• Title/Summary/Keyword: 환자의 접근

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Comparison of midsagittal reference plane in PA cephalogram and 3D CT (3차원 전산화 단층촬영의 Nasion, Sella, Basion으로 구성된 정중 시상 평면과 정면 두부방사선 규격사진의 정중 시상 평면 비교)

  • Cho, Jin-Hyoung;Moon, Ji-Yeon
    • The korean journal of orthodontics
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    • v.40 no.1
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    • pp.6-15
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    • 2010
  • Objective: The aim of this study is to find the most helpful midsagittal reference plane for diagnosis in PA cephalometry compared with 3D CT. Methods: The subjects consisted of 25 adults who showed no facial asymmetry by gross inspection. 3D CT and posteroanterior cephalogram of the subjects were taken. To find the most helpful midsagittal reference plane in PA cephalometry, we considered five kinds of midsagittal planes from which the distances to five landmarks were measured and compared the result with that of 3D CT. The midsagittal plane for 3D CT was determined by the landmarks Nasion, Sella and Basion. Results: PA measurements using the midsagittal reference plane on a perpendicular plane lying through the midpoint of the right and left latero-orbitales was closest to those of 3D CT. Conclusions: It was considered that latero-orbitale perpendicular could be used as the helpful midsagittal reference plane to assess facial asymmetry in PA cephalometry.

Oral Impact on Daily Performance and Happiness related to Orthodontic Treatment of Some Middle and High School Students with Malocclusion (부정교합을 가진 일부 중·고등학생들의 교정치료 여부에 따른 구강건강관련 삶의 질 및 행복감과 관련성)

  • Kang, You Ju;Seo, Ae-Rim;Kang, Yune-Sik;Jeong, Baek Geun;Park, Ki Soo
    • Journal of agricultural medicine and community health
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    • v.42 no.2
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    • pp.69-78
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    • 2017
  • Objectives: This study investigated whether the impacts of orthodontic treatment of malocclusion on oral health-related quality of life and happiness are positive with middle and high school students Methods: Subjects were 157 orthodontic patients and 83 non-orthodontic in malocclusion patients. Questionnaires were collected with the self-administered method, and consisted of the general characteristics, self-esteem, social support appraisal scale(friends, family, teacher), Oral Impact on Daily Performance (OIDP) and oxford happiness questionnaire (OHQ). Results: A physical factor was lower in the orthodontic treatment group ($5.8{\pm}2.48$) than in the non-orthodontic treatment group ($7.7{\pm}2.10$)(p<0.001), and OIDP was lower in the orthodontic treatment group ($7.0{\pm}1.79$) than in the non-orthodontic treatment group ($7.8{\pm}1.80$)(p=0.002). A feeling of happiness was higher in the orthodontic treatment group($4.6{\pm}0.81$) than in the orthodontic treatment group ($4.3{\pm}0.89$) (p=0.009). As results of multiple regression analysis, OIDP was affected of orthodontic treatment(${\beta}=-0.0222$, p=0.001) and OHP was affected of orthodontic treatment(${\beta}=0.087$, p=0.030) and OIDP(${\beta}=0.116$, p=0.003). Conclusions: Orthodontic treatment of malocclusion may positively affects happiness in teenager. Support policy for orthodontic treatment of malocclusion is necessary for adolescents.

Fracture of a Dental Needle during Inferior Alveolar Nerve Block in a Young Child: A Case Report (어린 아동의 하치조신경 전달마취 시 발생한 주사바늘 파절 : 증례보고)

  • Lee, Hanbyeol;Kim, Minkeun;Park, Howon;Seo, Hyunwoo;Lee, Juhyun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.43 no.3
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    • pp.320-326
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    • 2016
  • The fracture of a needle during local anesthesia in dental treatment is rare; however, when it occurs, the needle should be removed without damage to surrounding structures as soon as possible. A fractured needle fragment that is buried in soft tissue would be difficult to remove, and a careful surgical procedure under general anesthesia is recommended in such cases. Children who require dental treatment are often not capable of cooperative behavior, thus unexpected movements can increase the risk of needle fracture. Clinicians can reduce the incidence of needle fracture accidents with a few precautions. In the present case report, we report a case of needle fracture due to abrupt movement during inferior alveolar nerve block anesthesia in a young child, with the purpose of drawing attention to needle fracture incidents. This report describes the possible causes and prevention methods of local anesthetic needle fracture, and the localization methods and surgical procedure for needle fragment removal.

