• Title/Summary/Keyword: 기관수술

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TREACHER COLLINS SYNDROME : A CASE REPORT (Treacher Collins 증후군 환아의 증례보고)

  • Park, Ji-Hyun;Kim, Seung-Hae;Song, Je-Seon;Kim, Seong-Oh;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.3
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    • pp.374-380
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    • 2010
  • Treacher Collins syndrome(TCS) is a rare, incurable condition occurring in approximately 1 of 25,000 to 50,000 births. It may occur as a spontaneous mutation out of genetically normal parents or it may be manifested as an autosomal dominant pattern. TCS is characterized by facial deformities such as, underdevelopment of the maxilla, mandible and zygoma, malocclusion, bilateral deformities of auricles, antimongoloid slant of the palpebral fissures. The syndrome is often associated with cleft lip and palate, ear malformations and hearing loss, short stature, and anomalies of the heart and skeleton. Respiratory difficulty associated with air way obstruction may also be observed, and there is considerable difficulty in airway management during general anesthesia. It is necessary that dentists provide safe dental treatments and guidelines to TCS patients by providing adequate understanding about the characteristics of the syndrome and proper ways of managements. The purpose of this study is to report the dental and medical characteristics of the patient who visited the Department of Pediatric Dentistry, Yonsei University for multiple dental caries treatment and to review the literatures of TCS.

Dose-Dependent Inhibitory Effect of Nitric Oxide on Embryo Development (Nitric Oxide의 농도 의존적인 배발생 억제 효과)

  • Park, Sea-Hee;Joo, Bo-Sun;Moon, Hwa-Sook;Kim, Yoon-Yeon;Cho, Jae-Dong;Kang, Ho-Sung;Kim, Han-Do
    • Clinical and Experimental Reproductive Medicine
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    • v.26 no.2
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    • pp.203-211
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    • 1999
  • 목적: 일산화질소 (nitric oxide; NO)는 생식계를 비롯한 여러 생체내 기관에서 다양하고도 중요한 작용을 하는 것으로 알려져 있으며, 복강액은 난관내강과 연결되어 복강액 내의 세포 성분의 변화는 난관의 미세환경을 변화시켜 수정과 초기 배아 발생에 영향을 줄 수 있다. 본 연구는 배아 발생에 있어서 일산화질소의 역할을 이해하고 복강액 내의 NO농도 변화가 배아 발생에 미치는 역할을 조사하기 위해 수행되었다. 방법: 과배란시킨 1세대 잡종 암컷 생쥐 (C57BL${\times}$CBA/Ca)로부터 1세포기 배아를 얻어 10% synthetic serum substitute가 첨가된 modified human tubal fluid 배양액에서 4일 동안 체외배양하였다(대조군). 실험을 위해 이러한 배양조건에 sodium nitroprusside (SNP)를 $0{\sim}1mM$의 다양한 농도로 배양초기부터 첨가하거나, $200{\mu}M$ SNP를 2-, 4-, 8-세포기의 각기 다른 배아시기에 첨가하였으며, 복강경수술을 받는 42명의 여성으로부터 채취한 복강액을 SSS대신 단백질원으로 사용하여 포배아까지의 배아 발달율을 관찰하였으며, 복강액 내의 NO농도를 Griess방법에 의해 측정하였다. 배아의 apoptotic body는 H33342 염색법으로 조사하였으며 배아 발달율은 3회 이상 반복 실험한 결과의 mean${\pm}$SEM으로 나타내었다. 결과: SNP는 농도에 의존적으로 배발생을 억제하였으나 배아 단계에 대한 특이성은 관찰할 수 없었으며, 특히 $100{\mu}M$ 이상의 고농도의 SNP는 2-세포기 단계에서 배아 발생을 정지시켰다. 또한 단백질원으로 복강액 이용시 배 발생율은 복강액 내의 NO 농도에 따라 현저한 차이가 발견되었으며, $2.5{\mu}M$이상의 NO를 함유한 복강액에서 배양한 배아의 발생율은 현저하게 감소하였다. cGMP analogue인 8-bromo-cGMP를 배양액에 첨가시 배아 발생에는 변화가 없었으며, SNP에 의해 배발생이 정지된 2-세포기 배아에서 apoptotic body를 발견할 수 없었다. 결론: 이상의 결과로 보아 NO는 고농도에서 배아 발생을 저해하며, 복강액 내의 NO와 같은 성분의 변화는 배아 발생에 유해한 효과를 유발할 것으로 사료된다. 이러한 NO의 배아 발생 억제효과는 cGMP로 중재되는 경로나 apoptosis유발과는 관계가 없는 것 같다.

