technology and laying a practical foundation for the application of AI in education. This approach provides an opportunity to develop educational technology to meet the needs of individual learners while increasing the effectiveness of education.