TONGUE INJURIES BY SELF MUTILATION IN LESCH-NYHAN SYNDROME PATIENT: A CASE REPORT (Lesch-Nyhan 증후군 환아의 자해에 의한 혀의 외상)

  • Kim, Ji-Hee;Choi, Byung-Jai;Kim, Seong-Oh;Choi, Hyung-Jun;Son, Heung-Kyu;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.3
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    • pp.532-538
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    • 2008
  • Lesch-Nyhan syndrome is a rare X-linked recessively inherited disorder, caused by complete absence or decrease in activity of hypoxanthine guanine phosphoribosyl transferase(HPRT), an enzyme involved in purine metabolism. This enzyme deficiency gives rise to nephropathy symptoms, such as hyperuricosuria and hyperuricemia by excessive uric acid production and neuropathy symptoms, such as mental retardation, choreoathetosis and self mutilation behavior. Patients with Lesch-Nyhan syndrome have tendency to bite their lip, tongue and finger. In severe cases, partial or even total amputation of tongue or finger occur. Self-inflicted bites are often complicated by secondary infection to the injured site as well as pain. Furthermore tissue loss by biting results in esthetic problems. The dental management of self mutilation includes treatment with appliances such as soft mouth guard or lip bumper, extraction of all the teeth, and orthognathic surgery. We report a case of a 13 year-old boy with Lesch-Nyhan syndrome, who severely injured himself on his tongue. At first, conservative treatment using soft mouth guard was considered, but it could not prevent trauma on his tongue. Therefore, extraction of the lower anterior and posterior teeth was carried out.

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Treatment of Gingival Irritation Fibroma Using $CO_2$ Laser (이산화탄소 레이저($CO_2$ laser)를 이용한 치은에 발생한 자극성 섬유종의 치료)

  • Choi, Young-Chan;Park, Ju-Hyun;Ahn, Hyung-Joon
    • Journal of Oral Medicine and Pain
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    • v.35 no.2
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    • pp.119-122
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    • 2010
  • Carbondioxide($CO_2$) laser is one of the most widely employed lasers in oral soft tissue surgery because of its excellent affinity for water based soft tissues. It has some inherent advantages such as hemostasis, less postoperative swelling, reduction of bacterial population at surgical site, less need for suturing, less scarring, and less postoperative pain compared to conventional surgical therapies including the use of scalpel, diathermy, cryotherapy and electrosurgery. A 30-years-old male was presented with gingival swelling. Clinical examination revealed a well?defined pedunculated fibrotic mass on the buccal gingiva near right maxillary 1st molar. In radiographic examination, no remarkable abnormality was seen. Excisional biopsy was performed with $CO_2$ laser (continuous wave mode, 4.0W). Histological diagnosis was "Irritation fibroma". $CO_2$ laser has advantages those are suitable for surgical treatment of intraoral lesion. If appropriate training and experience are provided, the dentist would be able to manage intraoral lesions more efficiently and successfully with the use of the $CO_2$ laser.

Treatment of Subclavian Artery Injury in Multiple Trauma Patients by Using an Endovascular Approach: Two Cases (다발성 외상환자에서 혈관계 접근을 통해 치료한 쇄골하동맥 손상 2례)

