• Journal of Hospice and Palliative Care
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• v.5 no.1
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• pp.24-30
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• 2002

Background : Pain is one of the most feared consequences of cancer. $65{\sim}85%$ of cancer patients experienced severe pain, and sometimes high dose morphine is used to these patients. But many doctors still have 'opioid-phobia' and hesitate to use high dose morphine. We investigated the morphine therapy in terminal cancer patients during the last 1 week to death, and found any differences according to the morphine dosage. Methods : 93 patients admitted to National Health Insurance Corporation Ilsan Hospital, department of family medicine for hospice care between September 2000 and the end of October 2001 and lived more than 1 week entered in the study. We investigated the demographic data, laboratory tests and sufficient dosage of morphine for pain control. According to the calculated dosage by OME(oral morphine equivalent), patients were divided into low dosage group (${\leq}150mg/day$) and high dosage group (>150 mg/day). The chi-squared test were used to evaluate the influence of age, gender, tumor sites, metastasis and adverse effects of morphine. Results : Mean age was $65.0{\pm}13.1year$ in low dosage group and $59.9{\pm}11.6year$ in high dosage group. 32 men (50.0%) and 32 women (50.0%) were included in low dosage group and 15 men (51.7%) and 14 women (48.3%) in high dosage group. Stomach was the most frequent tumor site and lung was the next. Metastasis were found 58 (90.6%) in low dosage group and 28 (96.6%) in high dosage group. In other palliative radiotherapy and adverse effects, there were no differences in both group. Conclusion : During the last 1 week to death in cancer patients, there were no difference according to the morphine dosage. So we don't have to have 'opioid-phobia' in treating the terminal cancer patients.

• Journal of Hospice and Palliative Care
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• v.14 no.2
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• pp.91-100
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• 2011

Purpose: This study was performed to investigate patients' preferences on receiving life-sustaining treatments (LST) and to analyze the relationship between patients' characteristics and LST selection. We also examined any discrepancy between LST patients' choices regarding medical intervention and actual medical intervention given/not given within 48 hours before death. Methods: This cross-sectional study was performed from March 1, 2008 to August 31, 2008 in the Palliative Care Unit of Korea University Hospital. Electric medical records (EMR) of 102 hospice cancer patients were reviewed, and 74 patients with Glasgow coma scale (GCS) ${\geq}$10 at the time of signing the advance medical directives (AMD) were selected for the first analysis. Then, patients alive at the end of this study, transferred to other hospitals or dead within 48 hours were excluded, and the remaining 42 patients were selected for the second analysis. Results: Preferred LST included antibiotics, total parenteral nutrition, tube feeding, transfusion, and laboratory and imaging studies. The relationship between patients' characteristics and LST could not be analyzed due to skewed preferences. LST chosen at the time of signing the AMD and actual medical intervention given/not given in the last 48 hours showed discrepancy in most cases. Conclusion: When making AMD in hospice cancer patients, it is important to consider the time and possibility of changing the choices. Above all, patients must fully understand the AMD. Thus, LST should always be provided with careful consideration of all possibilities, because legal and social aspects of AMD have not been established yet.

• Korean Journal of Agricultural and Forest Meteorology
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• v.5 no.2
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• pp.61-69
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• 2003

Surface energy and $CO_2$ fluxes have been measured over a farmland in Haenam, Korea since July 2002. Eddy covariance technique, which is the only direct flux measurement method, was employed to quantitatively understand the interaction between the farmland ecosystem and the atmospheric boundary layer. Maintenance of eddy covariance system was the main concern during the early stage of measurement to minimize gaps and uncertainties in the dataset. Half-hourly averaged $CO_2$ concentration showed distinct diurnal and seasonal variations, which were closely related to changes in net ecosystem exchange (NEE) of $CO_2$. Daytime maximum $CO_2$ uptake was about -1.0 mg $CO_2$ m$^{-2}$ s$^{-1}$ in August whereas nighttime $CO_2$ release was up to 0.3 mg $CO_2$ m$^{-2}$ s$^{-1}$ during the summer. Both daytime $CO_2$ uptake and nighttime release decreased gradually with season. During the winter season, NEE was from near zero to 0.05 mg $CO_2$ m$^{-2}$ s$^{-1}$ . FK site was a moderate sink of atmospheric $CO_2$ until September with daily NEE of 22 g $CO_2$ m$^{-2}$ d$^{-1}$ . In October, it became a weak source of $CO_2$ with an emission rate of 2 g $CO_2$ m$^{-2}$ d$^{-1}$ . Long-term flux measurements will continue at FK site to further investigate inter-annual variability in NEE. to better understand these exchange mechanism and in-depth analysis, process-level field experiments and intensive short-term intercomparisons are also expected to be followed.

