골수강내 금속정 및 나사못 맞물림을 이용한 경골의 치료

최창혁,권굉우,김신근,이상욱,강창진 대구효성카톨릭대학교 1997 연구논문집 Vol.56 No.2

Fracture of the tibial shaft is the most common among the long bone fractures, and it is difficult to treat because of a high incidence of delayed union, nonunion and malunion. Interlocking Intramedullary mailing is considered to be valuable method in treating long bone fracture such as tibial fracture these days because it enables rigid fixation, early joint motion exercise and weight bearing. Between April 1993 and March 1997, we treated 63 cases of tibia fractures with interlocking intramedullary nailing. The results were as follows: 1. Among the 63 cases, 51 cases were closed fractures and 12 cases were open fractures. 2. Static interlocking nailing was done in all cases and dynamization was done in 7 cases in postoperative 13 weeks. 3. Average union time was 19.9 weeks, 19 weeks with closed tibia fracture and 2.4 weeks with open tibia fracture. According to fracture site, 22 weeks with proximal tibia fracture, 19.2 weeks with mid-tibia fracture and 21.4 weeks with distal tibia fracture. According to the Winquist-Hansen classification, Type I was 19.8 weeks, Type Ⅱ was 20.4 weeks, Type Ⅲ was 22 weeks and Type Ⅳ was 26 weeks. 4. Weight bearing was started at the time of subsidence of pain and tenderness of the fracture site, 11.5 weeks with closed fracture and 12.3 weeks with open fracture. 5. According to the functional result of Klemm and Borner, 44 cases were excellent, 9 cases were good, 7 cases were fair and 3 cases were poor.

3분 및 4분 상완골근위부 골절에서의 외반형 및 내반형에 따른 임상적 비교

최창혁,권굉우,김신근,이상욱,신동규,이승진 대한골절학회 2002 대한골절학회지 Vol.15 No.4

목 적 : 수술적으로 치료한 3분, 4분 상완골 근위부 골절을 외반형과 내반형으로 재분류하여 임상적 결과를 비교하고자 하였다. 대상 및 방법 : Neer 분류상 3분, 4분 상완골근위부 골절로 분류된 21례에 대해 수술적 치료를 시행하고 12개월 이상 추시된 증례를 대상으로, 골절부위의 각형성, 상완골두의 방향성, 그리고 우세 전위결절의 양상에 따라 외반형과 내반형으로 재분류하여 UCLA shoulder rating scale에 따른 기능적 평가를 시행하였다. 결 과 : 단순 방사선 소견을 기준으로 Neer의 3, 4분 상완골 근위부골절을 외반형과 내반형 및 각각의 아형(subtype)으로 분류할 수 있었다. 견관절 반치환술을 시술한 2례를 제외하고 분석한 각 그룹의 UCLA 기능적 평가는 외반형에서 양호 이상의 결과가 9례중 8례(89%), 내반형에서 10례중 4례(40%)로 외반형에서 더 우수한 임상적 경과를 보였다. 결 론 : 상완골 근위부 골절에서 골두의 방향성은 골절의 각형성 및 우세 전위결절의 양상과 높은 상관관계를 가졌으며, 내반형의 경우 혈행과 신경장애가 좀더 빈번하고 예후도 불량한 것으로 나타났고, 이러한 경우 수술시 도달 방법, 연부조직 상태에 대한 평가가 더욱 신중하게 고려되어야 할 것으로 생각되었다. Purpose : We reclassified three-and four-part proximal humerus fracture by Neer's classification into valgus & varus type, and compared the results of these groups. Materials & methods : 21 cases classified as three- and four-part fracture in Neer's classifiation were treated surgically and followed for 12 months. We reclassified the 21 cases vlagus and varus type fractures, according to angulation of fractures, facing of humeral head, and dominant displaced tuberosity. Functional evaluation was done by UCLA shoulder rating scale. Results : Neer's three- and four-part proximal humerus fractures could be reclassified based on angulation, facing of humeral head, and dominant tuberosity displacement. The functional results according to UCLA shoulder rating scale were good or excellent in 8 of 9 cases of valgus type(89%), and at 4 in cases of varus type(40%). The clinical result of the valgus type was better than that of the varus type. Conclusion : Based on reclassification system of proximal humerus fractures, clinical results and radiographic findings including angulation, facing of head and domonant tuberosity displacement showed close relationship. Neurovascular complication were more frequent in the varus type. Therefore, careful evaluation including surgical approach and soft tissue status should be considered in the varus type of complex proximal humerus fracture.

