• Korean Journal of Psychosomatic Medicine
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• v.18 no.1
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• pp.3-10
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• 2010

Gilles de la Tourette syndrome is a chronic motor and vocal tic disorder of childhood onset. Abnornmalities in basal ganglia-thalamo-cortical circuits may play an important role in the pathophysiology underlying the involuntary tics. It is often complicated by comorbid attention-deficit/hyperactivity disorder or obsessive-compulsive disorder. Transcranial magnetic stimulation(TMS) is a neurophysiologic technique with research ap-plication. As there is good evidence that this technique can modify cortical activity, repetitive TMS is also used for treatment to change the cortical excitability and therefore affect underlying interconnected cortical-sub-cortical loop. We reviewed the neurophysiologic parameters and the clinical applicability of TMS and rTMS.

• Journal of Korean Academy of Nursing
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• v.25 no.2
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• pp.341-350
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• 1995

A quasi-experimental study was conducted to examine the effect of ice pack application to post cardiac surgery toddlers before C-tube removal. Twenty toddlers aged 13 months to 24 months, who were admitted to the hospital for open heart surgery during the period from July, 1993 to October, 1993 were randomly assigned to the experimental or control group. An ice pack was applied to the C-tube insertion site for 8 minutes before C-tube removal for the experimental group. The children were videotaped during the procedure to assess pain behavior and crying time. The score on the Modified Behavioral Pain Scale(MBPS), crying time, and vital signs were measured to determine the effect of ice pack application. The data were analyzed using Mann-Whitney U test, Paired t-test, and Pearson correlation coefficient. The result of the study are as follows : 1. There was a significant difference between the experimental group and the control group in pain behavior (U=17.0, p=.01). 2. There was no significant difference between the two groups in crying time. 3. There was a significant difference between the two groups in heart rate (U=24.5, p=.05). 4. There was a significant difference between the two groups in systolic blood pressure (U=24.0, p=.05) 5. There was a significant difference between the two groups in diastolic blood pressure (U=23.0, p=.04). 6. There was no significant difference between the two groups in respiration rate. 7. Pain behavior was significantly correlated with heart rate, systolic blood pressure, and crying time (r=.50, .54 and .59, p<.05). The result showed that the ice pack application was effective to reduce pain related to C-tube removal for the toddlers. From the study, it is recommended that the effectiveness of the cold ap-plication to children undergoing different painful procedures be examined to determine the most effective length of cold application to reduce pain in children.

• Korean Journal of Head & Neck Oncology
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• v.16 no.1
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• pp.26-32
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• 2000

Background and Objectives: Various flaps are using for reconstruction of hypopharyngeal and esophageal defect. However, complication and indication of each flap are not fully analyzed. Patient and Methods: Records of 52 hypopharyngeal cancer patients who had surgical treatment and 13 other head and neck cancer patients who underwent hypopharyngeal and/or esophageal reconstruction with flap were retrospectively analyzed. Eighty three percent(54 cases) of patients needed reconstruction other than primary pharyngeal closure. Five split thickness skin graft, 1 pectoralis major myocutaneous flap, 20 forearm free flap, 13 jejunal free flap, 15 gastric pull up were used. Result: Flap failure was noted in 2 cases who had subsequent gastric transposition. Wound dehiscence and fistula were most common problem of forearm free flap. Most fistulas were developed in patients with conduit type reconstruction of forearm flap while there wasn't any fistula in patient with patch type reconstruction. Stenosis of lower anastomosis was the frequent problem of jejunal transfer. Gastric pull-up has frequent com-plication of stomal stenosis. All but three patients had reached oral feeding postoperatively. Conclusion: Based on this study, forearm flap is effective in partial hypopharyngeal defect while jejunum is the choice for circumferential defect. Gastric pull-up is for combined esophageal defect.

• Journal of Chest Surgery
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• v.30 no.10
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• pp.1044-1047
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• 1997

Pulmonary blastoma are a family of tumors in which the glands or mesenchyme composing the neoplasm are primitive or emb yonal in appearance. We report a pulmonary blastoma occurring in a 31 years old man. An abnormal shadow was detected in the right lower lung field in a routine chest X-ray film. The preoperative imaging films showed about a 5cm sized well circumscribed solid tumor of the right lung. A preoperative clinical diagnosis of primary lung cancer was considerd. The operative field showed that the hard, round mass, 6$\times$5$\times$4cm in diameter was localized in middle lobe of the right lung, and partially adhered to the upper lobe, pericardium and diaphragm. Right middle lobe lobectomy, right upper lobe wedge resection, partial pericardiectomy and diaphragm resection with plication was performed with radical Iymph node dissection. Histopathologic diagnosis was pulmonary blastoma (Biphasic blastoma). It is considered that the prognosis of biphasic blastoma is worse than WDFA(well differentiated fetal adenocarcinoma). There are no other available treatments except for surgical resection. It is suggeste that it is necessary to collect as many cases as possible, to make definite classifications and to examine the clinical course and prognosis of pulmonary blastoma.

