• Journal of Oral Medicine and Pain
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• v.30 no.1
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• pp.121-129
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• 2005

In this experiment, eleven volunteers were followed up for 15 months after the injection of botulinum toxin type A on right and left masseter muscles. The measurement of masseter muscle atrophy for each volunteer was performed by CT(computed tomography) three times: before the injection, three and fifteen months after the injection. The thickness and area of muscle were measured in three positions which are 10 (position 1), 20 (position 2), and 40 mm (position 3) above the inferior border of mandible(the injection site was nearest the position 1). The thickness of masster muscle was decreased in all three positions three months after the injection, but no significant change was observed fifteen months after the injection. On the other hand, the area of masster muscle was decreased in all three positions three months after the injection. Furthermore, the area was decreased significantly in positions 1 and 2, but not in position 3 fifteen months after the injection. As a result, toxin is still in effect even fifteen months after the injection. Finally, the present study shows that the measurement of muscle area provides more precise informations than that of muscle thickness does.

• Journal of Oral Medicine and Pain
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• v.30 no.1
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• pp.35-44
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• 2005

Purpose: The aim of this preliminary study was to evaluate the effect of Problem-Based Learning (PBL) curriculum on development of comprehension of basic medical knowledge and quality of semi-structured problem solving including scientific reasoning skill. This scientific reasoning contained five components including: size of simple, design of research cause-effect, construction of risk factor, analysis statistic of data, interpretation of result. Materials and Methods: Seoul National University Dental students (100) participated in this experience during two weeks, 2004. Forty eight multiple-choice questions (MCQ) concerned "Infection Control and Prevention" were asked before and after two sections of Lecture-Based Learning (LBL) and PBL (pretest-posttest control group design). A semi-structured problem in epidemiological research was asked to these students after two sections (posttest-only control group design). Data (mean and SD) were analysed using the t Test for two independent samples (p<.05), comparing PBL versus LBL. Results: Our analyse of scores show no difference between LBL and PBL in the development of comprehension of "Infection Control and Prevention". The quality problem solving (epidemiological research) was significantly different between the two groups (p=.029); specially, two components' scores of reflection on scientific reasoning cause-effect (p=.000) and interpretation of result (p=.001) were significantly better for PBL than for LBL. Conclusion: Theses results indicate that comparing LBL and PBL, PBL curriculum have not been disadvantaged in comprehension of basic knowledge, and have contributed to develop the scientific reasoning in problem solving.

• Proceedings of the Mineralogical Society of Korea Conference
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• 2003.05a
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• pp.51-51
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• 2003

