The goal of the present study was to evaluate the effects of PNAM appliance and cheiloplasty on alveolar molding. Samples consisted of 16 unilateral cleft lip and palate infants (10 males and 6 female, mean age=37.0 days after birth, average alveolar cleft gap=10.46m), who were treated with PNAM appliances by one orthodontist and rotation- advancement cheiloplasty by one surgeon in Seoul National University Hospital. Average duration of alveolar molding treatment was 13.10 weeks and these patients were recalled at average 8.31 weeks after cheiloplasty. These patients' models were obtained at initial visit (T0, mean age : $37.0\pm27.89$ days after birth), after successful alveolar molding (T1, mean age : $119.25\pm40.18$ days after birth), and after cheilopasty (T2, mean age : $190.81\pm42.78$ days after birth). Seven linear and five angular variables were measured using 1 : 1 photometry and soft ware program(V-ceph. Cybermed. Seoul, Korea). Paired t-test was performed to investigate statistical significance at p<0.05 level. 1 The posterior parts of alveolar segments were the stable structures during alveolar molding treatment period and after cheiloplasty in infants. 2. The closure of cleft gap during alveolar molding was usually due to backward bending of the whole part of the greater segment. 3. Although forward growth of the greater segment was hindered by alveolar molding, it resumed after cheiloplasty. 4. Increase of anterior inter-segment angle after cheiloplasty was due to the molding effect of the lip scar pressure.
Journal of the Korean association of regional geographers
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v.6
no.3
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pp.117-138
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2000
This study is, from the view point of constructive social studies which is the foundation of the 7th curriculum, to explore whether there is any viable program and to investigate it by which students, using photo resources in social studies, can organize their knowledge in the way of self-directed thinking. The main results are as follows: If it is a principle of knowledge construction process of constructive social studies that individual construction (cognitive construction) develops into communal construction(social construction) and yet communal construction develops itself, interacting with individual construction, it will be meet the objectives of social studies. In social studies, photos are a powerful communication tool. communicating with photos enables to invoke not only the visual aspects but also invisible aspects of social phenomena from photos. It, therefore, can help develop thinking power through inquiry learning, which is one of the emphasis of the 7th curriculum. Having analyzed photo resources appeared on the regional textbooks in elementary social studies, they have been appeared that even though the importance and amount of space photo resources occupy per page is big with regard to total resources, most of the photos failed to lad to self-directed thinking but just assistant material in stead. Besides, there appeared some problems with the title, variety, size, position, tone of color, visibility of the photos, and further with the combination of the photos. Developing of photo resources for constructive social studies is to overcome some problems inherent in current text books and to reflect the theoretical background of the 7th curriculum. To develop the sort of photo that can realize the point just mentioned, it would be highly preferable to provide photo database to facilitate study with homepage through web-based interaction. To take advantage of constructive photo resources, the instruction is strategized in four stages, intuition, conflict, accommodation, and equilibration stage. With the advancement of the era of image culture, curriculum developers are required to develop dynamic, multidimensional digital photos rather than static photos when develop text books.
College level educational training system for the allied health manpower in the country is one of the oldest junior college education programs, and has been developed at very steady phase. Since the school years of the programs limited for 2 to 3 years by the education related law, qualification of the manpower is insufficient to meet the rapidly changing needs in the field of allied health and medicine. The system is comparable with that of developed countries where 4-year baccalaureate degree programs are basically required to be an allied health personnel. Thus, education and training background of allied health program graduates of the country confronts the barriers in competition and cooperation with the graduates of foreign countries at equal basis. Beside, junior college graduates can hardly find the way through advanced courses at 4-year colleges in their specialties except a few programs such as environmental sicience or courses in hygiene. It has long been sought to develop the education and training programs for junior college graduates. Some of them are already materilized and some show remarkable progress while some need to tackle. Wide opening of the opportunity to enroll extensive education program for the junior college graduates of allied health science majors in 4-year colleges with eventual grant of bachelor's degree for those who successfully completed the programs should soon be substantiated. The study was focused to emphasize the necessity of the extensive education and training for the junior college graduate allied health manpower, and to show possibility of the education program development in connection with the 4-year degree granting education programs. The outcome of the study can be summarized as followings. 