• Archives of Plastic Surgery
• /
• 제38권5호
• /
• pp.616-620
• /
• 2011

Purpose: Mayer-Rokitansky-Kuster syndrome (MRK) is second common cause of primary amenorrhea. It is a syndrome of vaginal aplasia and Mullerian duct anomaly. Vaginal aplasia varies from agenesis of whole vagina to aplasia of upper 2/3. For reconstructing vagina, various methods are introduced. Gracilis myocutaneous flap was the first attempt in that the flap is used in vaginal reconstruction. Various flap-based vaginal reconstruction methods have been introduced. Modified Singapore flap (pedicled neurovascular pudendal thigh fasciocutaneous flap) is one of those methods that used posterior labial artery as pedicle, and pudendal nerve branch as sensory root. As its donor lies on inguinal crease that is easily hidden and there are benefits on sexual intercourse by early sensory recovery, authors think that modified Singapore flap is effective for young MRK syndrome patients. Methods: Eight patients underwent surgery between 2008 and 2010. The flap was designed on both groin area with external pudendal artery branch as a pedicle. All flaps were fixated in pelvic cavity with absorbable suture, and additional compression on neovaginal wall was supplied by polyvinyl alcohol sponge ($Merocel^{(R)}$). Results: All patients were successfully reconstructed without flap related complications such as congestion or partial flap loss. The average size of the flap (each side) was 69.34 $cm^2$. Polyvinyl alcohol sponge ($Merocel^{(R)}$) was inserted into neovagina for 5 days on every patient. One case of rectal laceration was occurred while making pelvic pocket by OBGY team. Other complications such as lumen narrowing, wound contracture or vaginal prolapsed were not reported during 8 months of follow up. Conclusion: Modified Singapore flap is a sensate fasciocutaneous flap that is thinner than other myocutaneous flap such as VRAM, and more durable over skin graft. Therefore this is a good choice for vaginal reconstruction in MRK syndrome. And known complications of Modified Singapore flap could be reduced with careful procedure and mild compression techniques.

• 한국임상약학회지
• /
• 제6권2호
• /
• pp.19-23
• /
• 1996

Carbamazepine is an anticonvulsant drug that has been shown to be as effective as phenytoin or phenobarbital in treatment of grand mal and complex partial seizures and is also approved as the drug of choice for treatment of the pain associated with trigerminal neuralgia. And the therapeutic or toxic effects of carbamazepine are better related to plasma concentration than to dosage, which can be attributed to interindividual variability in the pharmacokinetics. A slow rate of carbamazepine dissolution in the gastrointestinal tract is believed to be the cause of its relatively slow and erratic rate of absorption. For these reasons pharmacokinetic evaluation of newly formulated carbamazepine is neccessary. In this study, the bioequivalence in carbamazepine between the $TegretoI^{TM}$ CR tablet (Geigy Co.) and $Carmazepine^{TM}$ CR tablet (Myung In Co.) was evaluated. 12 normal volunteers (age $21\~27$ years old) was divided into two groups, and a randomized cross-over study was employed. The pharmacokinetic parameters ($C_{max},\;T_{max}$ and AUC) obtained of oral administration of each formulatim of carbamazepine 400 mg were evaluated and ANOVA was utilized for the statistical analysis of parameters. $C_{max}\;is\;8.26{\pm}3.1{\mu}g/ml\;(C.V.\;37.3\%)\;in\;TegretoI^{TM}\;and\;9.39\{pm}2.9{\mu}g/ml\;(C.V.\;30.5\%)$ in $Carmazepine^{TM},\;T_{max}\;is\;28.0{\pm}5.9\;hrs(C.V.\;21.1\%)$ in $Tegretol^{TM}\;and\;24.0{\pm}7.2\;hrs(C.V.\;30.2\%)$ in $Carmazepine^{TM}$ and AUC is $786.4{\pm}360.5{\mu}g{\cdot}hr/ml\;(C.V.\;45.8\%)$ in $TegretoI^{TM}\;and\;792.8{\pm}228.6{\mu}g{\cdot}hr/ml\;(C.V.\;28.8\%)$ in $Carmazepine^{TM}$, respectively. As the result of the data, two formulations are bioequvalent, and the lower C.V. of $Carmazepine^{TM}$ in every individual can be merit.

