• Archives of Plastic Surgery
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• 제37권3호
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• pp.233-238
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• 2010

Purpose: As the use of soft tissue fillers becomes more popular, complications such as foreign body granuloma (FBG) are increasing. We report 120 cases of facial FBG and review the available literatures. Methods: 120 patients of facial FBG in our clinic from Mar. 2003 to Feb. 2008 were complied and analyzed. A retrospective chart review was done and patient satisfaction was evaluated with a questionnaire using 5 score scale. Patients with severe inflammation sign or bizarre deformity underwent surgical excision and those with minimal symptoms or a history of hyaluronic acid injection received injection therapy using hyaluronidase. Results: 100 females and 20 males were observed. The average age was 43.7 years (from 16 to 74). 84 patients received surgical therapy and 36, injection therapy. Deformity of facial contour, foreign body sensation and inflammation sign were the three main chief complaints. 84 patients did not know what the injection materials were. The known materials are as follows: collagen, hyaluronic acid, silicone oil, paraffin. 92 cases were performed by unlicensed practitioners, 29 by physicians. Anatomical site most frequently affected by the foreign body granuloma was the cheek (25.8%), followed by forehead (19.2%), lips (15.8%), nose (9.2%), mentum (8.3%), eyelid and eyebrow (4.3%) and temple (0.8%). In 21 patients (17.5%), FBGs were found on multiple sites. Patients with inflammation sign got the highest satisfaction ($3.19{\pm}0.73$) (p=0.001) among 3 chief complaints. And patient satisfaction was statistically higher in surgical therapy group ($3.43{\pm}0.72$) than in injection therapy group ($2.97{\pm}0.88$) (p=0.003). Conclusion: We suggest that it may be beneficial to tailor the type of treatment for FBG relying on wound state and patient's chief complaints. In surgical therapy, resolute approach is necessary to correct facial deformity definitely and to minimize inflammation. Injection therapy could be another option for those with minimal symptoms or a history of hyaluronic acid injection. To prevent foreign body granuloma, not only plastic surgeons but also other physicians should inject soft tissue fillers with great caution and we should warn the public of disastrous consequences associated with illegal medical practice.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권4호
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• pp.324-331
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• 2010

The radial forearm free flap (RFFF) has become a workhorse flap as a means of reconstructing surgical defects in the head and neck region. We have transferred 12 RFFFs with fasciocutaneous type on oral cavity defects in 12 patients after cancer resection and submucous fibrotic lesion ablation from 2005 to 2007 at Department of oral and maxillofacial surgery, Pusan National University Hospital. We reviewed retrospectively patients' charts and followed up the patients. Clinical analysis on the cases with RFFFs focusing on flap morbidity, indications and available vessels was done. The results of study are follows: 1. RFFF could be applied for all kind of defects after resection of tongue, floor of mouth, buccal mucosa, denuded bone of palate, maxilla, and mandible. 2. All free flaps could be used for primary reconstruction. The survival rate of 12 RFFFs was 92%. Partial marginal loss of the flaps was shown as 3 cases among 12 cases. Large size-vessels like superior thyroid artery, facial artery, internal jugular vein were favorable for microvascular anastomosis. 3. Parenteral nutrition instead of nasal L-tube also can be favorable for postoperative a week for better healing of the flap if the patients couldn't be tolerable with nasal tubing. 4. Donor sites with thigh skin graft were repaired with wrist band for 2 weeks. The complications included scarring, abnormal sensation on hand, and reduced grip strength in few patients, but those didn't induce major side effects. 5. Most RFFFs were well healed even if mortality rate of cancer patients was shown as 50% (5/10 persons). The mortality of patients was not correlated with morbidity of the flaps. We could identify the usefulness of RFFF for restoration of oral function, esthetics if the flap design, tissue transfer indications, and well controlled operation are proceeded.

• 재활치료과학
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• 제9권3호
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• pp.7-21
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• 2020

