• International journal of thyroidology
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• 제11권2호
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• pp.109-116
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• 2018

갑상선 수술 후 발생한 성대마비는 삶의 질을 중요시하는 요즘 시대에 제일 치명적 합병증 중 하나이다. 그 결과 수술 중 신경감시시스템의 사용은 보편화되고 있으나 아직 기존의 시스템은 외과 의사가 사용하기에 불편하거나 문제점들이 있다. 그래서 새로운 방식의 신경 탐침과 신경 감시 장치의 개발이 필요한 시점이다. 이에 최근 모든 수술 기구(금속형 기구, 내시경 및 로봇 기구, 에너지 기반 디바이스)에 탈부착이 가능한 신경을 자극하는 신경 탐침 및 후두 떨림을 측정하기 위한 표면압력센서를 이용한 새로운 형태의 수술 중 신경감시시스템의 개발에 대한 연구가 기대된다.

• 대한두개안면성형외과학회지
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• 제19권4호
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• pp.260-263
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• 2018

Background: The alar and nasal tip are important subunits of the nose. Determining the optimal procedure for reconstructing a cutaneous defect in a nasal subunit depends on several factors including size, location, and involvement of deep underlying structures. We treated cutaneous defects after tumor ablation in the alar and nasal tip with a local flap, using an S-shaped design and a modified V-Y advancement flap with a croissant shape. Methods: We analyzed 36 patients with skin tumors who underwent flap coverage after tumor ablation. Rotation flaps were used in 26 cases and croissant-shaped V-Y advancement flaps were used in 10 cases. The primary cause of the defects was skin cancer, except for one benign tumor. Results: The mean patient age was 71 years. The size of the defects ranged from $0.49cm^2$ to $3.5cm^2$. No recurrence of skin cancer was noted and all flaps lasted until the end of follow-up. Partial desquamation of the epidermis was noted in one case. The postoperative appearance for most patients was excellent, objectively and subjectively. Conclusion: For cutaneous defects of up to about $4.0cm^2$ of the alar and nasal tip, local flaps using our methods offered a good cosmetic and therapeutic result. The main advantage of our flaps is the minimal dissection required compared to bilobed and other local flap methods. We believe our flaps are a suitable option for alar and nasal tip reconstruction.

• International journal of advanced smart convergence
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• 제8권1호
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• pp.24-34
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• 2019

In this research, a practical deep learning framework to differentiate the lesions and nodules in breast acquired with ultrasound imaging has been proposed. 7408 ultrasound breast images of 5151 patient cases were collected. All cases were biopsy proven and lesions were semi-automatically segmented. To compensate for the shift caused in the segmentation, the boundaries of each lesion were drawn using Fully Convolutional Networks(FCN) segmentation method based on the radiologist's specified point. The data set consists of 4254 benign and 3154 malignant lesions. In 7408 ultrasound breast images, the number of training images is 6579, and the number of test images is 829. The margin between the boundary of each lesion and the boundary of the image itself varied for training image augmentation. The training images were augmented by varying the margin between the boundary of each lesion and the boundary of the image itself. The images were processed through histogram equalization, image cropping, and margin augmentation. The networks trained on the data with augmentation and the data without augmentation all had AUC over 0.95. The network exhibited about 90% accuracy, 0.86 sensitivity and 0.95 specificity. Although the proposed framework still requires to point to the location of the target ROI with the help of radiologists, the result of the suggested framework showed promising results. It supports human radiologist to give successful performance and helps to create a fluent diagnostic workflow that meets the fundamental purpose of CADx.

• 한국방사선학회논문지
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• 제13권4호
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• pp.667-674
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• 2019

Technegas를 사용한 검사는 단순 확산 누적을 통해 폐 영상을 이미지화하기 때문에 검사를 마친 후에 검사실이 오염될 수 있다. 따라서 방사선 작업 종사자와 검사를 기다리는 환자는 technegas 흡입으로 인한 내부 피폭의 영향을 받게 된다. 이에 중력환기 전후의 시간경과에 따른 공간선량율 분포를 비교, 분석함에 따라 방사선사, 의료진, 대기 환자의 피폭선량 저감화 방법을 모색하고자 한다. 중력환기 전후 환자의 호흡기 위치에서 거리별, 각도별로 공간선량율을 10분 동안 측정하고 평균값, 표준 편차 및 감소율을 계산하였다. 실험 결과, 중력 환기 전후 감소율은 최고 95.31%였고 가장 높은 감소율은 1 ~ 3분 사이에서 나타났다. 중력환기를 통해서 방사선 작업종사자, 대기환자, 환자 보호자 및 간호사의 피폭선량을 감소시킬 수 있다. 결론적으로 중력환기를 통한 피폭선량 감소 결과는 방호 최적화를 이루는 역할을 할 것이며 ICRP 103에서 권고한 의료 피폭 저감화에 부합된다.