• 한국치위생학회지
• /
• 제5권2호
• /
• pp.297-309
• /
• 2005

The purpose of this study was to develop a standardized preschool oral health education program as one of educational media and to apply it to preschool education. It's ultimately meant to help improve the oral health education policy of the nation toward young children and to provide multiple information on that. The subjects in this study were 250 young children who were at the age of 7 and attended kindergartens in the city of S. To evaluate an oral health education program prepared in the study, the selected young children were taught by using it, and a survey was conducted twice before offering education and three weeks after it to assess their knowledge. Besides, their patient hygiene performance was tested. For data handling, SPSS program was utilized, and in order to see if there would be any changes in their oral health behaviors, statistical data on percentage were obtained and crosstab was employed. To track any possible additional changes in their relevant knowledge and Simplified Oral Hygiene Index, t-test was implemented. The findings of the study were as follows: 1. As for changes in oral health behaviors, there were significant differences in tooth brushing time(p<0.05), tooth brushing method(p<0.01) and toothbrush keeping method(p<0.001) between before and after the education. 2. Regarding changes in oral health knowledge, there was a significant gap between before and after the education(p<0.001). In detail, their knowledge about the cause of dental caries(p<0.05), the right choice of toothbrush(p<0.001) and toothbrushing after meals(p<0.01) became significantly different. 3. There was no gap in patient hygiene performance index between before and after the education. 4. To boost the effect of oral health education on kindergarteners, it seems necessary to give a lecture on oral health, to demonstrate tooth brushing by using dntiform, and to offer instruction by utilizing disclosing solution. 5. Repeated education should be provided on a regular basis by preparing standardized teaching plans tailored to the characteristics of kindergarteners, and a wide variety of teaching materials that could be easy to understand, authentic and provide motivation to them should be developed.

• 대한물리치료과학회지
• /
• 제4권2호
• /
• pp.405-419
• /
• 1997

This research has been conducted to provide the spinal cord injured patients with comprehensive necessity of and backup data for their rehabilitation in the community and make the aware of importance of overall community support to patients. The data was collected through questionnaire made to 83 patients charged to general hospital in Jeonbuk Province between 1 and 31 March 1997 to analyse the patients ability on activities of daily living through the research on general characteristics and Modified Barthel Index(MBI). As a result the outcome of the research was as follows : 1. Sexual distribution represented that 57 male (68.7%) and 26 female(31.3%) and in the age distribution majority group was 36 thirties (43.4 %) most active in social activities. 2. Analysis on occupation of patients showed majority group was in technicians, 21 people representing 25.4 % and the major cause of injury was traffic accident, 45people representing 54.2%, fall down, 17 people representing 20.5% and industrial accident, 13 people representing 15.7%, respectively. 3. In the multiple choice questionnaire on complications, the rate of appealing pain was highest and spasticity, pressure sore, contracture, depression which restrict the patients from activities of daily living ability were also appeared. 4. The theoretical points in MBI Should lie between 1 and 115 and the average point be 58 but the average point of the MBI among 83 patients was 63. 5. The MBI point by the level of injured represented statistically critical difference(P<0.001) and the MBI points tested by Duncan's Multiple Area Testing in lumbar(80.1) and in thoracic (65.8) represented critically higher than the one in cervical(42.5). 6. In the distribution of the method of Urination after spine injury, the intermittent catheterization represented highest numbar of 34(41.1 %). Testing by Duncan's Multiple Area Testing, as we found the critical difference in the analysis on MBI points(P<0.001), the point in independent self voiding patients ($90.87{\pm}29.34$) was higher than the one in other self voiding patients(P<0.05). 7. In th category of social activities after spine injury, the number of people classified in others, 41 people representing 49.5% was highest and in the MBI points of the spinal cord injured people in religious activity, hobby activity, private club, occupation was critically higher than the people classified in miscellancous(P<0.01) who are the spinal cord injured people and mostly depend on their family's assistance at home in their daily activities.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제33권6호
• /
• pp.497-504
• /
• 2011

Purpose: Patients who had a subcondylar fracture with a displaced or deviated condylar segment were treated with a retromandibular approach (RMA) or an endoscope-assisted transoral approach (EATA) in our department of oral and maxillofacial surgery. The clinical results of the approaches were compared. A comparative study of specific approaches for subcondylar fractures has not been published before in Korea. Methods: Twenty-one patients with subcondylar fractures of the mandible were included. Ten patients were treated with the retromandibular approach and 11 were treated with an endoscope-assisted transoral approach. We examined patient age, gender, fracture sites, classifications, period of maxillomandibular fixation, facial nerve (FN) or greater auricular nerve (GAN) injuries, maximal mouth opening, deflection, occlusal changes, number of plates, follow-up period, and other complications. Preoperative computed tomography and pre-operative, post-operative, and follow-up panoramic views were taken of each patient. Results: Mean maximal mouth openings were similar between the two approaches. FN and GAN injuries were more frequent in the RMA group but the deflective rate with mouth opening was higher in the EATA than that in RMA group. Two cases of post-operative infection occurred in the EATA group, and occlusal changes were observed in one case for both approaches. Conclusion: The RMA offers more direct access and visualization of the surgical field but it can cause scars and retractive injuries of the FN and GAN. But, EATA did not result in consequent nerve injuries or scars postoperatively, but unfavorable fractures such as $medial$ $override$ condyles were more difficult to reduce endoscopically. Except cases of an expected difficult reduction, the treatment of choice for a displaced subcondylar fracture may be an EATA.

