• Journal of Dental Rehabilitation and Applied Science
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• v.34 no.4
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• pp.306-316
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• 2018

Monolithic zirconia has been widely used in fixed partial dentures due to high strength and fracture toughness. Nevertheless, the usage of monolithic zirconia in anterior restoration was limited because of opacity. Recently, esthetic monolithic zirconia blocks are developed by improving translucency and using various shading systems. Manufacturer introduces 3M $Lava^{TM}$ Esthetic with increased cubic phase and fluorescent ingredients is more esthetic than previous monolithic zirconia. This case report describes favorable anterior restorations using translucent monolithic zirconia.

• Journal of Chest Surgery
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• v.40 no.10
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• pp.685-690
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• 2007

Background: In the past, radiotherapy was the gold standard for the treatment of upper esophageal cancer, but the long-term follow-up was disappointing. There is still ongoing debate on the surgical management of these patients. This study was undertaker to update our experience with upper esophageal carcinoma and to evaluate the effectiveness of surgery. Material and Method: From May 1995 to December 2005, 147 patients with esophageal cancer underwent surgery at our hospital. They were divided into two groups: one group consisted of 23 patients with upper esophageal (cervical and upper thoracic) cancer and another group consisted of 424 patients with lower esophageal (middle thoracic, lower thoracic and abdominal) cancer. We evaluated the effectiveness of surgical treatment between the 2 groups by measuring the rate of complete surgical resection, the postoperative complications, the postoperative mortality, tumor recurrence, the average life expectancy and the long-term survival. Result: On comparing both groups, there was no significant difference in the distribution of the pathological stage and no significant difference in the percentage of performing complete surgical resection. The percentage of post-operative complications was 39.1% (9 out of 23 patients) in the upper esophageal cancer group, and this was significantly higher than 16.9% (21 out of 124 patients) in the lower esophageal cancer group (p<0.05). However, there was no significant statistical difference between the groups for the percentages of postoperative mortality, tumor recurrence or the postoperative average life expectancy. Conclusion: There was no significant difference in operative mortality or surgical effectiveness between the 2 groups. Therefore, we thought that surgical treatment is also effective for treating upper esophageal cancer, but further investigation with large patient populations will be required.

• The Journal of Pediatrics of Korean Medicine
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• v.15 no.1
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• pp.261-265
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• 2001