목적 : 본 연구는 뇌졸중 환자와 노인 환자를 대상으로 퇴원 시기에 이루어지는 평가도구에 대한 체계적 문헌고찰을 통해 평가 항목과 평가도구들을 분석하여 효율적인 퇴원계획을 위한 기초자료를 제공하고자 한다. 연구방법 : 문헌 선정은 PubMed, Medline Complete(EBSCOhost), Scopus를 사용하여 2009년 1월부터 2018년 12월까지의 온라인 데이터에 등록된 연구를 대상으로 최종 22편의 연구를 선정하였고, 연구 설계 및 퇴원 시 주요 평가영역, 하위영역, 평가도구들을 분석하였다. 결과 : 선택된 연구들의 연구 설계 형태는 기술적 연구가 13편(59.2%)으로 가장 많았다. 퇴원 시 평가 영역은 의학적 상태, 일상생활활동, 삼킴 기능, 감각, 이동성, 인지·지각, 의사소통, 감정상태, 가정환경, 환자의 지식과 퇴원을 위한 준비, 사회적지지, 안녕감 등 12개 영역으로 나타났다. 평가 영역에 따라 사용된 평가도구를 분석한 결과, 가장 높은 빈도의 사용을 보이는 평가도구는 일상생활활동을 평가하는 Barthel Index, Functional Independence Measure, 안녕감을 평가하는 Short Form Health Survey, 이동성을 평가하는 Timed Up and Go test 등으로 나타났다. 결론 : 본 연구를 통해 뇌졸중, 노인 환자의 퇴원 시 이루어지는 다양한 평가 영역과 평가도구의 사용과 제한적이나 여러 영역을 포괄하는 평가도구들을 확인할 수 있었다. 이는 뇌졸중 환자의 퇴원 시 고려되는 평가 영역과 효과적인 평가도구의 선택을 돕고 적절한 퇴원계획 중재와 제안을 위한 포괄적인 평가도구의 개발의 기초자료가 될 것이다.

• 대한한의학방제학회지
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• 제20권2호
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• pp.177-186
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• 2012

In this study, we selected some herbal formulation about a series of Chijasi-tang in Dongeuibogam by using web-based open program;Prescription Lineage Graph (http://164.125.206.43/PrescriptionLineageGraph.aspx). And we compared and analyzed the changes of efficacy, major target symptoms of each herbal formulation according to compositional variation of each herbal formulation. Chijasi-tang, first appeared in Sanghanlun, consists of Capejasmine and Fermented soybean, and it is mainly used to treat insomnia due to vexation, heartburn and yellow greasy tongue fur. Capejasmine can clear away irritable feverish sensation in chest by flowing downward the heat, and Fermented soybean can disperse stagnated heat throughout the chest by expelling stagnated heat from the exterior In the case of the heat stagnation caused by relapsing of disease due to overstain, Chisijisil-tang can be used. And if symptom appear more on the upper or exterior than a case of Chisijisil-tang, Seosisi-tang could be more suitable, if half exterior and half interior, Omae-tang could be for it. In addition, if symptom caused by relapsing due to improper diet, Chisijihwang-tang could be proper formulation. In the case of the heat stagnation body inside and jaundice, if it is caused by alcohol, Chijadaehwang-tang could be used for the purpose of urgent purgation, Galchul-tang would be suitable for helping the function of the spleen and the stomach and for treatment of damp-heat of the spleen and the stomach. And if it is caused by pandemic infection, Jangdal-hwan would be good formulation for it. Samhwangseokgo-tang and Yangdokchija-tang could be appropriate formulation for the raging of noxious heat and pathogenic fire caused by febrile disease with toxic yang. Daehwangeum-ja is for severe constipation due to heat-dryness with stagnated fever, Haebaek-tang is appropriate for severe diarrhea due to heat type change of Soeum. According to the result of our investigation, although there are various target causes and symptoms of each herbal formulations, whatever pathogenetic cause is, the stagnated heat in interior side is the basis of symptoms. Therefore, the purpose of including Chijasi-tang in composition of each herbal formulation is treatment of the stagnated heat. For such reason, on the fundamental or ancillary basis of Chijasi-tang plus some herbs for each therapeutic purpose.

• 한국산학기술학회논문지
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• 제19권6호
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• pp.715-721
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• 2018

청각 및 후각의 다감각 자극을 통하여 에너지를 절감하기 위하여 불쾌해진 촉각을 보상함으로써 에너지는 절감하면서 근무자의 뉴로에너지(쾌적성, 집중력, 신체적 및 심리적 안정 등)는 증강시키는 연구를 하였다. 온도 $25[^{\circ}C]$, 상대습도 50[RH%], 조도 1,000[lux] 및 기류 속도 0.02[m/sec]의 항온 항습실에서 1/f의 변동리듬으로 청각을 자극하고 아로마 향기로 후각을 자극하여 실험을 진행하였으며, 접촉식으로 인체의 심리상태를 측정하는 뇌파, 학습능력 및 심박동변이도와 비접촉식으로 심리상태를 측정하는 진동이미지 방법을 사용하였다. 피험자는 신체적으로 활동하는데 지장이 없고, 심신의 안정과 집중력의 최대 상태를 가져오는 상대 ${\alpha}$파(8~13[Hz])의 활성도가 후두엽에서 높은 유형인 20대 대학생 8명(남성 4명, 여성 4명)으로 선정하였다. 측정자세는 쾌적한 열적 환경에서 의자에 착석해 안정을 취하고 있을 때의 활동량으로써 1met로 하였으며, 착의량 상태는 약 0.7clo로 통일하였다. 측정결과 쟈스민 향기와 변동리듬 a=1.106 음원의 다감각자극에서 감성 및 심신안정과 집중력이 가장 높아졌으며, 상대$M{\alpha}$파와 상대$M{\beta}$파가 각각 70.49[%], 89.72[%] 증가하였고, HRT는 38.09[%] 감소하였으며, 피로도와 긴장 불안은 각각 36.85[%], 15.54[%] 감소하였다.

