• 한국정보통신학회논문지
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• 제22권4호
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• pp.581-586
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• 2018

중증 질환 환자의 대부분은 치료 적기를 놓쳐 병을 키우게 된 경우가 많다. 높은 자각 증상이 나타나거나 강력한 통증이 없는 경우 병원 방문을 심각하게 고려하지 않는다. 치은염의 경우 잇몸에서 출혈을 일으키며 치아 붕괴를 일으키는 질환이지만 초기의 증상이 경미하다. 이 시점에서의 병원 치료는 매우 높은 효과를 가진다. 그러나 치료시기를 놓칠 경우 잇몸과 구강의 건강에 심각한 문제를 일으켜 음식을 섭취 할 수없는 상황까지 병증이 진행된다. 본 논문에서는 환자의 치주 이미지를 스마트 폰으로 촬영하여 실시간으로 치의료 기관에 구축된 환자 관리 시스템으로 정보를 전송한다. 전송된 정보를 담당 의사가 판단하며 이에 대한 치료 적기 정보를 환자에게 제공한다.

• Geomechanics and Engineering
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• 제18권3호
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• pp.259-266
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• 2019

This paper presents a comparison between experimental measurements and numerical estimations of penetration length of a cement grout injected in discrete joints. In the experiment, a joint was generated by planar acryl plates with a certain separation distance (; aperture) and was designed in such a way to vary the separation distances. Since a cement grout was used, the grout viscosity can be varied by controlling water-cement (W/C) ratios. Throughout these experiments, the influence of joint aperture, cement grout viscosity, and injection rate on a penetration length in a discrete joint was investigated. During the experiments, we also measured the time-dependent variation of grout viscosity due to a hardening process. The time-dependent viscosity was included in our numerical simulations as a function of elapsed time to demonstrate its impact on the estimation of penetration length. In the numerical simulations, Bingham fluid model that has been known to be applicable to a viscous cement material, was employed. We showed that the estimations by the current numerical approach were well comparable to the experimental measurements only in limited conditions of lower injection rates and smaller joint apertures. The difference between two approaches resulted from the facts that material separation (; bleeding) of cement grout, which was noticeable in higher injection rate and there could be a significant surface friction between the grout and joint planes, which are not included in the numerical simulations. Our numerical simulation, meanwhile, could well demonstrate that penetration length can be significantly over-estimated without considering a time-dependency of viscosity in a cement grout.

• Journal of Chest Surgery
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• 제56권6호
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• pp.374-386
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• 2023

Background: The heightened morbidity and mortality associated with repeat cardiac surgery are well documented. Redo median sternotomy (MS) and minimally invasive valve surgery are options for patients with prior cardiac surgery who require mitral valve surgery (MVS). We conducted a systematic review and meta-analysis comparing the outcomes of redo MS and minimally invasive MVS (MIMVS) in this population. Methods: We searched PubMed, EMBASE, and Scopus for studies comparing outcomes of redo MS and MIMVS for MVS. To calculate risk ratios (RRs) for binary outcomes and weighted mean differences (MDs) for continuous data, we employed a random-effects model. Results: We included 12 retrospective observational studies, comprising 4157 participants (675 for MIMVS; 3482 for redo MS). Reductions in mortality (RR, 0.54; 95% confidence interval [CI], 0.37-0.80), length of hospital stay (MD, -4.23; 95% CI, -5.77 to -2.68), length of intensive care unit (ICU) stay (MD, -2.02; 95% CI, -3.17 to -0.88), and new-onset acute kidney injury (AKI) risk (odds ratio, 0.34; 95% CI, 0.19 to 0.61) were statistically significant and favored MIMVS (p<0.05). No significant differences were observed in aortic cross-clamp time, cardiopulmonary bypass time, or risk of perioperative stroke, new-onset atrial fibrillation, surgical site infection, or reoperation for bleeding (p>0.05). Conclusion: The current literature, which primarily consists of retrospective comparisons, underscores certain benefits of MIMVS over redo MS. These include decreased mortality, shorter hospital and ICU stays, and reduced AKI risk. Given the lack of high-quality evidence, prospective randomized control trials with adequate power are necessary to investigate long-term outcomes.

