• Title/Summary/Keyword: 수술시기

Search Result 373, Processing Time 0.03 seconds

Investigation of the Earth Science Teacher Education Programs in the College of Education and their Improvement Plans (사범대학 지구과학 교사 양성 교육 과정 현황 분석 및 개선 방안 탐색)

  • Kim, Jong-Hee;Lee, Ki-Young
    • Journal of the Korean earth science society
    • /
    • v.27 no.4
    • /
    • pp.390-400
    • /
    • 2006
  • The purpose of this study is to propose an improvement plan based on an analysis of the current earth science teacher education curriculum in the department of education in the four fields of teaching profession theory: student-teacher practice, subject lesson education, and subject content education. The following are the conclusions and suggestions of this study. In case of teaching profession theory, too much emphasis is put on pedagogical theory over practical issues, and a problem arises upon completion. Therefore, it is sugguest that teaching profession theory might be completed before subject lesson education to ensure more authentic subjects performing teaching profession. The current term for student-teacher training is too short to understand the whole school system. Current school system does not have any off-job training course or internship system. Therefore, student-teacher training term should be increased by at least $3{\sim}6$ months to play a vital role in the current system. The credit number of subject lesson education is too small compared with subject content education. Consequently, the credit number of subject lesson education should be increased, and more professor majored in subject lesson education should be recruited. Significant deviation between the content of subject content education and that of middle school grade exists, and there is also much difference in the ratio of subject according to university. To get rid of these problems, subject content education should be connected with subject lesson education and appropriate number of credit needs to be assigned to each subject domain.

Analysis of alveolar molding effects in infants with bilateral cleft lip and palate when treated with pre-surgical naso-alveolar molding appliance (양측성 순구개열 신생아 환자의 수술전 비치조 정형장치 치료에 의한 치조골 조형(molding) 효과의 분석)

  • Nahm, Dong-Seok;Yang, Won-Sik;Baek, Seung-Hak;Kim, Sukwha
    • The korean journal of orthodontics
    • /
    • v.29 no.6 s.77
    • /
    • pp.649-661
    • /
    • 1999
  • The goals of this study were 1) to present pre-surgical naso-alveolar molding (PNAM) appliance for bilateral cleft lip and palate treatment and 2) to evaluate the effects of the PNAM appliance on the alveolar molding of the premaxilla and the lateral segments. Subjects consisted of 8 bilateral cleft lip and palate infants (7 males and 1 female, mean age at first visit = 61.6 days after birth) who were treated with PNAM appliances in Department of Orthodontics, Seoul National University Dental Hospital. Average alveolar cleft gap between the premaxilla and the lateral segment was $8.09{\pm}5.03mm$ and average duration of alveolar molding treatment was $8.8{\pm}3.1$ weeks. These patients' models were obtained at initial visit (T0) and after alveolar molding (T1). 20 linear and 14 angular variables were measured by using photometry and digital caliper, All statistical analyses were performed by Microsoft Excel 97 program. Paired t-test was used to discriminate the effect of alveolar molding by PNAM appliance. 1. Closure of the alveolar cleft gap in bilateral cleft cases by molding therapy was completed successfully, 2. Alveolar molding inhibited outward growth of lateral segments and produced inward bending of lateral segments. 3. By bending the anterior part of the vomer, the premaxilla could be rotated and moved. posteriorly via alveolar molding. Conclusion This appliance can be applied to bilateral cleft lip and palate infants with satisfactory results before cheiloplasty.

  • PDF

Effect of Ischemic Preconditioning for Preventing Ischemic Injury of the Spinal Cord (척추 신경의 허혈성 손상 예방을 위한 허혈성 전처치의 효과)