• The KIPS Transactions:PartD
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• v.11D no.5
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• pp.1095-1104
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• 2004

An electronic services which are based on Internet/Intranet business transactions are available to e-market places and get the broader business concepts. Component-based e-commerce technology is a recent trend towards resolving the e-commerce chanange at both system and ap-plication levels. The basic capabilities of component based systems should include the plug and play features at various granularities, interoper-ability across networks and mobility in various networking environments. E-business application developers are attempting to more towards web-service as a mechanism for developing component-based web-applications. Traditional process and development models are inadequately architectured to meet the rapidly evolving needs for the future of scalable web services. In this thesis, we focus specifically on the issues of e-business system architecture based on web service for establishing e-business system. We specifies and identifies design pattern for applying e-business domain in the context of multiple entities. We investigate prototype and frameworks to develope components for e-business application based suggested process. We present a worked example to demonstrate the behavior of Customer Authentication System(CAS) development with component and recommend process. Final]Y, we indicate and view on future directions in component-based development in the context of electronic business.

• Journal of Chest Surgery
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• v.43 no.5
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• pp.518-521
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• 2010

A one-day-old baby was transferred for cyanosis and heart murmur. Echocardiographic evaluation revealed that he had severe neonatal Ebstein's anomaly (Carpentier type C), pulmonary atresia, and pulmonary circulation via patent ductus arteriosus. Because the wall of the atrialized right ventricle was very thin, showed decreased contractility, and the small right ventricle showed pulmonary atresia, we decided that a two-ventricular repair was impossible. When the patient was one-month-old, he underwent right atrium reduction-plasty, a right ventricular exclusion procedure (including atrialized right ventricle resection and functional right ventricle plication), and right modified Blalock-Taussig shunt. He was discharged without specific problems. He received a bidirectional cavopulmonary shunt successfully at 4 months later.

• Journal of Chest Surgery
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• v.19 no.4
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• pp.644-662
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• 1986

Seventy cases of open heart surgery were performed in the department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, Inje College, from Oct. 1985 to Oct. 1986. And the results were summarized as follows. 1. Among the 70 cases, there were 48 cases of congenital heart anomalies and 22 cases of acquired rheumatic valvular heart diseases. Age range of the congenital patients was 7 months to 31 years with the mean age of 10 years, and the acquired patients was 18 to 62 years with the mean age of 40 years. 2. The heart-lung machine used for cardiopulmonary bypass was Sarns 7000, 5-head roller pump, and the number and type of oxygenators were 5 of membrane type and 65 of bubble type. For all cases GIK [glucose-insulin-potassium] solution was used as cardioplegic solution for myocardial protection during operation. 3. Among the 48 congenital anomalies, there were 12 cases of ASD group, 29 of VSD group, 3 of ECD, 3 of TOF and one of PDA + MR, and to all of which the appropriate radical operations were applied. 4. Among the 22 acquired valvular diseases, there were 11 cases of mitral valve diseases [MS; 4, MSr; 3, MRs; 4], 3 cases of aortic valve diseases [AR:1, ARs;1, ASr;1], 4 cases of double valve diseases [MRs+TR; 3, MRs+ARs; 1] and 4 cases of triple valve diseases [MSr+ASr+TR; 3, MSr+Ar+TR; 1]. To all the diseased mitral and aortic valves, artificial valve replacement was applied except one [As], in which valve plication was applied. And to all the diseased tricuspid valve, DeVega annuloplasty was applied. 5. The number of replaced artificial valves were 29 in 25 patients [congenital; 3, acquire; 22]. In MVR, 6 of mechanical valves [St. Jude Medical valve; 6] and 15 of tissue valves [Carpentier-Edward valve; 11, lonescu-Shiley valve; 4] were used. In AVR, 6 of mechanical valves [St. Jude Medical valve; 6] and 2 of tissue valves [Carpentier-Edward valve; 2] were used. 6. Postoperative complications were occurred in 12 cases. Among them 11 cases were recovered with intensive cares, but one patient [VSD + Fistula of Valsalva sinus] was expired with low cardiac out put syndrome.