TRISS Method와 ASCOT Method를 이용한 외상환자의 생존율 분석

김형수,배성만,양혁준,박철완,이근,고영관 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2

Despite traumatic injuries cause serious problems in our society, there are few adequate and objective scoring system that assess the severtiy of trauma patients. The Major Trauma Outcome Study(MTOS)in United States deisgned the TRISS(Trauma Score & Injury Severity Score)method by means of Revised Trauma Score(RTS),Injury Severity Score(ISS0,and age,while Champion et al deviced ASCOT(A Severtriy Characterizaiton Of Trauma)method to overcome the limitation of TRISS. This study attempted to make a comparison between TRISS and ASCOT by using date for 422 injured patients which were collected form September,1993 to February,1994. Ascot and TRISS were compared in their sensutivity,Specificity,disparity and Z-statistics. 1)Sex ratio of male to female was 2.8:1 and the commonest age of trauma patients was thirties (23.8%). 2)The average probability of survival(Ps)for 442 patient by TRISS method was 0.9228 and that of ASCOT method 0.9356. 3)Disparity of Ps between survival and non-survival using TRISS and ASCOT was relatively low for both indexes as 0.3507 and 0.3296, respectively. 4)The sensitivity rates(number of patients predicted to die who actually died/total who actually died)for the non-survival of both TRISS and ASCOT method were low (35.0%),but the specificity rates(number of patients predicted to live who actually lived/total who actually lived)for the survival of TRISS and ASCOT were 99.1%and 99.6%respectively. 5)Z-statistics(difference between predicted and actual number of death)of both TRISS(1.3224)and ASCOT(1.2234)resulted in positive value which meant that actual number of death exeeded predicted number of death. 6)The ASCOT that have presumed to be more accurate method for patients with head trauma and with multiple injuries to one portion of body,had its intricacy and difficult points in practical application. And the difference between the result of ASCOT and TRISS was not so significant. 7)It is thought that a new, more comprehensive index would like to be developed and thoroughly tested on a variety of data sets in order for it to be used in trauma system quality assurance evaluation.

Evidence for a role of CaMKIV in the development of opioid analgesic tolerance

Ko, Shanelle W.,Jia, Yongheng,Xu, Hui,Yim, Se-Jeong,Jang, Dong-Hyuk,Lee, Yong-Seok,Zhao, Ming-Gao,Toyoda, Hiroki,Wu, Long-Jun,Chatila, Talal,Kaang, Bong-Kiun,Zhuo, Min Blackwell Publishing Ltd 2006 The European journal of neuroscience Vol.23 No.8

<P>Abstract</P><P>cAMP response-element binding protein (CREB), a transcription factor involved in learning, memory and drug addiction, is phosphorylated by calcium–calmodulin-dependent protein kinase IV (CaMKIV). Here, we show that CaMKIV-knockout (KO) mice developed less analgesic tolerance after chronic morphine administration with no alteration in physical dependence or acute morphine-induced analgesia. The increase in phosphorylated CREB expression observed in wild-type mice after chronic morphine was absent in CaMKIV-KO mice, while there was no difference in the expression or phosphorylation of the µ-opioid receptor between groups. Morphine-treated CaMKIV-KO mice showed less G-protein uncoupling from the µ-opioid receptor than did wild-type mice, while uncoupling was similar in control wild-type and KO mice. In addition, morphine reduced inhibitory transmission to a greater degree in CaMKIV-KO mice than in controls after chronic morphine exposure. Our results provide novel evidence for the role of CaMKIV in the development of opioid analgesic tolerance but not physical dependence.</P>

Altered Functional Connectivity of the Nucleus Accumbens and Amygdala in Cyber Addiction: A Resting State Functional Magnetic Resonance Imaging Study

