• Journal of Oral Medicine and Pain
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• v.32 no.3
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• pp.283-292
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• 2007

In several treatment modalities for snoring and obstructive sleep apnea (OSA), oral appliances mainly including mandibular advancement appliance (MAA) and tongue retaining device (TRD) are recognized as a non-invasive, reversible alternative with favorable results. Tongue bulb is a major component of TRD which prevents the tongue from approaching the posterior wall of the pharynx and can be combined with MAA. Determination of tongue bulb size for the patient is important for therapeutic effect, but frequently needs time-consuming work. For effective fabrication and standardization of tongue bulbs, this study aimed to categorize tongue bulb size for healthy young men and to examine its relation with maximum retention force and with physical parameters including tongue-related variables. 36 non-snoring, asymptomatic young men with normal occlusion were voluntarily participated in this study (mean age: $24.47{\pm}2.58$ years). Experimental procedures consisted of prefabrication of tongue bulb set (20 types with a width of 27-36mm and thickness of 8 and 10 mm), determination of tongue bulb size and the maximum retention force for each subject, and measurement of physical parameters including body mass index (BMI), neck circumference and width, thickness and length of tongue. This study showed that there was significant difference of retention force among the bulb size-related groups both in upright and supine position (p<0.05) and that retention force increased with bulb size. Correlation of tongue bulb size with physical parameters was not clearly verified and there was no significant difference in retention force between upright and supine positions. Based on our results, it can be suggested that retention force relates with tongue bulb size, ultimately with tongue volume. A further study needs to be performed in the patients with snoring and OSA.

• The Korean Society of Law and Medicine
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• v.22 no.2
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• pp.111-138
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• 2021

'Unlicensed medical practice by a non-medical practitioner' often represented by surrogate surgery or so-called 'ghost surgery,' causes irreparable damage to life or body, and therefore calls for very strict and effective controls. The 'bill on installment of CCTVs in an operating room' to prevent unlicensed surrogate surgery has been discussed for a long time, but due to numerous issues and heated confrontations, it has been pending in the National Assembly. Nevertheless, it is expected that the bill will be discussed again in earnest in the National Assembly because surrogate surgery and factory-type cosmetic surgery, which has been performed mainly in the field of cosmetic surgery, has also been occurring in the field of therapeutic surgery. In general, an operating room is considered as being locked or closed, as well as disallowing implicit complicity among insiders. Hence, if the insiders conspire to commit or cover up an illegal act, or if a surgeon performs rapid cosmetic surgery and then leaves the recipient (or medical institution) so as to perform more operations for profit - even if it is legitimate practice - it may result in serious consequences in terms of the recovery of a patient. In this case, installation of CCTVs can be of great help in identifying an illegal act and assessing any occurrence of negligence. On the other hand, while the fundamental purpose of therapeutic surgery is to restore a patient's life or body - that is, lifesaving - installation of CCTVs may base the relationship between a surgeon and a patient on distrust and surveillance, so it may increase the number of requests for CCTV footage or lead to more disputes, as well as placing a burden on the surgeon when best results are not achieved for a patient. As a result, the surgeon may choose non-invasive treatment contrary to conscience instead of risky but necessary surgery, or he/she may have significant difficulty in determining the timing of surgery, which may limit the provision of effective surgical medical care. Then, in terms of the relationship between a surgeon and patient, and in the long run, there could be significant disadvantages for the public and patients if CCTV footage is allowed. In this paper, we review domestic and overseas cases and issues regarding installation of CCTVs in an operating room, and present various viewpoints and suggestions to promote legislation with minimized legal problems and side effects, thereby contributing to protection of the lives and health of the public, patients, and recipients of surgery.

• Clinical and Experimental Pediatrics
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• v.50 no.6
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• pp.549-555
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• 2007

Purpose : Pulse wave velocity (PWV) and ankle brachial index (ABI) are simple, non-invasive methods to assess arterial stiffness. These parameters are also known to be closely related to cardiovascular risk factors and diseases. The purposes of this study were to measure blood pressure, PWV, ABI in healthy Korean adolescents, set up their normal values and assess their correlations. Methods : Three hundred ninety two healthy adolescents (213 boys and 179 girls) underwent measurement of brachial ankle pulse wave velocity (baPWV), ABI, body mass index(BMI) and blood pressure from four extremities. Linear regression analysis was performed to reveal the correlations between PWV, ABI and independent variables. Results : Blood pressure and PWV were significantly higher in all extremities in males compared to females. Blood pressure of both brachial and ankle showed positive correlation with body weight, height, and BMI, whereas ABI showed no correlation with any of these indices. Conclusion : Blood pressure increases as body weight, height and BMI increases. PWV shows positive correlation with blood pressure. It will be helpful to predict the risks of cardiovascular diseases in adolescents.