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Orchiectomy in the Asiatic Black Bear (Ursus thibetanus) (반달가슴곰에서 시행된 고환절제술)

  • Jeong, Dong-Hyuk;Lee, Seung-Yong;Yang, Jeong-Jin;Seok, Seong-Hoon;Kong, Ju-Yeon;Park, Se-Jin;Jin, So-Young;Kim, Min-Hyang;Lee, Bae-Keun;Lee, Hee-Chun;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
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    • v.32 no.4
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    • pp.363-365
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    • 2015
  • The Asiatic black bear (Ursus thibetanus) is globally protected species and involved in a species restoration program by the Korea National Park Service. However, the bears could not be released into the wild were required regulation of population due to the limited space of breeding facility, so surgical castration was performed in two males. Bears were immobilized with a combination of 2 mg/kg tiletamine-zolazepam and $40{\mu}g/kg$ medetomidine, and general anesthesia was maintained with isoflurane via endotracheal tube intubation. Orchiectomy was carried out by the closed method using the LigaSure vessel sealing device through pre-scrotal incision. Subcutaneous tissues of the incision site were sutured by continuous pattern with absorbable suture material, and the skin incision was closed with tissue glue. The bears recovered uneventfully from general anesthesia after a duration of 58 min (bear A) and 53 min (bear B). Total surgical time was 26 min (bear A) and 24 min (bear B). No postoperative swelling or complications were observed. This is the first report that describes the use of the LigaSure for orchiectomy in the Asiatic black bear.

Characteristics of teeth referred to a dental university hospital for endodontic reason (근관치료적 이유로 치과대학병원으로 의뢰된 치아들의 특성)

  • Jeon, Su-Jin;Hwang, Soo-Jeong;Seo, Min-Seock
    • Journal of Dental Rehabilitation and Applied Science
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    • v.35 no.3
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    • pp.143-152
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    • 2019
  • Purpose: The aim of this study is to investigate the characteristics of patients and teeth referred to a university dental hospital for endodontic problem. Materials and Methods: From January, 2017 to December, 2018, patients who were referred to a university dental hospital for endodontic problem were collected from clinical records. A total of 1171 patient records were analyzed. The status of the referred teeth was divided into three groups according to whether they were treated endodontically based on radiographs and clinical records at the time of referred visit. Results: 69.9% of the referred teeth were maxillary and mandibular first and second molars. The average time from referral to actual visit is 9.03 days and 65.6% of the case referred with referring letter. The most primary reasons of referral were persistent clinical symptom (pain, swelling, and sinus tract) (37.9%), diagnosis difficulty (16.7%), blockage of canal space (13.8%) and difficult tooth anatomy (11.4%). In the case of referral before endodontic treatment, the most primary reason of referral was failure to make a proper diagnosis. If the teeth were referred in the middle of endodontic treatment, the most primary reason of referral was persistent clinical symptom and blockage of canal space. In the case of referral after root canal filling, the most primary reason of referral was persistent clinical symptom. Conclusion: In the case of molars, the rate of persistent clinical symptom and blockage of canal space were the most primary reason of referral, and the rate of apical surgery and management of trauma was high in the case of anterior teeth.

Dental institution selection factors for implant surgery among young adults aged 20-64 years (임플란트 수술환자의 치과의료기관 선택요인: 청장년층 20~64세를 대상으로)