• The Journal of the Korea Contents Association
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• v.11 no.5
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• pp.252-259
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• 2011

To identify the effects of the application of the adaptive statistical iterative reconstruction (ASIR) technique in combination with the other two factors of body mass Index (BMI) and tube potential on radiation dose in cardiac CT. The patient receiving operation the cardiac CT examination was divided four groups into according to kVp.[A group(n=20), Non-ASIR, BMI < 25, 100 kVp; B group(n=20), Non-ASIR, BMI > 25, 120 kVp; C group(n=20), 40% ASIR BMI < 25, 100 kVp; D group(n=20), 40% ASIR, BMI > 25, 120 kVp] After setting up the region of interest in the main artery central part and right coronary artery and left anterior descending artery, the CT number was measured and an average and standard deviation were analyzed. There were A group and the difference which the image noise notes statistically between C. And A group was high so that the noise could note than C group (group A, 494 ${\pm}$ 32 HU; group C, 482 ${\pm}$ 48 HU: P<0.05) In addition, there were B group and the difference noted statistically between D. And B group was high so that the noise could note than D group (group B, 510 ${\pm}$ 45 HU; group D, 480 ${\pm}$ 82 HU: P<0.05). In the qualitative analysis of an image, there was no difference (p>0.05) which a group, B group, C group, and D as to average, A group 4.13${\pm}$0.2, B group 4.18${\pm}$0.1, and C group 4.1${\pm}$0.2 and D group note statistically altogether with 4.15${\pm}$0.1 as a result of making the clinical evaluation according to the coronary artery segments. And the inappropriate image was shown to the diagnosis in all groups. As to the radiation dose, a group 8.6${\pm}$0.9 and B group 14.9${\pm}$0.4 and C group 5.8${\pm}$0.5 and D group are 10.1${\pm}$0.6 mSv.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.1
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• pp.59-72
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• 2000

In this study, the rate of bone formation and the pattern of bone to implant contact surface around HA coated implant and pure Ti implant inserted into the irradiated tibia of rabbit were compared. Sixteen mongrel mature male rabbits were used as experimental animal. Each rabbit received 15 Gy of irradiation. Four weeks after irradiation, two holes were prepared on the tibia of each rabbit for placement of HA coated type and pure Ti type implants. Prior to implant placement, one group received steroid irrigation and the control group was similarly irrigated with normal saline. This was immediately followed by placement of the two different types of implants. Postoperatively, tetracycline was injected intramuscularly for 3 days. For fluorescent labelling, 3 days of intramuscular alizarine red injection was given. 2 weeks before sacrifice, followed by intramuscular calcein green on the last 3 days before specimen collection. Each rabbit was sacrificed on the second, fourth, sixth and eighth week after the implantation. The specimens were observed by the light microscope and the fluorescent microscope. The results were as follows; 1. All implants inserted into the irradiated tibia of rabbit were free from clinical mobility and no signs of bony resorption were noted around the site of implant placement. 2. Under the light microscope, new bone formation proceeded faster around implants that received steroid irrigation compared to the control group irrigated with saline. Bone to implant contact surface was greater in the steroid irrigated group than the saline irrigated group. Therefore, better initial stabilization was observed in the group pretreated with steroid irrigation. 3. Under the light microscope. HA coated implants showed broader bone to implant contact surface than pure Ti implants, and HA coated implants had better bone healing pattern than pure Ti implants. 4. In the steroid pretreated group, acceleration of bone formation was demonstrated by fluorescent microscopy around the 2, 4 weeks group and the 6 weeks HA coated implant group. The difference in the rate of bone formation proved to be statistically significant(P<0.05). Faster bone formation was noted in the saline irrigated group in the 6 weeks pure Ti implants and 8 weeks group. The difference was not statistically significant(P<0.05). 5. For the rabbits that were sacrificed on the second and fourth week after the implant placements, the rates of bone formation around HA coated implants proceeded faster than those around pure Ti implants under the fluorescent microscopy. For the rabbits that were sacrificed on the sixth week after the implant placements, the rates of bone formation around pure Ti implants proceeded faster than those around HA coated implants under the fluorescent microscopy. But this result did not show statistical significance (P<0.05) For the rabbits that were sacrificed on the eighth week after the implant placements, the rates of bone formation around HA coated implants proceeded faster than those around pure Ti implants under the fluorescent microscopy. This result was statistically significant (P<0.05).

