• Archives of Plastic Surgery
• /
• 제40권5호
• /
• pp.546-552
• /
• 2013

Background The zygoma is a major portion of the midfacial contour. When deformity occurs in this area, a reduction should be conducted to correct it. If a sagittal fracture at the temporal root of the zygomatic arch occurs, this also requires reduction, but it is difficult to approach due to its anatomical location, and the possibility of fixation is also limited. Thus, the authors attempted the reduction of sagittal fracture by two- or three-point fixation and the Gillies approach without direct manipulation. The preoperative and postoperative results of the patients were evaluated. Follow-up was performed to establish a treatment guideline. Methods A retrospective study was done with 40 patients who had sagittal fractures at the temporal root of the zygomatic arch from March 2009 to June 2012. Only two- or three-point fixation was performed for the accompanying zygomatic-orbital-maxillary fracture. The Gillies approach was used for complex fractures of the zygomatic arch, while the temporal root of the zygomatic arch was only observed without reduction. Preoperative and postoperative computed tomography and X-ray scans were performed to examine the results. Results The result of the paired t-test on preoperative and postoperative bone gap differences, the depression level, and the degree of temporal protrusion showed a marked decrease in the mean difference at a 95% confidence interval. The results were acceptable. Conclusions In the treatment of sagittal fractures at the temporal root of the zygomatic arch, it is acceptable to use indirect reduction and non-fixation methods. This leads to a satisfactory aesthetic and functional outcome.

• Journal of Chest Surgery
• /
• 제46권5호
• /
• pp.346-352
• /
• 2013

Background: Transcatheter aortic valve implantation (TAVI) has been an alternative to conventional aortic valve replacement (AVR) in old and high risk patients. The goal of this study is to compare the early outcomes of conventional AVR vs. TAVI in high risk severe AS patients. Methods: From January 2008 to July 2012, 44 high risk severe aortic stenosis patients underwent conventional AVR, and 15 patients underwent TAVI. We compared echocardiographic data, periprocedural complication, and survival. The mean follow-up duration was $14.5{\pm}10$ months (AVR), and $6.8{\pm}3.5$ months (TAVI), respectively. Results: AVR group was younger ($78.2{\pm}2.4$ years vs. $82.2{\pm}3.0$ years, p<0.001) and had lower operative risk (Euroscore: $9.4{\pm}2.7$ vs. $11.0{\pm}2.0$, p=0.044) than TAVI group. There was no significant difference in early mortality (11.4% vs. 13.3%, p=0.839), and 1 year survival ($87.4%{\pm}5.3%$ vs. $83.1%{\pm}1.1%$, p=0.805). There was no significant difference in postoperative functional class. There was no significant difference in periprocedural complication except vascular complication (0% [AVR] vs. 13.3% [TAVI], p=0.014). TAVI group had more moderate and severe paravalvular leakage. Conclusion: In this study, both groups had similar periprocedural morbidity, and mortality. However, TAVI group had more greater than moderate paravalvular leakage, which can influence long-term outcome. Since more patients are treated with TAVI even in moderate risk, careful selection of the patients and appropriate guideline need to be established.

• Restorative Dentistry and Endodontics
• /
• 제39권3호
• /
• pp.164-171
• /
• 2014

Objectives: Designing in situ models for caries research is a demanding procedure, as both clinical and laboratory parameters need to be incorporated in a single study. This study aimed to construct an informative guideline for planning in situ models relevant to preexisting caries studies. Materials and Methods: An electronic literature search of the PubMed database was performed. A total 191 of full articles written in English were included and data were extracted from materials and methods. Multiple variables were analyzed in relation to the publication types, participant characteristics, specimen and appliance factors, and other conditions. Frequencies and percentages were displayed to summarize the data and the Pearson's chi-square test was used to assess a statistical significance (p < 0.05). Results: There were many parameters commonly included in the majority of in situ models such as inclusion criteria, sample sizes, sample allocation methods, tooth types, intraoral appliance types, sterilization methods, study periods, outcome measures, experimental interventions, etc. Interrelationships existed between the main research topics and some parameters (outcome measures and sample allocation methods) among the evaluated articles. Conclusions: It will be possible to establish standardized in situ protocols according to the research topics. Furthermore, data collaboration from comparable studies would be enhanced by homogeneous study designs.