Minsoo Ko(Minsoo Ko),Su-hyuk Chi(Su-hyuk Chi),Jong-ha Lee(Jong-ha Lee),Sang-il Suh(Sang-il Suh),Moon-Soo Lee(Moon-Soo Lee) 대한정신약물학회 2023 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.21 No.2

Objective: Cyber addiction, which is more vulnerable in adolescents, is defined as the excessive use of computers and the Internet that causes serious psychological, social, and physical problems. In this study, we investigated the resting-state functional connectivity (rsFC) in adolescents with cyber addiction. Methods: We collected and analyzed resting-state functional neuroimaging data of 20 patients with cyber addiction, aged 13−18 years, and 27 healthy controls. Based on previous studies, the seed regions included the dorsolateral prefrontal cortex, medial orbitofrontal cortex, lateral orbitofrontal cortex, dorsal anterior cingulate cortex, insula, hippocampus, amygdala, nucleus accumbens, and the ventral tegmental area. Seed-to-voxel analyses were performed to investigate the differences between patients and healthy controls. A correlation analysis between rsFC and cyber addiction severity was also performed. Results: Patients with cyber addiction showed the following characteristics: increased positive rsFC between the left insular−right middle temporal gyrus; increased positive rsFC between the right hippocampus−right precentral gyrus; increased positive rsFC between the right amygdala−right precentral gyrus and right parietal operculum cortex; increased negative rsFC between the left nucleus accumbens−right cerebellum crus II and right cerebellum VI. Conclusion: Adolescents with cyber addiction show altered functional connectivity during the resting state. The findings of this study may help us better understand the neuropathology of cyber addiction in adolescents.

Risk Factors Associated with Poor Outcomes in Patients with Brain Abscesses

Ko, Seok-Jin,Park, Kyung-Jae,Park, Dong-Hyuk,Kang, Shin-Hyuk,Park, Jung-Yul,Chung, Yong-Gu The Korean Neurosurgical Society 2014 Journal of Korean neurosurgical society Vol.56 No.1

Objective : The purpose of this study was to describe the clinical characteristics, treatment outcomes, and prognostic factors in patients with brain abscesses treated in a single institute during a recent 10-year period. Methods : Fifty-one patients with brain abscesses who underwent navigation-assisted abscess aspiration with antibiotic treatment were included in this study. Variable parameters were collected from the patients' medical records and radiological data. A comparison was made between patients with favorable [Glasgow Outcome Scale (GOS) ${\geq}4$] and unfavorable (GOS <4) outcomes at discharge. Additionally, we investigated the factors influencing the duration of antibiotic administration. Results : The study included 41 male and 10 female patients with a mean age of 53 years. At admission, 42 patients (82%) showed either clear or mildly disturbed consciousness (GCS ${\geq}13$) and 24 patients (47%) had predisposing factors. The offending microorganisms were identified in 25 patients (49%), and Streptococcus species were the most commonly isolated bacteria (27%). The mean duration of antibiotic administration was 42 days. At discharge, 41 patients had a favorable outcome and 10 had an unfavorable outcome including 8 deaths. The decreased level of consciousness (GCS <13) on admission was likely associated with an unfavorable outcome (p=0.052), and initial hyperglycemia (${\geq}140mg/dL$) was an independent risk factor for prolonged antibiotic therapy (p=0.032). Conclusion : We found that the level of consciousness at admission was associated with treatment outcomes in patients with brain abscesses. Furthermore, initial hyperglycemia was closely related to the long-term use of antibiotic agents.

Oral Presentation : Treatment of intrabony defects using guided tissue regeneration: case series

( Hyuk Jin Ko ),( Jae Mok Lee ),( Jo Young Suh ),( Jin Woo Park ) 대한치주과학회 2010 대한치주과학회 학술대회자료집 Vol.2010 No.1

APPLICATIONS OF ELECTROPLATING METHOD FOR HEAT TRANSFER STUDIES USING ANALOGY CONCEPT

Ko, Sang-Hyuk,Moon, Deok-Won,Chung, Bum-Jin Korean Nuclear Society 2006 Nuclear Engineering and Technology Vol.38 No.3

This study presents an idea of using analogy concept to the heat transfer studies regarding the HTGR development. Theoretical backgrounds regarding the idea were reviewed. In order to investigate the predictability of a mass transfer system for heat transfer system phenomenology, an electroplating system coupled with a limiting current technique was adopted. Test facilities for laminar forced convection and natural convections under laminar and turbulent conditions were constructed, for which heat transfer correlations are known. The test results showed a close agreement between mass transfer and heat transfer systems, which is an encouraging indication of the validity of the analogy theory and the experimental methodology adopted. This paper shows the potential of the experimental method that validates the little-understood heat transfer phenomena, even in complex geometries such as HTGR.

