• Journal of Oral Medicine and Pain
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• v.25 no.2
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• pp.173-189
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• 2000

The purpose of this study was to evaluate the effect of specific head positions on the mandibular rotational torque movements in maximum mouth opening, protrusion and lateral excursion. Thirty dental students without any sign or symptom of temporomandibular disorders(TMDs) were included as a control group and 90 patients with TMDs were selected and examined by routine diagnostic procedure for TMDs including radiographs and were classified into 3 subgroups : disc displacement with reduction, disc displacement without reduction, and degenerative joint disease. Mandibular rotational torque movements were observed in four head postures: upright head posture(NHP), upward head posture(UHP), downward head posture(DHP), and forward head posture(FHP). For UHP, the head was inclined 30 degrees upward: for DHP, the head was inclined 30 degrees downward: for FHP, the head was positioned 4cm forward. These positions were adjusted with the use of cervical range-of-motion instrumentation(CROM, Performance Attainment Inc., St. Paul, U.S.A.). Mandibular rotational torque movements were monitored with the Rotate program of BioPAK system (Bioresearch Inc., WI, U.S.A.). The rotational torque movements in frontal and horizontal plane during mandibular border movement were recorded with two parameters: frontal rotational torque angle and horizontal rotational torque angle. The data obtained was analyzed by the SAS/Stat program. The obtained results were as follows : 1. The control group showed significantly larger mandibular rotational angles in UHP than those in DHP and FHP during maximum mouth opening in both frontal and horizontal planes. Disc displacement with reduction group showed significantly larger mandibular rotational angles in DHP and FHP than those in NHP during lateral excursion to the affected and non-affected sides in both frontal and horizontal planes(p<0.05). 2. Disc displacement without reduction group showed significantly larger mandibular rotational angles in FHP than those in any other head postures during maximum mouth opening as well as lateral excursion to the affected and non-affected sides in both frontal and horizontal planes. Degenerative joint disease group showed significantly larger mandibular rotational angles in FHP than those in any other head postures during maximum mouth opening, protrusion and lateral excursion in both frontal and horizontal planes(p<0.05). 3. In NHP, mandibular rotational angle of the control group was significantly larger than that of any other patient subgroups. Mandibular rotational angle of disc displacement with reduction group was significantly larger than that of disc displacement without reduction group during maximum mouth opening in the frontal plane. Mandibular rotational angle of disc displacement without reduction group was significantly larger than that of disc displacement with reduction group or degenerative joint disease group during maximum mouth opening in the horizontal plane(p<0.05). 4. In NHP, mandibular rotational angles of disc displacement without reduction group were significantly larger than those of the control group or disc displacement with reduction group during lateral excursion to the affected side in both frontal and horizontal planes. Mandibular rotational angle of disc displacement without reduction group was significantly smaller than that of the control group during lateral excursion to the non-affected side in frontal plane. Mandibular rotational angle of disc displacement without reduction group was significantly larger than that of disc displacement with reduction group during lateral excursion to the non-affected side in the horizontal plane(p<0.05). 5. In NHP, mandibular rotational angle of the control group was significantly smaller than that of disc displacement with reduction group or disc displacement without reduction group during protrusion in the frontal plane. Mandibular rotational angle of disc displacement without reduction group was significantly larger than that of the disc displacement with reduction group or degenerative joint disease group during protrusion in the horizontal plane. Mandibular rotational angle of the control group was significantly smaller than that of disc displacement without reduction group or degenerative joint disease group during protrusion in the horizontal plane(p<0.05). 6. In NHP, disc displacement without reduction group and degenerative joint disease group showed significantly larger mandibular rotational angles during lateral excursion to the affected side than during lateral excursion to the non-affected side in both frontal and horizontal planes(p<0.05). The findings indicate that changes in head posture can influence mandibular rotational torque movements. The more advanced state is a progressive stage of TMDs, the more influenced by FHP are mandibular rotational torque movements of the patients with TMDs.

