• 대한두경부종양학회지
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• 제37권2호
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• pp.43-50
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• 2021

Background/Objectives: Shoulder function is an important aspect of health related quality of life (QOL). Neck dissection impairment index (NDII) is a simple shoulder-specific questionnaire. This study aimed to evaluate the association between QOL and NDII in patients who underwent neck dissection to validate the Korean version of NDII. Materials & Methods: This study enrolled 74 patients with head and neck cancer who underwent neck dissection from December 2013 to April 2014. Patients completed questionnaires on QOL including the European Organization of Research and Treatment of Cancer 30-item Core QOL questionnaire (EORTC QLQ-C30) and NDII which was translated into Korean. Validity was evaluated by calculating the Pearson correlation coefficient between NDII and EORTC QLQ-C30. Results: We compared preoperative, postoperative within a week, 1st and 3rd months NDII scores. The total NDII scores were 14.7, 47.4, 33.7 and 34.3 each. Clinical variables including gender, site of primary tumor, performing revision neck dissection, radiotherapy and flap reconstruction were not significantly associated with NDII. However NDII mean score of patients who underwent unilateral neck dissection over 3 levels is most increased after operation. During all periods NDII scores were significantly associated with functioning score. Although other scores are lower correlation than function scores, global health status scores and symptom scores are also correlation with NDII. Conclusion: NDII was valid instrument and can be used not only in the clinical practice to assess shoulder dysfunction but also in the simple instrument to evaluate global QOL in Korea patients with having neck dissection.

• Journal of Korean Neurosurgical Society
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• 제66권5호
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• pp.536-542
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• 2023

Objective : Surgical site infection is the most detrimental complication following cranioplasty. In other surgical fields, intrawound vancomycin powder application has been introduced to prevent surgical site infection and is widely used based on results in multiple studies. This study evaluated the effect of intrawound vancomycin powder in cranioplasty compared with the conventional method without topical antibiotics. Methods : This retrospective study included 580 patients with skull defects who underwent cranioplasty between August 1, 1998 and December 31, 2021. The conventional method was used in 475 (81.9%; conventional group) and vancomycin powder (1 g) was applied on the dura mater and bone flap in 105 patients (18.1%; vancomycin powder group). Surgical site infection was defined as infection of the incision, organ, or space that occurred after cranioplasty. Surgical site infection within 1-year surveillance period was compared between the conventional and vancomycin powder groups with logistic regression analysis. Penalized likelihood estimation method was used in logistic regression to deal with zero events. All local and systemic adverse events associated with topical vancomycin application were also evaluated. Results : Surgical site infection occurred in 31 patients (5.3%) and all were observed in the conventional group. The median time between cranioplasty and detection of surgical site infection was 13 days (range, 4-333). Staphylococci were the most common organisms and identified in 25 (80.6%) of 31 cases with surgical site infections. The surgical site infection rate in the vancomycin powder group (0/105, 0.0%) was significantly lower than that in the conventional group (31/475, 6.5%; crude odds ratio [OR], 0.067; 95% confidence interval [CI], 0.006-0.762; adjusted OR, 0.068; 95% CI, 0.006-0.731; p=0.026). No adverse events associated with intrawound vancomycin powder were observed during the follow-up. Conclusion : Intrawound vancomycin powder effectively prevented surgical site infections following cranioplasty without local or systemic adverse events. Our results suggest that intrawound vancomycin powder is an effective and safe strategy for patients undergoing cranioplasty.

• 대한화상학회지
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• 제22권2호
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• pp.66-70
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• 2019

