• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제50권2호
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• pp.86-93
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• 2024

Objectives: Orthognathic surgery is a surgical procedure performed by intraoral approach with established and safe techniques; however, excessive blood loss has been reported in rare cases. In response, investigative efforts to identify methods to reduce the amount of blood loss have been made. Among such methods, the administration of tranexamic acid was reported to reduce the amount of intraoperative blood loss. However, few studies to date have reported the effect of tranexamic acid in orthognathic surgery under hypotensive anesthesia. The present study aimed to investigate the effect of the administration of tranexamic acid on intraoperative blood loss in patients undergoing bimaxillary (maxillary and mandibular) orthognathic surgery under hypotensive anesthesia. Patients and Methods: A total of 156 patients (mean age, 27.0±10.8 years) who underwent bimaxillary orthognathic surgery under hypotensive anesthesia performed by the same surgeon between June 2013 and February 2022 were included in this study. The following data were collected from the medical records of each patient: background factors (age, sex, and body mass index), use of tranexamic acid, surgical procedures, previous medical history, duration of surgery, American Society of Anesthesiology physical status findings before surgery, intraoperative blood loss as a primary outcome, in-out balance, and blood test results. Descriptive statistics were calculated for statistical analysis, and a t-test and the chi-squared test were used for between-group comparisons. Group comparisons were performed after 1:1 propensity score matching to adjust for confounding factors. Statistical significance was set at P<0.05. Results: Comparison between the groups based on the use of tranexamic acid revealed a significant difference in operation time. Propensity score matching analysis revealed that intraoperative blood loss was significantly lower in the tranexamic acid group. Conclusion: The administration of tranexamic acid was effective in reducing intraoperative blood loss in patients undergoing bimaxillary orthognathic surgery under hypotensive anesthesia.

• 치위생과학회지
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• 제16권4호
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• pp.317-322
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• 2016

최근 성장 중인 아동에서 치근의 성장이 계속됨에 따라 치수가 괴사되어 치근의 병변이 있는 미성숙 영구치에서도 치수의 재혈관화(revascularization)가 실제로 일어날 수 있다는 가능성이 제시되고 있다. 소아치과영역에서 자주 접하게 되는 미성숙 영구치의 치근단 형성술의 목적은 열린 치근단에서 세균 침입을 제한하고 치근단 장벽 형성을 촉진하는 것이다. 미성숙 치아의 근관 치료에서 기존의 수산화칼슘을 이용한 치근단 형성술은 빈번한 내원과 장기간 소요되는 치료 기간, 환자협조 요구, 최종 처치의 지연, 장기간의 수산화칼슘 적용 이후 치아 파절 가능성의 증가 등의 단점이 보고되었다. 기존의 수산화칼슘 치근단형성술의 대체방법으로 MTA를 이용한 1-visit 치근단형성술을 시행하고 있다. MTA는 1990년대 초반 근관치료 분야에서 다양한 적용을 위해 개발되었다. MTA의 우수한 임상적 성질에 힘입어 국내에서도 OrthoMTA 및 Endo CEM 등의 mineral aggregate 제품이 출시되어 있다. 따라서 본 증례에서는 우리나라의 청소년에서 MTA 적용한 사례를 보고하는 데 있다. 이 연구를 통해 MTA를 이용하여 진료하는 임상가에게 소개하고자 한다. 이 연구는 11~12세의 파절이 된 치아에 MTA를 적용하여 근관 치료를 하였다. 치료 받은 환자의 치아 상태를 12개월 동안 추적 관찰하였고, 국내에서 개발된 OrthoMTA를 이용한 치근단형성술을 시행한 후 임상적 및 방사선학적 관찰 결과를 통해 근관치료재생술(REP)에 관한 만족할 만한 결과를 얻었으며, 치수괴사가 생긴 경우에서도 성공적으로 치수재생술을 적용할 수 있다는 정보를 제공하고 그 결과를 공유하기 위함이다.