• Journal of Hospice and Palliative Care
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• v.7 no.2
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• pp.232-237
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• 2004

Purpose: DNR order is generally accepted for cancer patients near the end of life at Hospice Ward. It means not only no CPR when cardiopulmonary arrest develops but no aggressive meaningless medical interventions. Usually on admission, we discuss with the patients' family about DNR order at the Hospice Ward. Recently, we experienced a terminal lung cancer patient who had been on the ventilator for two months after pulmonary arrest. CPR and artificial ventilation were performed because patient's family refused DNR order. There is no consensus when, who, and how DNR order could be written for terminal cancer patients in Korea, yet. Methods: Hospice charts of 60 patients who admitted between Jan and Jun 2003 to Hospice Ward were reviewed retrospectively. Results: The median age was 66(range $31{\sim}93$) and there were 31 males and 29 females. Their underlying cancers were lung (12), stomach (12), biliary tract (7), colon (6), pancreas (4) and others (19). The persons who signed DNR order were son (22), spouse(19), daughter (16) and others (3). But, there was no patients who signed DNR order by oneself. Thirty families of 60 patients signed on day of admission and 30 signed during hospitalization when there were symptom aggravation (19), vital sign change (4), organ failure (3) and others (4). There were 13 patients who died within 5 days after DNR order. Most of patients died at our hospice ward, except in 1 patient. The level of care was mostly 1, except in 2 patients. (We set level of care as 3 categories. Level 1 is general medical care: 2 is general nursing care: 3 is terminal care.) Conclusion: We have to consider carefully discussing DNR order with terminal cancer patients in the future & values on withholding futile intervention.

• Journal of The Association for Neo Medicine
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• v.2 no.1
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• pp.55-84
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• 1997

Inferential structure and reality problem is a serious issue to O.M.(oriental medicine). The study will analyze this issue through a philosophical and historical comparative study of W.M.M(Western modern medicine) and O.M. First, I presuppose some basic ideas. The first is the division of the 'the philosophy of medicine' and 'the medicine itself'. Second, there is a 'visibility' that discriminate between 'the abstractive concept' and 'the concrete object' in diagnostic terminology. The third is the separation of disease, the entity and disease, the phenomenon. Finally, the distinction between the cause of disease and the nature of disease. Through these basic concepts, this study will analyze O.M's diagnostic methodology, 'Pattern identification of the S.A.S(sign and symptom)'. The results are follows: 1. O.M's views disease as a phenomenon. So, the S.A.S, which is visible, is the disease itself. Tough the analysis and inference of the S.A.S, 證(zheng) the essence is derived. 2. 證(zheng) can be considered as 'the abstractive concept' reflecting the essence of a disease. 3. 證(zheng) is not arrived through causal sequence reasoning but rather by analogical reasoning. 4. 證(zheng) is 'the non-random correlative combination of S.A.S', pattern. These patterns secure the abstractive deduction in reality. that is, The causality, the positivism, the view of disease as entity, and anatomical knowledge are the traits peculiar to W.M.M. But, these properties can not be applied universally to every medical systems. Also, these properties do not indicate the superiority or inferiority of any medical system. 5. 證(zheng) summarizes the patients condition simultaneously with the S.A.S. However, 證(zheng) doesn't necessarily indicate the knowledge about the actual internal organ. That is, Early in O.M.'s history, the diagnostic terminologies including 證(zheng) were analogical reflections of a naive knowledge of internal organs and external environmental factors. Later, the naive knowledge in 證(zheng) changed int new nature, an abstractive concept. The confusion of the concept of disease, the indiscriminate acceptance of Western anatomical knowledge, and the O.M.'s theoretical evolution et are the challenge facing modern O.M. To find solutions, this study looks at the sequence of the birth of W.M.M. and then compares it's system with the O.M. system. The confusion of the concept of disease, the indiscriminate acceptance of Western anatomical knowledge, and the O.M.'s theoretical evolution et are the challenge facing modern O.M. To find solutions, this study looks at the sequence of the birth of W.M.M. and then compares it's system with the O.M. system. It is recommended that O.M. diagnostics should pay close attention to the ambiguity of the diagnostic methodology in order to further development. At present time, the concept and the system peculiar to O.M. can not be explained by common language. but O.M.'s practitioner can not persist in this manner an: longer. Along with the internal development of O.M., the adjustment of O.M.'s diagnostic terminology needs to be adopted.

