• 핵의학기술
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• 제13권1호
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• pp.47-50
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• 2009

목적 : 현재 소아 핵의학 검사 시 사용되는 방사성의약품 선량 산출 기준은 확립되어있지 않다. 그리하여 병원들은 몸무게 기준 산출 공식(mCi/kg), 체표면적 시준 산출 공식(mCi/$m^2$) 또는 미국, 유럽, IAEA의 선량 산출 공식 등 다양한 선량 기준을 따르고 있다. 그러나 이러한 선량 산출 공식들은 1세 이하의 영아나 50 kg 이상의 어린이들에 대한 정확한 선량을 산출하는데 어려움을 격고 있으므로 국내의 선량기준을 조사하여 이를 미국, 유럽, IAEA의 기준에 비교하고 각 기준의 문제점을 비교여 적절한 선량 기준의 확립을 권고 하고자 본 논문을 시행하게 되었다. 실험재료 및 방법: 객관적인 정보의 획득을 위하여 소아핵의학 검사를 가장 많이 시행하는 국내 4개 대학병원을 선정하여 설문을 실시하였으며 이에 대한 답변을 기초로 각 몸무게 당 사용되는 방사성의약품의 양을 multiplier로 변환하여 이를 미국, 유럽, IAEA의 multiplier와 비교하였다. 결과: 국민 대부분의 병원들은 몸무게 기준 산출 공식을 이용하여 소아 핵의학 검사 시 사용되는 방사성의약품의 양을 산출하고 있었으며 1세 이하의 영아와 50 kg 이상 어린이에 대한 과소량, 과잉량 투여 문제는 고려되고 있지 않은 것으로 나타났다. 결론 및 고찰: 본 논문을 통하여 대한민국의 기준을 비롯한 여러 기준들은 소아 핵의학 검사 시 적정한 선량 산출에 어려움을 겪고 있는 것으로 나타났다. 그러므로 성공적인 검사가 가능한 최소의 선량으로 방사선 피폭을 최소화 하는 세계적으로 인정된 선량 체계를 확립하여야 할 것이다. 또한 보다 우수한 영상 재구성 프로그램의 개발을 통하여 검사 시간을 단축함과 동시에 보다 나은 영상 구현을 실현하여야 할 것이다.

• 대한골관절종양학회지
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• 제12권1호
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• pp.9-14
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• 2006

목적: 근위 경골 육종의 절제 후 재건은, 특히 골성장이 완료되지 않은 환자의 경우 많은 문제점이 있다. 본 연구에서는 근위 경골 육종의 절제 후 재건에 따르는 문제점을 보완하기 위한 새로운 술식을 시도해 보고자 하였다. 대상 및 방법: 근위 경골에 발생한 골육종의 절제 후 반관절성형술을 시행한 4례를 대상으로 하였다. 평균 연령은 13세였으며 술후 평균 추시 기간은 64개월이었다. 전례에서 초고분자량 폴리에틸렌 삽입물(ultra-high molecular weight polyethylene liner)을 이용하여 관절면을 재건한 후 엔더정(Ender-nail)과 골시멘트를 이용하여 남아있는 경골에 고정하였다. 결과: 최종 추시상 MSTS 기준에 의한 기능적 점수는 23.5점(78.3%)이었다. 전례에서 술후 슬관절 동통, 불안정성은 관찰되지 않았다. 결론: 골성장이 완료되지 않은 소아 환자의 근위 경골 육종 절제 후 재건 방법으로서 반관절 성형술은 효과적인 술기로 판단된다.

• Journal of Korean Neurosurgical Society
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• 제52권3호
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• pp.267-269
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• 2012

Traumatic brachial plexus injuries can be devastating, causing partial to total denervation of the muscles of the upper extremities. Surgical reconstruction can restore motor and/or sensory function following nerve injuries. Direct nerve-to-nerve transfers can provide a closer nerve source to the target muscle, thereby enhancing the quality and rate of recovery. Restoration of elbow flexion is the primary goal for patients with brachial plexus injuries. A 4-year-old right-hand-dominant male sustained a fracture of the left scapula in a car accident. He was treated conservatively. After the accident, he presented with motor weakness of the left upper extremity. Shoulder abduction was grade 3 and elbow flexor was grade 0. Hand function was intact. Nerve conduction studies and an electromyogram were performed, which revealed left lateral and posterior cord brachial plexopathy with axonotmesis. He was admitted to Rehabilitation Medicine and treated. However, marked neurological dysfunction in the left upper extremity was still observed. Six months after trauma, under general anesthesia with the patient in the supine position, the brachial plexus was explored through infraclavicular and supraclavicular incisions. Each terminal branch was confirmed by electrophysiology. Avulsion of the C5 roots and absence of usable stump proximally were confirmed intraoperatively. Under a microscope, neurotization from the musculocutaneous nerve to two medial pectoral nerves was performed with nylon 8-0. Physical treatment and electrostimulation started 2 weeks postoperatively. At a 3-month postoperative visit, evidence of reinnervation of the elbow flexors was observed. At his last follow-up, 2 years following trauma, the patient had recovered Medical Research Council (MRC) grade 4+ elbow flexors. We propose that neurotization from medial pectoral nerves to musculocutaneous nerve can be used successfully to restore elbow flexion in patients with brachial plexus injuries.