Purpose: The necrotizing fasciitis is a terrifying infectious disease that can rapidly spreads to surrounding tissues when fascia is infected and it can cause sepsis to death if not properly diagnosed and treated. The purpose of this study is to investigate the characteristics, causes, and treatment methods of necrotizing fasciitis in Korea through reviewing patients admitted to our burn center. Methods: 21 patients with necrotizing fasciitis were selected for this study among those inpatients with electronic medical records (EMR) admitted to Hallym University Hangang Sacred Heart Medical Center from Jan 1, 2008 to June 30, 2019. The medical records and wound photos of those 21 selected subjects were reviewed. Results: There were 13 male and 8 female patients and mean age was 58.76 years old. 13 of 21 subjects were survived and 8 died (38% mortality rate). The surgical treatments performed were I&D, fasciotomy, debridement, allograft, burring, STSG, flap, and amputation. The most common causes were burns in 9 subjects (6 contact burns) and cellulitis occurred on skins in 5 subjects. And other various causes were observed as fournier's gangrene, stab wound, intramuscular injection, tumor and bleu toe syndrome (toe necrosis). The infected areas were 11 feet and legs, 7 hips, 3 abdomen and trunk in 21 subjects. Of the 8 deaths, 3 were infected in feet and legs, 2 were infected in hips, and 2 were infected in abdomen and trunk. As for underlying diseases, 12 patients with hypertension or diabetes were the highest and others such as cancer and stroke were found. Conclusion: The only method to increase the survival rate is to 'suspect' the disease as much as possible and perform early extensive excision. It is advisable to treat the disease by the burn center to properly provide adequate and optimal wound management, infection control, medical care and nutritional supports.

• 한국어류학회지
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• 제35권3호
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• pp.171-176
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• 2023

본 연구에서는 붕어 Carassius auratus와 떡붕어 C. cuvieri 후각기관의 형태 및 형태계측학적 특징을 실체현미경과 통계프로그램 SPSS를 이용하여 묘사하고 분석하였다. 형태에서 두 종의 후각기관은 외부적으로 반원형의 개방된 전비공, 후비공, 그리고 비경계판으로 구성하며 다수의 후판으로 이루어진 로제트를 보유한 비강 내 구조를 나타냈다. 독립표본 t-검정과 Pearson 상관계수를 이용한 두 종간 체장과 후판의 통계적 분석에서 후판의 개수는 붕어(14~20)가 떡붕어(14~16)보다 더 많았고(P<0.001), 체장대비 후판의 비율 또한 붕어(12.7±0.7%)가 떡붕어(8.2±0.6)보다 더 높은 값을 나타냈다(P<0.001). 결과적으로, 주둥이 위쪽의 개방형 비공의 위치와 모양은 외부의 후각 물질의 유입을 방해하는 경계층(boundary layer)의 감소와 연관되는 형태적 적응이며 떡붕어보다 더 작은 체장에도 불구하고 더 많은 수의 붕어 후판은 생존을 위해 더 높은 후각의존도를 반영하는 형태적 전략으로 간주되며 후판 수 차이와 체장대비 비율 차이는 두 종의 새로운 분류학적 형질로 사료된다.

• 대한영상의학회지
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• 제83권3호
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• pp.582-596
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• 2022

무릎 MRI를 정확하게 판독하려면 기본적인 반월연골 해부학을 아는 것뿐만 아니라 병적 상태와 구별하는 것이 중요하다. 따라서 반월연골 열상으로 쉽게 오인될 수 있는 정상 변이(위양성)와 쉽게 놓쳐서 자칫 정상으로 오인될 수 있는 반월연골열상들(위음성)을 아는 것이 판독에 도움이 될 것이다. 위양성에는 활막 오목, 반월연골 주름, 슬와 힘줄과 외측 반월연골 사이의 관계, 가로 인대, 반월연골 앞 근 및 반월대퇴 인대가 포함된다. 위음성에는 국소 방사열상, 피판 열상, 뒤 근 열상, 반월연골-관절낭 분리, 원반모양반월연골의 열상이 있다. 이번 임상화보에서는 앞서 언급한 상황들로부터 얻은 영상자료들을 검토해보았다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제25권4호
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• pp.281-294
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• 1999