• Journal of Chest Surgery
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• v.43 no.6
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• pp.681-686
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• 2010

Background: A chest computed-tomography has become more prevalent so that it is more common to detect small sized pulmonary nodules that have not been found in previous simple chest x-ray. If those detected nodules are undersized or located in pulmonary parenchyma, it is difficult to accomplish a biopsy since it is vulnerable to explore them either grossly or digitally. Thus, in our hospital, a thoracoscopic pulmonary wedge resection was performed after locating a lesion by means of hook wire with CT-guided. Material and Method: 31 patients (17 males and 14 female patients) from December in 2006 to June in 2010 became our subjects; their 34 pulmonary nodules were subjected to the thoracoscopic pulmonary wedge resection after locating a lesion by means of hook wire with CT-guided. Also we analyzed a possibility of hook wire dislocation, a frequency of conversion to open thoracotomy, time consumed to operation after location of a lesion, operation time, post operation complication, and histological diagnosis of the lesion. Result: 12 of 34 cases were ground glass lesion, whereas 22 cases of them were solitary pulmonary lesion. The median value of the lesion was 8mm in size (range: 3 to 23 mm), while the median value was 12.5 mm in depth (range: 1 to 34 mm). The median value of time consumed from location of the lesion to anesthetic induction was 86.5 minutes (41~473 minutes); furthermore the mean value of operation time was 103 minutes (25~345 minutes). Intrathoracic wire dislocation was found in one case, but a target lesion was successfully excised. Open thoracotomy was performed in four cases due to pleural adhesion. However, there was no case of conversion to open thoracotomy due to failure to detect a target lesion. In histological diagnosis, metastatic cancer were found in 15 cases, which were the most common, primary lung cancer were in 9 cases, non-specific inflammation were in 3 cases, tuberculosis inflammation were in 2 cases, lymph nodes were in 2 cases, active tuberculosis were in 1 case, atypical adenomatous hyperplasia was in 1 case and normal lung parenchymal finding was in 1 case, respectively. Conclusion: In our hospital, in order to accomplish a precise histological diagnosis of ground-glass lesion and pulmonary nodules in lung parenchyma, location of pulmonary nodules were exactly located with hook wire under chest computed-tomography, which was followed by lung biopsy. We concluded that this was an accurate, minimally invasive and valuable method to minimize the complications and increase of cost of medical service provided.

• Clean Technology
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• v.25 no.4
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• pp.316-323
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• 2019

In order to enhance combustion efficiency and reduce atmosphere pollutants, it is essential to measure carbon monoxide (CO) concentration precisely in combustion exhaust. CO is the important gas species regarding pollutant emission and incomplete combustion because it can trade off with NOx and increase rapidly when incomplete combustion occurs. In the case of a steel annealing system, CO is generated intentionally to maintain the deoxidation atmosphere. However, it is difficult to measure the CO concentration in a combustion environment in real-time, because of unsteady combustion reactions and harsh environment. Tunable Diode Laser Absorption Spectroscopy (TDLAS), which is an optical measurement method, is highly attractive for measuring the concentration of certain gas species, temperature, velocity, and pressure in a combustion environment. TDLAS has several advantages such as sensitive, non-invasive, and fast response, and in-situ measurement capability. In this study, a combustion system is designed to control the equivalence ratio. Also, the combustion exhaust gases are produced in a Liquefied Petroleum Gas (LPG)/air flame. Measurement of CO concentration according to the change of equivalence ratio is confirmed through TDLAS method and compared with the simulation based on Voigt function. In order to measure the CO concentration without interference from other combustion products, a near-infrared laser at 4300.6 cm^-1 was selected.

