• Asian Pacific Journal of Cancer Prevention
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• 제15권6호
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• pp.2533-2539
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• 2014

Aim: To take a deeper insight into the relationship between the root of the inferior mesenteric artery (IMA) and the autonomic nerve plexuses around it by cadaveric anatomy and explore anatomical evidence of autonomic nerve preservation in high ligation of the IMA in laparoscopic surgery for colorectal cancer. Methods: Anatomical dissection was performed on 11 formalin-fixed cadavers and 12 fresh cadavers. Anatomical evidence-based autonomic nerve preservation in high ligation of the IMA was performed in 22 laparoscopic curative resections of colorectal cancer. Results: As the upward continuation of the presacral nerves, the bilateral trunks of SHP had close but different relationships with the root of the IMA. The right trunk of SHP ran relatively far away from the root of IMA. When the apical lymph nodes were dissected close to the root of the IMA along the fascia space in front of the anterior renal fascia, the right trunk of SHP could be kept in suit under the anterior renal fascia. The left descending branches to SHP constituted a natural and constant anatomical landmark of the relationship between the root of IMA and the left autonomic nerves. Proximal to this, the left autonomic nerves surrounded the root of the IMA. Distally, the left trunk of the SHP departed from the root of IMA under the anterior renal fascia. When high ligation of the IMA was performed distal to it, the left trunk of SHP could be preserved. The distance between the left descending branches to SHP and the origin of IMA varied widely from 1.3 cm to 2.3 cm. Conclusions: The divergences of the bilateral autonomic nerve preservation around the root of the IMA may contribute to provide anatomical evidence for more precise evaluation of the optimal position of high ligation of the IMA in the future.

• 영재교육연구
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• 제11권3호
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• pp.45-68
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• 2001

영재들의 잠재 능력을 최대한으로 발현시키기 위해서는 영재들의 일반적인 인지적.정의적 특성 및 다양한 학습 요구를 반영할 수 있는 최적의 학습 환경, 즉 구성주의 학습 환경을 제공해줄 필요가 있다. 이를 위해 본 연구에서는 구성주의 원리에 바탕을 둔 협동학습 방안을 탐색하기 위해 ‘웹 기반 구조적 의사교류법 (Web-Based Structural Communication)’을 활용하여 고등학교 수학 영재들의 ‘2$\times$2행렬’학습 프로그램을 개발하고자 하였다. 최근 급속도로 발전하고 있는 컴퓨터 공학과 네트워크 및 인터넷의 보급으로 ‘구조적 의사교류법’의 활용 가능성 및 효율성이 그 어느 때 보다도 크게 기대된다. 특히 웹을 통한 상조적 협동학습은 학습자들로 하여금 지식 구성의 과정을 경험하게 하여, 결과적으로 객관적이고 다양한 관점을 지니게 되는 학습 활동을 구현할 수 있는 대표적인 학습도구로 활용될 수 있을 것이다. 그러나 본 연구에서는 ‘웹 기반 구조적 의사교류법’의 적용 가능성을 탐색하고자 프로그램을 개발하는데 목적이 있기에, 이 프로그램의 구체적 효과에 관해서는 앞으로 계속적인 연구가 필요하리라 여겨진다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권2호
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• pp.137-141
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• 2011

The extraction of an impacted third molar tooth is associated with many complications during the procedure and postoperative care. These complications include bleeding, swelling, pain, infection, as well as root fracture, proximal tooth injury, alveolar bone fracture, lingual nerve and inferior alveolar nerve injury etc. With the exception of a fractured root dislocation in the submandibular space, no direct submandibular gland injury related to extraction surgery has been reported until now. A 40 year old man visited the department of oromaxillofacial surgery at Yeouido St. Mary's Hospital for an extraction of the right mandible third molar. A partial third molar impaction was diagnosed by a clinical and radiographic examination. A surgical tooth extraction was practiced including buccal cortical bone osteotomy. During socket curettage, an encapsulated cyst-like lesion and a verified $3{\times}3\;cm$ neoplasm in the apically lingual direction were found during process of dissection. A biopsy confirmed that the neoplasm involved the submandibular gland and nerve trunk. This unusual anatomical organ injury during the surgical tooth extraction procedure is reported as a new complication during impacted third molar extraction.

• 한국동물학회지
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• 제33권3호
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• pp.354-364
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• 1990

무당거미의 많은 견사선들 중에서 포획사를 만들어내는 한쌍의 편상선은 분비관과 분비양, 그리고 말단분비부로 이루어져 있었고, 두쌍의 수상선과 함께 후방적돌기에서 triad 복합구조를 형성하고 있었다. 강한 섬유를 생성하기 위해 분비관은 길게 신장되어 있었고, 토사관과 근접된 원위부의 내벽에는 수분의 흡수와 관련된 subcuticle층이 비후되어 있었으며 분비낭에 가까운 근위부에서는 큐티클 전구물질의 수송현상이 관찰되었다. 분비낭의 상피는 원주상의 세포로 이루어져 있었고, 세포질에 구형의 분비과립을 함유하고 있었는데, 부위에 따라 과립의 형태와 전자밀도의 차이가 관찰되었다. 포획사의 주성분을 분비하는 말단분비부의 선상피세포에는 조면소포체가 특이적으로 발달되어 있었고, 생성된 견사물질은 이출분비의 기작에 의해 내강으로 방출되었다.