1. A total number of graduates from eight allied health sciences related programs of junior colleges by the year of 1995 are 109,320. 2. According to the survey report analysed through questionnaires, 99.7% of respondents including administrative deans and professors of junior colleges agreed with the establishment of extensive education and training programs in junior colleges. 53.9% of administrative deans, 52.9% of professors and 47.6% of the graduates expected that it is possible to learn more about their majors, and to earn bachelor's degree through the extensive education programs. Other opinions include that the programs can provide supplementary opportunities to fortify in the area of basic life science, and development of research and technology. 3. It was also found through the survey that 91.2% of the deans, 87.8% of the professors and 68.2% of the graduates responded that the most appropriate organizations to open the extensive education and training programs for allied health manpower are junior colleges where allied health personnel are taught and trained. The majority of the respondents agreed that the acceptable number of credits offered for the previous 2-year junior college graduates are $50\sim60$, and those for the current 3-year graduates are $20\sim30$ units. 4. It was strongly suggested through the survey that baccalaureate degree should be granted for those who successfully completed the extensive courses. The suggestion was claimed by 94.1% of the deans, 89.4% of the professors and 83.4% of the graduates. 5. The model curricula for the extensive education and training programs for the allied health manpower are designed for the purpose of broad capability in practice, enrichment of knowledge and promotion of proficiency for the self access in the major areas. 6. To meet the universal standards of allied health education and training program, it is recommended that opening of the curricula for the extensive, and as well as intensive, courses within junior colleges(continuation education institute) should be materialized. The special baccalaureate degree programs within junior colleges are also recommended to accommodate the junior college graduates and to grant the degree fellowing successful completion of the courses. As a part of the education revolution in progress, the school years at junior college level should be flexible depending upon the nature of course and trend of the universe. For instance, the school years for the allied health manpower should be extended to two to four years from current two to three years.
The Fontan operation has undergone a number of major modifications and clinical results have been improving over time. Nevertheless, during the follow-up period, life-threatening complications develop and affect the long-term outcomes. Surgical interventions for these complications are needed and are increasing. Material and Method: From April 1988 to January 2000, 16 patients underwent reoperations for complications after Fontan operation. The mean age at reoperation was 8.8 :-5.5 years. Initial Fontan operations were atriopulmonary connections in 8 and total cavopulmonary connections in 8. Total cavopulmonary connections were accomplished with intracardiac lateral tunnel in 5 and extracardiac epicardial lateral tunnel in 3. Five patients had variable sized fenestrations. The reasons for reoperations included residual shunt in 6, pulmonary venous obstruction in 3, atrial flutter in 3, atrioventricular valve regurgitation in 2, Fontan pathway stenosis in 1, and protein-losing enteropathy in 1 Result: There were 3 early and late deaths respectively Patients who had residual shunts underwent primary closure of shunt site (n=2), atrial reseptation for separation between systemic and pulmonary vein (n=2), conversion to lateral tunnel (n=1), and conversion to one and a half ventricular repair (n=1). Four patients who had stenotic lesion of pulmonary vein or Fontan pathway underwent widening of the lesion (n=3) and left pneumonectomy (n=1) In cases of atrial flutter, conversion to lateral tunnel after revision of atriopulmonary connections was performed (n=3). For the atrioventricular valve regurgitation (n=2), we performed a replacement with mechanical valve. In one patient who had developed protein-losing enteropathy, aorto-pulmonary collateral arteries were obliterated via thoracotomy. Cryoablation was performed concomitantly in 4 patients as an additional treatment modality of atrial arrhythmia. Conclusion: Complications after Fontan operation are difficult to manage and have a considerable morbidity and mortality. However, more accurate understanding of Fontan physiology and technical advancement increased the possibility of treatment for such complications as well as Fontan operation itself. Appropriate surgical treatment for these patients relieved the symptoms and improved the functional class, Although the results were not satisfactory enough in all patients.
Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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v.20
no.1
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pp.47-51
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2009
Background and Objectives: Intracordal cysts may occur secondary to voice abuse and overuse or may be secondary to a remnant of epithelium trapped within the lamina propria. They may occur spontaneously or may be associated with poor vocal hygiene. As the cyst enlarges it can start to significantly affect the vibratory region of the vocal fold. With the advancement of the microsurgical technique and the laryngeal stroboscopy, correct diagnosis of intracordal cyst have been increased. The aims of this study is to review the important clinical characteristics of the intracordal cyst. Materials and Methods: In the present study, 212 cases of the intracordal cysts were treated by the microsurgical technique. These lesions were diagnosed before the operation with indirect laryngoscopy, laryngeal endoscopy, laryngeal stroboscopy and confirmed with the findings observed during operations and the results of the biopsies. Results : The intracordal cysts were 212 cases in the 4,20 I patients who underwent laryngeal microsurgery (5.04%). Ductal cysts were 156 cases and epidermoid cysts were 56 cases. The lesions are more frequent in women and anterior third of true vocal cord is more frequently involved site. With the preoperative laryngoscopic examination, the intracordal cysts were mostly misdiagnosed as other disease of the vocal cord such as vocal polyps or nodules. And main cause of intracordal cysts was thought of vocal abuse. From view of the surgical approach, Ductal cysts was difficult to remove completely than epidermoid cyst without cystic wall rupture. Conclusion : Intracordal cysts are very similar to the other mucosal disorders of the vocal cord and it may be misdiagnosed as vocal polyps or nodules, frequently. Therefore careful preoperative examinations for the vocal cord lesions with stroboscopy and other endoscopic instruments are important part of the correct diagnosis. An ideal treatment is enucleation of the cysts without rupture of the cystic wall or injury of the lamina propria. And marsupialization is meaningful to ductal cyst that cannot be enucleated completely.
Medical tour can be said to be a new high added-value tour industry of 21st century. The development of varied and distinguished medical tour products by each country will further vitalize the medical tour industry. As the interest in such medical tour increases, it is necessary to analyze the demand and interests of tourists accurately and prepare medical tour products to be provided in order to develop and promote medical tour products. The government considers the medical tour industry as an industry with high expected effects in job creation through promotion of experts in global healthcare industry and national economy development through high added-value creation, and has expanded aid policies in medical tour field with improvement of medical tour immigration system, one-stop service system for medical tourists, and medical tour labor force promotion system. Nevertheless, there are disputes between foreign patients and medical tour inviting businesses, along with medical accident disputes between foreign patients and medical staff and disputes with those working in the tourism industry. This article reviews the types of disputes occurring around the inviting businesses related to medical tours and tried to review the resolutions. Through this, it was found that medical tour inviting businesses have the responsibility to connect the mediated benefits and risks and also the responsibility to process the tasks. Thus, in case dispute occurs due to passive actions from establishing agency agreement to active mediation results, it is difficult to escape the liabilities. Also, in a medical tour agency contract, the inviting business must be aware that it bears the responsibility to explain and advise the details on benefits and risks to foreign patients. The "Guide to arbitration system for resolution of medical disputes with foreign patients" by Korea Health Industry Development Institute Act presents a method to resolve disputes according to the [laws on medical accident damage relief and medical dispute arbitration] in case a dispute due to medical accidents occurs to foreign patients when the foreign patients prepare diagnosis agreement, Whether such method is sufficient to protect foreign patients, however, is thought to require discussions from more diverse perspectives. In order to vitalize medical tourism, the development of diverse products is also important, but the countermeasures against related disputes should also be prepared. Such is expected to contribute to a greater advancement based on trust of foreign medical tourists alongside excellent medical technologies.
Kim, Do-Kyun;Yoo, Kyung-Jong;Youn, Young-Nam;Yi, Gi-Jong;Lee, Sak;Chang, Byung-Chul;Kang, Meyun-Shick
Journal of Chest Surgery
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v.40
no.3
s.272
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pp.209-214
/
2007
Background: Failed percutaneous transluminal coronary angioplasty (PTCA) is occasionally required for emergency coronary artery bypass grafting (CABG). The aim of this study was to assess the outcome of patients receiving emergency CABG after failed PTCA. Material and Method: Between May 1988 and May 2005, 5712 patients underwent PTCA, where 84 (1.4%) failed. 27 patients underwent emergency CABG after failed PTCA. The mean age was $63.7{\pm}8.9\;(46{\sim}80)$ years, with 14 male patients (51.9%). Result: All patients underwent emergent surgical revascularization within 6 hours. 22 patients underwent conventional CABG and 5 underwent off-pump CABG. The causes of PTCA failure were coronary obstruction due to new thrombi formation during the procedure (n=4), coronary dissection (n=17), coronary artery rupture (n=3) and 3 due to other causes. The rate of in-hospital operative mortality after emergent operation was 18.5% (5/27). A univariate analysis revealed that patients who died more often had left anterior descending artery disease, a preprocedural shock status, postoperative use of multiple isotropics and postoperative use of intra-aortic balloon pump. The mean follow up duration was $53.6{\pm}63.4$ months. Conclusion: Although PTCA is known to be life saving, there is still a high risk for morbidity and mortality following emergency CABG after failed PTCA, despite the advancement in PTCA techniques. This result will help identify and more effectively treat patients selected for PTCA when emergency CABG is required.