  • Bo-Young, Park;Yu-Bin, Oh;Jeong-Min, Kim;Chae-Rin, Kim;So-Ryung, Eo;Yu-Jin, Jang;Ju-Hyun, Choi;Mi-Suk, Yoon
    • Journal of Korean Dental Hygiene Science
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    • v.5 no.2
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    • pp.25-33
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    • 2022
  • Background: This study was aimed at investigating factors influencing the selection of dental institutions for implant surgery among young adults (age: 20-64 years) and identifying differences in these factors according to general characteristics. Methods: We conducted an internet survey for approximately 2 months, from April to July 2022, and analyzed data from a total of 128 people. Dental institution selection factors included three items of convenience of transportation, five items of physical environment, three items of image of institution, five items of image of dental staff, five items of dental service, and four items of basic dental elements. The importance score for each item was investigated on a five-point scale. Results: The importance score for each dental institution selection factor was the highest for dental service (4.42 points), followed by basic dental element (4.00 points), physical environment (3.89 points), image of institution (3.81 points), convenience of transportation (3.76 points), and image of dental staff (2.78 points). The importance score for each item was the highest for dentists' technique, followed by cleanliness, reliability, and dentists' attitude. Women had higher average scores for all factors compared to men, with statistical significance in scores for convenience of transportation, physical environment, image of institution, dental service, and basic dental elements (p< 0.05). Conclusion: To attract patients seeking implants to a dental institution, attention should be paid to the patients' institution selection factors. In addition, the environment of a dental institution should be created in such a way that it favors patients' selection factors.

Verification of the Protective Effect of Functional Shielding Cream for the Prevention of X-ray Low-dose Exposure (X-ray 저선량 피폭방지를 위한 기능성 차폐크림의 방어 효과 검증)

  • Seon-Chil Kim
    • Journal of the Korean Society of Radiology
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    • v.17 no.4
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    • pp.497-506
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    • 2023
  • In the case of radiation workers in medical institutions, radiation exposure is made for patient protection and accurate procedures, so they have a problem of low dose exposure. Low-dose radiation exposure occurs mainly in parts of the body other than the Apron area, and the most frequent place is the skin of the back of the hand. In particular, since the medical personnel's hands require senses and fine movements during the procedure, they are defenseless in the radiation exposure area and are at risk of exposure. It can solve the problem of shielding such as lead gloves, and it is difficult to use by suggesting the activity of the hand during the procedure. To solve this problem, a shielding cream capable of obtaining a functional radiation protection effect was developed and its shielding performance was compared with lead equivalent of 0.1 mmPb. In the process of manufacturing shielding cream, the shielding performance was improved by adding a defoaming process to reduce air holes to increase the density of the cream. Therefore, the shielding cream using barium sulfate as the main material has a lower shielding rate than the lead plate, and in the realm of effective energy, it is 59%, At high effective energy, a difference of about 37% was shown, indicating that there is a functional radiation protection effect. The advantage is that it can be used directly on the skin, and it is considered that it can be used before wearing surgical gloves and has a permanent protective effect.

Development of a Prediction Model for Fall Patients in the Main Diagnostic S Code Using Artificial Intelligence (인공지능을 이용한 주진단 S코드의 낙상환자 예측모델 개발)

  • Ye-Ji Park;Eun-Mee Choi;So-Hyeon Bang;Jin-Hyoung Jeong
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.16 no.6
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    • pp.526-532
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    • 2023
  • Falls are fatal accidents that occur more than 420,000 times a year worldwide. Therefore, to study patients with falls, we found the association between extrinsic injury codes and principal diagnosis S-codes of patients with falls, and developed a prediction model to predict extrinsic injury codes based on the data of principal diagnosis S-codes of patients with falls. In this study, we received two years of data from 2020 and 2021 from Institution A, located in Gangneung City, Gangwon Special Self-Governing Province, and extracted only the data from W00 to W19 of the extrinsic injury codes related to falls, and developed a prediction model using W01, W10, W13, and W18 of the extrinsic injury codes of falls, which had enough principal diagnosis S-codes to develop a prediction model. 80% of the data were categorized as training data and 20% as testing data. The model was developed using MLP (Multi-Layer Perceptron) with 6 variables (gender, age, principal diagnosis S-code, surgery, hospitalization, and alcohol consumption) in the input layer, 2 hidden layers with 64 nodes, and an output layer with 4 nodes for W01, W10, W13, and W18 exogenous damage codes using the softmax activation function. As a result of the training, the first training had an accuracy of 31.2%, but the 30th training had an accuracy of 87.5%, which confirmed the association between the fall extrinsic code and the main diagnosis S code of the fall patient.