• The Journal of Korean Society for Radiation Therapy
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• v.29 no.2
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• pp.75-81
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• 2017

Purpose: To evaluate the reproducibility of image-guided radiotherapy using ultrasonography which is non-invasive, without radiation exposure for prostate cancer patients. Materials and Methods: We analyzed the setup variation of 1,105 images for 26 prostate cancer patients and the mean, standard deviation and 3D-error in AP, RL and SI directions. Setup variations were classified 0-1 mm, 1-3 mm, 3-5 mm, 5 mm and more. Results: The mean and standard deviation of setup variation in AP, RL and SI directions was $1.87{\pm}1.36mm$, $1.73{\pm}1.22mm$ and $2.01{\pm}1.40mm$. The 3D-error in AP, RL and SI directions was $3.63{\pm}1.63mm$. The frequency of setup variation in AP direction was 29 % in the range from 0 mm to 1 mm, 50.2 % in the range from 1 mm to 3 mm, 19.6 % in the range from 3 mm to 5 mm and 1.3 % in the range of 5 mm or more. In RL direction, the frequency was 31.3 % in the range from 0 mm to 1 mm, 52.5 % in the range from 1 mm to 3 mm, 15.8 % in the range from 3 mm to 5 mm and 0.5 % in the range of 5 mm or more. SI direction, the frequency of errors in the range from 0 mm to 1 mm was 26.3 %, 50.2 % in the range from 1 mm to 3 mm, 22.4 % in the range from 3 mm to 5 mm, and 1.1 % in the range of 5 mm or more. Conclusion: The setup error was highest in the SI direction of $2.01{\pm}1.40mm$. The frequency in each direction was the highest in more than 50 % in the range from 1 mm to 3 mm. $Clarity^{TM}$ Auto scan is possible to monitoring the motion of the prostate during the treatment and to repositioning the patient. In conclusion real-time image-guided radiotherapy using ultrasonography will be increase the reproducibility of radiation therapy.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.150-154
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• 2010

Purpose: Ejection fraction (EF) is one of the most important factors that evaluate heart function. Recently, according to echocardiography and myocardial perfusion SPECT, the number of gated blood pool scan (planar GBP) is declining. Measurement of left ventricular ejection fraction using gated blood pool SPECT (GBPS) is known as relatively correspond with echocardiography. We compared EF derived from plnar GBP, GBPS and echocadiography using modified simpson method to determine the accuracy. Materials and Methods: From January 2007 to June 2010, planar GBP and GBPS were performed on 34 patients who admitted to Pusan National University Hospital (men 23, women 11, mean age $52.6{\pm}27.2$). Each patient was injected with $^{99m}{TcO_4}^-$ of 20 mCi after pyrophosphate injection and then scanned using both planar GBP and GBPS techniques. For image analysis, we use ADAC Laboratories, Ver. 4.20 software. The result analyzed was processed by SPSS 17.0 Win statistic program and statistical method applied in data analysis is one-way anova, Tukey's post hoc test, pearson correlation test. Results: One-way anova test show no significant difference (planar GBP $56.3{\pm}13.9%$; GBPS $60.4{\pm}16.0%$; echocardiography $59.1{\pm}14.4%$, p=0.486, p>0.05). Tukey's post hoc test show no significant difference (planar GBP-echocardiography p=0.697; GBPS-echocardiography p=0.928; planar GBP-GBPS p=0.469, p>0.05). Values for EF obtained with planar GBP and GBPS correlated well with those obtained with echocardiography (planar-echocardiography r=0.697; GBPS-echocardiography r=0.928; planar GBP-GBPS r=0.469). Conclusion: The problems of accuracy and reproducibility for planar GBP still remain. But planar GBP is a safe and non-invasive method. In addition, planar GBP is useful to evaluate patient with low resolution echocardiography images. GBPS is not appicated clinically. but GBPS can be obtain various left ventricular functional parameters. planar GBP, GBPS and echocardiography show a good correlation between each other. Therefore, planar GBP and GBPS are useful for evaluating left ventricular ejection fraction.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.14 no.2
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• pp.141-147
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• 2011

Purpose: Ultrasonography (US) is widely used as a screening test in patients with abdominal pain (AP). We investigated the usefulness of US by a pediatrician in children with AP. Methods: We retrospectively analysed the medical records of children with AP who undertook US from December, 2008 to July, 2010. Results: A total of 628 patients (325 male, 303 female) were enrolled in this study. The mean age of patients was $8.08{\pm}4.61$ years. Duration of AP was acute in 427 and chronic in 201 patients. Localization of AP was diffuse (36.9%), periumbilical (24.4%), epigastric (21.0%), and right lower quadrant (8.1%). On the examination, there were no abnormal findings in 327 patients (52.1%). Abnormal ultrasonographic findings were mesenteric lymphadenitis (27.1%), intestinal mural thickening (10.0%), intussusception (3.0%), appendicitis (2.6%), choledochal cyst (1.6%), and pancreatitis (0.3%). We performed additional imaging studies such as computed tomography (CT) or magnetic resonance imaging (MRI) in 39 patients who showed obscure findings on the US. In 33 patients (84.6%), the same results were obtained from CT or MRI. Two cases of appendicitis, one case of pancreatitis and one case of Henoch-Sh$\ddot{o}$nlein purpura were diagnosed by the CT examination. However, there were two cases of appendicitis diagnosed by US thathad no evidence of appendicitis on the CT. Diagnostic accuracy of initial US in children with abdominal pain was 99.4%. Conclusion: US by a pediatrician as a screening test in children with AP provides a rapid and accurate diagnostic indication and has non-invasive and radiation-free advantages.

