• Clinical and Experimental Pediatrics
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• v.51 no.1
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• pp.78-83
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• 2008

Purpose : Osteosarcoma is the most common primary malignant bone tumor in children and adolescents. Although survival rate of osteosarcoma patients has markedly improved, about 20-30% of patients still have a relapse. This study was aimed to find factors that influence postrelapse survival of osteosarcoma in childhood and adolescents. Methods : Between 1985 and 2004, of 461 patients who were diagnosed and treated as osteosarcoma in Korean Cancer Center Hospital, 180 patients with recurrent osteosarcoma were retrospectively reviewed. We examined survival rates and analyzed prognostic factors, such as relapse site, post-relapse treatment methods, pathologic response to neoadjuvnat chemotherapy, metastasis at first diagnosis, and relapse free interval. Results : The overall recurrence rate of patients with osteosarcoma was 39%. The 5-year and 10-year postrelapse survival rates in the recurrent osteosarcoma were 13% and 4%, respectively. The 5-year post-relapse survival rate was influenced by site of relapse (lung, 39%; local, 0%; lung & bone, 25%; others, 12%; P<0.05), relapse-free interval (<12 months, 13%; ${\geq}12$ months, 44%, P<0.05), and post-relapse treatment methods (with surgery, 38%; without surgery, 11%; P<0.05). Conclusion : The survival rate of recurrent case is very low after 10 years, so new second-line chemotherapy and active treatment is needed to increase survival. Aggressive surgery with the removal of recurrence sites combined with multi-agent chemotherapy could either cure patients with recurrent osteosarcoma or significantly prolong their survival.

• Journal of Biomedical Engineering Research
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• v.19 no.6
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• pp.617-622
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• 1998

A cryotherapy system using cold air was developed. The developed system had superior low-temperature characteristics with various flow rates and nozzle sizes, and used R-404A, as a coolant, which has no destructive effects of Ozone layers. Flow rates and the treatment time can be easily altered during the operation. In addition, and alarm system was designed for the overload, overheat, and over-charge of the machine. For clinical applications, skin temperatures, intra-articular temperatures of the knee joint and intra-muscluar temperatures of the gluteal muscles were measured during and after the cryotherapy. After a 5-minute therapy, skin and intra-articular temperatures decreased by $23.3{\pm}4.7 and 4.1 {\pm}1.0^{circ}C$, respectively. A 5-minute cryotherapy was good enough to maintain low intra-articular temperatures for 2-3 hours. Resting intra-muscular temperatures in 2, 4, and 6cm deep in the gluteal muscle were $36.5{\pm}1.2, 36.9{\pm}0.2, 37.1{\pm}0.2^{circ}C$, respectively (p<0.05). Lowest temperatures in 2, 4, and 6cm depth were $35.1{\pm}0.7, 36.2{\pm}0.4, 36.9{\pm}0.3^{circ}C$, respectively (p<0.05). Temperatures after a 2-hour cold air application on the skin and in the muscle in dept도 of 2, 4, and 6cm were $32.2{\pm}1.1, 36.2{\pm}0.5, 36.6{\pm}0.3, 36.9{\pm}0.3^{circ}C$respectively (p<0.05). Temperatures on the skin and in the muscle significantly decreased after 2 hours, compared with before cold air application (p<0.05). The intra-muscular temperature was changed more slowly than the skin temperature, and the deeper the muscle, the lesser temperature changes. The effect of a 5-minute cold air application lasts up to 2 hours, and it seems that the rebound-rise of the temperature dut to the reactive vasodilatation does not occur in the gluteal muscle.

• Journal of dental hygiene science
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• v.7 no.3
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• pp.179-185
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• 2007