• 수산해양교육연구
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• 제13권1호
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• pp.99-116
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• 2001

Testing is a procedure used to measure a sample of behaviour in order to discover how well a seafarer performs, usually in comparison with others, or compared with identified performance criteria. In this context It is important that the test, in whatever form it is being used, yields consistent results by being valid, reliable and practical. Whilst we can only take a sample of a person's knowledge or comprehension about topic in this way, testing methods do provide a more reliable estimate of performance than most other observational techniques; unsystematic or irregular observation being too unreliable. The method of examination has been specified in the provisions of Regulation 12 of the Decree of the ship officers act as followings. Other necessary matters for conducting oral and written examinations have been set out by the Minister. But written examination is too shortage of period and small number of question to cover the qualification of each level and oral test is just simple and namely Traditionally, written examinations have been provided as the only means for determining the acquisition of knowledge by the mariner. Typically, the examination formats have taken the format of either an essay or multiple choice examinations. Essay items, used in the vast majority of subject examination(not in Korea), consisted of three basic types: situational, descriptive and computational. The level of certificate being examined determined the number and mix of the type of essay questions selected. Oral question has again been used by assessors of seafarer in a wide variety of contexts. Also, oral questioning is often used when observation of performance is undertaken to ask why a certain action has been taken, or to be broaden the scope of what has been observed. At end, Each techniques have their own advantage and disadvantage, so we have to choose some or all of the following techniques, depending upon the certificate, qualification or job for which the trainee is aiming. But in high lank, we have to use both of essay type and multiple choice and with enough time of oral test at least 30 minutes. Who would be the assessor? According to the STCW Code Section A-I/6, instructors, supervisor and assessors are appropriately qualified for particular types and levels of training or assessment of competence of seafarers either on board or ashore, as required under the Convention, in accordance with the provisions of this section.

• Journal of Periodontal and Implant Science
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• 제47권2호
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• pp.77-85
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• 2017

Purpose: Guided bone regeneration (GBR) is the most widely used technique to regenerate and augment bones. Even though augmented bones (ABs) have been examined histologically in many studies, few studies have been conducted to examine the biological potential of these bones and the healing dynamics following their use. Moreover, whether the bone obtained from the GBR procedure possesses the same functions as the existing autogenous bone is uncertain. In particular, little attention has been paid to the regenerative ability of GBR bone. Therefore, the present study histologically evaluated the regenerative capacity of AB in the occlusive space of a rat guided bone augmentation (GBA) model. Methods: The calvaria of 30 rats were exposed, and plastic caps were placed on the right of the calvaria in 10 of the 30 rats. After a 12-week healing phase, critical-sized calvarial bone defects (diameter: 5.0 mm) were trephined into the dorsal parietal bone on the left of the calvaria. Bone particles were harvested from the AB or the cortical bone (CB) using a bone scraper and transplanted into the critical defects. Results: The newly generated bone at the defects' edge was evaluated using micro-computed tomography (micro-CT) and histological sections. In the micro-CT analysis, the radiopacity in both the augmented and the CB groups remained high throughout the observational period. In the histological analysis, the closure rate of the CB was significantly higher than in the AB group. The numbers of cells positive for runt-related transcription factor 2 (Runx2) and tartrate-resistant acid phosphatase (TRAP) in the AB group were larger than in the CB group. Conclusions: The regenerative capacity of AB in the occlusive space of the rat GBA model was confirmed. Within the limitations of this study, the regenerative ability of the AB particulate transplant was inferior to that of the CB particulate transplant.

• Tuberculosis and Respiratory Diseases
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• 제57권2호
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• pp.148-159
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• 2004

연구 배경 : 본 연구는 비외상성 객혈을 주소로 내원한 환자에서 기관지 동맥 색전술의 생존 효과를 파악하고자 시행하였다. 방 법 : 환자에 대한 임상적인 정보는 의무기록, 전자처방기록(Order Communication System), 방사선 기록 등을 통하여 수집하였으며, 사망 관련 정보는 통계청 사망 자료를 통하여 획득하였다. 전체 환자를 최대 2년 동안 관찰하였으며, 기관지 동맥 시행 여부에 따라 시행군과 비시행군 등 두 군으로 나누어 관련 요인별로 생존과 사망에 대한 단변량 분석을 시행하였다. 기관지 동맥 색전술 시행 여부로 층화하여 Kaplan-Meier 생존곡선을 구한 후, 관련 요인을 보정하여 Cox-proportio-nal hazard regression analysis를 시행하여 기관지 동맥 색전술에 따른 생존 효과를 평가하였다. 결 과 : 대상 환자는 총 272명으로 이 중 기관지 동맥 색전술을 시행 받은 환자는 63명, 시행 받지 않은 환자는 209명이었으며, 원인 질환별로 악성 폐종양군은 69명, 양성 만성 폐질환군은 149명, 기타 질환군은 54명이었고 이 중 2년 이내에 사망한 경우는 69명이었다. 전체 환자를 대상으로, 그리고 악성 폐종양군, 양성 만성 질환군 등 세부 군을 대상으로 기관지 동맥 색전술의 생존효과를 평가하였을 때, 유의한 결과를 보여주지 않았다. 결 론 : 2년 동안의 관찰 기간 동안, 비외상성 객혈환자에서 기관지 동맥 색전술은 유의한 생존 효과를 보여주지 못하였다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권14호
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• pp.5907-5912
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• 2015

