• Journal of Preventive Medicine and Public Health
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• 제56권6호
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• pp.563-572
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• 2023

Objectives: The high readmission rate of patients with chronic obstructive pulmonary disease (COPD) has led to the worldwide establishment of proactive measures for identifying and mitigating readmissions. This study aimed to identify factors associated with readmission, as well as groups particularly vulnerable to readmission that require transitional care services. Methods: To apply transitional care services that are compatible with Korea's circumstances, targeted groups that are particularly vulnerable to readmission should be identified. Therefore, using the National Health Insurance Service's Senior Cohort database, we analyzed data from 4874 patients who were first hospitalized with COPD from 2009 to 2019 to define and analyze readmissions within 30 days after discharge. Logistic regression analysis was performed to determine factors correlated with readmission within 30 days. Results: The likelihood of readmission was associated with older age (for individuals in their 80s vs. those in their 50s: odds ratio [OR], 1.59; 95% confidence interval [CI], 1.19 to 2.12), medical insurance type (for workplace subscribers vs. local subscribers: OR, 0.84; 95% CI, 0.72 to 0.99), type of hospital (those with 300 beds or more vs. fewer beds: OR, 0.77; 95% CI, 0.66 to 0.90), and healthcare organization location (provincial areas vs. the capital area: OR, 1.66; 95% CI, 1.14 to 2.41). Conclusions: Older patients, patients holding a local subscriber insurance qualification, individuals admitted to hospitals with fewer than 300 beds, and those admitted to provincial hospitals are suggested to be higher-priority for transitional care services.

• 대한치과교정학회지
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• 제53권6호
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• pp.365-373
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• 2023

Objective: To investigate the potential correlation between fixed orthodontic retention failure and several patient- and treatment-related factors. Methods: Patients finishing treatment with fixed appliances between 2016 and 2017 were retrospectively included in this study. Those not showing fixed retention failure were considered as control group. Patients with fixed retention failure were considered as the experimental group. Additionally, patients with failure of fixed retainers in the period of June 2019 to March 2021 were prospectively identified and included in the experimental group. The location of the first retention failure, sex, pretreatment dental occlusion, facial characteristics, posttreatment dental occlusion, treatment approach and presence of oral habits were compared between groups before and after treatment separately by using a Fisher exact test and a Mann-Whitney U test. Results: 206 patients with fixed retention failure were included, 169 in the mandibular and 74 in the maxillary jaws. Significant correlations were observed between retention failure in the mandibular jaws and mandibular arch length discrepancy (P = 0.010), post-treatment growth pattern (P = 0.041), nail biting (P < 0.001) and abnormal tongue function (P = 0.002). Retention failure in the maxillary jaws was more frequent in patients with IPR in the mandibular jaws (P = 0.005) and abnormal tongue function (P = 0.021). Conclusions: This study suggests a correlation between fixed retention failure and parafunctional habits, such as nail biting and abnormal tongue function. Prospective studies with larger study populations could further confirm these results.

• Imaging Science in Dentistry
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• 제53권4호
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• pp.303-312
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• 2023

Purpose: This study investigated the prevalence of developmental and acquired pathologic conditions associated with impacted third molars (3Ms) in a Southern Brazilian population and evaluated whether demographic and tooth characteristics were correlated with the presence of bone or tooth lesions. Materials and Methods: Panoramic radiographs were assessed for developmental (bone-related) or acquired (tooth-related) pathoses associated with impacted upper or lower 3Ms. Data on tooth positioning, tooth development, and patient demographics were collected. A trained, calibrated postgraduate student evaluated all images. Binary and multivariate logistic regression models were used to assess associations between outcomes and the demographic and radiographic variables. The threshold for statistical significance was set at 5% (P<0.05). Results: The sample comprised panoramic radiographs from 2054 patients, predominantly female (59.2%), with a mean age of 27.2±11.5 years. Overall, 4066 impacted 3Ms were evaluated, revealing 471 (11.6%) developmental and 710 (17.5%) acquired pathoses. Among the developmental pathoses, 460 (95.2%) were indicative of dentigerous cysts. Male sex, lower 3M location, vertical or distoangular positioning, and incomplete root formation were associated with an elevated likelihood of developmental pathology. Lower tooth position, complete root formation, and partial eruption were linked to an increased probability of an acquired pathology in the third or second molar. Conclusion: The prevalence of pathologic conditions associated with impacted 3Ms was low. Male sex, lower 3M placement, horizontal or distoangular positioning, and incomplete root formation were associated with developmental pathoses, while lower tooth position, complete root formation, and partial eruption were related to acquired pathoses.