• Archives of Plastic Surgery
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• 제45권1호
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• pp.62-68
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• 2018

Background Amputation is commonly performed for toe necrosis secondary to peripheral vascular diseases, such as diabetes mellitus. When amputating a necrotic toe, preservation of the bony structure is important for preventing the collapse of adjacent digits into the amputated space. However, in the popular terminal Syme's amputation technique, partial amputation of the distal phalanx could cause increased tension on the wound margin. Herein, we introduce a new way to resect sufficient bony structure while maintaining the normal length, based on a morphological analysis of the toes. Methods Unlike the pulp of the finger in the distal phalanx, the toe has abundant teardrop-shaped pulp tissue. The ratio of the vertical length to the longitudinal length in the distal phalanx was compared between the toes and fingers. Amputation was performed at the proximal interphalangeal joint level. Then, a mobilizable pulp flap was rotated $90^{\circ}$ cephalad to replace the distal soft tissue defect. This modified toe fillet flap was performed in 5 patients. Results The toe pulp was found to have a vertically oriented morphology compared to that of the fingers, enabling length preservation through cephalad rotation. All defects were successfully covered without marginal ischemia. Conclusions While conventional toe fillet flap coverage focuses on the principle of length preservation as the first priority, our modified method takes both wound healing and length into account. The fattiest part of the pulp is advanced to the toe tip, providing a cushioning effect and enough length to substitute for phalangeal bone loss. Our modified method led to satisfactory functional and aesthetic outcomes.

• Journal of Chest Surgery
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• 제29권11호
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• pp.1270-1275
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• 1996

폐동맥류는 매우 드문 질환으로 일반적으로 폐혈류량을 증가시키고 폐성 고혈압을 초래하는 선천성 심결손과 동반되어 발생되는 경우가 대부분이다. 폐동맥류의 예후는 매우 치명적 일 수 있는데, 그 이유는 동맥류의 파열에 대한 가능성과 대부분의 경우 심한 폐성 고혈압이 동반되어 있기 때문이다. 40세 여자 환자가 교통사고후 두통을 주소로 본원에 입원하였다. 내원 당시 이학적 검사상 좌흉골연을 따라 2번째와 3번째 늑간에서 연속성 심잡음이 청진되었고, 단순 흉부 X-선 사진상 좌측 폐문부의 석회화된 낭성 종괴가 우연히 발견되었다. 심도자검사상 좌-우 단락이 주폐동맥에서 관찰되었고, 폐동맥압이 증가되어 있었다. 그리고 폐동맥조영술상 주폐동맥에서 좌폐동맥 기시부로 연장되는 폐동맥류의 소견을 보였다. 저자들은 동맥관개존증을 동반한 주폐동맥류로 진단하고, 심폐우회하에 동맥류 절제, 동맥관 봉합 및 Dacron 이식편 치환술을 시행하였다. 술후 경과는 양호하였으며, 환자는 건강한 상태로 퇴원하였다.

• Biomolecules & Therapeutics
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• 제6권2호
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• pp.130-138
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• 1998

In this study, the effect of verapamil (VER) on cyclosporin A (CsA)-induced nephrotoxicity was investigated in uninephrectomized rats. Male Wistar rats were administered CsA (50 mg/kg/day, p.o.) or VER (0.5 mg/kg/day, i.p.) with CsA (50 mg/kg/day, p.o.) for 20 days. The urinary N-acetyl-$\beta$-D-glucosaminidase (NAG) activity along with BUN, serum creatinine, creatinine clearance (CLcr), body weight, and 24 hr-urine output were measured and histopathologic changes of kidney were evaluated by light and electron microscopy. The results obtained from this study can be summarized as follows: While NAG activity, BUN and serum creatinine was progressively increased and CLcr significantly decreased in CsA group, VER almost signifi-cantly (p<0.05) suppressed and normalized CsA-induced changes in VER+CSA group. While urine output increased until 12th days and thereafter progressively decreased in CsA group, it gradually increased in control and VER+CSA group. While body weight progressively made a gain in control and VER+CSA groups, it significantly (p<0.05) lost in CsA group. On light microscopy, the glomerular hyperemia and proximal convoluted tubular (PCT) dilatation, focal tubular cell vacuolation and necrosis were clearly evident in CsA group, but, were not seen in other groups. Ultrastructural studies revealed thickened glomerular endothelium and basal lamina of capillary, irregular shaped pedicels of podocytes, indistinct slit pores and narrowed bowman's space. The large oval vacuoles with dense debris and phagosome were distributed in apical zone and deformed microvilli and mitochondria were seen in the PCT cell of CsA group. But, glomeruli and PCT cell were relatively preserved in normal apperance in other groups. In conclusion, it is suggested that verapamil has a protective effect on cyclosporine-induced nephrotoxicity in uninephrectomized rats.