• Journal of Chest Surgery
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• v.37 no.9
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• pp.762-767
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• 2004

With the developement of non-invasive surgical techeniques, coronary artery bypass graft without cardiopulmonary bypass has become popular. We compared the preoperative risk factors and in-hospital outcomes of patients having off-pump CABG with these having on-pump CABG. Material and Method： From January 2001 to June 2003, 87 patients underwent CABG. Thirty-sin patients underwent on-pump CABG, fifty-one patients under-went off-pump CABG. Preoperative risk factors, extent of coronary disease, operative time, postoperative endotracheal intubation time, duration of ICU stay & hospital stay, the amount of bleeding and postoperative levels of cardiac enzymes were compared in both groups, Result: The were no differences in their sex ratios, ages, preoperative risk factors, preoperative Ml, Canadian classes, extent of coronary artery diseases and, echocardio-graphic ejection fraction between Off-pump CABG and On-pump CABG groups. Off-pump CABG group had significantly lower mean operative time (270$\pm$79.3 min vs 372$\pm$142.2 min, p＜0.001), mean ventilation time (17.1$\pm$13.4 hr vs 24.3$\pm$17.8 hr) and CK-MB level (8,9$\pm$18.7 IU/L vs 25.7$\pm$8.4 IU/L) than on-pump CABG groups, On-pump CABG group had more distal grafts (2.2$\pm$0.5 vs 1.7$\pm$0.71 than Off-pump CABG groups did. There were no differences in their postoperative complications and outcomes including amount of postoperative bleeding for 24 hrs, reoperation for bleeding control, mean in-hospital days, postoperative infection, renal failure and neurologic complications between Off-pump CABG and On-pump CABG groups. Conclusion: This study showed that patients who underwent Off-pump CABG had less operation time & intubation time and lower CK-MB level; however, they also have less distal graft. Even though CABG without CPB provided satisfactory results, more clinical experience & longer follow-up is required.

• The Journal of Korean Medicine
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• v.29 no.4
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• pp.205-212
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• 2008

Background and purpose: So far it was reported that acupuncture increased cerebral blood supply and stimulated the functional activity of brain nerve cells. A previous study demonstrated a correlation between LI4-11 electro-acupuncture (EA) and rCBF increase in frontal lobe. However, there remained a need to study further using various controls in acupuncture research. Transcutaneous electrical nerve stimulation (TENS) has been used as a non-invasive control in acupuncture study. This study was to evaluate the effect of LI4-LI11 TENS on regional cerebral blood flow (rCBF) in normal volunteers using single photon emission computed tomography (SPECT) and statistical parametric mapping (SPM). Methods: In the resting state, $^{99m}Tc-ECD$ brain SPECT scans were performed on 10 normal volunteers (9 males, 1 female, mean age 26.6$\pm$0.5 years; age range from 26 to 27 years). On the other day, 7 days after the resting examination, 15 minute TENS were applied at LI 4 and LI 11 on the right side of the subjects. Immediately after LI4-LI11 TENS, the second SPECT images were obtained in the same manner as the resting state. Significant increases and decreases of regional cerebral blood flow after LI4-LI11 TENS were estimated by comparing their SPECT images with those of the resting state using paired t statistics at every voxel, which were analyzed by statistical parametric mapping with a threshold of p = 0.001, uncorrected (extent threshold: k=100 voxels). Results: TENS applied at right LI4-LI11 increased rCBF in the left somatosensory association cortex (Brodmann area 5, 7). However there was no area where LI4-11 TENS decreased rCBF. Conclusion and suggestions: These results demonstrate that right LI4-LI11 TENS increased rCBF only in corresponding somatosensory association cortex, which was different from the previous results using LI4-11 EA. It is suggested that there be a different mechanism between TENS and EA.