• Child Health Nursing Research
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• 제4권2호
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• pp.207-220
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• 1998

The purpose of this study was to build a substantive theory about the experience of the maternal uncertainty in childhood chronic illness. The qualitative research method used was grounded theory. The interviewees were 12 mothers who have cared for a child who had chronic illness. The data were collected through in-depth interviews with audiotape recording done by the investigator over a period of nine months. The data were analyzed simutaneously by a constant comparative method in which new data were continuously coded into categories and properties according to Strauss and Corbin's methodology. The 34 concepts were identified as a result of analyzing the grounded data. Ten categories emerged from the analysis. The categories were lack of clarity, unpredictability, unfamiliarity, negative change, anxiety, devotion normalization and burn-out. Causal conditions included : lack of clarity, unpredictability, unfamiliarity and change ; central phenomena : anxiety, being perplexed ; context. seriousness of illness, support ; intervening condition : belief action/interaction strategies devotion, overprotection ; consequences : normalization, burn-out. These categories were synthesized into the core concept-anxiety. The process of experiencing uncertainty was 1) Entering the world of uncertainty, 2) Struggling in the tunnel of uncertainty, 3) Reconstruction of the situation of uncertainty. Four hypotheses were derived from the analysis : (1) The higher the lack of clarity, unpredictability, unfamiliaity, change, the higher the level of uncertainty (2) The more serious the illness and the less the support, the higher the level of uncertainty. (3) The positive believes will influence the devoted care and normalization of the family life. Through this substantive theory, pediatric nurses can understand the process of experiencing maternal uncertainty in childhood chronic illness. Further research to build substantive theories to explain other uncertainties may contribute to a formal theory of how normalization is achieved in the family with chronically ill child.

• Childhood Kidney Diseases
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• 제12권1호
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• pp.105-110
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• 2008

신성 고혈압은 소아기 이차성 고혈압의 흔한 원인이며, 그 중 신동맥 협착에 의한 신혈관성 고혈압은 치료 가능한 고혈압의 가장 흔한 원인이다. 신혈관성 고혈압 치료로 최근 경피적 신동맥 혈관 성형술은 비침습적인 방법으로 각광 받고 있다. 저자들은 작은 직경을 가진 신동맥 분지 혈관 협착에 의한 신혈관성 고혈압 소아에서 관상동맥용으로 쓰이는 풍선 카테터를 이용하여 경피적 신동맥혈관 성형술을 성공적으로 시행한 경험을 하였으므로 보고하는 바이다.

• Restorative Dentistry and Endodontics
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• 제38권4호
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• pp.215-221
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• 2013

Objectives: To determine the retentive strength and failure mode of undercut composite post, glass fiber post and polyethylene fiber post luted with flowable composite resin and resin-cement. Materials and Methods: Coronal parts of 120 primary canine teeth were sectioned and specimens were treated endodontically. The teeth were randomly divided into 6 groups (n = 20). Prepared root canals received intracanal retainers with a short composite post, undercut composite post, glass fiber post luted with flowable resin or resin-cement, and polyethylene fiber post luted with flowable resin or resin-cement. After crown reconstruction, samples were tested for retentive strength and failure mode. Statistical analysis was done with one-way ANOVA and Tukey tests (p < 0.05). Results: There were statistically significant differences between groups (p = 0.001). Mean bond strength in the undercut group was significantly greater than in the short composite post (p = 0.030), and the glass fiber post (p = 0.001) and the polyethylene fiber post group luted with resin-cement (p = 0.008). However, the differences between the undercut group and the groups with flowable composite as the luting agent were not significant (p = 0.068, p = 0.557). Adhesive failure was more frequent in the fiber post groups. Conclusions: Although the composite post with undercutting showed the greatest resistance to dislodgement, fiber posts cemented with flowable composite resin provided acceptable results in terms of retentive strength and fracture mode.

• International Neurourology Journal
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• 제22권4호
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• pp.287-294
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• 2018

Purpose: Augmentation cystoplasty (AC) is a surgical procedure used in adults and children with refractory bladder dysfunction, including a small bladder capacity and inadequate bladder compliance, and in whom conservative and medical treatment has failed. This study was aimed to determine the long-term outcomes of AC in children. Methods: A retrospective analysis was conducted of 42 patients (31 males; mean age, $14.2{\pm}6.2years$) who underwent AC for neurogenic and nonneurogenic bladder dysfunction, with a median $12.0{\pm}1.5years$ of follow-up. All patients underwent AC using the ileum with or without continent reconstruction. Pre-AC, concurrent, and post-AC procedures and complications were analyzed. Patients who underwent ureterocystoplasty, were lost to follow-up, or had less than 10 years of follow-up were excluded. The primary outcomes were the complication and continence rates, the post-AC linear rate of height and weight gain, and renal function. The Student t-test was used to evaluate between-group differences and the paired t-test was used to evaluate longitudinal changes in measured variables. Results: Renal function was stable or improved in 32 of 42 patients (76.2%), with a post-AC continence rate of 88.1%. Thirty patients (71.4%) required 72 procedures post-AC. There was no statistically significant difference in the mean percentile of height (P=0. 212) or weight (P=0.142) of patients in the pre- and post-AC periods. No cases of bladder perforation or malignancy were detected. Conclusions: We consider AC to be a safe and effective procedure that does not negatively affect future physical growth, while achieving a good rate of stable renal function. Patients need long-term follow-up to address long-term complications.