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.3
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• pp.301-311
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• 2009

Statement of problem: Flapless implant surgery using a soft tissue punch device requires a circumferential excision of the mucosa at the implant site. To date, Although there have been several reports on clinical outcomes of flapless implant surgeries, there are no published reports that address the appropriate size of the soft tissue punch for peri-implant tissue healing. Purpose: In an attempt to help produce guidelines for the use of soft tissue punches, this animal study was undertaken to examine the effect of soft tissue punch size on the healing of peri-implant tissue in a canine mandible model. Material and methods: Bilateral, edentulated, flat alveolar ridges were created in the mandibles of six mongrel dogs. After a three month healing period, three fixtures (diameter, 4.0 mm) were placed on each side of the mandible using 3 mm, 4 mm, or 5 mm soft tissue punches. During subsequent healing periods, the peri-implant mucosa was evaluated using clinical, radiological, and histometric parameters, which included Gingival Index, bleeding on probing, probing pocket depth, marginal bone loss, and vertical dimension measurements of the peri-implant tissues. Results: The results showed significant differences (P <0.05) between the 3 mm, 4 mm and 5 mm tissue punch groups for the length of the junctional epithelium, probing depth, and marginal bone loss during healing periods after implant placement. When the mucosa was punched with a 3 mm tissue punch, the length of the junctional epithelium was shorter, the probing depth was shallower, and less crestal bone loss occurred than when using a tissue punch with a diameter $\geq$ 4 mm. Conclusion: Within the limit of this study, the size of the soft tissue punch plays an important role in achieving optimal healing. Our findings support the use of tissue punch that 1 mm smaller than implant itself to obtain better peri-implant tissue healing around flapless implants.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.4
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• pp.628-633
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• 2005

Deep caries in primary molars without early intervention frequently induce a pulpal disease and consequent furcation lesion with fistulous openings Up to now, majority of the textbooks on pediatric dentistry and literatures have described that extraction of the inflicted teeth is indicated for these cases and in reality these teeth have usually been extracted in the dental clinics. However when we recognize the excellent capacity of bone regeneration in children and the presence of numerous accessory canals at furcation areas, the removal of infection source in pulp by pulpectomy and inflammatory granulation tissues at furcation areas by furcal curettage might open the possibility of rapid healing at the furcation regions. In this report, 10 cases of primary molars in 3 to 6-year-old children with fistulous openings and furcation lesions in moderate size of 2 to 4mm in depth radiolucency at furcation lesion have been chosen. After pulpectomy and furcal curettage, evident bone regeneration was detected radiographically in all cases. Through the cases, we came to realize that all the cases previously described are not the indications of extraction and this approach could make many cases with pulp and furca combined lesions survive and remain healthy in the children's dental arches. However, in order for this approach to acquire objective appropriateness, it is thought that more scrupulous evaluation is desirable on the various factors regarding the indication such as the extent of furcation lesions, absorption status of teeth, amount of covering bone on succeeding teeth and so on.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.2
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• pp.169-179
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• 2004