소아의 소화성궤양은 소아 소화계질환 중에서 발병율이 점차 늘어나고 있는 추세에 있다. 최근 소아과에서 내시경의 활용이 활발해지면서 장기적으로 반복하여 위완통(胃脘痛), 변혈 (便血)및 구혈(嘔血)이 나타나는 경우 궤양성질환의 가능성이 높은 것으로 밝혀지고 있다. 본원에서는 유명한 중의사 왕붕비(王鵬飛) 교수의 비완통(脾脘痛) 치험방을 토대로 많은 임상을 거쳐 위평충제(胃平沖劑)를 개발하여 1992년6월부터 1997년12월까지 위내시경 검사를 통하여 위궤양으로 진단된 98명의 소아환자에게 투여하여 관찰한 바 만족스러운 효과가 나타나 이를 보고한다. 위평충제(胃平衝劑)의 처방구성은 자초(紫草), 청대(靑黛), 곽향(藿香), 유향(乳香), 회향(茴香), 정향(丁香), 황련(黃連), 적석지(赤石脂), 황정(黃精) 등이다. 한의학적 이론에 따르면 불규칙하고 자극성이 강한 음식섭취 습관은 비위(脾胃)를 손상시켜 중주(中州)를 옹체(壅滯)시키므로 기(氣)의 원활한 소통이 이루어지지 않으면 부통즉통(不通卽痛)의 기전으로 발전한다. 또한 근래 소아들이 각종 정신적인 압박으로 스트레스가 쌓이면서 간기울결(肝氣鬱結)을 초래하여 울화(鬱火)로 인하여 혈락(血絡)이 손상되면서 출혈증상이 나타난다. 왕교수의 견해에 따르면 체내에 어혈이 제거되지 않으면 기혈(氣血)의 순환이 더욱 악화되어 어적(瘀積)이나 궤양 또는 경새(梗塞) 등을 일으키게 된다고 하였다. 따라서 위평충제(胃平沖劑)는 활혈화어(活血化瘀), 청열해독(淸熱解毒)과 더불어 익기양위(益氣養胃), 거어지통(祛瘀止痛)의 효능이 있는 약물들로 구성되었다. 동물실험에서 위평충제(胃平衝劑)는 궤양표면을 보호하고 치유하며 재발을 방지하는 효과가 있는 것으로 확인되었고, 위액의 분비, 위단백질효소의 활성에 대한 억제 및 진통효과도 있는 것으로 입증되었다.행하여 사용하는 것이 바람직하며, 단순한 중약 투여는 일부 양약에 의한 소아성장에 미치는 영향을 피할 수 있어 더 많은 임상연구가 이어져야 한다.(當歸) 목단피(牧丹皮) 울김(鬱金) 정력자(?歷子) 세신(細辛) 오미자(五味子) 구기자(枸杞子) 산수황육(山茱黃肉) 황기(黃?) 감초(甘草) 등을 기본적으로 사용한다. 비신양허형(脾腎陽虛型)은 온보비신(溫補脾腎) 화어척담(化瘀滌痰)을 원칙으로 하며, 처방에는 구마황( 灸麻黃) 세신(細辛) 오미자(五味子) 당귀(當歸) 단삼(丹蔘) 울김(鬱金) 정력자(?歷子) 반하(半夏) 보골지(補骨脂) 선령비(仙靈脾) 태자삼(太子蔘) 황기(黃?) 감초(甘草) 등을 기본적으로 사용한다. 치험(治驗): (1) 천식의 실증(實證)은 치료를 한 뒤 완화단계에 접어들면서 허증(虛證)으로 전화되는데, 허천(虛喘)도 역시 천식이니 만큼 단순히 보법(補法)만 사용하여서는 안된다. 시종일관 천식치료에는 척담화어(滌痰化瘀)의 원칙을 지켜야 한다. 폐내(肺內)의 담어(痰瘀)가 철저하게 제거되어야 폐(肺)의 순환기능을 개선시켜 기도(氣道)의 염증을 신속히 흡수하고 치유할 수 있다. 이와 같은 치료과정은 약 3-6개월이 필요하다. 완화단계의 기간이 길어질수록 완치될 확률도 높아진다. (2) 급성기 천식은 폐(肺)를 다스려야 한다. 폐(肺)를 다스리는 방법에는 선폐(宣肺), 청폐(淸肺), 온폐(溫肺), 윤폐(潤肺) 및 척담거어(滌痰祛瘀) 등이 있다. (3) 증상이 완화되면 신(腎)을 다스린다. 천식은 신허(腎虛)가 근본적인 원인이므로 완화단계에서 심지어 발작기에도 보신제(補腎劑)를 추가하여 사용하면 배의 효과를 얻을 수 있다. (4) 비(脾)의 기능을 강화하여 근본을 채우는 부비배본(扶脾培本)도 중요하다. 후천의 수곡정미(水穀精微)로 선천을 충족시키고 자양하는 것은 질병에 대한 저항력을

• Korean Journal of Psychosomatic Medicine
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• v.11 no.2
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• pp.182-195
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• 2003

Background: Marriage is one of the major life events and the primary source of individual happiness and meaning of life. It is not possible to predict who will marry whom and which marriage will be successful. Marital adjustment has significant influences on an individual and relationship functioning and is associated with mental health. Good marital quality may imply good general relationship. There are several factors that correlate with or predict good marital quality. Especially individual personality factors may be a major factor in achieving and maintaining marital stability, satisfaction and happiness. The aim of the present study was to investigate the possible relationship between dyadic adjustment and personality dimensions in urban married women. Methods: Dyadic Adjustment Scale, Eysenck's Personality Questionnaire, Beck Depression Inventory and State-Trait Anxiety Inventory were administered to 215 married women. Data analysis was based on 170 women who provided reliable informations. The descriptive statistics of demographic data and 4 scales were obtained. Then the possible relationships between each data were tested by calculating Pearson's product moment correlations. To test the effects of depression and anxiety on dyadic adjustment, stepwise multiple regression analysis was done. Results: Age and length of marriage were negatively correlated with affectional expression and dyadic cohesion. Educational level was positively correlated with total dyadic adjustment score and dyadic satisfaction. Family income was positively correlated with total dyadic adjustment score, dyadic consensus, dyadic satisfaction and dyadic cohesion. Different family type showed different total dyadic adjustment score, dyadic satisfaction and dyadic cohesion. Psychoticism was negatively correlated with total dyadic adjustment score, dyadic consensus, dyadic satisfaction, affectional expression and dyadic cohesion. Neuroticism was negatively correlated with total dyadic adjustment score, dyadic consensus, dyadic satisfaction and affectional expression. Extraversion and lie were not correlated with any factors. Beck Depression Inventory and State-Trait Anxiety Inventory scores were negatively correlated with total dyadic adjustment score, dyadic consensus, dyadic satisfaction, affectional expression and dyadic cohesion. The result of multiple regression analysis indicated that psychoticism was correlated with dyadic adjustment. Conclusion: These results showed that the demographic factors such as age, length of marriage, educational level, family income and family type were significantly correlated with dyadic adjustment. Psychoticism and neuroticism measured by Eysenck Personality Inventory were significantly correlated with dyadic adjustment. But the correlations with extraversion and lie were not significant. Especially correlation between neuroticism and dyadic adjustment seemed to be mediated by emotional state such as depression and anxiety. These findings suggest that personality factors may be involved in marital relationship and that clinician must consider personality aspect in dealing with marital problems. Future study about differences between control group and psychiatric patient group will be needed.