Computed Tomography of the Left Atrium and Left Atrial Appendage: A Pictorial Essay on the Anatomy, Normal Variants, and Pathology (좌심방과 좌심방이의 전산화단층촬영 소견: 해부학, 정상변이 및 질환에 관한 임상화보 )

  • Minji Song; Sung Jin Kim;Hyun Jung Koo;Moon Young Kim;Jin Young Yoo
    • Journal of the Korean Society of Radiology
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    • v.81 no.2
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    • pp.272-289
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    • 2020
  • Current advances in CT techniques allow thorough evaluation of the beating heart. The strengths of cardiac CT relative to echocardiography and magnetic resonance imaging are its high availability in most institutions, rapid production of high-quality images, and outstanding delineation of the anatomy. For many normal variants and pathologic conditions, such as thrombi, masses, and congenital abnormalities of the left atrium, CT findings are sufficient to make a presumptive diagnosis. Assessments of the left atrium and left atrial appendage are particularly important for the management of atrial fibrillation, as various catheter-based procedures are aimed at the mechanical and electrical isolation of these structures. CT offers information crucial to a successful catheter-based procedure or surgery. Therefore, a comprehensive review of the geometry (shape, size, and relative position), along with various CT imaging features of pathologic states, should be provided in radiology reports to be of clinical value.

A Study on Recent Discussions ahout the Pysician's Explanation in Medical Litigation (의료소송에서 의사의 설명에 대한 최신 지견)

  • Baek, Kyounghee
    • The Korean Society of Law and Medicine
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    • v.24 no.4
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    • pp.37-63
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    • 2023
  • In medical litigation, there are various cases where a doctor's 'explanation' of a patient becomes problematic. Medical explanations and guidance are required from the doctor, starting from the beginning of diagnosis, through treatment processes such as surgery, when hospitalization is necessary for treatment, during hospitalization, upon discharge, and after discharge. Furthermore, notification from the doctor or medical institution may be requested regarding the economic costs that will be incurred due to medical treatment. South Korea's judiciary has been developing legal principles regarding such doctor's explanations by distinguishing between explanations for obtaining consent for medical treatment and medical explanations related to guidance on patient treatment methods, taking into account related laws such as the stage of treatment and the Medical Service Act. Additionally, the Constitutional Court recently ruled on the non-benefit cost notification system linked to the explanation of economic costs. However, holding a doctor accountable solely because the doctor's explanation was insufficient has aspects that do not correspond to the actual situation in clinical reality, and may have a reflexive disadvantage that results in a decline in legal rights. Therefore, the doctor's explanation needs to be examined from both perspectives: guaranteeing the patient's right to self-determination and protecting his or her right to decision.

Effect of Low Night Temperature on Reproductive Organ Development in Relation to Pollen Viability of Bell Pepper (야간 저온조건이 파프리카 화분 활력 및 생식기관 발달에 미치는 영향)

  • Lim, Chae-Shin
    • Journal of Life Science
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    • v.19 no.5
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    • pp.581-586
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    • 2009
  • Bell pepper plants (Capsicum annuum cv. Plenty) were grown under low night temperatures (LNT: day/night temperature of $28/13^{\circ}C$) and optimum night temperatures (ONT: day/night temperature of $28/20^{\circ}C$) in growth chambers. Pollen grains were collected from plants in the growth chamber and incubated at 10, 15, 20, 25, and $30^{\circ}C$. After 24 hr incubation, in both ONT and LNT, the highest percent pollen germinations were observed at $25^{\circ}C$ followed by germinations at $30^{\circ}C$. Percent pollen germination at $25^{\circ}C$ was 42% in ONT - two times higher than in LNT at 21%. Pollen tube length was much longer at ONT than at LNT, regardless of incubation temperature. Compared with other treatments, earlier and quicker pollen tube elongation was observed in ONT pollen grains incubated at $25^{\circ}C$. To find pollen viability in plant growing conditions, pollen grains were incubated in LNT ($28/13^{\circ}C$) and ONT ($28/20^{\circ}C$) growth chambers for 24 hr. Petri-dishes with pollen grains were put in the growth chambers at the beginning of the night condition. Pollen grains in the LNT growth chamber did not germinate at night ($13^{\circ}C$), but began to germinate when the day condition ($28^{\circ}C$) started. Pollen grains in the ONT condition, however, started germinating from the early night ($20^{\circ}C$) and germination continued during the day ($28^{\circ}C$). Plants in LNT showed increased flower stalk length, ovary diameter, stamen length, flower weight, and fruit length. LNT conditions did not impair seed set. There were no differences in seed sets between fruits at LNT and ONT. Normal seed sets in LNT show that fertilization may be completed during daytime. However, further investigation is needed to find what extent of temperature stress causes malformed and/or parthenocarpic fruits in this bell pepper.