• Journal of Chest Surgery
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• v.27 no.12
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• pp.1002-1007
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• 1994

The spontaneous pneumothorax occurs subsequent to a disruption in the continuity of the visceral pleura with escape of free air into the pleural space included primary & secondary pneumothorax that is unrelated to identifiable etiologies such as trauma. In. the 33 year period 1960 to 1993, the 230 cases of open thoracotomy were carried out for definitive treatment of spontaneous pneumothorax, at the Dept. of Thoracic & Cardiovascular Surgery, National Medical Center, Seoul, Korea. There were 193 men & 37 women. They ranged in age from 15 years old to 72 years old. The lesion site was on the right side in 117 and on the left in 97, the 16 cases were in bilateral lesions.Surgical indications included recurrence in 98 cases, persistent air leak in 68 cases, nonexpansion of the lung 37 cases, roentgenologically apparent bullae & blebs in 23 cases, bilateral lesions in 16 cases,combined hemothorax & prevent for recurrence in each 2 cases. The types of operation were bullectomy in 207 cases, wedge resection in 13 cases, decortication & B.P.F. closure in 6 cases,lobectomy in 2 cases, pneumonectomy, plication in each I case. The post operative complication developed in 18 cases[7.8 %], there was I case of death due to sepsis. We believed that open thoracotomy with resection or obliteration of blebs & pleurodes is provided the best protection against recurrence.

• Archives of Plastic Surgery
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• v.35 no.4
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• pp.455-460
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• 2008

Purpose: We have classified blepharoptosis into the categories including pseudoptosis in Koreans and compared with other previous studies. Methods: Total of 250 patients(398 eyes) who underwent surgery for blepharoptosis from 1987 to 2006 were studied. By classification of Beard, patients were categorized into congenital, acquired and pseudo blepharoptosis and later they were reclassified by their etiologies. Also addition of pseudoptosis to the classification of Frueh, blepharoptosis were categorized into neurogenic type, myogenic type, aponeurotic type, mechanical type and pseudoptosis. And we divided these cases by the degree of blepharoptosis, levator function and the operation methods. Results: Out of the 250 patients, 175 patients were congenital type, 49 were acquired type and 26 were pseudoptosis. According to the mechanistic classification, 177 myogenic type, 30 aponeurotic, 7 mechanic, 8 neurogenic and 28 pseudoptosis were categorized. Regarding severity of blepharoptosis, there were 29.2% of mild, 40% of moderate, and 30.8% of severe cases. Out of the 398 cases, in terms of the operation methods, there were 39 aponeurosis plication, 184 levator resection, 5 Muller tucking, 60 Orbicularis oculi muscle flap, 66 frontalis transfer, and 21 blepharoplasty. Conclusion: The cause and degree of ptosis, and levator function are very important when considering the amount of resected muscle. There were only a few studies about blepharoptosis classification including pseudoptosis category. Therefore, through this study, we can investigate the relationship between the pseudoptosis and the others. This study could be useful for the making future management plans of blepharoptosis in Korean patients.

• Archives of Plastic Surgery
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• v.40 no.5
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• pp.603-609
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• 2013

Background Although the conventional direct brow lift operation provides a simple means of managing lateral brow ptosis, the scars produced have been unacceptable. However, using the modifications proposed here, scarring showed remarkable improvement. This article reviews our experiences with the presented technique, mainly with respect to postoperative scarring. Methods Measured amounts of supra-eyebrow skin and subcutaneous fat were excised en bloc in the conventional manner under 'hyper-hydrated' local infiltration anesthesia. The lower flap and the edge of the upper flap were undermined above the muscular plane, and the orbicularis oculi muscle was directly suture-plicated and suspended upward to the distal frontalis muscle. Skin closure was performed in a basic plastic surgical manner. Results From April 2007 to April 2012, a consecutive series of 60 patients underwent surgery using the above method. The average width of the excised skin was 8 mm (range, 5-15 mm) at the apex of the eyebrow. Preoperative complaints were resolved without occurrence of significant complications. The surgical scars showed remarkable improvement and were negligible in the majority of the cases. Conclusions The direct brow lift operation combined with plication/suspension of the superior and lateral portion of the orbicularis oculi muscle provides a simple, safe, and predictable means of correcting lateral brow ptosis. The scars were acceptable to all of the patients. For proper management of the frontalis tone, upper blepharoplasty and/or repair of eyelid levator function must be considered in addition to brow lift procedures.