• 대한방사선기술학회지:방사선기술과학
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• 제42권4호
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• pp.271-277
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• 2019

CareDose 4D which is the Siemens's Automatic Exposure Control (AEC) can adjust the level of radiation dose distribution which is based on organ characteristic unlike other manufacturer's AEC. Currently, a wide scan range containing different organs is sometimes examined at once (defined as one scan). The purpose of this study was to figure out which organ characteristic option is suitable when one scan method is utilized. Two types of anthropomorphic phantoms were scanned in the same range which were from frontal bone to carina level according to three different organ characteristics such as Thorax, Abdomen, and Neck. All scans and image reconstruction parameters were equally applied and radiation dose were compared. Radiation dose with Thorax organ characteristic was lower than that with Neck. Also, that with Abdomen oran characteristic was lower than Thorax. There were significant differences in radiation dose according to different organ characteristics at the same parameters (P<0.05). Usage of Neck organ characteristic had a result of the highest radiation dose to all phantom. On the other hand, utilization of Abdomen organ characteristic showed the lowest radiation dose. As a result, it is desirable to set appropriate organ characteristic according to examined body part when you checkup patients. Also, when you implement one scan method, selection of Abdomen-based organ characteristic has reduced more radiation dose compared with two different organ characteristic.

• 한국전문물리치료학회지
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• 제29권3호
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• pp.171-179
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• 2022

Background: The application of Kinesio tape (KT) has become an alternative treatment for the reduction of edema owing to its distinct characteristics that mimic skin behavior. Although many studies have found that KT application has a positive effect on edema related to breast cancer and rehabilitation following mandibular third molar surgery, there is little evidence to support the use of KT for musculoskeletal injuries. Objects: The purpose of this study was to review the literature related to KT application for reducing edema caused by musculoskeletal disorders. Methods: A literature search (July 2022) was performed on PubMed for articles published between January 2012 and June 2022. The following keywords were used: "Kinesio taping," "Kinesio tape," "swelling," and "edema," with different combinations and derivations. Only articles available in English were included in this study. Results: Among 68 identified studies, seven met our search strategy and criteria and were included in the literature review. Five of these studies investigated musculoskeletal disorders of the knee joint; two of them reported that KT application had a positive effect on edema measured using perimetry following total knee replacement and anterior cruciate ligament reconstruction. However, the KT application did not improve swelling in patients with acute lateral ankle sprains. Pediatric patients with acute proximal phalangeal joint sprain experienced a more significant improvement in the reduction of swelling than the group using a splint. Conclusion: This literature review found discrepant evidence to support using KT for edema control in musculoskeletal disorders. Further research is needed to determine the effectiveness of KT for controlling edema following musculoskeletal injuries.

• Journal of Gastric Cancer
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• 제23권2호
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• pp.275-288
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• 2023

Purpose: This study aimed to examine the effects of 4 main types of gastrectomy for proximal gastric cancer on postoperative symptoms, living status, and quality of life (QOL) using the Postgastrectomy Syndrome Assessment Scale-45 (PGSAS-45). Materials and Methods: We surveyed 1,685 patients with upper one-third gastric cancer who underwent total gastrectomy (TG; n=1,020), proximal gastrectomy (PG; n=518), TG with jejunal pouch reconstruction (TGJP; n=93), or small remnant distal gastrectomy (SRDG; n=54). The 19 main outcome measures (MOMs) of the PGSAS-45 were compared using the analysis of means (ANOM), and the general QOL score was calculated for each gastrectomy type. Results: Patients who underwent TG experienced the lowest postoperative QOL. ANOM showed that 10 MOMs were worse in patients with TG. Four MOMs improved in patients with PG, while 1 worsened. One MOM was improved in patients with TGJP versus 8 MOMs in patients with SRDG. The general QOL scores were as follows: SRDG (+39 points), TGJP (+6 points), PG (+3 points), and TG (-1 point). Conclusions: The TG group experienced the greatest decline in postoperative QOL. SRDG and PG, which preserve part of the stomach without compromising curability, and TGJP, which is used when TG is required, enhance the postoperative QOL of patients with proximal gastric cancer. When selecting the optimal gastrectomy method, it is essential to understand the characteristics of each and actively incorporate guidance to improve postoperative QOL.