임진강대의 변성이질암은 전형적인 바로비안형 변성분대를 보이며, 남쪽으로 갈수록 변성도가 증가하여 석류석$\longrightarrow$십자석$\longrightarrow$남정석 대를 정의한다. 우리는 반상변정의 성장과 여러번에 걸친 광역변형작용의 연관성을 밝히기 위해 광물의 반응관계와 성장순서 그리고 미구조(microstructure)를 -특히 석류석에 대해서- 연구하였다. 임진강대는 크게 세 번에 걸쳐 변형작용을 받은 것으로 해석된다: (1) 지각 두께의 증가에 수반된 압축변형작용 (D$_{n-1}$), (2) 주 엽리(Sn)를 만든 변형작용(Dn), 그리고 (3) 연성전단작용에 수반된 신장변형작용(D$_{n+1}$ ). 석류석대의 석류석 반상변정에서는 약간 휘어진 포유물 궤적(inclusion trail)이 주 엽리면에 대해 연속적이며, 이는 Dn과 동시기에 반상변정이 생성되었음을 지시한다. 이러한 석류석은 녹니석과 백운모로 구성된 주 엽리를 치환하면서 자라기 때문에, 녹니석+백운모+석영=석류석+흑운모+$H_2O$의 반응에 의해 만들어진 것으로 해석된다. 석류석 자형변정(idioblast)이 주 엽리를 자르면서 성장하기도 하는데, 이는 Dn 이후에도 석류석이 후구조(post-tectonic) 광물로 성장했음을 지시한다. 또한, 이러한 석류석은 흑운모를 치환하기 때문에, 동구조(syn-tectonic) 석류석의 생성반응에서와는 달리 흑운모가 반응물임을 알 수 있다. 한편, 십자석대의 석류석은 포유물 궤적에 의해 정의되는 S$_{n-1}$면이 주 엽리면과 사각을 이루며 단속적이기 때문에, D$_{n-1}$과 Dn 사이에 자란 것으로 해석된다. 이와는 대조적으로 십자석은 주 엽리를 치환하면서 자라고 있어서 Dn과 동시기 혹은 Dn 이후에 자랐을 것으로 해석된다..의 환경문제를 발생하지 않으며, 공정액에 첨가제를 투입하지 않으므로 순환형 친환경공정으로 각광받을 수 있다. 본 연구에서는 고온, 고농도의 NaOH 수용액의 처리에 적합한 막소재와 발생될 수 있는 제반 문제점 등을 파악하였고, 장기간의 실험을 거쳐 최적 투과 압력(Trans membrane pressue), 세정 조건 및 주기, 막재질에 있어서 보강하여야 할 Point, 최적 운전 조건들을 토출해 내었고, 향후 실제 Plant에 적용할 계획이다.는 양적으로 다른 두 가지의 유사한 마그마가 수반된 것으로 추정된다. 것으로 추정된다.를 사용하지 않음으로써 효과적이고 만족할 만한 심근보호 효과를 보였다.를 보였다.4주까지에서는 비교적 폐포는 정상적 구조를 유지하면서 부분적으로 소폐동맥 중막의 비후와 간질에 호산구 침윤의 소견이 특징적으로 관찰되었다. 결론: 분리 폐 관류는 정맥주입 방법에 비해 고농도의 cisplatin 투여로 인한 다른 장기에서의 농도 증가 없이 폐 조직에 약 50배 정도의 고농도 cisplatin을 투여할 수 있었으며, 또한 분리 폐 관류 시 cisplatin에 의한 직접적 폐 독성은 발견되지 않았다이 낮았으나 통계학적 의의는 없었다[10.0%(4/40) : 8.2%(20/244), p>0.05]. 결론: 비디오흉강경술에서 재발을 낮추기 위해 수술시 폐야 전체를 관찰하여 존재하는 폐기포를 놓치지 않는 것이 중요하며, 폐기포를 확인하지 못한 경우와 이차성 자연기흉에 대해서는 흉막유착술에 더 세심한 주의가 필요하다는 것을 확인하였다. 비디오흉강경수술은 통증이 적고, 입원기간이 짧고, 사회로의 복귀가 빠르며, 고위험군에 적용할 수 있고, 무엇보다도 미용상의 이점이 크다는 면에서 자연기흉에 대해 유용한 치료방법임에는 틀림이 없으나 개흉술에 비해 재발율이 높고 비용이 비싸다는 문제가 제기되고 있는 만큼 더 세심한 주의와 장기 추적관찰이 필요하리라 사료된다.전 도부타민 심초음파는 관상동맥우회로술 후

• Journal of the Korean Society of Radiology
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• v.10 no.3
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• pp.171-180
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• 2016

This study was to evaluate the change in characteristics of concentration of ozone after exposure to high energy radiation in linac room. Background ozone concentration of linac room was measured and compared to ozone concentration around linac room. Background ozone concentration of linac room was mean $17.4{\pm}7.9ppb$. It was 50% of the ozone concentration($36.8{\pm}22.3ppb$) around linac room(p<0.05). The concentration of ozone after exposure to high energy radiation in linac room was elevated to double of background ozone level, intensity after exposure. with exposure time concentration of ozone increased proportionally. It showed maximum level at 130~180seconds and slowed a tendency to saturate. It required more than 10 minutes for ozone concentration in linac room to drop to ozone concentration around linac room. The concentration of ozone after exposure to high energy radiation is high enough to cause specific physical symptoms, such as acute dyspnea or chest pain due to dry cough. Exposure to high concentration of ozone in sealed linac room can aggravate pulmonary disease, so special attention is needed.

• Pediatric Infection and Vaccine
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• v.22 no.3
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• pp.210-215
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• 2015

Macrophage activation syndrome (MAS) is a rare complication in systemic lupus erythematosus (SLE) that can be triggered by infections. Due to the fact that MAS may mimic clinical features of underlying rheumatic disease, or be confused with an infectious complication, its detection can prove challenging. This is particularly true when there is an unknown/undiagnosed disease; and could turn into an even greater challenge if MAS and SLE are combined with a viral infection. A-14-year-old female came to the hospital with an ongoing fever for 2 weeks and a painful facial skin rash. Hepatomegaly, pancytopenia, increased aspartate aminotransferase, elevated serum ferritin and lactate dehydrogenase were reported. No hemophagocytic infiltration of bone marrow was reported. The patient was suspected for hemophagocytic lymphohistiocytosis. Her skin rashes were eczema herpeticum, which is usually associated with immune compromised conditions. With the history of oral ulcers and malar rash, positive ANA and low C3, C4 and the evidence of hemolytic anemia, she was diagnosed as SLE. According to the diagnostic guideline for MAS in SLE, she was diagnosed MAS as well, activated by acute HSV infection. After administering steroids and antiviral agent, the fever and skin rash disappeared, and the abnormal laboratory findings normalized. Therefore, we are reporting a rare case of MAS triggered by acute HSV infection as the first manifestation of SLE.