Vasospasm causes microvascular surgery to fail as a main factor in the loss of transferred flap dye to the diminution of blood flow in reconstruction surgery. Although there has been extensive research to resolve the vasospasm problem, no one has reached an ideal solution to date. However, cryotherapy, which is often used for destruction of tumor lesions, is being presented as a new way of releasing vasospasm. After making a histomorphometric measurement on vasodialation during the course of 1, 3 and 7 days, 2 and 4 weeks, and 5 months periods and observing the change of blood vessel in a histologic, immunohistochemical, and scanning electronic microscopic approach, the results were as follows : 1. Vascular inner diameters of the experimental 1 and 3 days groups were measured $476.3{\pm}28.20{\mu}m$, $497.15{\pm}48.79{\mu}m$ respectively showing statistically meaningful vasodilation(P<0.05), which continued by the experiment 4 weeks group. However, in the experimental 5 months group, the vascular inner diameter appeared similar to the control groups. Even though the thickness of smooth muscular layers come out to be thinner in all the experimental groups compared to the control group, it was difficult to find any statistical meaningfulness. In addition, the vascular external diameters of every experimental groups were shown to be longer than the control group. 2. In light microscopic view, severe injury was evident on the smooth muscular layer cell from the experimental 1 day group, started recovering partially from the experimental 7 days group, and was mostly restored in the experimental 4 weeks group and layer of adventitial stripping were nearly recoverd 2 weeks group. 3. The PCNA positive cells of smooth muscular layer were observed from the experimental 7 days group and had a tendency to increase by the experimental 2 weeks group. In the experimental 4 weeks and 5 months group, the number of PCNA possitive cells observed was comparable to the control group. 4. ${\alpha}$-SMA level of smooth muscular layer cells, having been significantly lower than the control group in the severly damaged experimental 1 day group. It was seen to be increased in the experimental 7 days group and turned out to show similar ${\alpha}$-SMA level in 4 weeks to the control group. 5. In the view of SEM, the endothelial cells were destructed and falling off, and also present the appearance of flattening in the experiment 1 day group. The endothelial layer cells started partially recovering from the 7 days group after the freezing injury. On 4 weeks and 5 months, the endothelial cells were fully coverd the damaged area, also it's appearance is similar to control group. In conclusion, the vascular freezing after the removal of adventitia caused damages to smooth muscular layer cells, and brought about vasodilation, which continued by the 4th week. The smooth muscular layer cells started partially reviving from the 7rd day after the damage by vascular freezing, and recovered their similar figure to the control group's 4 weeks later. This was considered the result of cells which surround the damaged blood vessel being influxed into the smooth muscular layers. Therefore, this local freezing injury on the blood vessel was thought to be applied clinically to relieve severe vasospasm which cannot be treated by vasodilation drug, a microvascular surgery.

• Journal of Periodontal and Implant Science
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• 제24권2호
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• pp.219-237
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• 1994

치주조직재생에 중요하게 생각되는 요건으로는 치근면의 상태, 전구세포의 증식, 치유 부의 상피조직배제, 치유부의 안정화를 들 수 있으며 이중 가장 중요한 요건중의 하나가 치유부에 치주조직재생을 도모할 수 있는 전구 세포가 실수부로 이주하여 부착과 증식, 분화를 통하여 교원질섬유를 포함한 결체조직의 부착과 백악질, 골조직을 재형성하는 것이다. 최근에 이러한 전구세포들을 자극하고 원치 하는 세포들을 저지하기 위한 방법으로 성장 인자에 대한 연구가 활발히 진행되고 있다 골조직을 조절하는 인자로 알려진 인슐린유사성장인자- I (Insulin-like growth factor-I)는 폴리펩타이드계 성장인자로서 골세포의 증식, 기질합성 등을 촉진시킨다고 보고되고 있으나, 치주조직 재생에 대한 IGF- I 의 영향을 잘 규명되어 있지 않으므로 배양된 치주인대세포에 IGF- I 을 농도별로 주입하여 세포의 증식능, 교원질 및 단백질 합성능, 알카린인산효소활성도를 측정해 보므로써 IGF- I 이 치주인대세포의 활성에 미치는 영향을 알아보고자 하였다. 교정치료를 위해 내원한 환자로부터 건강한 제일소구치를 발거하여 치주인대세포를 분리, 배양하여 IGF- I 을 주입시키지 않은 군을 대조군으로 하고, IGF- I 을 각각 0.1, 1, 10, 100 ng//ml로 주입시킨 군을 실험군으로 하여 DNA합성능, 총단백질과 교원질 합성능 및 알카린인산효소활성도를 측정하여 다음과 같은 결과를 얻었다. DNA 합성능에 미치는 IGF- I 의 효과는 농도가 증가함에 따라 0.1ng/ml를 제외하고는 DNA 합성능이 증가하는 경향을 보였고, 대조군에 비해 10, 100ng/ml투여군에서 통계적으로 유의한 차이(P<0/05)를 나타내었다. 치주인대세포의 총단백질 합성양에 미치는 IGF- I 의 효과는 농도가 증가함에 따라 총단백질 합성양이 증가하는 경향을 보였으며, 대조군에 비해 1, 10, 100ng/ml 투여군에서 통계학적으로 유의한 차이(P<0.001)를 나타내었다. 총단백질을 교원질(collagenase digestible protein : CDP)과 비교원성 단백질(non-collagenous protein : NCP)로 분류하여 비교하였을때 IGF- I 의 농도가 증가함에 따라 비교원성 단백질 합성양과 교원질 합성양이 증가하는 경향을 보였으며, 비교원성 단백질 합성양이 교원질 합성양보다 약간 높게 나타났고, 대조군에 비해 1, 10, 100ng/ml 투여군에서 통계적으로 유의한 차이(P<0.05, P<0.001)를 나타내었다. 총단백질에 대한 교원질합성의 상대적 비율은 농도가 증가함에 따라 각 군당 별차이를 보이지 않았으며, 대조군에 비해 통계적으로 유의한 차이 (P>0.05)를 나타내지 않았다. 알카린인산효소활성도에 미치는 IGF- I 의 효과는 모든군에서 7일째보다 14일째에서 약간 높은 알카린인산효소활성도롤 나타내었으며, 7, 14일 모두 농도가 증가함에 따라 효소활성도가 증가하였으며, 7일째 대조군에 비해 100ng/ml 투여군에서 통계적으로 유의한 차이(p<0.05)를 나타내었다.