• 대한치과마취과학회지
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• 제9권2호
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• pp.108-115
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• 2009

Trauma to any nerve may lead to persistent paresthesia. Trauma to the nerve sheath can be produced by the needle. The patient frequently reports the sensation of an electric shock throughout the distribution of the nerve involved. It is difficult for the type of needle used in dental practice to actually sever a nerve trunk or even its fibers. Trauma to the nerve produced by contact with the needle is all that is needed to produce paresthesia. Hemorrhage into or around the neural sheath is another cause. Bleeding increases pressure on the nerve, leading to paresthesia. Injection of local anesthetic solutions contaminated by alcohol or sterilizing solution near a nerve produces irritation; the resulting edema increases pressure in the region of the nerve, leading to paresthesia. Persistent paresthesia can lead to injury to adjacent tissues. Biting or thermal or chemical insult can occur without a patient's awareness, until the process has progressed to a serious degree. Most paresthesias resolve in approximately 8 weeks without treatment. In most situations paresthesia is only minimal, with the patient retaining most sensory function to the affected area. In these cases there is only a very slight possibility of self injury. But, the patient complaints the discomfort symptoms of paresthesia, such as causalgia, neuralgiaform pain and anesthesia dolorosa. Most paresthesias involve the lingual nerve, with the inferior alveolar nerve a close second. This is the report of a case, that had the persistent paresthesia care on left lingual & buccal shelf regions after the lingual and long buccal nerve block anesthesia.

• Archives of Plastic Surgery
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• 제38권5호
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• pp.602-608
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• 2011

Purpose: Nasal bone fracture is the most common type of facial bone fracture and most of nasal bone fracture is combined with septal fracture frequently. Nasal septum is important to support the distal nose and to maintain the nasal airway. But nasal septal fractures are usually unrecognized and untreated at the time of operation. Recently, various materials were using for nasal packing after closed reduction, however these materials are not focused on the correction of nasal bone and nasal septal fracture and many patients are suffered from nasal packing materials. Thus, the purpose of this study is to compare routine packing materials and rolled silastic sheet with respect to postoperative effect of correction of nasal bone fracture and discomfort of nasal packing materials. Methods: We examined 320 patients treated nasal bone fracture from January 2008 to December 2010. For Group I (n=92), $Merocel^{(R)}$ was used for nasal packing, for Group II (n=152) vaseline gauze was used, and Rolled silastic sheet (RSS) with vaseline gauze packing (VGP) was used for Group III (n=76). Under the general anesthesia, all patients were operated by closed reduction and nasal packing was done using three kinds of packing materials. At the time of postoperative 7 days, packing material was removed and studied for pt's satisfaction and postop. complications. Results: In patients with RSS with VGP, the complaints (nasal obstruction, foreign compressive sensation and discomfort during food ingestion) of keeping the nasal packing were decreased ($p$ <0.05) and the postoperative complication (deviation) were decreased comparing to vaseline gauze packing and $Merocel^{(R)}$ packing, however, these differences were not statistically significant ($p$ >0.05). Conclusion: Postoperative nasal packing with RSS with VGP was more comfortable to the patients and it was more effective method to correct the nasal bone fracture and nasal septal fracture.

• 동의생리병리학회지
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• 제20권6호
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• pp.1732-1741
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• 2006

Obesity is chronic disease which influenced on health severly. The causes of obesity have been known as life change, lack of excercise, genetic factor, mental and social economic factors. Especially the obesity of women increased the risk of the diseases such as DM, osteoarthritis, cardiovascular disease, breast cancer and infertility. The limitations of the widely used negative definition of health as the absence of disease and WHO's 1946 definition of health as total social, psychological and physical well-being have long been recognized (WHO 1958). The Quality of Life (QoL) includes functional ability, the degree and quality of social and community interaction, psychological well-being as somatic sensation and life satisfaction. I investigated to compare the differences between obese women (n=63), non-obese women (n=37) in clinic and general women (n=43, control) on baseline characteristics and WHO QoL-BREF. The purpose of this study is to assist the diagnosis and treatment of obesity. WHO QoL-BREF is self administered type which consisted of 26 questions. The prospective question is calculated with 5 scores by Likert's method. The results are as follows : The means of physical, psychological, social, overall and total scores of QoL were significant among BMI group (P<0.05). The score of control group (BMI < 25) was higher than other groups significantly (P<0.05). In multiple regression analysis, the variable of high school/below middle school was significant in environmental and overall domain of QoL scores (P<0.05). The variable of college/below middle school was significant in environmental, overall domain and total score of QoL scores (P<0.05). The variable of above university/below middle school was significant in physical health, environmental, overall domain and total score in QoL scores (P<0.05). The variable of Health perception (moderate/bad) was positively significant in physical health, environmental, overall domain and total score of QoL scores (P<0.05). The variable of Health perception (good/bed) was positively significant in physical health, environmental, social, overall domain and total score of QoL scores (P<0.05). The variable as BMI non-=obese women/control was negatively significant in social domain of QoL scores (P<0.05). Above the results, It suggests that the variable as BMI did't affect on the QoL in patients and control, but the variables as education and health perception affected on the QoL scores. Further study is required to conduct QoL differences between before and after treatment of obese patients.