  • Cho, Jayun;Jung, Heekyung;Kim, Hyung-Kee;Lim, Kyoung Hoon;Park, Jinyoung;Huh, Seung
    • Journal of Trauma and Injury
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    • v.26 no.3
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    • pp.243-247
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    • 2013
  • Introduction: Surgical treatment of subclavian artery (SA) injury is challenging because approaching the lesion directly and clamping the proximal artery is difficult. This can be overcome by using an endovascular technique. Case 1: A 37-year-old male was drawn into the concrete mixer truck. He had a right SA injury with multiple traumatic injuries: an open fracture of the right leg with posterior tibial artery (PTA) injury, a right hemothorax, and fractures of the clavicle, scapula, ribs, cervical spine and nasal bone. The injury severity score (ISS) was 27. Computed tomography (CT) showed a 30-mm-length thrombotic occlusion in the right SA, which was 15 mm distal to the vertebral artery (VA). A self-expandable stent($8mm{\times}40mm$ in size) was deployed through the right femoral artery while preserving VA flow, and the radial pulse was palpable after deployment. Other operations were performed sequentially. He had a viable right arm during a 13-month follow-up period. Case 2: A 25-year-old male was admitted to our hospital due to a motorcycle accident. The ISS was 34 because of a hemothorax and open fractures of the mandible and the left hand. Intraoperative angiography was done through a right femoral artery puncture. Contrast extravasation of the SA was detected just outside the left rib cage. After balloon catheter had been inflated just proximal to the bleeding site, direct surgical exploration was performed through infraclavicular skin incision. The transected SA was identified, and an interposition graft was performed using a saphenous vein graft. Other operations were performed sequentially. He had a viable left arm during a 15-month follow-up period. Conclusion: The challenge of repairing an SA injury can be overcome by using an endovascular approach.

Statistical Approach of Measurement of Signal to Noise Ratio in According to Change Pulse Sequence on Brain MRI Meningioma and Cyst Images (뇌 수막종 및 낭종에서 자기공명영상 펄스 시퀀스 변화에 따른 신호대잡음비의 통계적 접근)

  • Lee, Eul-Kyu;Choi, Kwan-Woo;Jeong, Hoi-Woun;Jang, Seo-Goo;Kim, Ki-Won;Son, Soon-Yong;Min, Jung-Whan;Son, Jin-Hyun
    • Journal of radiological science and technology
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    • v.39 no.3
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    • pp.345-352
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    • 2016
  • The purpose of this study was to needed basis of measure MRI CAD development for signal to noise ratio (SNR) by pulse sequence analysis from region of interest (ROI) in brain magnetic resonance imaging (MRI) contrast. We examined images of brain MRI contrast enhancement of 117 patients, from January 2005 to December 2015 in a University-affiliated hospital, Seoul, Korea. Diagnosed as one of two brain diseases such as meningioma and cysts SNR for each patient's image of brain MRI were calculated by using Image J. Differences of SNR among two brain diseases were tested by SPSS Statistics21 ANOVA test for there was statistical significance (p < 0.05). We have analysis socio-demographical variables, SNR according to sequence disease, 95% confidence according to SNR of sequence and difference in a mean of SNR. Meningioma results, with the quality of distributions in the order of T1CE, T2 and T1, FLAIR. Cysts results, with the quality of distributions in the order of T2 and T1, T1CE and FLAIR. SNR of MRI sequences of the brain would be useful to classify disease. Therefore, this study will contribute to evaluate brain diseases, and be a fundamental to enhancing the accuracy of CAD development.