• 대한영상의학회지
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• 제81권6호
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• pp.1486-1491
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• 2020

기쿠치병은 주로 아시아에 거주하는 젊은 여성에서 경부 림프절 비대와 열을 주소로 나타나는 조직구 괴사성 림프절염이며 자연적으로 치유되는 양성질환이다. 기쿠치병이 전형적으로 발현하는 위치가 아닌 림프절에서 발생하면 진단이 어려워지고 악성 질환으로 오인되기도 한다. 저자들은 2주간 지속되는 발열을 주소로 내원하여 시행한 초음파와 CT, 18F-fluorodeoxyglucose PET/CT에서 비장 종대와 경부, 액와부, 복강, 후복강, 서혜부 림프절 비대를 보여 림프종을 의심하였던 15세 여자 환아 증례를 보고한다. 복강 림프절 절제술로 기쿠치병을 진단하였다. 이후, 환자는 스테로이드로 보존적인 치료를 받고 발열 증상이 호전되어 퇴원하였다.

• 대한영상의학회지
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• 제81권6호
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• pp.1497-1503
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• 2020

염증성 근섬유모세포종(inflammatory myofibroblastic tumor)은 드문 종양으로, 조직학적으로 근섬유모세포성 방추세포의 증식과 다양한 염증 세포들의 침윤을 특징으로 한다. 이 종양은 전신의 모든 해부학적 위치에서 생길 수 있으나 주로 폐, 장간막, 대망에서 생긴다고 보고되어 있으며, 대부분의 경우 어린이 또는 젊은 성인에서 발생한다. 췌장에서 발생하는 경우는 매우 드물며, 악성 종양을 포함한 다른 종양과 구별하기 어렵기 때문에 정확한 영상의학적 진단이 어려운 경우가 흔하다. 이에 저자는 중년 여성의 췌장 두부에서 발생한 염증성 근섬유모세포종의 사례를 초음파, 컴퓨터단층촬영, 자기공명영상 소견들과 함께 제시하고 문헌을 검토하고자 한다.

• 대한두경부종양학회지
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• 제39권2호
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• pp.75-78
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• 2023

Squamous cell carcinoma of the lip is a common malignant tumor originating from oral cancer. However, unlike other areas, the lips hold significant functional and aesthetic importance as a part of the face. As a result, a tailored approach based on the tumor's size, type, and location is essential. The Karapandzic flap is especially suitable for reconstructing lesions located on the lip, particularly when the size of the cancer is large and other surgical treatments like free flaps are not feasible. It allows for extensive resection beyond the size of the lower lip. In this case, considering the patient's overall condition, successful reconstruction of the lower lip was achieved using the Karapandzic flap.

• 대한영상의학회지
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• 제84권1호
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• pp.275-279
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• 2023

과립 세포 종양은 신체의 모든 부위에서 발생할 수 있으나, 특히 두경부에서 주로 발생하는 드문 양성 연부 종양이며, 이 중 5%-8%가 유방에서 발생한다. 저자들은 드문 부위인 액와부 부유방에 발생한 과립 세포 종양 1예를 보고하고자 한다. 50세 여자에게 2개월 전부터 좌측 액와부에 만져지는 종괴가 있었다. 이학적 검사, 유방 촬영술 및 초음파 소견에서 유방의 악성 종양을 먼저 생각하였다. 조직 검사에서 양성 과립 세포 종양으로 진단되었으며 이후 광범위 국소 절제술을 시행하였다. 환자는 수술 후 2년의 추적 관찰 기간 동안 재발하지 않았다. 대부분의 과립 세포 종양은 양성이지만, 재발의 가능성 때문에 종양의 광범위한 완전 절제와 추적 관찰이 필요하다. 영상의학과 의사는 불필요한 치료를 막기 위해 유방 및 액와부 병변의 감별 진단으로 과립 세포 종양의 특징에 대해 알고 있어야 한다.