• Journal of Korean Neurosurgical Society
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• v.29 no.3
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• pp.324-329
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• 2000

Objective : Psychological factors may have a major influence on the outcome of treatment for back pain. We investigated the relationship between the outcome and some psychological factors, such as self-reported pain intensity, disability, sleep disturbance and fatigue. Method : The study was conducted as a survey using a questionnaire and telephone interviews. The survey included consecutive 294 patients who visited the neurosurgical out-patient department complaining of low back pain and contacted by telephone on average seven months after the first visit. Pain intensity was measured by visual analog scale, and disability was assessed by Waddell's chronic disability index. Results : The outcome of treatment for back pain was recovered in 36.7%, improved in 30.6%, almost same in 28.6%, and aggravated in 4.1%. Overall rate of improvement was 67.3%. The rate of improvement was related to the duration, patterns and intensity of the symptom, and Waddell index. It was not influenced by the doctors, special studies, and methods of treatment. When the duration was more than 6 months, there were the symptoms of both back and legs, and the self-reported Waddell index was 1-3, the rate of improvement was relatively low. Although the intensity of the pain and disability was closely related to the degree of sleep disturbance, fatigue, appetite, or indigestion, the outcome of treatment for back pain was not always bad in patients with high psychological stress. Actually the outcome of the patients who complained severe pain and disability was better than the outcome of the others. Conclusion : The outcome of the back pain can be predicted by the duration, patterns and intensity of the symptom, and Waddell index. The multidisciplinary treatment will be necessary for the patients whose expected outcome is not good to reduce not only the physical symptoms but also the psychological stress.

• Journal of the Korean Arthroscopy Society
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• v.13 no.3
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• pp.212-219
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• 2009

Medially retracted large-sized rotator cuff tears includes large-sized tears, massive tears and irreparable tears. Generally arthroscopic repair or open repair of rotator cuff tears is used in reparable tears. However, arthroscopic repair requires long period practice and endurance. In irreparable tears, arthroscopic debridement, partial repair, latissimus dorsi transfer and retrograde arthroplasty can be the option. Arthoscopic debridement gives temporal relief who experienced improvement in pain and increase in range of motion after subacromial local anesthetic injection. Also arthroscopic partial repair gives good results in irreparable cases, especially in suprascapular nerve traction neurapraxia. Tendon transfer can be used in mild to moderate muscle weakness in shoulder abduction for long term treatment. Pectoralis major transfer can be used in anterosupeior tears and latissimus dorsi transfer can be used in posterosuperior tears. Reverse shoulder prosthesis is used in extreamly weakened shoulder pseudoparalysis. The authors discussed the method of arthroscopic repair in irreparable tears. The debridement, partial repair, and tendon transfer could be used in medially retracted large-sized rotator cuff tears.

• Journal of Oral Medicine and Pain
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• v.25 no.3
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• pp.279-289
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• 2000