Purpose: To evaluate and update evidence for prognostic effects of kidney-sparing (KS) management and nephroureterectomy (NU) for upper tract urothelial carcinomas. Materials and Methods: Pubmed, Embase and the Cochrane Library were retrieved for the identification of comparative studies of kidney-sparing procedure and nephroureterectomy for upper tract urothelial carcinoma prior to December 2014. The data were extracted independently by 2 reviewers and the quality of the included studies was assessed. Review Manager 5.3 and STATA 13 were used to perform the meta-analysis. Results: Twenty-three observational studies including 1,587 KS and 3,996 NU were evaluated. The results of the meta-analysis showed that nephroureterectomy had no significant benefit with regard to intravesical recurrence (IRFS), metastasis (MFS), cancer specific survival (CSS) and overall survival (OS) except the total tumor recurrence (RFS) when compared with kidney sparing management. The respectively pooled outcomes were HR 1.36 (0.69-2.68, P=0.38) for IRFS, 1.09 (0.59-2.01, P=0.78) for MFS, 1.17 (0.77-1.79, P=0.47) for CSS, 1.50 (0.90-2.48, P=0.12) for OS and 1.61 (1.03-2.51, P=0.04) for RFS. Conclusions: On the whole, kidney-sparing management had equivalent prognostic effect on upper tract urothelial carcinoma as the standard nephroureterectomy except in tumor recurrence. However, the results should be interpreted with caution for lack of stage and grade stratification and multi-center randomized controlled trials are still needed to verify our results.

• Journal of Korean Neurosurgical Society
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• 제63권6호
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• pp.806-813
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• 2020

Objective : Lumbar disc herniation (LDH) is a common disease, and lumbar discectomy (LD) is a common neurosurgical procedure. However, there is little previous data on return to work (RTW) after LD. This study investigated the period until the RTW after LD prospectively. Clinically, the pain state at the time of RTW also checked. RTW failure rate 6 months after surgery also investigated. Methods : Patients with daily/regular jobs undergoing LD between September 2014 and December 2018 were enrolled. Pain was assessed by the Oswestri Disability Index (ODI) and the Numeric Rate Scale (NRS). Employment type was divided into self-employed, regular and contracted. Monthly telephone interviews were conducted to check RTW status and self-estimated work capability after surgery. Results : Sixty-seven patients enrolled in this study. Three patients failed to RTW, and three others resigned within 6 months after surgery. The preoperative NRS and ODI were 7.2±1.2 and 22.1±7.9, respectively. The average time to RTW was 5.1±6.0 weeks. At RTW, NRS was 1.5±1.8 and ODI was 6.3±3.9. Amongst patients that successfully returned to work were 16 self-employed workers, 42 regular employees, and three contracted workers. The time to RTW of self-employed, regular, and contracted workers were 5.9±8.8, 4.2±4.3 and 13.3±2.3 weeks, respectively (p=0.011). Thirty-six of the patients that returned to work self-reported a 22.8±15.6% reduction in work capability at 6 months. Conclusion : RTW may vary depending on the employment status. In this study, we found that while employment type may affect the length to RTW, most patients were able to RTW and >40% of patients reported no loss of work capabilities 6 months postoperatively, hopefully alleviating some patient hesitation towards LD.

• Asian-Australasian Journal of Animal Sciences
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• 제31권11호
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• pp.1818-1827
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• 2018