• Journal of Periodontal and Implant Science
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• 제26권3호
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• pp.605-624
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• 1996

Various bonegraft materials and the technique of guided tissue regeneration have been used to regenerate lost periodontal tissue. Calcium sulfate has been known as a bone graft material because of good biocompatibility, rapid resorption and effective osteoinduction. It has been known that calcium sulfate works as a binder to stabilize the defect when it is used with synthetic graft materials. The effects on the regeneration of pericxiontal tissue were studied in dogs after grafting 3-wall intrabony defects with calcium carbonate and calcium sulfate and covering with calcium sulfate barrier. The 3-wall intrabony defectstdmm width, 4mm depth, 4mm length) were created in anterior area and treated with flap operation alone(contol group), with porous resorbable calcium carbonate graft alonetexperirnental group 1), with calcium sulfate graft alonetexperimental group 2) and with composite graft of 80% calcium carbonate and 20% calcium sulfate with calcium sulfate barriertexperimental group 3). Healing responses were histologically observed after 8 weeks and the results were as follows: 1. The alveolar bone formation was $0.59{\pm}0.19mm$ in the control group, $1.80{\pm}0.25mm$ in experimental group 1, $1.61{\pm}0.21mm$ in experimental group 2 and $1.94{\pm}0.11mm$ in experimental group 3 with statistically significant differences between control group and all experimental groups(P<0.05). There were statistically significant differences between experimental group 1 and group 2 (P<0.05). 2. The new cementum formation was $0.48{\pm}0.19mm$ in the control group. $1.72{\pm}0.26mm$ in experimental group 1, $1.43{\pm}0.17mm$ in experimental group 2, $1.89{\pm}0.15mm$ in experimental group 3 with statiscally significant differences between control group and all experimental groups (p<0.05). There were statistically significant differences between experimental group 1 and group 2, and between experimental group 2 and group 3(P<0.05). 3. The length of junctional epithelium was $1.61{\pm}0.20mm$ in the contol group, $0.95{\pm}0.06mm$ in experimental group 1, $1.34{\pm}0.16mm$ in experimental group 2, $1.08{\pm}0.11mm$ in experimental group 3 with statiscally significant differences between control group and experimental group 1. and btween control group and experimental group 3(p<0.05). There were statistically significant differences between experimental group 1 ,and group 2, and between experimental group 2 and group 3(P<0.05). 4. The connective tissue adhesion was $1.67{\pm}O.20mm$ in the control group, $1.33{\pm}0.24mm$ in experimental group 1. $1.23{\pm}0.16mm$ in experimental group 2, $1.08{\pm}0.14mm$ in experimental group 3 with statistically significant differences between control group and all experimental groups(p<0.05). There were nostatistically significant differences between all experimental groups. As a result, epithelial migration was not prevented when calcium sulfate was used alone, but new bone and cementum formation were enhanced. Epithelial migration was prevented and new bone and cementum formation were also enhanced when calcium carbonate was used alone and when both calcium carbonate and calcium sulfate were used.