• Asian Pacific Journal of Cancer Prevention
• /
• 제13권12호
• /
• pp.6391-6395
• /
• 2012

Background: Ovarian cancer is ranked as the fifth most common cause of cancer death in women. In Malaysia, it is the fourth most common cancer in females. CA125 has been the tumor marker of choice in ovarian cancer but its diagnostic specificity in early stages is only 50%. Hence, there is a critical need to identify an alternative tumor marker that is capable of detecting detect ovarian cancer at an early stage. HE4 is a new tumor marker proposed for the early diagnosis of ovarian cancer and disease recurrence. Currently, none of the normal ranges of HE4 quoted in the literature are based on data for a multiethnic Asian population. Therefore, the aim of this study was to determine reference intervals for HE4 in an Asian population presenting in University Malaya Medical Centre, a tertiary reference hospital. Materials and Methods: 300 healthy women were recruited comprising 150 premenopausal and 150 postmenopausal women, aged from 20-76 years. All women were subjected to a pelvic ultrasonograph and were confirmed to be free from ovarian pathology on recruitment. Serum HE4 levels were determined by chemiluminescent microparticle immunoassay (CMIA, Abbott Architect). The reference intervals were determined following CLSI guidelines (C28-A2) using a non-parametric method. Results: The upper limits of the $95^{th}$ percentile reference interval (90%CI) for all the women collectively were 64.6 pmol/L, and 58.4 pmol/L for premenopausal) and 69.0 pmol/L for postmenopausal. The concentration of HE4 was noted to increase with age especially in women who were more than 50 years old. We also noted that our proposed reference limit was lower compared to the level given by manufacturer Abbott Architect HE4 kit insert (58.4 vs 70 pmol/L for premenopausal group and 69.0 vs 140 pmol/L in the postmenopausal group). The study also showed a significant difference in HE4 concentrations between ethnic groups (Malays and Indians). The levels of HE4 in Indians appeared higher than in Malays (p<0.05), while no significant differences were noted between the Malays and Chinese ethnic groups. Conclusions: More data are needed to establish a reference interval that will better represent the multiethnic Malaysian population. Probably a larger sampling size of equal representation of the Malay, Chinese, Indians as well as the other native ethnic communities will give us a greater confidence on whether genetics plays a role in reference interval determination.

• 한국건설관리학회:학술대회논문집
• /
• 한국건설관리학회 2008년도 정기학술발표대회 논문집
• /
• pp.624-627
• /
• 2008

도시재정비촉진을 위한 특별법(이하 도촉법) 발표 이후 우리나라의 도시재정비사업은 규모가 더욱 커졌다. 이러한 도시재정비사업은 과거의 양적 수요충족에 치중한 것과는 달리 공공복리의 증진과 국민의 삶의 질 향상을 목적으로 하고 있다. 그러나 공공성의 확보를 우선시 함으로써 발생하는 개인의 자유권 침해는 사업추진과정에서 많은 갈등의 소지를 내재하고 있다. 또한 하나의 사업에 여러 이해관계자들이 개입함으로서 매우 다양한 갈등이 발생하고 있다. 이러한 갈등의 분석을 위해 도촉법이 발효된 2006년 7월 이후부터 현재까지 발생한 갈등 사례들을 보도자료를 기반으로 조사하였다. 그 결과 충 44건의 갈등사례가 조사되었고, 그 중 사업시행인가단계와 관리처분계획단계가 가장 많은 비중을 차지하였다. 이는 주민의 참여가 사업지구지정까지만 이루어지고, 지정이 승인된 이후에는 의견 반영이 거의 이루어지지 않는 것에 그 원인이 있다. 본 연구에서는 이러한 갈등을 절차별로 분류하고, 그 해결방안으로 정부의 역할 축소 및 주민과 해당사업자간의 의견 조율 활성화의 필요성을 파악하였다. 이를 위해 도시재정비사업의 기준이 되는 절차의 변형과 시공사 선정 방식의 변화 등을 통하여 주민의 의견을 적극적으로 반영할 수 있는 방안들을 제시하였다.