Objective: The objective of this work was to determine the prevalence of the pathologies that caused the condemnation of pig carcasses in an area of intensive pig farming and Mediterranean climatology and to evaluate their influence in a risk-based inspection procedure for slaughterhouses. Methods: A retrospective observational investigation was carried out from 2002 to 2016 into the pathological processes that caused the condemnation of pig carcasses in a slaughterhouse from South-eastern Spain. The seasonal effect on the causes of condemnation carcass was reported. Negative binomial model was used to evaluate the effect of season on the rate of antemortem rejections and post-mortem condemnations. Histopathological examinations were performed to confirm the diagnosis. Results: The risk of antemortem rejections (0.0564%) was significantly greater in summer (risk ratio [RR] = 1.57). Autumn was associated with higher rate (RR = 1.69) of the total postmortem condemnations (0.1046%). Significantly higher rates of pronounced anaemia (0.0111%) were observed in summer (RR = 3.20). The main causes of anaemia were observed gastroesophageal ulcers and haemorrhagic enteropathies. Significantly highest risk of erysipelas (0.0074%) were observed in autumn (RR = 5.485). About other zoonosis, only eight cases (0.0013%) of carcasses were declared unfit due to tuberculosis lesions. Porcine muscular cysticercosis was not detected. Nevertheless, nonspecific causes such as generalized infections and emaciation represented the half of the condemned carcasses (50.90%). Conclusion: The pathologies leading to the condemnation of carcasses in this study can be considered representative of the pathologies that affect the pig population from a region with a high intensive production and Mediterranean climatology because this slaughterhouse receives a lot of animals from many farms of different size in a high intensive pig production zone (Mediterranean region). Increased knowledge of environmental factors that may foment the appearance of the diseases is essential for implementing inspection programs based on risk assessment in pig's slaughterhouses.

• 한국전산구조공학회:학술대회논문집
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• 한국전산구조공학회 1995년도 가을 학술발표회 논문집
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• pp.111-121
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• 1995

교량의 내하력이나 건전도 평가에 있어서 중요한 역할을 하는 동적 매개변수들을 계측함에 있어서, 계측장치를 포함하는 적절한 계측계획 뿐만 아니라 계측된 자료를 처리하는 과정이 계측결과로부터 정확한 자료를 구하는 데 큰 영향을 미친다. 특히, 동적변위를 계측시 고정점을 확보할 수 없는 경우에는 변위계의 설치가 곤란하여 변위웅답의 계측에 어려움을 겪고 있으며, 가속도의 적분을 통해 이를 구하는 경우도 이산처리 과정에서 주요한 진동수 성분이 누락될 수 있어 실제 거동과 크게 다를 수 있다. 동적계측에서 주로 측정되는 가속도 기록에는 가속도계나 기록장비의 특성에 따라 또는 자료의 이산화 과정에서 오차들이 발생하게 된다. 계측기계의 특성에 따른 오차는 계측기 제작기술의 발달로 어느 정도 보정이 되고 있지만, 이산화 과정의 오차는 지금까지 정확한 보정을 하지 못해 가속도 기록을 이용하는 데 한계가 있었다. 따라서, 가속도 기록의 수치처리 과정에서 발생할 수 있는 오차가 언급되며, 특히 이산화 처리과정에서 표본화 주파수를 적절하게 선정할수 있는 방법을 제시한다. 제안된 방법을 이용할 경우, 동적하중에 따른 변위응답을 가속도 기록으로부터 정확하게 구할 수 있으므로, 교량 또는 동하중을 받는 대형 구조물의 건전도 평가에 크게 기여할 수 있을 것으로 사료된다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제21권2호
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• pp.119-128
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• 2021

Background: This study assessed anticipatory dental anxiety levels among 8- to 12-year-old children based on subjective and physiological measures and their correlation. The variations in anxiety based on sex, age, temperament, and academic performance were evaluated. Methods: An observational study was conducted in 60 children recruited from the waiting room over a 6-month period. The operator recorded subjective anxiety in the children using a novel visual facial anxiety scale. The operator also noted the demographic details and child's temperament using the nine dimensions of the Thomas and Chess criteria, and graded children as "easy," "slow to warm-up," and "difficult." The academic performance of the children was graded (parental ratings) on a five-point Likert scale. Physiological variables (heartrate [HR], oxygen saturation[SpO2], and blood pressure [BP]) were recorded by another evaluator. The correlation between anxiety levels and physiological variables was also assessed. The effects of age, sex, temperament, and academic performance on anxiety were evaluated. Results: The study included 60 children aged 8-12 years, including 36 boys and 24 girls. Seventy percent of children had mild to moderate levels of pre-extraction anxiety, while 30% of children demonstrated high anxiety. A significant positive correlation was noted between anxiety levels and HR (rs = 0.477, P < 0.001⁎) and systolic BP (rs = 0.294, P < 0.05), while a significant but inverse correlation was observed with SpO2 (rs = -0.40, P < 0.05). Anxiety did not influence diastolic BP. Children with difficult temperament and poor academic performance had significantly higher anxiety. Conclusion: A high percentage (70%) of children aged 8-12 years had mild to moderate anxiety prior to the extraction procedure. Increased HR, systolic BP, and reduced SpO2 were significantly associated with high levels of anticipatory dental anxiety. Pre-extraction anxiety was significantly related to the temperament and scholastic performance.