현대에는 날로 복잡해지는 생활양식의 변화에 따라 다양한 스트레스에 노출되고 그로 인한 면역계, 신경계 또는 각종 장기의 기능이상이 점차로 증가되고 있다. 최근 치과에 내원하는 환자들 중 구강건조증을 호소하는 환자들의 다수는 스트레스에 노출되어 있고, 임상적으로도 방사선 타액선 기능 검사에서 타액선, 특히 악하선의 기능이 현저하게 저하되어 있는 소견을 관찰할 수 있 다. 더욱이 이는 타액선 조영술에서 이미 보고된 바 있는 면역성 질환인 $Sj\ddot{o}gren$ 증후군과는 다른 양상으로 관찰되고 있어, 이에 본인은 백서에 스트레스와 관련이 깊은 내분비적 환경 변화를 유도함으로써 이와같은 변화가 악하선 조직의 병리적 변화와 어떠한 연관성을 갖는 지를 관찰하고자 본 실험을 시행하였다. 생후 7주된 Sprague-Dawley계 웅성 백서(165-209g/bw) 40마리를 2 개의 실험군(부신 제거군 : ADX 군, 부신 제거 후 dexamethasone 투여군 : DEX 군)으로 나누어 실험하였다. ADX 군은 외과적으로 부신을 제거한 후 다른 조건을 부여하지 않았고, DEX 군은 외과적으로 부신을 제거한 후 매일 dexamethasone($1.5*10^{-46}mg/g$ I.V./day)을 투여하였으며, 이들을 각각 실험 후 즉시, 1일, 3일, 5일, 7일에 희생시켰다. 그 후에는 즉시 악하선을 적출하여 면역조직화학법으로 Clusterin의 발현 정도 및 부위를 관찰하였다. 그 결과는 다음과 같았다. 1. 광학현미경 하에서, 양 군 모두 유의할만한 조직학적 변화는 관찰되지 않았다. 2. ADX 군에서는 실험기간 전반에 걸쳐 도관세포와 선포세포에서 clusterin이 발현되었다. 3. DEX 군에서는 소수의 선세포에서 국소적으로 clusterin이 관찰되었으나, 전반적으로 도관세포, 선포세포에서 공히 clusterin이 관찰되지 않았다. 부신을 제거한 군에서는 실험기간 전반에 걸쳐 clusterin이 발현되었는데, 이는 clusterin이 스트레스의 생리적 반응의 결과로서 세포보호작용을 한다는 사실에 기초하여 볼 때, 부신을 제거하였을 때도 스트레스를 받았을 때와 같은 영향이 백서의 악하선에 가해졌을 것으로 생각된다. 반면, 부신제거후 glucocorticoid agonist인 dexamethasone을 투여하였을 때, clusterin이 감소 내지 관찰되지 않았던 것은 부신제거에 의해 악하선에 가해졌던 영향을 dexamethasone이 길항하여 나타난 결과로 볼 수 있어, 스트레스에 의해 부신으로부터 분비되는 glucocorticoid가 타액선을 보호하는데 중요한 작용을 하는 것을 시사한다.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.3
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• pp.417-422
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• 2019

Hemodynamically unstable pelvic fractures show a remarkably high mortality rate of 40% to 60%. However, their standard of care remains controversial. We report here a case of a 78-year-old woman who was admitted to the Emergency Department with pelvic pain following a fall. Based on pelvic radiography, she was diagnosed with an unstable pelvic fracture. Her blood pressure was 60/40 mmHg, and owing to her unstable vital signs, emergency angiography was performed without computed tomography (CT). Both internal iliac arteries were embolized without sub-branch selection for prompt control of pelvic bleeding. Following embolization, her vital signs were stabilized. Subsequent CT revealed free intra-abdominal air, suggesting bowel perforation had occurred and necessitating emergency laparotomy. An approximately 1 cm-sized free perforation of the small intestine was identified intraoperatively, and primary closure was performed. A retroperitoneal hematoma identified intraoperatively was not explored further because it was a non-expanding and non-pulsatile mass. The patient was admitted to the Intensive Care Unit and transferred to the general ward on postoperative day 3. In this case, the hemodynamically stable pelvic fracture with bowel perforation was successfully and safely treated by prompt angioembolization without conducting CT.

• Archives of Hand and Microsurgery
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• v.23 no.4
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• pp.248-253
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• 2018

Purpose: The purpose of this study was to evaluate the clinical results of anatomic reduction of bony mallet finger using modified-intrafocal pinning technique. Methods: From March 2014 to October 2017, 18 patients with bony mallet finger were treated with modified-intrafocal pinning technique. Kirschner-wire was used to directly reduction the bony fragment, and extension block pinning and distal interphalangeal joint fixation were additionally performed to minimize the loss of reduction. Postoperative pain, range of motion, and radiological evaluation were performed. Duration of bone healing, functional recovery and complication rate were evaluated and Crawford's criteria was used to determine functional outcome after surgery. Results: Bone union was achieved in all cases after a postoperative mean of 6 weeks (5-7 weeks). An average of $2.8^{\circ}$ ($0^{\circ}-10^{\circ}$) extension loss occurred in all patients. All patients showed satisfactory joint congruency and reformation of the joint surface, the mean flexion angle of the distal interphalangeal joint at the final follow-up was $72.2^{\circ}$ ($70^{\circ}-75^{\circ}$). According to Crawford's classification, 12 patients (66.7%) were excellent and 6 patients (33.3%) were good. Conclusion: Modified-intrafocal pinning technique is a method of obtaining anatomical bone healing by directly reduction and fixation of the bony fragment. Combined with other conventional percutaneous pinning procedures, it is expected that good results can be obtained if applied to appropriate indications.