• 한국컴퓨터정보학회논문지
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• 제29권5호
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• pp.123-129
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• 2024

구급대원에게 심폐소생술은 매우 중요하나 이동하는 주들것에서 수행하는 가슴압박은 정확도가 떨어진다. 이 연구의 목적은 이동 중 주들것에서 수행하는 심폐소생술 효과를 높이기 위하여 C-step을 이용하여 주들것의 측면에서 가슴압박을 수행하는 것과 환자의 복부 위에 위치하여 가슴 압박을 수행하는 것에 대하여 차이를 알아보고자 수행되었다. 연구는 C-step 군 20명과 복부 위군 20명을 대상으로 이동 중 주들것에서 2분간 연속된 가슴압박을 수행하였다. 연구결과 C-step을 적용한 군에서 적정한 깊이(t=4.132, p=.000)와 속도(t=7.177, p=.000)를 나타내었으며 정확도가 더 높은 것으로 나타났다(t=6.774, p=.000). 또한 C-step을 적용한 군에서 위치불량(t=-5.197, p=.008)과 너무 얕은 오류가 적은 것으로 나타났다. 결론적으로 C-step을 장착한 주들것에서의 가슴압박은 심폐소생술의 질을 높이고 병원 전 환자의 생존율을 높이는데 도움을 줄 것으로 판단된다.

• Journal of Korean Neurosurgical Society
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• 제67권4호
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• pp.431-441
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• 2024

Objective : Gamma Knife radiosurgery (GKRS) is an effective and noninvasive treatment for high-risk arteriovenous malformations (AVMs). Since differences in GKRS outcomes by nidus type are unknown, this study evaluated GKRS feasibility and safety in patients with brain AVMs. Methods : This single-center retrospective study included patients with AVM who underwent GKRS between 2008 and 2021. Patients were divided into compact- and diffuse-type groups according to nidus characteristics. We excluded patients who performed GKRS and did not follow-up evaluation with magnetic resonance imaging or digital subtraction angiography within 36 months from the study. We used univariate and multivariate analyses to characterize associations of nidus type with obliteration rate and GKRS-related complications. Results : We enrolled 154 patients (mean age, 32.14±17.17 years; mean post-GKRS follow-up, 52.10±33.67 months) of whom 131 (85.1%) had compact- and 23 (14.9%) diffuse-type nidus AVMs. Of all AVMs, 89 (57.8%) were unruptured, and 65 (42.2%) had ruptured. The mean Spetzler-Martin AVM grades were 2.03±0.95 and 3.39±1.23 for the compact- and diffuse-type groups, respectively (p<0.001). During the follow-up period, AVM-related hemorrhages occurred in four individuals (2.6%), three of whom had compact nidi. Substantial radiation-induced changes and cyst formation were observed in 21 (13.6%) and one patient (0.6%), respectively. The AVM complete obliteration rate was 46.1% across both groups. Post-GKRS complication and complete obliteration rates were not significantly different between nidus types. For diffuse-type nidus AVMs, larger AVM size and volume (p<0.001), lower radiation dose (p<0.001), eloquent area location (p=0.015), and higher Spetzler-Martin grade (p<0.001) were observed. Conclusion : GKRS is a safe and feasible treatment for brain AVMs characterized by both diffuse- and compact-type nidi.

• 대한핵의학회지
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• 제27권2호
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• pp.183-190
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• 1993

저자들은 이소갑상선이 의심되어 갑상선신티그라피로 확진된 19명의 환자를 대상으로 갑상선 스캔과 갑상선 기능검사의 결과 및 임상증상등을 조사하여 다음과 같은 결과를 얻었다. 1) 이소갑상선의 성별분포는 여자 16명, 남자3명으로 여자가 남자의 5.3배였고, 30세 이전인 경우가 97%였다. 2) 이소갑상선이 발견된 위치는 설근부 10예, 설하부1예, 전 후두부 5예 그리고 Combined form이 3예였다. 3) 갑상선기능검사를 시행한 16예에서 갑상선기능저하증이 7예, 준임상적 갑상선기능저하증이 4예 그리고 갑상선기능 정상이 5예였다. 4) 설갑상선의 경우는 갑상선기능저하증이 90%에서 나타났으나, 이보다 아래로 내려온 경우에는 33%로 갑상선 기능이상은 이소갑상선의 위치에 따라 유의한 차이가 있었다(p<0.05). 5) 갑상선의 주된 임상증상은 설근부의 인후이물감, 연하곤란이었고, 이보다 아래에 위치한 경우는 전경부의 종괴가 주된 임상증상이었다. 6) 갑상선기능저하증으로 진단된 7예와 준임상적 갑상선 기능저하증 4예중 3예에서는 갑상선호르몬을 투여하였고 갑상선 기능이 정상인 2예에서 이소갑상선 제거술이 시행되었으며 그 나머지는 추적관찰하였다. 7) 설근부나 전경부에 종괴가 있을 경우에는 반드시 갑상선스캔을 시행하여 이소갑상선의 가능성을 배제하여야 한다. 또한 이소갑상선의 기능이 정상인 환자에서도 갑상선기능저하증으로 진행될 수 있으므로 추적관찰이 필요하다.