• 대한영상의학회지
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• 제84권4호
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• pp.835-845
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• 2023

골반 외상은 대부분 고에너지 손상을 동반하며, 이에 따른 치명률 및 사망률이 높은 편이다. 관련된 출혈은 대부분 골반내 정맥이 손상되거나 해면골이 골절되어 발생하고 혈종에 의해 안정화되지만, 10%-20%에서 동맥 출혈이 동반되며, 골반 용적이 증가된 상태에서 동맥 출혈이 지속된다면 이로 인한 사망률은 36%-54%까지 증가한다. 골반의 해부학적 구조상 다양하고 풍부한 혈관이 분포되어 있고, 골반 외상 환자 대부분이 많은 양의 혈종을 동반하기 때문에, 수술적 치료는 시야 확보의 어려움과 눌림 효과에 따른 지혈효과를 없애 출혈을 더 조장할 수 있어, 1차적으로 인터벤션 치료가 권고되고 있다. 또한 출혈의 위치가 대부분 골절된 부분이기 때문에 CT를 통해 시술 전 출혈 부위를 특정하여 빠른 시간 내에 출혈에 대한 색전술을 시행할 수 있다. 이처럼 올바른 진단과 치료를 동시에 할 수 있다는 장점으로 인해 골반 외상 환자에 있어 인터벤션 치료는 중추적인 역할을 담당하고 있다. 본 연구에서는 문헌고찰을 통해 골반 외상에 대한 올바른 진단 및 인터벤션 치료의 유용성과 고려 사항에 대해 알아보고자 한다.

• 콘크리트학회논문집
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• 제22권3호
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• pp.409-417
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• 2010

지진에 의한 사회기반 구조물의 손상은 대형참사를 유발할 가능성이 크므로, 적절한 내진성능평가가 이루어져야한다. 특히 지진하중 하에서 구조물의 거동은 상부 하중을 지탱하는 기둥의 거동에 지배되므로 기둥에 대한 해석 및 실험을 통한 내진성능평가는 가장 핵심적인 요소이다. 현재 내진성능평가 실험의 일환으로 준정적실험, 유사동적실험, 진동대실험 등이 대표적으로 수행되고 있으며 이러한 실험을 수행 시 시험체의 크기, 실험장비 성능의 한계, 경제적인 이유 등으로 원형 구조물을 대신하여 축소모형을 통해 실험을 수행하고 있다. 이러한 축소모형실험을 위해서는 적절한 상사법칙을 적용해야 하는데, 현재 일반적으로 적용되고 있는 상사법칙은 탄성범위 내에서 유도가 되어 있기 때문에 지진하중하 구조물의 비탄성 거동을 예측하는데 무리가 있다. 또한 마이크로콘크리트를 사용한 축소모형에 대해서는 필연적으로 재료특성에 있어서 원형재료와 축소모형재료 사이에 왜곡이 발생하여 결과의 신뢰성에 영향을 주게된다. 따라서 이 연구에서는 재료의 왜곡과 비탄성 거동을 고려하여 새로운 상사법칙을 제시하였다.

• Journal of Chest Surgery
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• 제33권8호
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• pp.638-642
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• 2000

Background: In an effort t enhance long term patency of coronary bypass grafts, utilization of arterial conduits have been on an icrease. With the same objective, we have been using the right gastroepiploic artery(RGEA)in coronary artery bypass procedures since 1998. The current paper has been undertaken with the aim of assessing the apropriateness, problems, and short term results of using the RGEA as an arterial graft conduit by studying the postoperative clinical results of 100 patients than received coronary artery bypass grafting (CARG) with this artery. Material and Method: Between May of 1998 and May of 1999, an analysis of the mortality, postoperative myocardial infarction, and the need for IABP insertion as a result of low cardiac output were made between 100 consecutive patients undergoing CABG with the RGEA. Result: There was one postoperative death due to cerebral infarction. Postoperative complications/morbidity comprised myocardial infarction in 2, cerebral infarct in 3, reoperation due to bleeding in 1, mediastinitis in 1, and low cardiac output syndrome necessitating IABP in 3 patients. Complicatons related to harvesting of the arterial grafts were not experienced in any of the patients. Conclusion: The results of the current data show that utilization of the RGEA in CABG is not associated with increased mortality/morbidity and demonstrates satisfactory short term results suggesting the usefulnessof this conduit as an arterial graft.