• Journal of Korean Orthopaedic Sports Medicine
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• v.2 no.2
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• pp.168-175
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• 2003

Fracture about proximal humerus may be classified as the articular segment or the anatomical neck, the greater tuberosity, the lesser tuberosity, and the shaft or surgical neck. Now, usually used, Neer's classification is based on the number of segments displaced, over 1cm of displaced or more than 45 degrees of angulation , rather than the number of fracture line . Absolute indication of a operative treatment a open fracture, the fracture with vascular injury or nerve injury , and unreductable fracture-dislocation . Inversely, the case that are severe osteoporosis, and eldly patient who can't be operated by strong internal fixation is better than arthroplasty used by primary prosthetic replacement and early rehabilitation program than open reduction and internal fixation. The operator make a decision for the patient who should be taken the open reduction and internal fixation, because it's different that anatomical morphology, bone density, condition of patient. The operator decide operation procedure. For example, percutaneous pinning, open reduction, plate & screws, wire tension bands combined with some intramedullary device are operation procedure that operator can decide . The poor health condition for other health problem, fracture with unstable vital sign and severe osteoporosis , are the relative contraindication. The stable fracture without dislocation is not the operative indication . The radiologic film of the prokimal humerus before the operation can not predict for fracture evaluation. It's necessary to good radiologic film for evaluation of fracture form. The trauma serise is better than the other radiologic film for evaluation. The accessary radiologic exam is able to help for evaluation of bone fragment and anatomy. The CT can be helpful in evaluating these injury, especially if the extract fracture type cannot be determined from plain roenterogram of the proximal humerus, bone of humerus head. If the dislocation is severe anatomically , we could consider to do three dimentional remodelling. The MRI doing for observing of bony morphology before the operation is not better than CT If we were suspicious of vascular injury, we could consider the angiography.

• 재활복지
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• v.21 no.2
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• pp.217-231
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• 2017

We have to consider two parts of the evaluation and treatment for the patients with head and neck burns. The primary consideration is swallowing function for nutrition supply for them and the next is speech function for efficient communication and aesthetic impression of them. The purpose of this study is to summarize the preliminary questions of Communication Screening Protocols which can help understand comprehensively on swallowing disorder, motor speech disorder and voice disorder of patients with head and neck burns. We divided the evaluation into 4 evaluation areas including 'oral mechanism', 'respiration/voice', 'articulation', and 'swallowing' by referring to overseas studies dealing with various communication disorders caused by burns, and prepared the final questionnaires by conducting the content validity verification by five expert (speech & language pathologist). The range of Content Validity Index was shown relatively appropriate with .50~.84. There was a conflict of opinions in experts whether the items in the areas of respiration/voice and swallowing may be appropriate, whereas there was no different view of the oral mechanism and articulation area. Through the different characteristics of communication difficulties of patients with head and neck burns, we expect it will be modified appropriately according to the patients through evaluation of burn patients by type and severity.

• Journal of Dental Rehabilitation and Applied Science
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• v.38 no.1
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• pp.42-51
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• 2022

Esthetic restoration of maxillary anterior implant heavily depends on the direction of installation of implant fixture. In patients with malpositioned implant, it is crucial to communicate the limitations of prosthetic outcome with the patient before starting on a restoration. To facilitate the communication, three-dimensional virtual representation by superimposing facial and intraoral digital scans with Computed Tomography (CT, dicom file) was used for visualization of the limitations of prosthesis. Through digital diagnostic wax-up, the profile of right maxillary anterior incisor implant was expected to be protrusive, which the patient was not satisfied with. Since the patient already had done root canal treatment on left maxillary anterior incisor due to previous trauma, a new prosthetic design including both right and left maxillary anterior incisors was presented to the patient. The second design was chosen and his comments were delivered to dental lab. The patient was satisfied with the new prosthesis, aesthetically and functionally.