A Hierarchical Phosphorylation Cascade That Regulates the Timing of PERIOD Nuclear Entry Reveals Novel Roles for Proline-Directed Kinases and GSK-3{beta}/SGG in Circadian Clocks.

Ko, Hyuk Wan,Kim, Eun Young,Chiu, Joanna,Vanselow, Jens T,Kramer, Achim,Edery, Isaac The Society 2010 The Journal of neuroscience Vol.30 No.38

<P>The daily timing of when PERIOD (PER) proteins translocate from the cytoplasm to the nucleus is a critical step in clock mechanisms underpinning circadian rhythms in animals. Numerous lines of evidence indicate that phosphorylation plays a prominent role in regulating various aspects of PER function and metabolism, including changes in its daily stability and subcellular distribution. In this report, we show that phosphorylation of serine 661 (Ser661) by a proline-directed kinase(s) is a key phospho-signal on the Drosophila PER protein (dPER) that regulates the timing of its nuclear accumulation. Mutations that block phosphorylation at Ser661 do not affect dPER stability but delay its nuclear entry in key pacemaker neurons, yielding longer behavioral rhythms. Intriguingly, abolishing phosphorylation at Ser661 also attenuates the extent of dPER hyperphosphorylation in vivo, suggesting the phosphorylated state of Ser661 regulates phosphorylation at other sites on dPER. Indeed, we identify Ser657 as a site that is phosphorylated by the glycogen synthase kinase GSK-3관 (SHAGGY; SGG) in a manner dependent on priming at Ser661. Although not as dramatic as mutating Ser661, mutations that abolish phosphorylation at Ser657 also lead to longer behavioral periods, suggesting that a multi-kinase hierarchical phosphorylation module regulates the timing of dPER nuclear entry. Together with evidence in mammalian systems, our findings implicate proline-directed kinases in clock mechanisms and suggest that PER proteins are key downstream targets of lithium therapy, a potent inhibitor of GSK-3관 used to treat manic depression, a disorder associated with clock malfunction in humans.</P>

Esthetic treatment of gingival melanin hyperpigmentation with a Nd:YAG laser and high speed rotary instrument: comparative case report

Ko, Hyuk-Jin,Park, Jin-Woo,Suh, Jo-Young,Lee, Jae-Mok Korean Academy of Periodontology 2010 Journal of Periodontal & Implant Science Vol.40 No.4

Purpose: The purpose of this study was to evaluate the clinical effectiveness of and patient's satisfaction with treatment of gingival melanin hyperpigmentation with a Nd:YAG laser and a high speed rotary instrument. Methods: Three patients with melanin hyperpigmentation in the anterior parts of the gingiva were chosen for this case study. Clinical photographs were taken at the preoperative state and three patients were treated under local anesthesia. In the maxilla, the gingival deepithelization was conducted with a high speed diamond bur, whereas, in the mandible with a Nd:YAG laser. Clinical photographs were taken immediately after the procedures and at the 1st, 2nd, and 4th week to evaluate clinical color changes. A week after the procedure, the patients filled out a questionnaire about any pain or discomfort. At the 4th week after the procedure, the patients filled out questionnaires about esthetic aspects of the results of treatment. Results: In all cases, both anterior gingival areas were depigmented with satisfaction and the patients did not complain of severe pain or discomfort. At the 1st week of healing, the gingiva showed moderate to fast epithelization. Two weeks after the procedure, clinically, the gingiva showed almost complete healing. Four weeks after the procedure, there was significant improvement in gingival melanin hyperpigmentation. Conclusions: The Nd:YAG laser and the high speed rotary instruments seem to be effective for the esthetic treatment of gingival melanin hyperpigmentation.