• Journal of Chest Surgery
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• v.40 no.7 s.276
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• pp.485-491
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• 2007

Background: Thoracoplasty has become a rarity in current clinical practice, although it has been widely employed for well over a century as a procedure for reducing the capacity of the thoracic cavity. Yet we have perform tailoring thoracoplasty following or concomitant with pulmonary resection in 20 patients. The aim of this study is to evaluate the early and late clinical results and also the significance of tailoring thoracoplasty. Material and Method: From March 1995 to June 2005, modified thoracoplasty following or concomitant with pulmonary resection was performed in 20 patients out of a total of 298 pulmonary resections for closing air leaks and for treating persistent pleural space following pulmonary resections, and to tailor the thoracic cavity to accept a diminished lung volume. Of the 20 patients, 14 patients had tailoring thoracoplasty performed concomitant with pulmonary resection, and the remaining 6 patients also had tailoring thoracoplasty performed following pulmonary resection. The subjects ages ranged from 24 to 77 (mean $59.1{\pm}6.4$) and a male preponderance was noted (17 : 3); the number of left and right surgeries was equal. The preoperative primary underlying diseases were lung cancer in 7 patients, pneumothorax with giant bullous change in 6 patients, bronchiectasis in 2 patients, previous pulmonary tuberculosis associated with aspergilloma in 2 patients, empyema with fibrothorax in 2 patients and multiple lung abscesses & destruction due to previous trauma in 1 patient. The operative methods were apicolysis and subperiosteal removal of the 2nd, 3rd and 4th ribs (the costochondral junction to the posterior portions of the ribs) with preservation of the first rib and compression of the anterior chest via cotton bags and elastic bandages. Result: The mean duration of the air leaks after thoracoplasty was $1.6{\pm}0.2$ days (range: $0{\sim}7$ days) and the mean duration of an indwelling chest tube was 7 days (range: $5{\sim}11$ days); the mean duration of hospitalization was $19.2{\pm}2.8$ days (range: $8{\sim}47$ days). The postoperative complications were wound infection (2) and pneumonia (2); reoperation was done due to bleeding (1) in one patient who underwent concomitant thoracoplasty and there was 1 case of wound infection (1) after postresection thoracoplasty. The mortality was 1 patient in the early phase and 4 patients in the late phase. Conclusion: We conclude that tailoring thoracoplasty may be performed to close anticipated persistent pleural spaces and to accommodate the diminished lung volume with acceptable cosmetic results when this procedure is combined with pulmonary resection in selected patients.

• Journal of The Korea Institute of Healthcare Architecture
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• v.17 no.2
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• pp.53-59
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• 2011

본 연구는 미국 텍사스 주의 소도시에 있는 스캇 앤 화이트 클리닉의 외부공간을 대상으로 하여 외래환자와 방문객들이 직면하는 길찾기의 문제점을 분석한다. 연구의 공간적 범위는 클리닉의 외부공간으로 한정하여 진입도로에서 진입하여 주차한 후 출입구에 도달하는 경로에서 관찰되는 행태적 특성을 분석한다. 분석의 초점은 진입도로에서 이루어지는 경로선택의 결정과 그것이 클리닉에 진입하기 위한 출입구 결정에 미치는 영향관계에 둔다. 분석은 외부공간에서의 길찾기에 관한 기존 연구문헌을 참고하여 작성한 연구모형에 의해 이루어진다. 구체적으로 보면, 이용자들이 보이는 날씨, 성별, 그리고 나이에 따른 길찾기 행태의 차이를 클리닉의 남동측 출입구와 남서측 출입구에서 발생하는 이용자들의 하차 빈도를 측정하였다. 또한 하차의 위치를 행태 지도에 기록하여 연구모델에 나타나는 상관성을 분석하였다. 길찾기 행태분석 결과를 통해 파악된 외부주차장에 주차한 후 클리닉에 접근하는 이용자들의 경로선택의 문제점과 클리닉의 입구 공간에서 하차한 이용자들의 입구선택에서 나타나는 문제점을 토대로 하여 외부공간에서 발생하는 길찾기 행위의 효율성을 증진시키기 위한 디자인 추천 사항을 다음과 같이 제시한다: (1) 시각적 단서를 제공하기 위해 남서쪽 출입구의 형태와 색채 차별화; (2) 도로에서 클리닉 진입공간에 위치한 안내판의 글자 크기 확대; (3) 학습된 길찾기 행태를 보조하기 위해 동쪽에 랜드마크 시설물 설치 및 목적 지점의 최종경관 개선; (4) 과도한 클리닉의 정보에 의해 감소되는 가독성을 고려하여 안내판의 정보 간략화; (5) 색채의 대조를 고려(출입구 벽에 설치된 클리닉의 이름이 갈색에 푸른색으로 설치되어 있어 색채의 대비가 낮아 가독성 떨어짐); (6) 클리닉 중앙 출입구의 하차 공간 상부에 설치된 캐노피 기둥의 과도한 크기에 의해 발생하는 가시공간의 감소에 의해 발생하는 하차 공간 사용의 혼잡 문제를 제거하기 위해 기둥규모 축소; (7) 하차점 6까지 캐노피를 확장하여 우천시에 발생하는 공간 사용의 문제점 제거; 그리고 (8) 올바른 하차공간 사용을 위해 진입 접근도로에 차선 설치.

• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.2
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• pp.145-156
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• 2010

Loss of posterior support may cause overloading and excessive wear of remaining teeth. Moreover, the extrusion of antagonistic teeth leads to the destruction of the occlusal plane. The loss of vertical dimension of occlusion (VDO) also emerges clinically, which may bring the loss of esthetic appearance and function. These patients who suffer from the loss of posterior support, often require vigorous periodontal treatments (osteotomy, crown lengthening) and extensive oral rehabilitation. Sixty three years old female patient visited for the prosthetic treatment of the posterior edentulous area. She had no other systematic disease and parafuctional habits for prosthetic treatment. Intraoral and radiographic examinations were done. The evaluation of VDO and vertical dimension of rest position were evaluated for proper prosthetic procedures and diagnostic wax up was done. As a result of diagnosis, VDO was increased by 2 mm considering the loss of VDO and space for the prosthetic treatment. After the pretreatments, initial preparation of teeth and provisionalization were carried out. Six weeks later of provisionalizaion, final preparation and impression was performed. Using the duralay resin copings, jaw relation was registered. The master cast was mounted and definitive restoration was fabricated. After the evaluation of esthetic and function, pick up impression for clinical remounting was done. Lucia jig was made for new jaw relation and occlusal adjustment on the articulator. Definitive restoration was delivered and the patient was periodically recalled for additional occlusal adjustment. From this case, the satisfactory functional and esthetic results through full mouth rehabilitation with increase vertical dimension were achieved.

• Journal of the Korean Geographical Society
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• v.42 no.6
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• pp.863-878
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• 2007

The time-spatial distribution of Scrub typhus and its relationship with environmental ecology, such as climate, and habitat change are analyzed in respect of the geography of disease. Scrub typhus was firstly reported in 1951, and reemerged in 1986 mainly in southwestern Korea. later it has sharply increased and spreaded out toward whole country in 1998 and 2004, except mid-eastern mountainous region. Hwasung City is the typical example of sudden upsurge of Scrub typhus. High incidence of Scrub typhus patients might due to elevated temperature and decreased precipitation during the summer, as well as milder autumn. Sharp increase of Scrub typhus patients at rural area since 1980's might also be the result of the rapid changes of land use pattern, which eventually have contributed for the active development of dense vegetation and propagation of chigger mites around cultivated land.

• Journal of the Korean association of regional geographers
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• v.17 no.5
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• pp.617-637
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• 2011

This study employs qualitative approaches to examining geographical characteristics and patients' determinants of online referrals in terms of regionalization. In this light, I conducted interviews with 20 patients receiving online referrals in Choongbook, Korea, and investigated their behaviors regarding these referrals between July and August 2009. I found that many patients who suffered from various levels of illness preferred tertiary care centers outside of Choongbook and did not enjoy their experience with the local medical institutions as the online referral service sites. This result might be because patients choose online referrals for psychological considerations such as quality and level of health care services, personal stakes in online referral service sites, acceptability and credibility of good tertiary care centers, and easy access to and use of medical institutions. Meanwhile, immediate benefits with regard to the technological value of online referrals, such as convenience, utility, and original purpose associated with regionalization, did not influence patients' decision-making. Therefore, the social and public networks affiliated with online referrals plus the effect of Korean medical laws play hostage to private decisions made by citizens, who prefer high-level medical institutions. Accordingly, the technological contribution of online referrals does not halt the outflow of patients from local, tertiary care centers. Especially, the existing health care system and patients' behaviors are deeply related to referrals in the online system. To protect regionalization, the improvement of health care services from the present state of affairs is required.