• 동아시아식생활학회지
• /
• 제15권4호
• /
• pp.397-404
• /
• 2005

The propose of this study was to investigate taurine intake in formula-fed and breast-fed infants and to estimate the level of taurine of blood and urine in order to determine the requirement of taurine intake in infants. These results will be useful to suggest the guideline of requirement of taurine intake and may contribute toward the proper use of breast milk substitutes. Experimental groups were breast-fed infants (n=10) and formula-fed infants (n=10) of 20 normal delivery infants in general hospital. This study was longitudinal study from birth up to 16weeks (0 week, 4 weeks, 8 weeks, 12 weeks, 16 weeks). The items of test were anthropometry(weight, height, head circumference, chest circumference), intake of taurine, taurine level of blood and urine in breast-fed and formula-fed infants. There were no significant differences between breast-fed and formula-fed infants in weight, height, head and chest circumference. There is a need for future studies of exclusive infants with larger samples to determine which growth pattern should be considered as the norm. Taurine concentration of plasma and urine did not differ between breast-fed and formula-fed infants. Taurine intake recommendations for infants is about 30mg/day from this study. This data will be useful for production of human-like formula milk and suggestion of an index of selection of a consumer in taurine.

• 근관절건강학회지
• /
• 제25권2호
• /
• pp.135-147
• /
• 2018

Purpose: The purpose of this study was to develop evidence-based guidelines for infection control in nursing homes in Korea (ENIK). Methods: Three steps were planned for the development which were developing a draft and testing the content validity. First, the draft was based on evidence and developed through focus group interviews with nurses in nursing homes, a comprehensive review of international guidelines and literature, and systematic reviews of interventions for infection control and outbreaks in long-term care facilities. Clinical applicability was established through reviews of nursing records and job assignments in one nursing home. The final step consisted of experts evaluating the content validity. The ENIK was revised to fit Korean nursing homes. Results: The ENIK consisted of recommendations in 9 compositions and a one-page practical algorithm. The principles of infection control were presented by statements and specific strategies were recommended in resident care programs. The infection control practical algorithm was organized into 3 steps: screening at admission, prevention, and control at the early stage. The practice to control infection was composed of a 5-step process. Conclusion: The ENIK will contribute to improving the competency of infection control practice because it provides standardized practice and is tailored to Korean nursing homes.

• Clinical and Experimental Pediatrics
• /
• 제55권8호
• /
• pp.272-279
• /
• 2012

Purpose: The aim of this study was to develop an appropriate nursing information guideline according to corrected age, after investigating parents' concerns about the growth, development, and diseases of their premature infants after discharge from the neonatal intensive care unit (NICU). Methods: The parents of premature infants (birth weight, <2,500 g; gestational age, <37 weeks) who went to a neonatal follow-up clinic after NICU discharge at Seoul St. Mary's Hospital from January 2005 to December 2009, were asked with regard to their concerns about their infants through a questionnaire survey. The results of physical examinations, including body measurements and neurodevelopmental status at 4, 8, 12, and 18 months of corrected age, were retrospectively reviewed in 390 infants. Results: The most common parental concerns were developmental delay, poor growth, and feeding and nutritional problems. Parental concerns about developmental delay, growth failure in improvement in body weight and length, and overweightness were high in specificity but very low in sensitivity. After NICU discharge, 30% of premature infants experienced infectious diseases before 18 months of corrected age, the most common of which was respiratory tract infection. Conclusion: For guiding of premature infants in outpatient day clinics after NICU discharge, it is necessary to identify the parents' highest concerns, to educate them about the possibilities of growth and neurodevelopmental disabilities in their infants and to provide them with handouts containing guidelines on the management of infectious diseases, especially respiratory infections.