• Tuberculosis and Respiratory Diseases
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• v.50 no.1
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• pp.106-116
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• 2001

Background : Pulmonary thromboembolism is relatively frequent and potentially fatal. However, it is commonly misdiagnosed. The incidence of pulmonary thromboembolism is not decreasing despite advances in diagnosis and effective prophylatic measures. Its potential for significant sequela necessitates a prompt diagnosis and treatment. Unfortunately, there are many difficulties and problems regarding accurate diagnosis. There is a low prevalence of deep vein thrombosis and pulmonary thromboembolism in Korea and only few reports on this subject are available. Method : The clinical features of 36 patients, who were diagnosed with pulmonary thromboembolism at the Korea University medical center, were reviewed. Results : 1) There was no significant difference in prevalence between men an women, and the mean age was 50.9 years in men 59.2 years in women. 2) The frequent causes of pulmonary thromboembolism were malignancies (22.2%), surgery (22.2%), and heart disease(8.2%). Specific causes were not identified in 33.3%. 3) The most common symptom was dyspnea(72.2%), and the most common sign was tachypnea(61.1%). 4) The EKG findings were normal in 28.6%, an S1Q3T3 pulmonale pattern in 25.7%, ST or QRS changes in others. 5) The chest X-ray findings indicated pulmonary infiltration in 37.5%, cardiomegaly in 15.6%, pleural effusion in 12.5%, and normal in 27.8%. The perfusion lung scan showed a high probability in 66.7%, and intermediate or low probability in 33.3%. 6) The pulmonary arterial pressure(PAP) in the high probability groups was 57.9mmHg with a higher mortality rate(35%). Conclusion : Pulmonary thromboembolism is not uncommon in Korea and its clinical features do not differ greatly from thase reported in the literature. When pulmonary thromboemblism of unknown causes are diagnosed, a search for an occult malignancy is recommended. Rapid diagnosis and treatment are achieved when thromboemblism is suspected.

• Clinical and Experimental Pediatrics
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• v.46 no.11
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• pp.1067-1072
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• 2003

Purpose : Non-accidental intracranial hemorrhage in children is not low in incidence and results in high mortality and serious sequelae. So, the authors have researched the distribution of sex and age, causes, symptoms and signs, hemorrhagic types, mortality rate and sequelae of the patients hospitalized with non-accidental intracranial hemorrhage at Hallym University Sacred Heart Hospital. Methods : The medical records of twenty patients, aged 15 or younger, and excluding neonatal patients, were analyzed retrospectively. The patients in this study were admitted with non-accidental intracranial hemorrhage from January 1999 to June 2002. Results : Of the twenty cases, the ratio of male to female was 1 : 0.8. The patients aged one or less and between 11 and 15 were discovered to be the most frequent cases. Shaken baby syndrome and arteriovenous malformation were found to be the most frequent causes. Seizure was most frequently found to be a symptom and a sign. Hemorrhagic type was classified into subdural hemorrhage eight, intracerebral hemorrhage five. There were three mortal cases. Twelve surviving patients, excluding five not-followed ones, were reclassified into six cases of complete recovery and six of sequalae. Conclusion : Non-accidental intracranial hemorrhage in children is not low in incidence, with a high mortality rate and a high incidence of serious sequelae after survival. Consequently, early diagnosis and appropriate treatment are required. In addition, appropriate rehabilitation after treatment is needed because the high survival rate due to advanced medical treatment results in an increasing number of neurologic sequelae.

• Research in Community and Public Health Nursing
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• v.5 no.2
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• pp.181-202
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• 1994