• Journal of Korean Neurosurgical Society
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• 제62권5호
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• pp.551-560
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• 2019

Objective : Intracranial aneurysms are not common in young age patients. We sought to find the characteristics of the intracranial aneurysms in patients under 20 years of age. Methods : We reviewed 23 consecutive patients ${\leq}20$ years of age treated for their intracranial aneurysms during the period from 1995 to 2017. From medical records and imaging studies, we gathered data on age, sex, presentation, associated medical condition, location and characteristics of aneurysms, treatment and clinical outcomes. Results : The patients' ages ranged from 13 months to 20 years (median, 14 years). There were 16 males and seven females (male to female ratio, 2.3 : 1) with 31 aneurysms. Clinical presentations included sudden severe headache in 61%, followed by altered mentality in 17% and seizure in 17%. More than one-fourth patients had specific medical conditions related to the development of the cerebral aneurysms. The majority of aneurysms occurred in the anterior circulation (71%), and were saccular (71%). There were each three patients with false aneurysms (13%) and giant aneurysms (13%), and only one patient with multiple aneurysms (4%). We treated 22 patients : 21 aneurysms with the endovascular methods, three with open surgery, and one with combined treatment. Good functional outcome could be achieved in 86% during the follow-up period. Conclusion : In this series, the young-age patients with intracranial aneurysms were characterized by male predominance, related specific medical conditions, low incidence of multiple aneurysms, high incidence of giant aneurysms and good functional outcome after treatment.

• 대한두개안면성형외과학회지
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• 제20권2호
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• pp.76-83
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• 2019

Background: The mental V-Y advancement flap method is useful for reconstruction of lower lip defect because of its many advantages. However, it is not easy to select the optimal reconstructive method for the vermilion defect that remains after application of the mental V-Y advancement flap. In choosing the representative surgical method for vermilion mucosal reconstruction including mucosal V-Y advancement flap, buccal mucosal flap, and buccal mucosal graft. We describe an efficient technique to large lower lip defects combining mental V-Y advancement flap and buccal mucosal graft Methods: This study included 16 patients who underwent reconstructive surgery for full-thickness and large defect (> half the entire width) of the lower lip from October 2006 to September 2017. The operation was conducted using mental V-Y advancement flap with various vermilion mucosal reconstruction methods considering the location of the defect and the amount of residual tissue of the lip coloboma after excision. Results: All patients underwent mental V-Y advancement flap. In vermilion mucosal reconstruction, five patients underwent mucosal V-Y advancement flap, three underwent buccal mucosal flap, and eight underwent buccal mucosal graft. There were good aesthetic and functional results in all patients who underwent buccal mucosal graft. However, two patients who underwent mucosal V-Y advancement flap complained of oral incompetence, and all patients who underwent buccal mucosal flap had oral commissure deformity. Conclusion: Buccal mucosal graft combined with mental V-Y advancement flap can produce suitable functional and aesthetic outcomes in near total lower lip reconstruction in patient with large mucosal defect including vermilion portion.

• The Journal of Advanced Prosthodontics
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• 제11권2호
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• pp.88-94
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• 2019