• 대한임상검사과학회지
• /
• 제54권2호
• /
• pp.133-141
• /
• 2022

혈류 감염(BSI)의 주요 원인균의 하나로 입원환자에서 이환율과 사망률을 높이는 칸디다의 항진균제 내성률을 조사하여 칸디다 혈증(candidemia)의 경험적 치료 방침에 중요한 정보를 제공하고자 한다. 2009~2018년 S병원의 혈액배양 검사에서 분리된 Candida 균주(973건) 중 Candida spp. (932 균주)에 대한 fluconazole 감수성 시험결과에서 4.7% (N=44)가 내성(resistant, R)을 보였고 C. albicans, C. parapsilosis, C. tropicalis, C. glabrata에서 내성 균주를 확인하였다. 또한, Candida spp. (947 균주)의 amphotericin B에 대한 감수성 결과에서는 내성(N=6, 0.6%)이 나타났고, 전체 Candida spp.(973 균주)에 대한 flucytosine 감수성 시험에서는 내성(N=23, 2.4%)을 보였다. Candida spp. (768 균주)의 voriconazole에 대한 감수성 시험에서는 내성(N=24, 3.1%)을 보였다. C. albicans는 fluconazole (N=23, 6.9%), voriconazole (N=21, 6.0%)이 내성이고 통계학적으로 C. albicans과 non-albicans Candida species은 fluconazole (P=0.039), voriconazole (P<0.001)로 나타났다. 칸디다 혈증의 감염률을 이해하고 예방하기 위한 감시 시스템이 요구되고 항진균제의 적절한 투여와 치료가 요구된다. 따라서 항진균제 감수성 결과의 모니터링을 통한 칸디다의 내성을 추적하는 감염감시활동 정책이 필요할 것으로 사료된다.

• 디지털융복합연구
• /
• 제12권6호
• /
• pp.23-34
• /
• 2014

본 연구의 목적은 정부가 추진하고 있는 청소년 인터넷중독 대응(예방 및 해소) 정책의 추진과정에서 발생한 정책딜레마의 발생 원인과 대응 전략을 분석하는 것이다. 이의 분석을 위해 딜레마 모형을 분석틀로 하여 맥락 및 상황변화, 정책가치와 대안 변화, 정책 행위자, 정책 결정자의 대응 전략을 통해 변화한 딜레마의 양상을 분석하였다. 분석결과의 주요 내용은 첫째, 청소년 인터넷중독 예방 및 해소정책 추진과정에서 '맥락과 상황 변화', '정책의 가치와 대안', '정책행위자', '정책결정자'는 정책 전반의 딜레마를 형성하는데 결정적인 원인으로 작용하였다. 둘째, 정책딜레마 상황에서 정부의 정책대응 전략은 정책중복 및 대립 발생, 형식적 대응, 가치 재규정 형태로 나타났다. 이에 따라 결과적으로 다음의 특징이 드러났다. 첫째, 정부는 하나의 정책 내에 정책중복과 대립의 문제가 발생하자 해당딜레마를 형식적으로 대응함으로써 더욱 강력한 딜레마를 초래했다. 둘째, 정부는 두 가지 가치(청소년 보호 및 게임 산업 진흥)를 재규정하고자 노력하였고, 이 결과 정책딜레마는 전보다 약화되었지만, 근본적 딜레마의 문제를 해결하지는 못하였음이 드러났다. 본 연구는 분석결과를 바탕으로 추후 심화되는 정보사회생태에서 보다 실효적인 청소년 인터넷중독 대응정책의 추진을 위해 범정부 차원의 통합적 정책 가치 및 비전 수립하여 일관되고 내실 있는 정책 추진을 위한 시사점을 제안하였다.

• 농약과학회지
• /
• 제17권1호
• /
• pp.33-40
• /
• 2013

온실가루이와 담배가루이의 살충과 행동에 미치는 pyrifluquinazon의 효과를 조사하였다. Pyrifluquinazon은 가루이류의 성충에 대해 50 ppm부터 12.5 ppm까지 90% 이상의 살충활성을 나타내었으나, 알과 약충에는 효과가 없었다. 뿌리와 잎을 통한 침투이행효과는 없었으나, 잔효성 검정에서 처리 후 5일차까지 90% 이상의 살충활성을 나타내었고, 90% 이상의 방제효과를 나타내었다. 접촉독성과 섭식독성에 의한 가루이류의 행동과 발현속도를 조사한 결과, 접촉 1시간 이후부터 가루이류는 바닥에 떨어져 심한 날개경련과 마비를 일으키는 증상을 나타내었으며, 섭식 3시간 이후부터 유사한 증상을 나타내었다. 한편, 선택시험에서 가루이류는 방사 1시간 이후부터 기피행동을 나타내었다. 따라서 pyrifluquinazon는 온실가루이와 담배가루이에 속효적으로 작용하고 날개 경련과 마비증상을 유발하여 식물체로부터 바닥으로 떨어져 아사하는 효과를 나타내지만, 직접적인 섭식억제효과는 없는 것으로 여겨졌다.