• The Journal of the Convergence on Culture Technology
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• v.7 no.2
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• pp.291-296
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• 2021

The purpose of this study is to investigate the effect of gardening programs using vertical gardens on helplessness, depression, and self-esteem in patients with chronic mental disorders. This study was applied to 21 patients with chronic mental disorder who were admitted to the rehabilitation hospital of E Hospital in Seoul from June to October 2018. The group was treated as an experimental group (N = 21) 5 times a week. For 20 weeks, each session lasted 30 minutes. Patients in the experimental group programmed 4 sessions of general occupational therapy, which combined treatments to improve cognition and training, and 1 session of a horticultural program using a vertical garden. Helplessness, depression, and self-esteem were evaluated for pre and post evaluation of the horticultural program. After completing the program, the average score of helplessness in the experimental group decreased by 0.91 points from 47.38 to 46.47, and there was a statistically significant change (p=0.043). The mean score of depression in the experimental group was 9.23 before and after 9.08, which was statistically significant (p = 0.035). The average score of self-esteem in the experimental group increased by 3.14 points from 27.99 to 31.13 at a statistically significant level (p = 0.001). This result suggests that a gardening program using vertical gardens has an effect on helplessness, depression, and self-esteem in patients with chronic mental disorders. And this means that long-term plans and effective programs for recovery from chronic mental disorders to the community are needed. With a horticultural work program using a vertical garden, the helplessness of the mentally impaired in a closed treatment space is restored, and such treatment space needs to be increased.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.4
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• pp.445-450
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• 2016

Piezography, prosthetic space recorded by pronunciation, can be used as a reference for arrangement of artificial teeth and polishing surface of a denture. In this case, a 67 year old female patient was presented for new dentures. Old dentures had class II relationship and poor retention. For fabrication of stable dentures, using piezography and lingualized occlusion was planned. After taking impressions with conventional method, conventional denture bases with wax rim were fabricated. Then, additional mandibular denture base was fabricated for piezography. With fast setting silicon impression material, piezography was recorded by using six pronunciations, 'si', 'so', 'me', 'te', 'de', and 'mu'. According to the piezographic space, mandibular artificial teeth were arranged and modified for lingualized occlusion. As a result, the patient was satisfied with new dentures functionally and esthetically.

• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.4
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• pp.463-476
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• 2010

Inadequate or unstable posterior support cause extrusion of antagonistic teeth and overloading of remaining teeth. Extrusion of antagonistic teeth result in collapsed occlusal plane and decreased prosthetic space. Also, overloading of remaining teeth increase occlusal wear or anterior extrusion of anterior teeth, which is resulting in loss of anterior guidance, disharmony of occlusion and decreased prosthetic space. In this case, careful evaluation of OVD(occlusal vertical dimension) is the general first trial to regain appropriate function and esthetics. Simultaneously, adequate anterior guidance and harmonious occlusal plane should be established in the repeatable reference position of the mandible. We report this case because severely worn dentition achieved functional and esthetic results from full mouth rehabilitation with increased vertical dimension and use of centric relation.

• The Journal of Korean Academy of Prosthodontics
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• v.59 no.1
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• pp.107-115
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• 2021

Excessive pathological attrition over the entire dentition can cause decreased masticatory function, and pathological problems of the temporomandibular joint and the muscular nervous system. In this case, 71 year-old male patient with severe attrition and fracture across the entire tooth was treated by full mouth rehabilitation for regaining space of restoration. In order to determine the appropriate vertical dimension of the patient's occlusion, facial appearance, aesthetics, restoration space were evaluated, and provisional restoration of the raised vertical dimension was made. After 4 months of evaluation, the entire restoration of monolithic zirconia crown using CAD-CAM was completed. Through the above process, satisfactory aesthetic and functional results were obtained.

• Journal of The Korea Institute of Healthcare Architecture
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• v.27 no.2
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• pp.57-64
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• 2021

Purpose: The relationship between the staff area and the patient's private area is the key factor in designing the structure and the environmental characteristics of ward spaces in a psychiatric hospital. Recent research has found that for the purpose of treatment and securing privacy, psychiatric patients need to be in an open space of relief rather than closed confined environment and under the watch of nursing staffs. Methods: A survey at three kinds of wards in a private psychiatric hospital in Japan was conducted in October 2002. These wards include an acute ward, a psychiatric convalescence ward, and a stress care ward. All three kinds of wards have the same structure. At each ward, spatial preferences of the 145 psychiatric inpatients were surveyed and data concerning the patient's diagnostic category, symptoms, and activities of daily living were recorded. Results: The patients in the stress care ward prefer to stay in private spaces than public spaces. On the other hand, in the acute ward the patients seem to have a preference between managed public spaces where are monitored by nursing staffs and their private rooms where the nurse station is close. In addition, the patients in the psychiatric convalescence ward spend most of their time in the public space, such as the hallways or the day room. Implications: Base on this research, the spaces at the acute ward that could be monitored by the nursing station serves effectively as a safety space for patients was concluded. However, in the stress care ward, the patients may perceive the monitoring by the nursing staff as interruption or nuisance to their relaxation. In order to design an ideal healing environment for psychiatric patients in psychiatric ward, it is important to consider how environmental characteristics of space affect the environmental sense of patients in each ward.