• Journal of Oral Medicine and Pain
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• v.32 no.2
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• pp.187-200
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• 2007

This study attempted to contribute to the clinical application of implant operation by making a quantitative nerve examination using a neurometer for the evaluation of sensory disturbances that could be incurred after the implantation in the dental clinics, and it intended to establish an objective guideline in the evaluation of sensory nerve after the operation of implant. An inspection was performed with the frequencies of 2000Hz, 250 Hz and 5 Hz before and after the operations of tooth implant using $Neurometer^{(R)}$ CPT/C (Neurotron, Inc. Baltimore, Maryland, USA) for 44 patients who had performed an implant operation among the patients coming to Daejeon Sun Dental Hospital in 2006 and 30 people for control group. The measuring sites were maxillary nerve ending and mandibular nerve ending of trigeminal nerve according to the implant operating regions. The current perception threshold (CPT) by each nerve fiber was specifically responded under the electric stimulation of 2000 Hz in case of $A{\beta}$ fiber and of 250 Hz in case of $A{\delta}$ fiber and of 5Hz in case of C fiber. The CPT test could be performed to assess the damages of peripheral nerve in the trigeminal nerve area and it stimulated selective nerve fibers by generating the electricity of specific frequency in the peripheral nerve area. The nerve fibers with varied thickness were responsive selectively to the electric stimulation with different frequencies; accordingly, they applied the electric stimulation with different frequencies and the reaction threshold of $A{\beta},\;A{\delta}$ and C fibers selectively responsive to each electric current could be individually evaluated. In the assessment through the CPT, the increase and decrease of the CPT could be measured so that sensory disturbances such as hyperaesthesia or hypoaesthesia could be diagnosed. This study could obtain the following results after the assessment of the CPT before and after the implant operation. 1. In the assessment before and after the implant operation, the CPT in the frequencies of 2000 Hz, 250 Hz, 5 Hz for maxillary branch increased on the whole after the operation and the CPT for mandibular branch in the $A{\beta}$-fiber(2000 Hz) and C-fiber(5 Hz )after the operation increased statistically significantly. 2. For the groups of patients with medically compromised or its subsequent medicinal prescription, there were no significant differences before and after the implant operation and for the control groups, significantly high CPT was shown after the implant operation in the left $A{\beta}$-fiber(2000 Hz) and C-fiber(5 Hz). 3. In the comparison of the measured value of the CPT before the operation between the control group and the implant operation group, the latter group had a significantly high measured value of the CPT in the right $A{\beta}$-fiber(2000 Hz) and C-fiber(5 Hz) and there were significant differences in $A{\beta}$-fiber(2000 Hz) in the CPT assessment after the implant operation for the control group. 4. Male participants had higher CPT than female counterparts; however, there were no statistic significances. In the CPT evaluation before and after implant operation, there were no statistical differences in the male group while the right C-fiber(5 Hz) and left $A{\beta}$-fiber(2000Hz) were significantly high in the female group. 5. In the comparison between the group who complain sensory disturbance and the other group, the CPT increased on the whole in the former group, but there were no statistical significances. In the groups, whom there was an increase in VAS, the CPT after the implant operation in the right C-fiber(5 Hz) increased significantly; meanwhile, in case that the VAS mark was '0' before and after the operation, the CPT after the operation in the left $A{\beta}$-fiber(2000 Hz) increased significantly. This study suggested that the CPT measurements using $Neurometer^{(R)}$ CPT/C, provide useful information of objective and quantitative sensory disturbances for tooth implantation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.6
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• pp.421-429
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• 2003