  • 홍종면;차성일;송우익;홍장수;임승운;임승운;임승평
    • Journal of Chest Surgery
    • /
    • v.34 no.11
    • /
    • pp.823-830
    • /
    • 2001
  • Background: Paraplegia is a serious complication of thoracic or thoracoabdominal aortic operations, which is related to ischemic injury of the spinal cord induced by low perfusion pressure during cross clamping of the aorta. Ischemic preconditioning of heart or brain with reversible sublethal ischemic injury induces resistance to subsequent lethal ischemia. The aim of this study is to investigate whether ischemic tolerance could be induced by the preconditioning of the spinal cord using swine model. Material and Method: The animals were randomly assigned to three groups: sham group(n=3), control group(n=6) and pre-conditioning group(n=8). In the sham group, we performed the left thoracotomy only without any ischemic injury. In the preconditioning group, the swine received reversible spinal cord ischemic injury by aortic clamping for 20 minutes, whereas control group had no previous aortic cross- clamping. Forty-eight hours later, the aorta was clamped for 30 minutes in both groups. Neurological examination was done 24 hours later, then the animals were euthanized for histopathology and malonedialdehyde(MDA) spectrophotometry assay of the spinal cord. Result: Statistically significant difference in neurological outcome was observed between the control and preconditioning groups at 24 hours after ischemic injury. The incidence of paraplegia and severe paresis was 100% in the control group, and 62.5% in the preconditing group(p=0.028). There was no statistically significant difference in histopathology and MDA assay of the ischemic spinal cord between these two groups with borderline statistical difference in MDA assay(p=0.0745). Conclusion: In the present swine study, ischemic preconditioning could induce tolerance against 30 minute ischemic insult of the spinal cord, although the animals did not completely recover(stand-up or walk). We expect that combining this preconditioning with other currently existing protection methods might lead to a synergistic effect, which warrants further investigation.

  • PDF

Human Lung Cancer Cell Xenografts Implanted under the Capsule of Kidney, Spleen and Liver (폐암 세포주를 사용한 신, 비장 및 간 피막하 분식법의 비교)

  • 김수현;김종인;이해영;조봉균;박성달;김송명
    • Journal of Chest Surgery
    • /
    • v.36 no.10
    • /
    • pp.711-720
    • /
    • 2003
  • Bakground : Complete resection by the surgery has been selected as the treatment of choice in lung cancer patients, but in cases of recurrence after excision or inoperable cases, the importance of anticancer chemotherapy has been emphasized. If one can select a set of the sensitive chemotherapeutic agents before anticancer chemotherapy, it will give more favourable results. Subrenal capsular assay has been recognized as a useful in-vivo chemosensitivity test of thoracic and abdominal tumors and it can be done in a short time for a rapid interpretation of tumor responsiveness to anticancer chemotherapeutic drugs. It has been reported that various kinds of cancer cells can be implantable to the kidney, but so far there is no comparative study of xenogeneic cell implantation on liver, spleen and kidney. The author implanted the human lung cancer cells under the capsule of S.D rat's liver, spleen and kidney respectively and compared the pattern of growth and histology. Material and Method: After incubation of human lung cancer cell line (SW-900 G IV) in RPMI 1640 (Leibovitz L-15 medium) culture media, 3${\times}$3${\times}$3 mm size fibrin clots which contain 108 cancer cells were made. Thereafter the fibrin clots were implanted at subcapsule area of liver, spleen and kidney of S.D. female rat. For immune suppression, cyclosporin-A (80 mg/Kg) was injected subcutaneously daily from post-implantation first day to sixth day. The body weight was measured at pre and post implantation periods. The growth pattern and the size of tumor mass were observed and the pathologic examination and serum tumor marker tests were performed. Result: Body weight increased in both of control and experimental groups. Serum Cyfra 21-1 was not detected. Serum levels of CEA and NSE revealed no significant change. The SCC-Ag increased significantly in implanted group. The growth rate of human lung cancer cells which was implanted on spleen was higher than on liver or kidney. The surface area, thickness, and volume of tumor mass were predominant at spleen. The success rates of implantation were 80% on kidney, 76.7% on spleen and 43.3% on liver. Pathologic examination of implanted tumors showed characteristic findings according to different organs. Tumors that were implanted on kidney grew in a round shape, small and regular pattern. In the spleen, tumors grew well and microscopic neovascularization and tumor thrombi were also found, but the growth pattern was irregular representing frequent daughter mass. Human lung cancer cells that were implanted in the liver, invaded to the liver parenchyme, and had low success rate of implantation. Microscopically, coagulation necrosis and myxoid fibrous lesion were observed. Conclusion: The success rate of implantation was highest in the kidney. And the mass revealed regular growth that could be measured easily. The SCC-Ag was presented earlier than CEA or Cyfra21-1. The Cyfra21-1 was not detected at early time after implantation. The best model for tumor implantation experiment for chemosensitivity test was subrenal capsular analysis than liver and spleen and the useful serum tumor marker in early period of implantation was the SCC-Ag.