The purpose of this study targeted on high school student in the department of liberal arts, industry in Daegu metropolitan city, is to get basic data necessary for the development of dental educational program, to discern prevention and treatment of temporomandibular joint disorder by observing the situation temporomandibular joint disorder and contribution element, of relationship of school life stress The results are as follows.: 1. The percentage of occurring temporomandibular joint disorder in the high school resulted in a joint noise at 61.8% and joint dislocation 6.9%, sharp pain 47.5% at time of chewing. 29.8% at the time of the non-chewing, lockjaw 11.3%, a headache appeared at 40.4%.2. In the contribution factor of occurring temporomandibular joint disorder, the cause of joint noise was the clench one's teeth, lip and cheek clench, For the pain at the time of chewing clench one's teeth, one side chewing, over-chewing, lip clench, sideways sleeping showed the difference. (P < 0.01) For the pain at the time of non-chewing, clench one's teeth, bruxism, one side chewing, lip and cheek clench were similar, and for the lockjaw, clench one's teeth, bruxism, sideways sleeping showed the difference. The plum evil thing period at time of the fault writing that statistically showed the difference. For the headache, the contribution factors were the all bad habits mentioned above excluding one side sleeping.(P < 0.01, P < 0.05). 3. The rate of experiencing temporomandibular joint disorder by oral and maxillofacia was 13.4% in industrial department, and 19.6% in liberal arts. And for the factor of wound was that exercise 26.8%, others 24.4%, fall-down 19.5%. And for the industrial, exercise 44.4%, fall-down 22.2%, others 14.9%. The treatment experience appeared at 5.0% in industrial department, 2.9% in liberal arts. And for the medical institutions, liberal arts were dental clinic 50%, orthopedics 50%, and the industrial department orthopedics 40%, oriental medicine clinic 30%, dental clinic 30%. 4. In case of temporomandibular joint disorder, there were no difference by grades or educational background. And at the time of chewing or non-chewing showed similar difference.(P < 0.01). 5. Compared to stress in the high school, it generally showed higher in liberal arts than in industrial department due to school record. Its scope was $3.75{\pm}1.14$ in liberal arts, $3.01{\pm}1.23$ in industrial department. 6. The school record, school life, stress problems by teachers, chewing/non-chewing pain of temporomandibular joint disorder, joint noise had a similar correlation.(P < 0.01, < 0.05).

• Journal of Biomedical Engineering Research
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• v.19 no.4
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• pp.393-401
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• 1998

Based on clinical observations, it is suspected that the bone-tendon origin is the site where piratical failure, leading to pathophysiological changes in the humeral epicondyle after repetitive loading, is initiated Mechanical properties and failure patterns of the common extensor and flexor tendons of the humeral epicondyle under static and repetitive loading have not been well documented. Our goal was to determine mechanical properties of failure strength and strain changes, to correlate strain changes and the number of cyclic repetitions, and to identify the failure pattern of bone-tendon specimens of common extensor and flexor tendons of the humeral epicondyle. Mechnaical properties of human cadaver bone-tendon specimens of the common extensor and flexor tendons of the humeral epicondyle were tested under two different loading rates. No statistically significant difference in ultimate tensile strength was found between male and female specimens or between slow (10 mm/sec) and fast elongation (100 mm/sec) rates. However, a statistically significant difference in ultimate tensile strength between the common extensor (1190.0 N/$cm^2{\pm}$388.8) and flexor 1922.0 N/$cm^2{\pm}$764.4)tendons was found (p<0.05). When loads of 25%, 33%, and 41% of the ultimate tensile strength of their contralateral sides were applied, the number of cycles required to reach 24% strain change for the common extersor and flexor tendons were approximately 8,893, 1,907, and 410, respectively. The relationship between cycles and loads was correlated ($R^2$=0.46) Histological observation showed that complete or partial failure after tensile or cyclic loadings occurred at the transitional zone, which is the uncalcified fibrocartilage zone between tendon and bone of the humeral epicondyle. Sequential histological sections revealed that failure initiated at the upper, medial aspect of the extensor carpi radialis brevis tendon origin. Biomechanical and hstological data obtained in this study indicated that the uncalcified fibrocartilage zone at the bone-tendon origin of the common extensor and flexor tendons is the weak anatomical structure of the humeral epicondyle.

• Journal of Preventive Medicine and Public Health
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• v.29 no.1 s.52
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• pp.133-143
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• 1996

This study was conducted to assess the referral patterns to specialist from general practitioners in health center and perceived needs of referred patients for specialist care in health center. The study subjects were 249 patients who visited to health centers and were referred to other medical facilities. The data were obtained from questionnaire survey which was conducted in Kyongju-City Health Center, Seongju-Gun Health Center and Koryong-Gun Health Center in Kyongsangbuk-Do, from June 10 to October 17, 1995. The total referral rate was 2.7%. The proportion of patients who wished to be referred to medical specialists was 85.9%, and the proportion of patients referred by general practitioners in health centers was 14.1%. Among the patients who wished to be referred to medical specialists, 45.9% visited directly to health centers, 34.6% visited health centers via local clinics and 19.5% visited health centers to get referral permission only. The reasons for getting referral permission in health centers were easy geographical accessibility(34.6%), easy to get referral permission in health centers(27.1%), and very difficult to get referral permission in local clinics(16.4%). Among the diseases of referred patients, diseases of the musculoskeletal system and connective tissue were most prevalent on a whole, but diseases of nervous system and sensory organs were comparatively high among the patients who wished to be referred to medical specialists and infectious and parasitic diseases were comparatively high among the patients referred by general practitioners in health centers. The most favorable medical facility was general hospital including university hospital in both groups of patients who wished to be referred to medical specialist and the patient referred by general practitioners in health centers. Regarding the needs for specialist care in health center, 75.2% of patients who wished to be referred to medical specialists and 74.3% of patients referred by general practitioners in health center wanted the specialist care. The most frequently requested specialty is internal medicine(47.1%), and then orthopedics and general surgery. Based on above results, this study revealed that the majority of patients referred from health center wished to be referred to medical specialists at their own will, so, referral system at health center level should be changed. And if specialist care in health center be provided, the medical care by internist could be provided first, and then that of orthopedics and general surgery could be provided. These kinds of medical cares could be covered by local clinicians as a part-time job on a voluntary basis.