Background: Due to the advancement of video assisted thoracoscopic techniques, an operation for primary spontaneous pneumothorax is now considered a common procedure. However, whether a preventive operation is necessary when a contralateral bulla is found on High Resolution Computed Tomography (HRCT) at the time of the first primary spontaneous pneumothorax attack is still unknown. In this retrospective study, it was our intension to find whether contralateral bullae are related to the occurrence of pneumothorax. Material and Method: Between January 1999 and April 2006, 550 patients were admitted to the Chungnam University hospital with primary spontaneous pneumothorax, which was confirmed by the HRCT scans in 190 patents. In these 190 patients, 159 had not received a bilateral operation after their first primary spontaneous pneumothorax attack. In these 159 patients, the relationship between the presence of contralateral bullae and the occurrence of pneumothorax was measured. Result: In these 159 patients, 67 had contralateral bullae confirmed inform the HRCT scan, and 92 had no visible contralateral bullae, During the follow up period, 6 patients (8.9%) with contralateral bullae had an occurrence of contralateral pneumothorax, and 5 patients (5.4%) without contralateral bullae had an occurrence of contralateral pneumothorax. (p=0.529 [Fisher's exact test]) Conclusion: In patients with unilateral primary pneumothorax, an HRCT scan is a useful way of confirming contralateral pulmonary bullae. However, the presence of bullae is not a significant predictive sign of an occurrence of contralateral pneumothorax. Also, surgery for pneumothorax is not completely uncomplicated, and bilateral surgery is still doubtful. A further prospective study will be required to find the relationship between the bullae found on HRCT and the occurrence of pneumothorax.
This study aimed to analyze the appropriateness of chemistry teaching-learning programs for the gifted in science in middle school gifted classes and to propose improvements. For this study, 5 chemistry teaching-learning 4-6 hour programs developed for science gifted classes by Korea Education Development Institute (KEDI) and 3 chemistry teaching-learning programs developed for science gifted classes by three middle schools in K province were selected. A standard model for gifted education programs was used as tool for analyzing the program targets, program contents, teaching-learning methods, and assessment items. The results showed that all chemistry teaching-learning programs for the gifted in science presented well attainable objectives in the program targets. However, most program targets did not offer differentiated objectives from the general education. Program contents of KEDI stresses intensified education, and also presented a high ratio of sub-elements of creativity, which can enhance gifted creativity. On the other hand, program contents developed by three middle schools focused on acceleration in advancement, and presented low ratio of creativity sub-elements, which could be insufficient in enhancing gifted creativity. Differentiated and personalized, integrated science and interscience, updated research contents were hardly found in programs developed by KEDI and three middle schools. However, teaching-learning methods were composed to fit the learning objectives in the teaching process and the procedures, and were made to self-directed learning. There were no assessment for the feedback after class. Therefore, teaching-learning programs for the gifted in science should be developed further in order to fulfill the objectives of gifted education and gifted characteristics. Also, it is necessary to construct infrastructure to carry out the developed teaching-learning programs.
The Korean genetics and genomics reveal a firm willingness to participate in and contribute to the production of creative scientific knowledge at a world level at present, though they have short past histories of introduction from the Western counterparts and those of education for the next generations. But the Korean genetics and genomics have been developed in a fragmented and biased manner. By reconfiguring the various research projects of genomics into the Genome Project of Korea, which reflect a worldly trend in life science, but have been established in a scattered fashion in Korea, and incorporating some neglected areas of genetics, such as human genetics and theoretical and population genetics which can be reconstructed in a new way, a genetics-genomics research system can be formulated on the multi-tiered perspective of concept, knowledge, and institution, while the system being a subsystem of the national research system of life science in Korea. Innovation can be pursued in the systematic practice through a culturalist strategy. The culturalist strategy with the practice based on the research system consists of 1) intensification of fundamentalness of genetics and genomics, 2) advancement of communitarianism in geneticist-genomicist community, 3) research on the cultural bio-species along with the promotion of scientific arts and culture, and 4)formation of the Korean science studies of genetics-genomics and the diffusion of the knowledge produced. The first two strategy components are the ones that intends to bring out changes in the structural aspect of the scientist community in Korea. The third is the one that attempts to magnify the interface between the scientist community and the Korean society at large and increase its connectivity between both, while the fourth is the one that has an intentionality toward the Korean society outside of the scientist community. This culturalist strategy is intended to increase the cultural constructivity of the genetics-genomics research system in Korea.
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