• Progress in Medical Physics
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• v.18 no.4
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• pp.194-201
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• 2007

Although Gamma Knife irradiates much more radiation in a single session than conventional radiotherapy, there were only a few studies to measure absolute dose of a Gamma Knife. Especially, there is no report of application of International Atomic Energy Agency (IAEA) TRS-398 which requires to use a water phantom in radiation measurement to Gamma Knife. In this article, the authors reported results of the experiments to measure the absorbed dose to water of a Gamma Knife Model C using the IAEA TRS-398 protocol. The absorbed dose to water of a Gamma Knife model C was measured using a water phantom under conditions as close as possible to the IAEA TRS-398 protocol. The obtained results were compared with values measured using the plastic phantom provided by the Gamma Knife manufacturer. Two Capintec PR-05P mini-chambers and a PTW UNIDOS electrometer were used in measurements. The absorbed dose to water of a Gamma Knife model C inside the water phantom was 1.38% larger than that of the plastic phantom. The current protocol provided by the manufacturer has an intrinsic error stems from the fact that a plastic phantom is used instead of a water phantom. In conclusion, it is not possible to fully apply IAEA TRS-398 to measurement of absorbed dose of a Gamma Knife. Instead, it can be a practical choice to build a new protocol for Gamma Knife or to provide a conversion factor from a water phantom to the plastic phantom. The conversion factor can be obtained in one or two standard laboratories.

• Journal of Chest Surgery
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• v.34 no.6
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• pp.447-453
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• 2001

Background: Although pulmonary resection is the standard approach for the management of pulmonary metastases from soft tissue sarcoma, most of them are unresectable and chemotherapy remains the only option. The effectiveness of the cytotoxic drugs may be limited by the toxicities that occur before the therapeutic dose is reached. The regional administration of doxorubicin using pulmonary arterial perfusion in a rodent model can produce 10 to 25 times higher concentrations in the lung than systemic administration with minimal systemic toxicities. However, it is unclear whether a high concentration of doxorubicin has beneficial effects for killing cancer cells. Material and Method: We studied this to evaluate the dose-dependent cytotoxic and apoptotic effects of doxorubicin on methylcholanthrene-induced rat fibrosarcoma(MCA) cells. This study examined the cytotoxicity and apoptosis-related gene expressions(Fas, FasL, Bax, caspase 1, caspase 2, caspase 8, Bcl-2, Bcl-xL, Bcl-xS) in MCA cells after 24 hours exposure to various concentrations of doxorubicin such as 1, 5, 10, 50, and 100 $\mu$M. Result: Dose-dependent cytotoxicity was observed after 24 hours exposure to doxorubicin. However, peak apoptosis after 24 hours exposure was observed at 5 $\mu$M of doxorubicin. Above 5 $\mu$M, apoptotic activity was decreased with dose-increment. All mRNA levels of apoptosis-related genes after 24 hours exposure were up-regulated above the control level at 1 $\mu$M of doxorubicin and then decreased by doxorubicin dose-increment except caspase 8, which showed higher levels than the control level at 5 $\mu$M. Apoptosis-related protein levels were highest at 1 $\mu$M of doxorubicin and then decreased by doxorubicin dose-increment. However, Bax and Bcl-xL proteins steadily showed higher levels than the control throughout the different concentrations of doxorubicin. Conclusion: These results suggest that apoptosis is the main cytotoxic mechanism in low concentrations of doxorubicin in MCA cells and apoptosis-related genes, such as Bax, caspase 8, and Bcl-xL, are involved. At high concentrations, doxorubicin still can kill MCA cells, even when apoptosis is inhibited, and have its propriety for achieving much cytotoxicity against MCA cells.

• Korean Journal of Psychosomatic Medicine
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• v.7 no.1
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• pp.124-133
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• 1999

Objective : Postpartum depression(PPD) was known to be caused by many factors including various psychosocial risk factors. This study was performed to identify the psychosocial risk factors for ppd, preliminarily in Korea. Methods : A group of 119 postpartum women, each of whom was at 6 to 8 weeks after delivery was identified at the time when they visited to the child health clinic or postnatal check-up clinic. The risk factors were surveyed by the self-reported questionnaire. The items of questionnaire were consisted of known risk factors in other studies and other possible stress-related factors. PPD was assessed by the Edinburgh Postnatal Depression Scale(EPDS) and the degree of postpartum depression was determined by its score. Results : 16 women(13.45%) in the high risk group were diagnosed as PPD among the 119 women. Risk factors including past experience of depressive symptoms and low level of marital satisfaction were founded more frequently in women in the high risk group than in the low risk group. The score of EPDS was significantly high in the group who experienced depressive symptoms in the past, anxiety or depression during pregnancy, stressful life event during the period of recent pregnancy and postpartum, and who had low level of marital satisfaction. There was a positive correlation between age and the score of EPDS. However, the postpartum depressive symptoms were not influenced by the level of education, job, retirement due to pregnancy and delivery, wanted or unwanted pregnancy, delivery method, feeding method, the hospitalization of infant, expected and real gender of infant. Conclusion : These results suggest that PPD is quite frequent at postpartum period. Various risk factors contribute to the development of PPD. If clinicians pay attention to the risk factors of PPD and give appropriate psychiatric intervention to the mothers during pregnancy and postpartum, it will be easy for the clinicians to recognize and treat PPD in the early stage.