• Transactions of the Korean Society of Mechanical Engineers B
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• v.36 no.4
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• pp.431-438
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• 2012

The mechanical behavior of the polymeric material, HDPE depends on both time and temperature. The study of the tensile behavior at different strain rates is important in engineering design of the orthopedics device such as X-band plate. The mechanical properties and deformation mechanisms of HDPE are strongly dependent on the applied strain rate. Generally, the deformation behavior of HDPE based on the stress-strain curve is complex because of the highly inhomogeneous nature of plastic deformation, particularly that of necking. Therefore, we attempted to determine the mechanical behavior of HDPE in this study. Normally, tensile testing under various strain rates of the HDPE has been used to determine the mechanical behavior. We performed tensile tests at various strain rates (1 to 500 %/min) to analyze the viscoelastic behavior on increasing the strain rate. A tensile stress-strain curve was plotted from the data, and the point of transition was marked to calculate the transition stress, strain, and modulus.

• Journal of East-West Nursing Research
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• v.13 no.2
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• pp.160-169
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• 2007

Background: Hwa-Byung is known as a specific Korean cultural syndrome which corresponds to DSM-IV(MMPI). Some Korean women who have experienced heart aching anger(Hwa-Byung) complain physical pains as well as psychological problems. As for these physical pains, upper limb arthropathy(e.g. golf elbow pains, tennis elbow pains, or shoulder-joint pains) have not been paid attentions. In spite of not having done her excessive physical endeavor or exercise, some Korean middle aged women complain those arthropathy pains. And they go round orthopedics, pain clinics, and oriental medicine clinics. Purpose: This study was practiced in Severance Oriental Medicine Clinic. The oriental medicine doctor had a question about the major origin of upper limb pains which were not caused by excessive physical endeavor. To answer the question, this study has been practiced. In the process of interview with some those women, the major cause of those syndromes has been revealed as Hwa-Byung. The purpose of this study is to discover the meanings of the women's life who have been experienced Hwa-Byung with upper limb arthropathy. Results: These upper limb arthropathy can be explained by meridian theory. Shoulder-joint pain and golf elbow with Hwabyung can be explained by Heart meridian of hand-shoyin and the points of these pains are in the flow of this meridian. Tennis elbow with Hwabyung can be explained by Small intestine meridian of hand-taiyang and this point is in the flow of this meridian. The results of interview with 9 middle aged women was analyzed and interpreted according to Spradley's method of ethnography. The analysis revealed three core cultural themes : 1) There are certainly external cause to provoke Hwa-Byung. A patricentric family system, husband's playing around with another woman, cruel treatment by husband's family, or financial failure may be present anteriorly. 2) The chief existing condition is the discord between husband and wife. The stoppage of mutual communication, lacking in understanding, unfeeling, heartless, or unsympathetic is an major phenomenon of married life. So the important factor is not the sexual relations or problems but the discords of communication. 3) The feeling of anger, the sense of nihility, the desire to escape, and the effort to forgiveness coexist together. At a glance, they seemed to be a process. For example, anger seemed to present at first, then nihility seemed at second, then escape seemed at third, and then forgiveness seemed at last. But at point of visiting clinic to be treated, they are mixed up together as if in a jumble.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.4
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• pp.430-435
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• 2000