This study was conducted in order to grasp the condition of the student's knowledge and attitude about tuberculosis. And to offer the basic materials for the prevent tuberculosis in elementary school. The objects were comprised 395 of volunteered 6th grade students who study in two elementary schools. The material of this study was the questionaire(chronbach $\alpha=.9016$) suited to the purposed of this research which has been made through studying references. All the questionaire were collected immediately without explanation. The data was collected from 13rd to 25th of May on 1994. Analysis of the data was done utilizing SPSS for percentage, mean, ANOVA and pearson-Correlation Coefficient. The Result are as follows; 1. General features of the objects of study. Sex distribution was similar. Salary of 1000-1500 thousand won were highest (40.2%), nuclear family was highest (87.1%), fathers of graduated high school were the highest(44.0%), mothers of graduated high school were the highest(56.8%). And there was nobody about tuberculosis patient in one's close relatives were highest(95.4%). 2. The conditions of attitude about tuberculosis. Having experience of tuberculin test were highest(59.0%). Less than 9mm indulation among the tuberculin tested group were 85.1%, more than indulation were 14.9%. Have a B. C. G. injection among the less than 9mm indulation were 83.2%. Leave alone among the more than 10mm indulation were 56.0%. Think it too much trouble to do not tuberculine test were 63.0%. Do not take a chest X-ray in the past were 60.3%. And take a chest X-ray in the past were 39.7%. Health educated group was 74.3%. If tuberculosis sign was developed, notified to parent was 73.8%. 3. The condition of knowledge about tuberculosis. When 5 points was given to 'very affiming' and 1 point was given to 'very deny', the total average was 3.54. And symptom of tuberculosis secion was 3.67, vaccination of tuberculosis section was 3.66, tuberculine test section was 3.56, epidemiology of tuberculosis section was 3.54, infection of tuberculosis section was 3.38. And every section showed affirmative correlation(P<.001). 4. Correlation between the general features and attitude variables. High incomed group may have more attitude on tuberculin test than low incomed group($x^2=16.$ 190, P<.01). High educated group may have more attitude on tuberculin test than low educated group(Father : $x^2=28.530$, P<.001, Mother: $x^2=26.060$, P<.001). High educated group may have more attitude on health education than low educated group(Father: $x^2=20.$ 767, P<.000, Mother: $x^2=10.639$, P<.05). Nuclear family may have more attitude on notify to parent than others($x^2=51.45$, P<.000). Tuberculosis patient in one's close associates have more attitude on notify to parent than others($x^2=51.$ 45, P<.000). 5. Difference between the general features and knowledge of tuberculosis. High incomed group were highest score in knowledge (F=3.99, P<.01). High educated group were highest score in knowledge(Father : F=8.81, P<.000, Mother: F=9.09, P<.000). 6. Difference between the attitude and knowledge of tuberculosis. Tuberculin tested group were highest score in knowledge(t=9.88, P<.000). Taken chest X-ray group were highest score in knowledge (t=2.07, P<.05). Received health education group were highest score in knowledge(t=6.83, P<.000). Notified symptoms to teachers and parent group were highest score in knowledge(F=3.89, P<.01).

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.4
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• pp.360-365
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• 1999

This study was aimed to suggest to better treatment method of jaw cyst that the maximum diameter was wider than 3cm, using different treatment and clinical and radiographic result. We divided the 60 patients into three groups, group A(20 patients) were treated with cyst enucleation and Decalcified Freeze-Dried Allogeneic Bone(DFDB) graft, group B(20 patients) were treated with cyst enucleation and autogenous bone graft, group C(20 patients) were treated with only cyst enucleation. Each group was evaluated with panoramic radiograph and clinical sign & symptom at pre-op and post-op(immediate, 6, 12, 24, 36 month). Bone density was evaluated with disital densitometer. The result was as follows : 1. Post-Op infection was higher in group C(4 pts.) than in group A(1 pt.) and B(1 pt.) 2. Post-Op gingival recession was higher in group C(3 Pts.) than in group A(1 pt.) and B(1 pt.) 3. Anatomic distortion was higher in group C(3 Pt.) than in group A(1 Pt.), and B(1 pt.) 4. Reoperation was done in two patients who were in group C 5. There were donor site morbidity in two patients 6. There was no significant difference between group A and B in their bony density in their follow up period(p>0.05). 7. There were significant differences between group A, B and group C in their bony density until post-op 24 months but a little differences at post-op 36 months(P<0.01)

• Tuberculosis and Respiratory Diseases
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• v.52 no.1
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• pp.46-53
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• 2002

Background: Pulmonary aspergilloma is relatively common in korea. It arises from the colonization and proliferation of Aspergillus in preexisting lung parenchymal cavities, in particular tuberculosis. The most common symptom in this disorder is hemoptysis, which mayor may not be massive and life threatening. A routine chest radiography and computed tomography (CT) are the most important diagnostic procedures. A surgical resection of the aspergilloma has recently been recommended, because of the relatively low incidence of postoperative complications than in the past. A more concentrated sample of patients with aspergilloma, who either underwent a thoracotomy or tested positive for aspergillus antibodies, were reviewed. Method : The medical records of twenty-two patients with aspergilloma, who had a proven thoracotomy (9 cases), or who tested positive for the diagnostic procedure and/or aspergillus antibodies (13 cases) from January 1995 to December 2000, were reviewed retrospectively. Results : The most common underlying lung disease was a current or old healed tuberculosis, and 3 patients had cultures of mycobacterium other than tuberculosis (MOTT). The mean time until the aspergilloma was detected 5.91 years in the healed tuberculosis cases. The others cases involved a lung abscess, bronchiectasis and without lung disease. The extrapulmonary disease was alcoholism and diabetes. Hemoptysis was most common in 72.7%. A computed tomography (CT) is useful for diagnosis. The right upper lobe, especially the posterior segment, is the most common location. Bronchial artery embolization is ineffective for a long term follow-up. A lobectomy is most common in a thoracotomy, and intra-operative and post-operative complications are rare. During follow-up, the mortality rate, not from the aspergilloma but from respiratory failure, was 13.6%. Conclusion : Aspergilloma is a common cavitary lung disease, It mainly arises from tuberculosis, either current or healed, but extra-pulmonary disease including alcoholism or diabetes are other possible risk factors. Their most common problem in aspergilloma is hemoptysis. Surgery has a low risk of post-operative complications and is recommended in relatively preserved lung function or healthy patients. Medical maneuvers including embolization, and the local insertion of certain materials needs to be studied more closely.