Mini-transposon을 사용한 단백질의 세포내 분포 결정

  • 최의열
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1993.04a
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    • pp.134-134
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    • 1993
  • Tn3 Transposon을 이용한 Shuttle Mutagenesis방법으로 효모의 Genome 상에 무작위적으로 $\beta$-gal 표지 유전자를 삽입하고 효모생활사의 각 세포시기 마다 특이하게 발현되는 유전자를 X-Gal plate상에서 찾아내고 이들 효모 유전자의 단백질이 세포내에 어떤 위치에 분포하는가를 간접 면역현미경법으로 추적해보았다. 먼저 효모의 genomic library를 38bp의 Tn3 Termial repeat를 가지고 있지 않은 pHSS6 Vector에 patial fill-in 방법으로 조성하였으며 최종적으로 20 Genome equivalent에 해당하는 18개 Pool의 genomic library를 만들었다. 이들 library를 조사하여 본 결과 모든 클론이 평균 3kb 크기의 insert를 가지고 있었으며 이는 99.99%의 효묘 genome을 대표하였다. 특정한 유전자의 발현을 알아보기 위해 먼저 mini-Tn3로 shuttle mutagenesis를 실시하고 vegetative growth동안 발현되는 유전자를 X-gal을 사용하여 골라내었다. 지금까지 16823개의 클론을 조사하였는데 이중 13%에 해당하는 2187개가 X-gal plate상에서 양성반응을 보여주었다. 양성반응을 보여주는 융합단백질의 세포내 분포틀 anti-$\beta$-galactosidase 항체를 사용하여 추적해보았다. 항체론 이용한 형광염색결과 약 70%의 세포가 background이상의 염색을 보여주었으며 이중 novel한 염색 pattern을 나타내는 클론도 다수 탐지되었다. 이상의 결과를 종합하면 Tn3틀 이용한 Shuttle Mutagenesis 방법으로 지금까지 전통적인 유전학적인 접근 방식으로 탐지되지 않았던 다수의 새로운 효모 유전자를 찾아낼 수 있을 것으로 사료된다.tamine제중 triprolidine이 $K_{M}$ /K$_{H}$ 비가 가장 높았고 diphenidol이 가장 낮았다. 이상의 결과로 보아 항 histamine제의 muscarinic receptor 차단작용은 이들 약물의 항 alleragy 효과에 필요한 작용이 아니며 본 실험에서 추정된 항 histamine제의 H$_1$-receptor와 muscarinic receptor에 대한 상대적 역가는 이들 약물의 선택과 평가에 중요한 지표가 될수 있을 것으로 생각된다.ing ischemic insults. The nature of the receptor is being explored by molecular genetic techniques, and we have recently cloned two of the major subunits; some of the data will be presented.LIFO, 우선 순위 방식등을 선택할 수 있도록 확장하였다. SIMPLE는 자료구조 및 프로그램이 공개되어 있으므로 프로그래머가 원하는 기능을 쉽게 추가할 수 있는 장점도 있다. 아울러 SMPLE에서 새로이 추가된 자료구조와 함수 및 설비제어 방식등을 활용하여 실제 중형급 시스템에 대한 시뮬레이션 구현과 시스템 분석의 예를 보인다._3$", chain segment, with the activation energy of carriers from the shallow trap with 0.4[eV], in he amorphous regions.의 증발산율은 우기의 기상자료를 이용하여 구한 결과 0.05 - 0.10 mm/hr 의 범위로서 이로 인한 강우손실량은 큰 의미가 없음을 알았다.재발이 나타난 3례의 환자를 제외한 9례 (75%)에서는 현재까지 재발소견을 보이지 않고 있다.

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Change in Fertility Rates in Korea: Causes and Future Prospect (최근 한국사회의 출산율 변화원인과 향후 전망)