The purpose of this study was to discriminate clinically and radiographically among the three groups of dentigerous cysts studied. First, Group I, involved area of dentigerous cyst was successive permanent tooth area beneath deciduous tooth. Second, Group II, involved permanent molar area, and the last, Group III involved maxillary anterior supernumerary tooth area. The author observed and compared the clinico-radiographic features of 49 cases of Group I, 36 cases of Group II, and 15 cases of Group III of dentigerous cyst and this observation and comparison had been done by based on the charts and panoramic films. The obtained results were as follows: 1. The cases of Group I were 29 cases and, those of Group II were 36 and those of Group III were 15. 2. The incidence of dentigerous cyst is high in first decade. In Group I, before first decade and early first decade was 87.8%, in Group II and Group III, was discovered more lately. 3. The frequency of dentigerous cyst is 2.5 times higher in male than in female. 4. The sequence of chief complaint was swelling(50%), routine examination(32%), and pain(9%). 5. When considering the type of the cyst, lateral type is many most in Group I (71.4%) and central type is many most in Group II (94.4%) and Group III (100%). 6. The most size of dentigerous cyst was 2 crown size in Group I, 1 crown size in Group II, above of 4 crown size in Group III. 7. Almost involved teeth showed displacement and some tooth of displaced teeth showed delayed root development and dilaceration of root. 8. The most many response of alveolar bone was buccal bone expansion in Group I (67.3%), no bone expansion in Group II(66.7%) and palatal bone expansion in Group III (60.0%). 9. The percentage of involved teeth were as follows : The mandibular third molar was 31% and many most. The mandibular second premolar was 30%. Mesiodens of maxillary anterior area was 15%. The maxillary canine was 8%. The mandibular first premolar was 5%. 10. In the Group I, causes suggesting of dentigeous cyst are pulpotomized deciduous tooth(59.2%), severe dental caries of deciduous tooth, untreated traumatic history on the deciduous tooth etc. 11. The treatment method of dentigerous was marsupialization in 61.2% of cases of Group I and that was enucleation in 61.1% of cases of Group II and in 80.0% of cases of Group III.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.1
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• pp.90-96
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• 2012

Supernumerary tooth occurs most frequently at premaxilla area. Followed by mandibular premolar area, mandibular fourth molar area, maxillary paramolar area. Mesiodens are mainly impacted in the palatal area and surgical approach is made at palatal side. The time of surgery remains controversial. In case of inverted or horizontal impacted supernumerary tooth, intraosseous tooth movement and vertical growth of premaxilla makes surgical extraction more difficult. And also the more quantity of removed bone is, the higher degree of difficulty is. Inverted mesiodens of these cases were impacted superior to apex level of adjacent permanent incisor. Although CT examination revealed exact location of impacted tooth, surgical procedure including ostectomy may take a long time more than expected. So, before surgical extraction, it's need to be considered several factors such as necessity of CT taking, degree of difficulty, direction of surgical approach, necessity of general anesthesia etc.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.3
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• pp.317-327
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• 2010

Among the permanent teeth, the first permanent molars play the greatest role in occlusion and function. So, early diagnosis for congenital missing, abnormal eruption and abnormal formation is very important to the first permanent molars in the course of arch development. The aim of this study is to analyse the differences between right and left first permanent molar's formation and eruption and between upper and lower one. A total of 545 children were selected am ong children who had visited our clinic, investigate eruption and calcification stage of permanent first molar, based on Gleiser and Hunt criteria for this study. 1. Gingival emergence of mandibular first molar is faster than maxillary first molar by 0.75~0.8 years, gingival emergence of maxillary first molar in girls faster than boys by 0.45 years, and that of mandibular first molar in girls faster than boys by 0.5 years. 2. There is the significant difference between right and left first molar on the eruption score and the calcification stage ; 5 year old children show the significant difference on the eruption score. 7 year old children show the significant difference on both the eruption score and calcification stage. 3. It shows the most active eruption movement of crown on the maxilla while the root is rapidly widening its furcation and completing root formation to 2/3, on the other hand, the most active crown emerging on mandible is shown when the root formation completed to 1/4 to 1/2.