• 한국치위생학회지
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• 제5권2호
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• pp.263-278
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• 2005

This study investigated the current oral health conditions of the elderly at home and welfare facilities in their age over 65 years around some rural areas in Gangwon province, which would expect the fewer medical benefits even with lower interest than urban areas, despite of relatively high ratio of elder populations, so that it could prepare a basic document necessary to determine certain planned quantification for the benefit of elder's oral healthcare. As of the end of December 2004 both 50 elders at home and 50 elders at welfare facilities were randomly sampled in their age over 65 years in Samcheok city. As a result of this study, it was found that the elders at welfare facilities scored 15 pts. in DMFT index level typical of oral health conditions, which was higher than the elders at home. In addition, the elders at welfare facilities scored 26.0% in the coexistence of immobile bridge and partial denture higher than the elders at home with regard to the presence of intraoral prosthetic appliance. The results of analyzing the difference in the one-year dental visiting experience of respondents hereof showed that the elders at home were relatively more in ratio(62.0%) than those at welfare facilities, while many of the former group(38.0%) had relatively more handicap in masticatory movement than the latter one with regard to the conditions of dental prosthesis in use. Besides, many of the elders at facilities(30% or more) felt subjective symptoms of periodontal disease including bleeding or swelling, which indicates higher ratio than the elders at home. Finally, the elders at home used to brush their teeth at more frequency on a daily basis than those at facilities, while the latter group suffered general body disease more than the former group. Summing up, it is concluded that a formulated oral healthcare system will become more needed in near future than now for the benefit of the elderly living in welfare facilities, while nationwide policy-level supports would be urgent for them in the aspect of national welfare.

• Archives of Plastic Surgery
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• 제46권6호
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• pp.511-517
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• 2019

Background Cleft treatment is frequently performed in Indonesia, mostly in charity missions, but without a postoperative protocol it is difficult to establish the risks and complications of cleft treatment. The present study was designed to give an overview of current cleft lip and palate treatment strategies in Indonesia and to assess the complication rates during and after surgery. Methods This prospective study evaluated anesthetic, intraoperative surgical, and short-term postoperative complications in patients undergoing primary, secondary, or corrective surgery for cleft lip and palate deformities. The population consisted of 98 non-syndromic cleft patients. The main anesthetic complication that occurred during general anesthesia was high blood pressure, whereas the main intraoperative surgical complication was excessive bleeding and the main early postoperative complication was extremely poor wound hygiene. Results In this study, there were no cases of perioperative or postoperative mortality. However, in 23 (23.4%) of the 98 operations performed, at least one perioperative complication related to anesthesia occurred. The intraoperative and early postoperative complications following cleft lip and/or palate were assessed. There was a significant difference in the complication rate between procedure types (χ²=0.02; P<0.05). However, no relationship was found between perioperative complications related to anesthesia and the occurrence of postoperative complications (χ²=1.00; P>0.05). Nonetheless, a significant difference was found between procedure types regarding perioperative complications and the occurrence of postoperative complications (χ²=0.031; P<0.05). Conclusions Further evaluation of these outcomes would help direct patient management toward decreasing the complication rate.