  • Kim, Seung-Kwon
    • Korea journal of population studies
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    • v.27 no.2
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    • pp.1-34
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    • 2004
  • 최근 한국사회에서는 출산율의 저하로 인한 사회경제적 영향을 우려하여 대책방안을 강구하여야 한다는 논의가 증대되고 있다. 그런데 국가정책을 개발${\cdot}$추진하기 이전에 반드시 요구되는 것은 저출산 현상의 올바른 인식과 철저한 원인규명이다. 따라서 본 연구에서는 출산율 변화의 원인을 다각적으로 살펴보고, 향후 변화방향을 전망해 보고자 한다. 먼저 자녀출산의 변화를 결혼상태 변화와 유배우부인의 출산율 변화 부분으로 나누어 살펴본 결과, 과거와는 달리 최근의 출산율 저하는 유배우 부인에 의해서가 아니라 미혼자의 결혼연장 또는 독신생활에서 기인되는 것으로 나타났다. 이들 두 요인에 영향을 주는 변수로는 경기침체 및 직장불안정, 결혼가치관의 변화와 초혼연령의 상승, 자녀양육 관심증대, 자녀양육비 부담, 가정과 직장의 양립을 위한 사회적 인프라 부족, 여성의 자아욕구 및 사회참여 증대, 자녀효용가치 감소, 이혼 등 가족해체의 증대, 그리고 불임부부의 증대 등인 것으로 판단된다. 향후 출산율 변화를 전망해 보면, 저출산을 일찍 경험한 서구 선진국의 경우와는 달리 정책의 추진에 한계가 있어 선진국보다 더 낮은 출산율을 회복하는 데는 많은 어려움이 있을 것이라는 판단이다. 더군다나 젊은 미혼남녀의 가치관이 개인주의화 되는 경향이 있다는 점을 감안한다면 출산율 회복정책을 추진한다 하더라도 한계가 있을 수밖에 없을 것이다. 수년간 실시된 각종 실태조사를 분석한 결과에 의하면 현재의 경기침체가 회복될 경우 약 20%의 출산율 상승 가능성이 있으며, 이 때의 합계출산율은 약 1.43명 수준이 될 수 있을 것으로 예견된다. 또한 종합적 체계적 출산회복정책을 효과적${\cdot}$효율적으로 추진한다면 약 10년 후에는 합계출산율이 약 1.6 수준으로 회복될 것이라는 낙관적 견해를 가져본다. 그렇지만 정책의 강도에 따라서 회복수준은 현저하게 상이할 것이다.를 진단, 치료함에 있어 진행성 신질환의 가능성을 시사하는 예후인자가 없다면 신생검보다는 지속적이고 정기적인 추적관찰만으로도 충분할 것으로 생각된다도 등은 양군 사이에 유의한 차이가 관찰되지 않았다. 발견 당시 혈청 $C_3$치의 감소는 모두 11명(61.1%)에서 관찰되었는데, 증상군에서는 7명(87.5%), 집단뇨검사군에서는 4명(40%)으로 증상군에서 혈청 $C_3$치의 감소가 보다 현저하였다. 그러나 추적관찰 기간 동안 증상군에서는 7명 중 4명, 집단뇨검사군에서는 4명 중 1명에서 혈청 $C_3$치는 정상범위로 증가하여 최종 관찰시점에서는 6명 (33.3%)에서만 혈청 $C_3$치의 감소가 지속되고 있다. 혈청 $C_3$치의 감소를 보인 경우를 다시 병리조직학적 분류에 의해 세분하여보면 발병당시에는 I형 8명(61.5%), II형에 1명(100%), III형 2명(50%)에서 관찰되었는데, 최종 시점에서는 I형 4명(30.8%), II형 1명(100%), III형 1명(33.3%)이었다. 또한 증상군에서 세포성 반월체형성과 세뇨관위축의 빈도가 높았으며, 사구체 혈관벽 비후와 사구체 간질의 증가의 정도가 집단뇨검사군에 비해 통계적으로 유의하게 높았다. 결론: 무증상성 요이상을 가진 환자에서 신장조직검사 실시 후 MPGN으로 진단되는 증례가 증가하고 있고, 오히려 증상을 동반하는 경우보다 빈도가 증가한다는 사실은 집단뇨 검사에서 소변의 이상소견이 발견되어 신장 조직검사를 실시할 경우 혈청 $C_3$치의 감소 여부에 관계없이 MPGN도 진단적 고려 대상이 되어야 한다고 생각한다.신장 조직검사를 시행한 결과 진행성 경과를 취할 수 있는 막 증식성 사구체 신염과 매우 희귀한 증례인 신유전분증 등으로 진단됨으로써 지속성 단백뇨의 경우 정확 진단적 접근이 필수적임을 알 수

Clinical data analysis in retrospective study through equality adjustment between groups (후향적연구의 집단 간 동등성확보를 통한 임상자료분석)

  • Kwak, Sang Gyu;Shin, Im Hee
    • Journal of the Korean Data and Information Science Society
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    • v.26 no.6
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    • pp.1317-1325
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    • 2015
  • There are two types of clinical research to figure out risk factor for disease using collected data. One is prospective study to approach the subjects from the present time and the other is retrospective study to find the risk factor using the subject's information in the past. Both approached and study design are different but the purpose of the two studies is to identify a significant difference between two groups and to find out what the variables to influence groups. Especially when comparing the two groups in clinical research, we have to look at the difference between the impact clinical variables by group while controlling the influence of the baseline characteristics variables such as age and sex. However, in the retrospective study, the difference of baseline characteristic variables can occur more frequently because the past records did not randomly assign subjects into two groups. In clinical data analysis use covariates to solve this problem. Typically, the analysis method using the analysis of covariance of variance, adjusted model, and propensity score matching method. This study is introduce the way of equality adjustment between groups data analysis using covariates in retrospective clinical studies and apply it to the recurrence of gastric cancer data.