• Journal of Periodontal and Implant Science
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• 제33권4호
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• pp.599-613
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• 2003

The goal of periodontal treatment is regeneration of the periodontium. Bone graft and absorbable PLA/PGA membrane have been used for this purpose. In this study, 4${\times}$4mm 1-wall intrabony defects were surgically created bilaterally in the mandible of five male beagles. The control group went through a conventional flap operation, while the experimental group I was treated with absorbable PLA/PGA membranes only, group II was treated with absorbable membrane and calcium phosphate. The results are the following : 1. The defect height was 4.82${\pm}$0.45mm in the control group, 4.93${\pm}$0.79mm in the experimental I group, and 4.92${\pm}$0.62mm in the experimental II group. There was no statistically significant difference among 3 groups(P <0.05). 2. The amount of junctional epithelium migration was 30.90${\pm}$9.92% of the defect height in the control group, 39.16${\pm}$7.51% in the experimental I group, and 38.68${\pm}$12.22% in the experimental II group. There was no statistically significant difference among 3 groups(P <0.05). 3. The amount of connective tissue adhesion was 36.38${\pm}$9.03% in the control group, 14.73${\pm}$3.93% in experimental I group, and 27.87${\pm}$9.70% experimental II group. Experimental group I was a statistically significantly different from control group(P <0.05). 4. The amount of new cementum regeneration was 32.92${\pm}$10.51%, 50.04${\pm}$7.61%, and 39.62${\pm}$12.14% for the control, experimental I, and experimental II group respectively. Experimental group I was a statistically significantly different from control group(P<0.05). 5. The amount of new alveolar bone regeneration was 27.24${\pm}$7.49%, 40.75${\pm}$8.03%, and 36.47${\pm}$15.11% for the control, experimental I, and experimental II group respectively. Experimental group I was a statistically significantly different from control group(P <0.05). The results suggest that the use of PLA/PGA membrane in 1-wall intrabony defect of beagle dogs may promote periodontal regeneration. Further studies are required to determine their regeneration effects.

• 대한골관절종양학회지
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• 제11권2호
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• pp.141-147
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• 2005

목적: 악성 흑색종의 치료 중 가장 중요한 것은 외과적 전절제술이며, 수술시 광범위 절제술을 시행한다. 저자 등은 광범위절제와 면역화학요법을 시행한 후 각 병기별 5년 생존율을 알아보고 예후에 영향을 주는 요인을 주는 요인들을 분석하고자 한다. 대상 및 방법: 1995년 3월부터 2003년 8월까지 악성 흑색종으로 진단 받았던 35명(남자 17명, 여자 18명)을 대상으로 광범위절제술과 면역화학요법을 시행한 후 추시 관찰하였다. 절제술은 종양의 크기나 피부층의 침범정도와 상관없이 종양의 변연으로부터 2 cm으로 하였고, 절제술 후 덮이지 않는 피부 결손부는 피판 이식술이나 전층 피부 이식술을 이용하였다, 면역화학요법으로는 dacarbazine (DTIC) 400 mg과 인터페론-${\alpha}$ 300만 IU를 병용 투여 하는 방법을 사용하였다. 면역화학요법은 III기 이상의 환자에게 시행하였고, 병기는 2002년 개정된 AJCC 병기를 이용하여 판정하였다. 또 이들 환자들에 대해 국소재발과 국소전이, 그리고 원격전이여부를 조사하였고, 각 병기별 5년 생존율을 조사하였다. 결과: 발생부위는 족부가 15명(42.8%)으로 가장 많았고, 족관절부 5명(14.2%), 하퇴부 2명(5.7%), 대퇴부 2명(5.7%), 수부에 5명(14.2%)이었다. 병기별 발생빈도는 IA 8명(22.8%), IB 9명(25.7%), IIA 4명(11.4%), IIB 2명(5.7%), IIIA 1명(2.8%), IIIB 2명(5.7%), IIIC 2명(5.7%) 그리고 IV기는 7명(20.0%) 이었다. 각 병기별 5년 생존율은 I기에서 94.1%, II기에서 66.8%, III기에서 40%, IV기에서 14.3%로 나타났다. 결론: 악성 흑색종은 III기 이상에서는 5년 생존율이 낮았다. 악성 흑색종의 치료는 초기에 진단하여 병기에 따라 치료의 방법을 달리하므로 수술전 병기의 확인이 매우 중요하다. 광범위 절제연에 대해서는 종양 두께에 따라 1~3 cm의 절제연으로 광범위 절제를 권유한다.