• 인간행동과 음악연구
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• 제15권2호
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• pp.93-114
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• 2018

본 연구의 목적은 마음챙김 방법으로써 음악심상기법(music and imagery, 이하 MI)을 탐색하는 것이다. 이를 위해 예비음악치료사를 대상으로 집단 MI를 시행하고 참여자의 경험을 분석하였다. 집단 MI는 총 8회기가 시행되었고 음악치료 인턴훈련과정에 있는 예비음악치료사 11명이 참여하였다. 이들의 MI경험에서 마음챙김 상태에 해당하는 요소가 나타나는지를 분석하기 위해 MI세션동안의 참여자 언어 반응을 녹취하여 필사한 후 수정된 근거이론방법을 적용하여 경험의 차원과 속성을 분석하였다. 분석에 앞서 연구자는 선행연구를 고찰하여 다양한 용어로 정의되고 있는 광범위한 마음챙김의 범위를 '자각하기', '수용하기', '거리두기'로 규명하였다. 연구결과를 살펴보면, 참여자의 음악심상 경험에서 마음챙김에 해당하는 의미단위 114개를 발견하였다. 이로부터 7개의 하위범주, 즉 '정서', '감각', '사고', '대면', '관점 확장', '정서분리', '감각분리'가 나타났다. 범주화에서 나타난 참여자 경험을 통해 음악과 심상이 마음챙김 상태를 촉진하는 매체임을 확인할 수 있었다. 한편 참여자 경험의 속성이 유사한 반면 차원에는 차이가 있는 것으로 나타났으며, '자각하기'는 '수용하기'와 '거리두기'에 선행하는 상태인 것으로 확인되었다. 이에 본 연구의 제언으로 음악과 심상의 어떠한 특성이 마음챙김 상태에 기여하는지와 그 경험의 과정에 기여하는 다양한 요인에 관한 심층 탐색을 제안하였다.

• 공연문화연구
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• 제40호
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• pp.5-35
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• 2020

정동(affect)은 신체가 외부 세계를 감각함으로써 생성되는 강렬함(intensity)과 특질(quality)이다. 이렇게 체험된 정동 중에서 의미와 해석이 부여된 관념이 감정(emotion)이다. 정동 이론(affect theory)은 감정과 정동을 분별하고 정동에 주목함으로써 신체의 반응과 변화를 분석할 수 있는 방법을 제공하고 있으며, 신체를 매체로 하는 공연예술 연구에 새로운 가능성을 제시하고 있다. 농악은 '재현'(representation)보다는 정동의 발생 자체에 주력하는 예술이다. 농악은 소리, 색깔, 질감, 신체 운동 등이 중첩되어 공감각적으로 현존하는 공연이다. 여기에는 인간의 신체를 중심으로 악기, 소품, 의상, 무대장치 등 물질적인 것들과 리듬, 기분, 분위기 등 비물질적인 것들이 동원된다. 신체는 이런 것들에 자극되어 공연에 적절하도록 경향성을 띄며, 공연에 몰입할수록 '이미지 없는 신체'(the body without an image)가 되어 '의사-신체성'(quasi-corporeality)을 보이며 행동한다. 마치 의식이 없는 것처럼 자동으로 움직이는 이런 신체는 집단 속에서 더 쉽게 나타난다. 일상의 개인을 집단 속의 '이미지 없는 신체'로 이행(transition)시키기 위해서 농악에서는 '진풀이'라는 집단적인 신체 운동을 수행한다. 이런 신체 운동은 비언어적인 교감과 소통을 높여 정동을 증강시키고, 상호 신뢰와 귀속감 속에서 개개인들의 창조력을 발휘하게 한다. 농악이 일으키는 정동과 감정은 자신과 집단의 존재, 활력, 능력을 확인하고 긍정하는 것으로 작용한다. 이런 긍정성은 집단의 차원에서 농악을 의미 있고 중요한 가치로 기억하게 하였고, 보존하고 전승해야 하는 공연양식으로 인식하게 하였다.