• Pediatric Infection and Vaccine
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• v.4 no.1
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• pp.90-96
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• 1997

Purpose : Recently a shift in hepatitis A incidence from children to adults has been well noted. We experienced under 15-years old 31 patients who presented hepatitis A infection. In order to prepare for the prevention on hepatitis A outbreak in the future, we studied the clinical and epidemiologic manifestations of these patients. Methods : We enrolled patients from July to December in 1996 (6 months) and evaluated the monthly incidence, geographical distribution, age and sex, and clinical manfestations, including laboratory fadings. Results : Many cases of hepatitis A occured in the summer months, especially August (16/31 cases). Most of patients (87%) were living in the Seo-Ku area (northwest district of the city). In age distribution, there were no cases under 3 years of age, 3 cases from 4~5 years, 13 cases from 6~10 years, 15 cases from 11~15 years. Clinical profiles showed that dark urine, nausea and vomiting, anorexia, abdominal pain, fever, and fatigue were the common presenting symptoms. The initial presenting laboratory tests included total bilirubin 3.3mg/dl, alkaline phosphatase of 856units/L, and serum asparate aminotransferase and alanine aminolransferase levels of 910IU/L and 1239IU/L, respectively. No patient presented atypical clinical courses or complications. Conclusions : Hepatitis A in children shows benign clinical features. This study showed that the possibility of another outbreak of Hepatitis A in the TaeJon area or elsewhere in the near future Korea will be possible. To prevent an outbreak we will be concerned about the anti-HAV IgG prevalance rate in children and preventive modalities including vaccination against hepatitis A.

• Korean Journal of Soil Science and Fertilizer
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• v.27 no.2
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• pp.98-104
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• 1994

Effects of paddy-upland rotation system on nutrients distribution in soil profile and nutrient balance were studied in paddy fields from 1989 to 1993. The obtained results are summarized as follows. 1. $NO_3{^-}-N$, Av.$P_2O_5$, Ex.-K, and EC were high by small extent in surface layer of 0~20cm soil depth without the sign of salt movement to deeper layers. On the contrary Ex.-ca, Ex.-Mg, and pH became high with increase of soil depths. 2. $NO_3{^-}-N$, Av.$P_2O_5$, Ex.-K, and EC in surface soil were high in the order of Converted, Paddy-Upland Rotation, Potato-Chinese Cabbage>2 Year, Rotation, Potato-Chinese Cabbage>Converted, Paddy-Upland Rotation, Soybean>Continous Paddy, which responded well to fertilizer application rates. On the other hand Ex.-Ca, Ex.-Mg, and pH in whole layers were high in the order of Converted, Paddy-Upland Rotation, Soybean>Converted, Paddy-Upland Rptation, Potato-Chinese Cabbage>2 Year, Rotation, Potato-Chinese Cabbage>Continuous Paddy, which largely depended on plant absorption. 3. Nutrient balance in upland cropping system cultivating potato and Chinese cabbage showed that the input of chemical fertilizer of nitrogen and potassium was less than the plant uptake, while it was reverse for phosphorus with much gap between fertilizer input and plant uptake. Therefore, phosporous was expected to be accumulated by 27kg/10a every year. 4. Nutrient balance in upland cropping system cultivating soybean showed that nitrogen was not deficient to soybean crops even the chemical fertilizer input was less than plant uptake because of nitrogen fixation by rhizobia. However, there was about 1kg/10a deficit of potassium, which resulted dificiency symptom in the middle stage of soybean growth. For phosphorous there was excess of 4kg/10a, which was expected to be short for maintaining phosphorous fertility of upland soils.