Hematologic Changes and Factors Related to Postoperative Hemorrhage Following Cardiopulmonary Bypass (체외순환에 따른 혈액학적 변화와 술후 출혈에 관계하는 인자에 관한 연구)

  • 김하늘루;황윤호;최석철;최국렬;김승우;조광현
    • Journal of Chest Surgery
    • /
    • v.31 no.10
    • /
    • pp.952-963
    • /
    • 1998
  • Background: Cardiopulmonary bypass(CPB)-induced hemostatic defects may result increased possibility of excessive hemorrhage and additional multiple transfusion reactions or reoperation. Particularly, fibrinolytic activation and decreased platelet count and function by CPB were proposed as a predictor of hemorrhage during postoperative periods in several reports. Materials and methods: Present study, which was conducted in 20 adult patients undergoing CPB, was prospectively designed to examine the hematologic changes, including fibrinolytic activation during and after CPB and to clarify the relationships between these changes and the magnitude of the postoperative nonsurgical blood loss. The serial blood samples for measurment of hematologic parameters were taken during operation and postoperative periods. Blood loss was respectively counted via thoracic catheter drainage at postoperative 3, 6, 12, 24, 48 hours and total period. Results: The results were obtained as follows:Platelet count rapidly declined following CPB(p<0.01), which its decreasing rate was an inverse proportion to total bypass time(TBT, r=0.55, p=0.01), And platelet count in postoperative 7th day was barely near to its control value. Fibrinogen degradating product(FDP) and D-dimer level significantly increased during CPB(p<0.0001, p<0.0001, respectively), and both of fibrinogen and plasminogen concentration correlatively decreased during CPB(r=0.57, p<0.01), implying activation of fibrinolytic system. Postoperative bleeding time (BT), postoperative activated partial thromboplastin time(aPTT) and postoperative prothrombin time (PT) were significantly prolonged as compare with each control value (p=0.05, p<0.0001, p<0.0001, respectively). Total blood loss was positively correlated with patient's age, aortic clamping time (ACT) and TBT, while there was negative correlation between platelet count and blood loss at pre-CPB, CPB-off and the 1st postoperative day, and in some periods. Postoperative aPTT and postoperative PTwere positively related to postoperative 6 hr and 48 hr blood loss(r=0.53, p=0.02; r=0.43, p=0.05) but not to total blood loss, whereas there was no relationship between postoperative BT and blood loss at any period. Conclusions: These observations suggest that CPB results various hematologic changes, including fibrinolytic activation and severe reduction in platelet count. Diverse factors such as age, platelet count, ACT, TBT and postoperative aPTT and PT may magnify the postoperative bleeding. This study will be a basic reference in understanding CPB-induced hemostatic injuries and in decreasing the postoperative hemorrhage

  • PDF

Analysis of Patients with Mandibular Nerve Damage after Root Canal Therapy (근관치료 후 발생한 하악신경 손상 환자에 대한 분석)

  • Lee, Ji-Soo;Song, Ji-Hee;Kim, Young-Gun;Kim, Seong-Taek
    • Journal of Dental Rehabilitation and Applied Science
    • /
    • v.27 no.3
    • /
    • pp.327-336
    • /
    • 2011
  • Reported causes of mandibular nerve injury in relation to neuropathic pain in dentistry include extraction, dental implant surgery, oral and maxillofacial surgery, periodontal treatment, and root-canal therapy. This study analyzed the characteristics of pharmacologic management of neuropathy after root-canal therapy. 32 patients who complain of abnormal sensation or pain after root-canal therapy and were referred to Department of Oral Medicine and the Temporomandibular Joint and Orofacial Pain Clinic at the Dental Hospital of Yonsei University, Seoul, Korea from 2004 to 2011 enrolled in this analysis and improvement of symptom was evaluated after pharmacologic management. Thirty-two patients who had hypoesthesia or dysesthesia at the initial visit were analyzed(9 men, 23 women; mean age: 44 years). The causes of neuropathy were local anesthesia(46.9%), chemical trauma from the sealant in root-canal(25%), endodontic surgery(15.6%), and unknown causes(12.5%). Medications such as steroids, anticonvulsants, antidepressants, and analgesics were took for improvement of symptoms and titrated for a variety of period from 1 week to 11 months. It was found that neuropathy of the inferior alveolar nerve and the lingual nerve was in 25 and 7 patients. The improvement of neurosensory disturbance and no improvement after pharmacotherapy was in 21(66%) and 11(34%) patients respectively. The hypoesthesia and dysesthesia was improved 67% and 65% respectively. These results suggest that symptomatic improvement by pharmacologic management can be possible in patients with neuropathy after root-canal therapy. But improvement of symptoms was influenced by the causes and degree of nerve injury, the periods of pharmacotherapy, and the choice of treatment methods. So, further investigation is needed by quantitative measurement of more variables in more individuals.