Purpose : Neoadjuvant chemotherapy is commonly used to treat cancer patients as adjunct treatment, but if the microvascular tissue transfer is performed simulataneously with cancer resection surgery, the induction chemotherapy might affect the survival rate of vascularized free flap. Our study will focus on the effect of induction chemotherapy on the free flaps which were made on white rat abdomen after injection of 5-FU. Materials and Methods: The experimental rat groups were divided into three groups (total 24 rats) as a normal control group, 24 hrs group after 5-FU injection, 3 days group after 5-FU injection. Inferior abdominal island flaps of 8 Sprague Dawley rats on each group were made and immediately were induced into an ischemic state by clamping the supplying inferior epigastric artery and vein with microvascular clamp for a hour to induce a similiar free flap circumstance, then the inferior abdominal skin flaps were reperfused by releasing the clamps. The flaps on abdomen were repositioned and sutured. The experimental data for flap survival rate was collected by digital photo taking, analysed by computer image program to compare with the flap luminosity. The rats were sacrificed at 3 days, 5 days, 7 days after flap preparation and specimens of the flap were taken and stained with H-E staining. The microscopic finding was made under magnification of 200 and 400. Results: 1. Gross findings on each groups showed the healing condition was good as following sequences; normal, 24 hrs group after chemotherapy, 3 days group after chemotherpy. 2. The values of flap luminosity for evaluation of flap survival rate also showed the same sequences as gross findings of healing state. 3. The microscopic findings of epidermis necrosis, inflammation state, dermis fibrosis, vessel change, fatty tissue layer thinning were compared with each group. The 3 days group after chemotherapy showed remarkably poor healing condition compared to other groups. Conclusion: Chemotherapy agents affected the healing process of free flap, but healing condition was recovered spontaneously as post-injection periods passed out. In opposite to our expectation, 3 days group showed the bad flap condition in comparing with 24 hours group which was considered as immatured body circulation state of chemotherapy agent. It showed that 3 weeks in human being after chemotherapy was not proper as timing of microvascular tissue transfer if 3 days group in rat was considered as same healing period of 3 weeks in human being. More delayed healing timing than 3 weeks might be required in clinical application of free tissue transfer.

• Sim-seong Yeon-gu
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• v.37 no.2
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• pp.184-254
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• 2022

Through this thesis, the psychological meaning of the Korean folktale 'the servant who ruined the master's house' was examined. The opposition between the master and the servant is a universal matter of the human psychology. It can be seen as a conflict between the hardened existing collective consciousness and the new consciousness to compensate for and renew it. From different angles, it has become the opposition between man's spiritual and instinctive aspects, between the conscious and the unconscious, or between the ego and the shadow. In the folktale, the master tries several times to get rid of the youngest servant, but the servant uses tricks and wits to steal food, a horse, the youngest sister, and all money from the master, and finally, take his life. It ends with the marriage of the youngest sister and the servant. Enantiodromia, in which the master dies, and the servant becomes the new master, can be seen that the old collective consciousness is destroyed, and the new consciousness that has risen from the collective unconscious takes the dominant position. In an individual's psychological situation, it can be seen that the existing attitude of the ego is dissolved and transformed into a new attitude. In the middle of the story, the servant marries the youngest sister by exploiting naive people to rewrite the back letter written by the master to kill him. This aspect can be understood negatively in the moral concept of collective consciousness, but it can also be seen as a process of integrating mental elements that have been ignored in the collective consciousness of the Joseon Dynasty, symbolized by a woman, a honey seller, and a hungry Buddhist monk. The new consciousness, represented by the servant, has the characteristics of a trickster that is not bound by the existing frame, so it can encompass the psychological elements that have been ignored in the collective consciousness. Such element may represent compensation or an alternative to the collective consciousness in the late Joseon Dynasty. The master puts the servant in a leather bag and hangs it on a tree to kill the servant. However, the servant deceives a blind man; he opened his eyes while hanged. Instead of the servant, the blind man dies, and the servant is freed. As the problem of the conflict between master and servant is finally entrusted to the whole spirit (Self) symbolized by a tree, the blind man gets removed. It can be understood as an intention of the Self to distinguish and purify the elements of recklessness, stupidity, and greed included in the trickster. Through these processes, the servant, which symbolizes a new change in collective consciousness or a new attitude of ego, solves the existing problems and takes the place of the master. While listening to the cunning servant's performance, the audience feels a sense of joy and liberation. At the same time, in the part where the blind man and the master's family die instead and the servant becomes the master, they experience feelings of fear and concern about the danger and uncontrollability of the servant. The tricksters appearing in foreign analogies are also thoroughly selfish and make innocent beings deceive or die in order to satisfy their desires and escape from danger. Efforts to punish or reform these tricksters are futile and they run away. Therefore, this folktale can also be seen as having a purpose and meaning to let us know that this archetypal shadow is very dangerous and that consciousness cannot control or assimilate it, but only awe and contemplate it. Trickster is an irrational manifestation of revivifying natural energy that rises from the unconscious as a compensation for hardened existing structure and order. The phenomenon may be destructive and immoral from the standpoint of the existing collective mind, but it should be seen as a function of the collective unconscious, a more fundamental psychic function that cannot be morally defined. The servant, a figure of the trickster archetype, is a being that brings transformation and has the duality and contradiction of destructiveness and creativity. The endings of this folktale's analogies are diverse, reflecting the diversified response of the audience's mind due to the ambivalence of the trickster, and also suggesting various responses toward the problem of the trickster from the unconscious. It also shows that the trickster is a problem of inconclusive and controversial contradictions that cannot be controlled with a conscious rational attitude, and that we can only seriously contemplate the trickster archetype within us.