PURPOSE. This study was conducted to investigate patterns of adjacent tooth displacement in the posterior implant with interproximal contact loss (ICL) by 3-D digital superimposition method. MATERIALS AND METHODS. Posterior partially edentulous patients, restored with implant fixed partial prostheses before 2011 and suffered from food impaction of ICL between 2009 and 2011, were included. Two dental casts, at the time of delivery and at the time of food impaction in a same patient, was converted into 3-D digital models through scanning and superimposition was performed to assess chronologic changes of the dentition. Directions of tooth displacement were evaluated and the amount of ICL was calculated. Correlations between the amount of ICL and elapsed time, or between the amount of ICL and age after function, were assessed at a significance level of P<.05. RESULTS. A total number of 13 patients (8 males, 5 females) with a mean age of $65.76{\pm}9.94years$ and 17 areas (4 maxillae, 13 mandibles) were included in this retrospective study. Teeth adjacent to the implant restoration showed complex displacements but characteristic tendency according to the location of the arch. The mean amount of ICL was $0.33{\pm}0.14mm$. Elapsed time from function to ICL was $61.47{\pm}31.27months$. There were no significant differences between the amount of ICL and elapsed time, or age (P>.05). CONCLUSION. Natural teeth showed various directional movements to result in occlusal change in the arch. The 3-D superimposition of chronologic digital models was a helpful method to analyze the changes of dentition and individual tooth displacement adjacent to implant restoration.

• 대한장애인치과학회지
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• 제14권2호
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• pp.71-77
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• 2018

This study was designed to evaluate basic data about dental treatment under general anesthesia in pediatric dentistry of Wonju Severance Christian Hospital. Sex, Age, location, preoperative physical status, intubation methods, inhalation agents, duration of anesthesia and treatment, performed treatment and postoperative follow-up period and frequency were collected based on electronic medical records of 239 patients who visited pediatric dentistry at Wonju Severance Christian Hospital from March 2011 to February 2017. There were the most patients between the ages of 5 - 9, and there was no significant difference between male and female. The largest number of patients visited the hospital from Wonju, where the hospital was located. Most of preoperative status was ASA Class I. Orotracheal intubation was used in 169 of patients (70.7%). As an anesthesia maintenance agent, drug containing sevoflurane was used in 153 of patients (64.0%). In performed treatment, dental restoration, sealant and stainless steel crowns were performed 3.8, 1.8 and 1.1 times per person. 129 patients (54.0%) attended follow-up appointments under 6 months and those of the number of appointments were 1 - 4 times in average. General anesthesia as a behavior guidance in pediatric dentistry is increasing. Clinical guidelines for pediatric patients under general anesthesia are required through follow-up studies.

• 고신대학교 의과대학 학술지
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• 제33권3호
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• pp.358-368
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• 2018

Objectives: To identify the relationship between surgical success rate and preoperative nasal mucosal thickness around the lacrimal sac fossa, as measured using computed tomography. Methods: We reviewed 33 eyes from 27 patients who underwent endoscopic dacryocystorhinostomy after diagnosis of primary nasolacrimal duct obstruction and who were followed-up with for at least six months between 2011 and 2014. We measured preoperative nasal mucosal thickness around the bony lacrimal sac fossa using computed tomography and analyzed patient measurements after classifying them into three groups: the successfully operated group, the failed operation group, and the non-operated group. Results: Surgery failed in six of the 33 eyes because of a granuloma at the osteotomy site and synechial formation of the nasal mucosa. The failed-surgery group showed a clinically significantly greater decrease in nasal mucosal thickness at the rearward lacrimal sac fossa compared with the successful-surgery group. However, nasal mucosal thickness of fellow eyes (i.e., non-operated eyes) was not significantly different between the two groups, and the location of the uncinate process did not appear to influence mucosal thickness. In the failed group, posteriorly located mucosal thickness of operated eye fossa was thinner than that of the non-operated eyes, but not significantly so. Conclusions: Our results from this quantitative anatomical study suggest that nasal mucosal thickness is a predictor of endoscopic dacryocystorhinostomy results.

• 한국정보통신학회논문지
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• 제24권1호
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• pp.100-106
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• 2020

본 논문에서는 저전력장거리 기술과 임베디드 보드를 이용한 치매 돌봄 스마트 신발과 응용 소프트웨어를 구현하였다. Cortex-M3 보드와 로라 모듈로 구성된 통신 모듈은 신발 밑창의 홈에 내장 된다. 위치추적 응용 소프트웨어는 임베디드 보드에서 제공하는 신호와 GPS와 로라 망을 이용하여 보호자가 치매 환자의 위치 추적할 수 있다. 외부 환경에서 스마트 신발의 위치 추적 및 데이터 전송 동작이 성공적으로 확인되었다. 이러한 실험을 통해 본 논문에서 개발한 스마트 신발이 치매 환자의 돌봄을 위한 실종을 막는 안전장치로 응용 가능할 것으로 판단된다.