Cleft lip and palate is one of the congenital anomalies which need comprehensive and multidisciplinary treatment plan because 1) oral cavity is an important organ with masticatory function as a start of digestive tract, 2) anatomic symmetry and balance is esthetically important in midfacial area, and 3) it is also important to prevent psycho-social problems by adequate restoration of normal facial appearance. There are many different protocols in the treatment of cleft lip and palate, but our department has adopted and modified the $Z{\"{u}}rich$ protocol, as published in the Journal of Korean Cleft Lip and Palate Association in 1998. The first challenge is feeding. Type of feeding aid ranges from simple obturators to active orthopedic appliances. In our department we use passive-type plate made up of soft and hard acrylic resin which permits normal maxillary growth. We use Millard's method to restore normal appearance and function of unilateral complete cleft lip. In consideration of both maxillary growth and phonetic problems, we first close soft palate at 18 months of age and delay the hard palate palatoplasty until 4 to 5 years of age. When soft palate is closed, posterior third of the hard palate is intentionally not denuded to allow normal maxillary growth. In hard palate palatoplasty the mucoperiosteum of affected site is not mobilized to permit residual growth of the maxilla. We have treated a patient with unilateral complete cleft lip and palate by Ajou protocol, which is a kind of modified $Z{\"{u}}rich$ protocol. It is as follows: Infantile orthopedics with passive-type plate such as Hotz plate, cheiloplasty with Millard's rotation-advancement flap, and two stage palatoplasty. It is followed by orthodontic treatment and secondary osteoplasty to augment cleft alveolus, orthognathic surgery, and finally rehabilitation with conventional prosthodontic treatment or implant installation. The result was good up to now, but we are later to investigate the final result with longitudinal follow-up study according to master plan by Ajou protocol.

• Journal of Korean Public Health Nursing
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• v.13 no.2
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• pp.26-44
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• 1999

The study was done to improve the job training course for Community Health Practioners (CHPs) by evaluating the level of help that the training provided to the CHPs in carrying out their work and to analyze the management activities of the CHPs in order to develop a more effective CHP training program. The methodologies used in the study were a questionnaire survey. The survey results were analyzed using SPSS Windows. The study results are as follows. 1. The total average level of help from the job training(Theory. Practice and Field Practice) for carrying out the CHP work was found to be $3.04\pm.53$ (of a possible 4), which indicates a high level of help. The average for clinical practices was $3.16\pm.60$. for theory. $3.11\pm.40$ and for field practice. $2.84\pm.60$. 2. For the theory content of the job training courses. the help level was low in the area of mother and child health management/family planning with an average of $2.65\pm.62$ and in the area of health information system development with an average of $2.62\pm.83$. The reason for these deficiencies were. in order of frequency. few opportunities to apply learning. training content that was inadequate. training methodologies which were incongruent with content. improper training items and insufficient class hours. For the practice. the clinical work in rehabilitation/orthopedics departments and in ENT/Opthalmology departments had averages of $2.96\pm.86$ and $2.97\pm.80$ respectively. This low level resulted from the lack of direct experience. lack of sincerity during the practice time. lack of practice guidance. insufficient time and lack of practice equipment. in that order. For the field practice. the delivery management averaged $2.06\pm.90$ as the lowest help level. In this case 68% of respondents replied that there were no relevant reasons for this deficiency. 21% responsed that there was a lack of direct experience, 7%, a lack of practice guidance and 4.8%, insufficient time. 3. There were significant differences for several demographic variables when comparing the help level of the clinical courses (practice and Field Practice). A higher help level was reported by older nurses as compared to younger ones, experienced nurses as compared to scholarship nurses, and married over single. Also for nurses who had finished more other programs and were qualified or licensed in several areas the level was high. Although it was not statistically significant the level was higher if the work area was in a rural county, not a city, and if one had more recently completed the job training(P<,05). 4. Of the respondents 58.6% replies stated the period of job training for the CHP was adequate, but 51.7% reported that the period for theory courses was too short while an other 48.3% responded that it was sufficient. For practice locations, 50% responsed that it was good to practice in medical institutions(primary, secondary and tertiary) at the same time. While 48.3% agreed that doing theory and practice simultaneously was good, and 56.9% agreed that field practice should be done after completing theory and practice training. Hence, the development of new field practice guidelines suitable for changing environments of health management are required in place of the existing ones which were considered low in help level to the practical work of the CHPs.

• Transactions of the Korean Society of Mechanical Engineers B
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• v.36 no.3
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• pp.351-361
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• 2012

The leading surgical method for correcting the misalignment of the varus and valgus in the knee joint is the high tibial osteotomy (HTO). In the opening wedge HTO (OWHTO), there is no concern about damaging the peroneal nerve on the lateral tibia of the proximal fibula. OWHTO has been the preferred choice, as the opening of the correction angle can be modulated during the operation. The correction of the varus and valgus on the coronal plane are performed adroitly. Nevertheless, there have been numerous reports of unintended changes in the medial tibial plateau and posterior slope angle (PSA). The authors have developed an HTO method using computer-assisted surgery with the aim of addressing the abovementioned problems from an engineer's perspective. CT images of the high tibia were reconstructed three-dimensionally, and a virtual osteotomy was performed on a computer. In addition, this study recommends a surgical method that does not cause changes in the PSA after OWHTO. The results of the study are expected to suggest a clear relationship between the anteromedial cortex oblique angle of each patient and the PSA, and an optimal PSA selection method for individuals.