Arthroscopic Treatment of Septic Knee Arthritis in Old Aged Group: Prognostic Factor (50세 이상에서 발생된 화농성 슬관절염의 관절경적 치료: 예후 인자)

  • Lee, Dong-Chul;Shon, Oog-Jin;Kong, Byung-Sic
    • Journal of the Korean Arthroscopy Society
    • /
    • v.14 no.2
    • /
    • pp.114-119
    • /
    • 2010
  • Purpose: The purpose of this study was to assess the result of arthroscopic treatment in septic knee arthritis and evaluate the prognostic factor over 50 years old. Materials and Methods: Fifty-two patients were treated by arthroscope for septic knee arthritis from January, 2002 to August, 2005. The mean follow-up period was 27.5months. We assessed Lysholm score as functional result, CRP normalized period as laboratory result, and knee range of motion as clinical result. We evaluated patient's age, underlying disease, causative organism, previous knee status (Kellgren stage), clinical status of septic arthritis (G$\ddot{a}$chter stage) and history of intra-articular injection as prognostic factor. Results: Mean Lysholm score was improved from 40.7 to 67.1. And the mean CRP normalized period was 38.7days. At last follow-up, almost patient (92%) were recovered to prior knee full range of motion and 45 patient (74%) were completely cured by one stage operation. The microorganism isolated were MSSA (n=13), MSSE (n=3), MRSA/MRSE (n=4),no microorganism (n=27) and others (n=5). In Lysholm score, young age (42.8(preop.)$\rightarrow$83.5(postop.)), Kellgren stage 0 ($45.5{\rightarrow}84.2$), G$\ddot{a}$chter stage I ($39.3{\rightarrow}73.1$) and no microorganism (442.1{\rightarrow}72.6$) were more increased than old age (439.3{\rightarrow}61.7$), Kellgren IV ($28.3{\rightarrow}43.7$), G$\ddot{a}$chter stage IV ($40.2{\rightarrow}67.1$) and MRSA/MRSE ($40{\rightarrow}58.75$). In case of old age (42.3days), G$\ddot{a}$chter stage IV (55.5), Kellgren stage IV(43.7), DM patient (42.1) and intra-articular injection history (52.1), the CRP titer normalized period was longer than mean period. MRSA/MRSE(n=3,75%) were not normalized in CRP titer at last follow-up. Conclusion: Arthroscopic treatment of septic knee would be an effective and satisfactory procedure. Age, previous knee status (Kellgren stage), underlying disease (DM), intra-articular injection history, microorganism and Ga¨chter stage effect end result outcome.

  • PDF

An Immunological Study Before and After Tonsillectomy (편도적출 전 후의 면역학적 연구)

  • 김순웅;윤병용;김순호
    • Proceedings of the KOR-BRONCHOESO Conference
    • /
    • 1982.05a
    • /
    • pp.16.2-16
    • /
    • 1982
  • The palatine tonsils which are located in entrance of digestive and upper respiratory tracts are the most important organ in anatomical and functional structures of the pharyngeal lymphatic tissues. As for function of the tonsil, there have been many suspected theories that were included hematopoietic, hormonal, digestive function and production of vitamin, entry of bacteria with other antigenous materials and defence mechanism of which has taken charge by Virchow in 1860 in past. But among these theories, in recently, defence mechanism of the tonsil was strongly accepted immunologically. For the purpose of elucidating immune response of the tonsil, the author observed serum immunoglobulin levels, peripheral total lymphocyte counts and populations of T, B and Null lymphocytes before and after tonsillectomy in 30 cases of patients with chronic tonsillitis and 29 cases of healthy controls. The results obtained were as follows; 1) Serum Ig M level was significantly higher in patient group than in control group but was not significantly different preoperative from postoperative patient group. 2) Population of T-lymphocyte more significantly decreased in patient group than in control group but it was not significantly different preoperative from postoperative patient group. 3) Population of B-lymphocyte more significiantly increased in patient group than in control group but it was not significantly different preoperative from postoperative patient group. On the basis of these results, it may be suggested that tonsil play partially a role in the immune response of human.