• Journal of Korean Neurosurgical Society
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• 제43권6호
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• pp.265-269
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• 2008

Objective : Outcome of gamma knife radiosurgery (GKS) in the consecutive 100 cases with cerebral arteriovenous malformations (AVMs) was analyzed. Methods : Data from initial 100 patients treated with GKS in the authors' institute were reviewed retrospectively. Spetzler-Martin grade at diagnosis were I in 18 patients, II in 27, III in 36, IV in 11, and V in 8. Thirty-five patients had experienced previous bleeding, 27 patients presented with seizure, and 31 patients presented with headache. The mean volume of the lesion was $4.3\;cm^3\;(0.1-29.3\;cm^3)$. The median radiation dose delivered to the margin was 20.0Gy (13-32Gy). Mean follow-up period was 37.5 months (5-63 months). Results : Angiographic follow-up was performed in 48 patients at least 2 years after GKS. Sixteen patients were lost in follow up following 2 years from GKS. Twenty-eight of 48 patients (58%) showed complete obliteration and 20 patients (42%) showed partial obliteration. Seven patients presented with post-GKS hemorrhage. Adverse radiation effect (ARE) was observed at follow-up MRI in 25 of 76 patients, and it was symptomatic in 5 patients. Complete obliteration was confirmed in 24 of 31 (77%) patients with volume less than $4\;cm^3$, meanwhile only 4 of 17 (24%) patients with volume of $4\;cm^3$ or more showed complete obliteration. Complete obliteration rate was 67% with 20Gy or higher marginal dose, 63% with 15-20 Gy, and 17% with less than 15Gy. Conclusion : GKS can provide high rates of obliteration with acceptable risk of morbidity in a subgroup of small AVMs. However, overall outcome in whole spectrum of AVMs, in which large proportion of cases have unfavorable characteristics for radiosurgery, is much worse. More effective therapeutic strategy needs to be developed for large AVMs that are difficult to be managed with current available treatment modalities.

• 대한한의학회지
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• 제33권3호
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• pp.1-9
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• 2012

Objectives: This research was aimed 1) to find out various subjective symptoms cancer patients had, 2) to find out the quantitative difference of symptoms occurring according to the area of cancer, current treatment methods, and relapse of the cancer and 3) to analyze the relationship between the occurrence of symptoms. Methods: This study was a survey about the various subjective symptoms cancer patients had. The subjects were 48 cancer patients in a double-blinded randomized controlled trial about the effectiveness of Korean Red Ginseng (KRG) treatments. Surveys were examined before Korean Red Ginseng (KRG) treatments. The questionnaire consisted of demographic research, patient history and accompanying symptoms. The symptoms part consisted of 4 questions on general symptoms (vertigo, hot flush, rash, insomnia), 2 questions on digestion symptoms (anorexia, dyspepsia), 2 questions on excretions (diarrhea, constipation), and 5 questions on symptoms in different body parts (headache, dryness of lips, chest pain, aphthous ulcer, nose bleeding). The questionnaire was used to research presence of symptoms and relationships between the occurrence of symptoms. Results: A total of 48 patients took part in this survey. Dizziness was the most frequent subjective symptom patients had (64.58%), followed by dry mouth (43.75%), headache (43.75%), insomnia (41.67%), anorexia (37.5%) and chest discomfort (37.5%). The presence of these subjective symptoms was partially related to the patient's history details - type of cancer, method of cancer treatment (chemotherapy, radiotherapy), termination of treatment, presence of pain, fatigue and recurrence, etc. Factor analysis was conducted to analyze the relationship between the occurrence of symptoms. It suggested 5 factors as a result, but there was a limitation that only a low level of correlation was shown among them. Conclusions: We were able to analyze the occurrences and the relationships among them for accompanying subjective symptoms in cancer patients. However the results of the study are limited in that only 48 patients participated. The symptoms in cancer patients showed a tendency for clustering, occurring simultaneously or continuously rather than occurring alone. The study of these symptom clusters is worth further study, for it is similar to the Symptom Differentiation System in Traditional Korean Medicine. For effective approach to the treatment of cancer in Traditional Korean Medicine, further research on the Korean traditional view of cancer patients should be done based on this research, regarding various symptoms and those relationships on a larger scale.