• Annals of Clinical Neurophysiology
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• 제3권2호
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• pp.143-146
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• 2001

Background : Backpack palsy was described in military personnel with shoulder girdle and proximal upper extremity symptoms, predominantly motor in nature related to the use of heavy backpack. Currently, backpack were used for sports, transporting school books and child carriers. We evaluated clinical and electrophysiological feature of backpack palsy. Methods : We included 11 patients with brachial plexopathy as a result of wearing a heavy backpack on long distance marches. All patients were done routine blood sampling, chest X-ray, C-spine X-ray and electrophysiological studies. Results : All patients were right handed person and were not as having a thoracic outlet syndrome. Sensory changes were main initial symptoms and major persistent symptoms were motor weakness. 9 patients(81.8%) were damaged the brachial plexus on non-dominant side, 1 patient was dominant and 1 patient was bilateral involvement. 10 patients(90.9%) were damaged to upper trunk of the brachial plexus by EMG findings. The prognosis was good, 10 patients(90.9%) were complete recovery during 8 weeks, 1 patient was developed reflex sympathetic dystrophy confirmed by 3-phase bone scan. Conclusions : Depression of the clavicle and costoclavicular space probably plays a certain role in pathogenic mechanism. The non-dominant side is more frequently affected, probably due to underdevelopment of the musculature in that side.

• Archives of Plastic Surgery
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• 제50권3호
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• pp.279-287
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• 2023

Background Hypothenar free flaps (HTFFs) have been widely used for reconstructing palmar defects. Although previous anatomical and clinical studies of HTFF have been conducted, this technique still has some limitations. In this study, we describe some tips for large flap design that allows for easy harvesting of HTFFs with minimal donor site morbidity. Methods A total of 14 HTFF for hand defect reconstruction were recorded. The oblique flap was designed in the proximal HT area following relaxed skin tension line along the axis between fourth web space and 10 mm ulnar side of pisiform. A flap pedicle includes one or two perforators with ulnar digital artery and HT branch of basilic vein. In addition, innervated HTFF can be harvested with a branch of ulnar digital nerve. Electronic medical records were reviewed to obtain data on patients' information, operative details, and follow-up period. In addition, surgical outcome score was obtained from the patient, up to 10 points, at the last follow-up. Results Mean harvest time was 46 minutes, and two perforators were included in 10 cases. The mean flap area was 10.84 cm². There were no problems such as donor site depression, scar contracture, keloids, wound dehiscence, numbness or neuroma pain at donor sites, and hypersensitivity or cold intolerance at flap site, either functionally or aesthetically. Conclusion Palmar defect reconstruction is challenging for hand surgeons. However, large HTFF can be harvested without complications using the oblique axis HTFF technique. We believe our surgical tips increase utility of HTFF for palmar defect reconstruction.

• Annals of Occupational and Environmental Medicine
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• 제34권
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• pp.10.1-10.11
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• 2022

Background: Repetitive hand use increases the risk of hand osteoarthritis (OA). This study aimed to investigate characteristics of and risk factors for hand OA in Korean women farmers. Methods: This cross-sectional study included women farmers resident in Jeollanam-do, Korea. The participants were interviewed, and radiographs were taken of both hands. Radiological hand OA was defined based on the Osteoarthritis Research Society International imaging criteria of joint space narrowing or the presence of osteophytes. The participants were divided into age groups of < 60 and ≥ 60 years. Obesity was defined as body mass index of > 25 kg/m². Annual working time was divided into < 2,000, 2,000-2,999, and ≥ 3,000 hours. Agricultural working type was divided into rice farming and field farming. Robust Poisson regression was used to identify factors associated with radiographic hand OA, with adjustment for age, obesity, annual working time, and agricultural classification. Results: A total of 310 participants with a mean age of 58.1 ± 7.6 years, were enrolled. The prevalence of radiologically confirmed OA was 49.0%, with an OA prevalence of 39.4% the interphalangeal joint in the thumb (IP1). The prevalence of OA was higher in the distal interphalangeal joint than in the proximal interphalangeal, metacarpophalangeal, and carpometacarpal joints. The prevalence of OA varied by age, annual working time, and agriculture type. Conclusions: Korean women farmers have a high prevalence of OA, particularly in the IP1 joints. OA is associated with age, working hours, and agriculture type.