  • PDF

Internal Fixation of Proximal Humerus Fracture with Polyaxial Angular Stable Locking Compression Plate in Patients Older Than 65 Years (65세 이상의 상완골 근위부 골절 환자에서 다축 각안정 잠김 압박 금속판을 이용한 내고정술)

  • Lee, Ki-Won;Choi, Young-Joon;Ahn, Hyung-Sun;Kim, Chung-Hwan;Hwang, Jae-Kwang;Kang, Jeong-Ho;Choo, Han-Ho;Park, Jun-Seok;Kim, Tae-Kyung
    • Clinics in Shoulder and Elbow
    • /
    • v.15 no.1
    • /
    • pp.25-31
    • /
    • 2012
  • Purpose: The clinical and radiographic outcomes of the internal fixation, which were executed on patients over the age of 65 with proximal humerus fracture by using a polyaxial angular stable locking compression plate (Non-Contact-Bridging proximal humerus plate, Zimmer, Switzerland, NCB), were evaluated. Materials and Methods: Thirty two patients over the age of 65 among the proximal humerus fracture treated with NCB plate, between August 2007 and January 2011, were chosen as the subjects. The average age of patients was 71 years, and the average postoperative follow-up period was 11.5 months. The fractures included 14 two-part and 18 three-part fractures. The clinical results were evaluated, using the visual analog scale (VAS) score and the Constant score. The radiological results were evaluated by time to union and Paavolainen method, which measures the neck shaft angle. Results: At the last follow-up examination, the mean VAS score was 3 points and the mean Constant score was 64.5 points, with bone union achieved after the average of 16.2 weeks following the surgery in all the cases. The mean neck shaft angle was 125.9 and 24 cases had good results, while 8 cases had fair results by Paavolainen method, at the last follow-up. There were 1 case of delayed union and cerclage wire failure, and 3 cases of subacromial impingement. There were no complications, such as loss of reduction, nonunion, screw loosening, or avascular necrosis of the humeral head. Conclusion: Internal fixation, using a NCB plate, was considered to be an effective surgical method in treating proximal humerus fracture in the elderly patients, on whom the fixation of the fracture and maintenance of reduction are difficult.

Modified Blalock-Taussig Shunt for the Patients with Complex Congenital Heart Defects in Early Infancy (조기 영아기에 시행된 복합 심기형 환자들에서의 변형 Blalock-Taussig 단락술)

  • Lim Hong Gook;Kim Woong-Han;Hwang Seong Wook;Lee Cheul;Kim Chong Whan;Lee Chang-Ha
    • Journal of Chest Surgery
    • /
    • v.38 no.5 s.250
    • /
    • pp.335-348
    • /
    • 2005
  • Background: This retrospective review examines the preoperative condition, postoperative course, mortality and cause of death for the patients who underwent modified Blalock-Taussig shunt for complex congenital heart defects in early infancy. Material and Method: Fifty eight patients underwent modified Blalock-Taussig shunts from January 2000 to November 2003. The mean age at operation was $23.1\pm16.2$ days ($5\~81\;days$), and the mean body weight was $3.4\pm0.7\;kg\;(2.1\~4.3\;kg)$. Indications for surgery were pulmonary atresia with ventricular septal defect in 12 cases, pulmonary atresia with intact ventricular septum in 17, single ventricle (SV) in 18, and hypoplastic left heart syndrome (HLHS) in 11. Total anomalous pulmonary venous return (TAPVR) was associated with SV in 4 cases. Result: There were 11 ($19.0\%$) early, and 5 ($10.6\%$) late deaths. Causes of early death included low cardiac output in 9, arrhythmia in 1, and multiorgan failure in 1. Late deaths resulted from pneumonia in 2, hypoxia in 1, and sepsis in 1. Risk factors influencing mortality were preoperative pulmonary hypertension, metabolic acidosis, use of cardiopulmonary bypass, HLHS and TAPVR. Twenty four patients ($41.4\%$) had hemodynamic instability during the 48 postoperative-hours. Six patients underwent shunt revision for occlusion, and 1 shunt division for pulmonary overflow. Conclusion: Modified Blalock-Taussig shunt for complex congenital heart defects in early infancy had satisfactory results except in high risk groups. Many patients had early postoperative hemodynamic instability, which means that continuous close observation and management are mandatory in this period. Aggressive management may appear warranted based on understanding of hemodynamic changes for high risk groups.