• 대한의용생체공학회:학술대회논문집
• /
• 대한의용생체공학회 1993년도 춘계학술대회
• /
• pp.57-60
• /
• 1993

A finite element-based computer simulation of excimer laser susery was conducted to study some factors on the surgery. In particular, the radius of curvature at the apex of the cornea was examined under various surgical conditions. Corneal tissue was assumed to be a nearly incompressible, linear elastic, homogeneous, isotropic material under very small deformation. The geometry of the human cornea was taken from the experimental data[1]. The simulation utilized ANSYS(Swanson Analysis System Inc.Rev.4.4A). In this study, the major factors which affect the outcomes of the excimer laser surgery were investigated. First, two patterns of surgery with various surgery thickness(40-70micrometers) were examind. The pattern#1 describes the meridian from the apex to the edge of the surgery area to be straight. And the corresponding meridian of the pattern 2 can be expressed as a quardratic function. The results show that the pattern #2 is more realistic and effective. Then, the effects of other factors were investigated based on the pattern #2. Other factors are:various diameters of the surgical area (3-8 milimeters), Young's modules(3.5-4.5MPa), and depth of surgery at the apex(40-70micrometers). Compared with the computer simulation of the radial keratotomy surgery[2], the excimer laser surgery was proven to be more effective in treating myopia patients. In conculusion, the results of the simulation are qualitative agreement with clinical experience[3] indicating the potential of the finite element model of the surgery as a guideline to the surgeon before actual surgery.

• Tuberculosis and Respiratory Diseases
• /
• 제56권4호
• /
• pp.356-363
• /
• 2004

2002년도 제주도내 폐결핵 발생자로 등록된 262명에 대한 조사를 실시한 결과 보건소의 관리실태와 비교해 볼 때, 의원급의 진단 및 추구검사 시행이 제대로 되지 않고 있는 것을 확인하였다. 이런 상황에서 의원 및 병원의 치료 성공률은 각각 38.5%, 63.3%로, 이를 합친 민간의료기관에서의 치료 성공률은 59.8%로 조사되어 보건소의 치료 성공률 80%에 비하여 낮은 수준을 보였다. 민간의료기관에서 치료 실패의 주 원인은 임의의 치료중단 이라는 점에서, 현재 국가결핵관리사업의 이원화된 체계 하에서 민간의료기관에 대한 시급한 시스템보완이 필요하다.

• 여성건강간호학회지
• /
• 제10권1호
• /
• pp.32-41
• /
• 2004

Purpose: The purpose of this study was to explore and describe the process of life adaptation in women with cervical cancer. Method: A grounded theory method with guided data collection and analysis was used. Fifteen women with cervical cancer who had some kind of treatment at the hospital were asked open-ended and descriptive questions with a guideline. All interviews were tape-recorded and transcribed verbatim. Result: The core category that emerged from the comparative analysis was "overcoming cancer" named as a process of life adaptation in the participants. The process of overcoming cancer evolved three stages - "admitting reality", "attempting health-care" and "continuing health-care". Depending on the paradigm model, the central phenomena of the experiences was "powerlessness". The internal factors motivating women to overcome cancer were "denial of cancer" and "desire for life". Strategies of overcoming cancer included "living as a cancer patient," "selective food eating," "steady exercising," "getting rid of stress," and "preparing for death". The intervening conditions, "supportive system," "forms of life," and "burden on family," influenced overcoming cancer. Conclusion: The results of this study could help clinical nurses to understand life adaptation in cervical cancer patients and establish efficient coping strategies in dealing with the problems they face.

• 재활복지공학회논문지
• /
• 제8권1호
• /
• pp.57-66
• /
• 2014

본 연구는 현재 국내 연하장애 환자를 대상으로 하는 연하장애 기능적 전기 자극 치료 장비의 사전 사후 점검과 유지 보수와 관련한 설문조사를 실시하고 장비사용 현황과 관리 실태를 분석함으로서 체계적인 치료 장비 관리 가이드라인 개발의 필요성을 제시하는데 그 목적이 있다. 연구대상은 상급종합 병원, 종합병원, 재활병원, 요양병원을 포함하는 총62개 기관 중 최종적으로 설문에 응답한 50개 기관이었다. 연하장애 기능적 전기 자극 치료 장비의 사전 사후 점검과 유지 보수 현황과 실태를 파악하기 위한 설문지를 개발한 후, 이를 기초로 2013년 8월 21일부터 2013년 11월 10일간의 연구 자료를 분석에 사용하였다. 연구 결과, 장비는 활발히 사용하고 있었으나 장비의 사용 전 작동 검사, 사용 후 작동 검사, 유지 및 보수, 소독 보관 등의 항목에서 체계적인 관리를 하지 않고 있었다. 혼수상태이거나 인지가 현저히 저하된 환자에게 적용하는 방법과 관련한 항목에서도 표준화된 방법이 없거나 가이드 라인이 제시되었더라 하더라고 실제 사용하지 않고 있는 것으로 밝혀졌다. 이는 장비의 사전 사후 점검과 유지 보수에 대한 표준화된 가이드라인 및 질 관리 지표 개발에 대한 연구의 필요성을 제시한다.