• Archives of Plastic Surgery
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• 제49권1호
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• pp.1-2
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• 2022

• Archives of Plastic Surgery
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• 제49권6호
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• pp.703-703
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• 2022

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제42권2호
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• pp.99-104
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• 2016

Objectives: Submental intubation has been advocated as an alternative to classical tracheostomy for certain indicated panfacial trauma surgeries. Surgeons should have various options for airway management in maxillofacial trauma patients. Most maxillofacial injuries involve occlusal derangements, which might require intraoperative occlusal corrections; hence, orotracheal intubation is not ideal. Maxillofacial surgeons generally prefer nasotracheal intubation; however, in cases with concomitant skull base fracture or nasal bone fracture, nasotracheal intubation might not be suitable; in these situations, tracheostomy is typically performed. However, the possible complications of tracheostomy are well known. Due to trauma situations and to avoid the complications of tracheostomy, submental intubation would be an ideal alternative procedure in selected maxillofacial trauma surgery patients. This study aimed to evaluate the safety and usefulness of a submental intubation technique for panfacial trauma surgery. Moreover, we intended to share our experience of submental intubation and to recommend this simple, safe procedure for certain panfacial trauma surgeries. Materials and Methods: In five panfacial trauma patients, we performed submental intubation for airway management; the mean time required for the procedure was only eight minutes. Results: We were able to execute this procedure safely in a short time without any intraoperative or postoperative complications. Conclusion: Submental intubation is a safe and simple technique for airway management in indicated panfacial trauma surgery patients.

• 정신신체의학
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• 제2권1호
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• pp.98-106
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• 1994

The authors investigated 131 nonpsychiatric physicians' attitudes toward psychiatric consultation, using questionnaires. A comparison was made as regards psychiatric consultation from nonpsychiatric physicians over position(staffs vs. residents) and department(medical vs. surgical). These findings are as follows ; 1) 51.9 percent of nonpsychiatric physicians estimated that less than 30 percent of their patientshadpgychiatricproblems. 2) The percentage of the patients referred for psychiatric consultation were 30 or less than 30 percent 3) Staffs tried to refer their patients to psychiatric department for psychiatric consultation more frequently than residents. 4) Medical physicians tried to refer their patients to psychiatric department for psychiatric consultation more frequently than surgeons. 5) Psychiatric consultation was estimated to be most frequently requested for overt psychiatric symptoms(23.0%) and past history of psychiatric treatment(20.8%). 6) The most frequent causes of not referring to department of psychiatry were found to be the patients' rejection(46.8%) and non-psychiatric physicians' dissatisfaction with the results of consultation (22.2%). 7) Medical physicians tended to explain the reasons for psychiatric consultation more adequately than surgeons. 8) Residents more specifically wrote the reasons for psychiatric consultation on the chart than staffs. The results suggest that staffs are more active in psychiatric consultation than residents, whereas medical physicians are more active than surgeons. Thus, education should be more emphasized for surgeons and residents, especially for the latter for effective consultation-liaison activity. On the other hand, psychiatrists should try to improve nonpsychiatric physicians' dissatisfactions with the results of psychiatric consultations, which will positively change their attitudes toward psychiatric consultation.

• 한국응용약물학회:학술대회논문집
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• 한국응용약물학회 2001년도 추계학술대회 및 정기총회
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• pp.108-108
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• 2001

Axin2/Conductin/Axil and its ortholog Axin are negative regulators of the Wnt signaling pathway, which promote the phosphorylation and degradation of ${\beta}$-catenin. While Axin is expressed ubiquitously, Axin2 mRNA was seen in a restricted pattern during mouse embryogenesis and organogenesis. Because many sites of Axin2 expression overlapped with those of several Wnt genes, we tested whether Axin2 was induced by Wnt signaling. Endogenous Axin2 mRNA and protein expression could be rapidly induced by activation of the Wnt pathway, and Axin2 reporter constructs, containing a 5.6 kb DNA fragment including the promoter and first intron, were also induced. This genomic region contains eight Tcf/LEF consensus binding sites, five of which are located within longer, highly conserved non-coding sequences. The mutation or deletion of these Tcf/LEF sites greatly diminished induction by ${\beta}$-catenin, and mutation of the Tcf/LEF site T2 abolished protein binding in an electrophoretic mobility-shift assay. These results strongly suggest that Axin2 is a direct target of the Wnt pathway, mediated through Tcf/LEF factors. The 5.6 kb genomic sequence was sufficient to direct the tissue specific expression of d2EGFP in transgenic embryos, consistent with a role for the Tcf/LEF sites and surrounding conserved sequences in the in vivo expression pattern of Axin2. Our results suggest that Axin2 participates in a negative feedback loop, which could serve to limit the duration or intensity of a Wnt-initiated signal.

• Asian Pacific Journal of Cancer Prevention
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• 제13권4호
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• pp.1675-1682
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• 2012

Aim: The study aim was to determine the frequency with which women decline clinicians' treatment recommendations and variations in this frequency by age, cancer and service descriptors. Design: The study included 36,775 women diagnosed with early invasive breast cancer in 1998-2005 and attending Australian and New Zealand breast surgeons. Rate ratios for declining treatment were examined by descriptor, using bilateral and multiple logistic regression analyses. Proportional hazards regression was used in exploratory analyses of associations with breast cancer death. Results: 3.4% of women declined a recommended treatment of some type, ranging from 2.6% for women under 40 years to 5.8% for those aged 80 years or more, and with parallel increases by age presenting for declining radiotherapy (p<0.001) and axillary surgery (p=0.006). Multiple regression confirmed that common predictors of declining various treatments included low surgeon case load, treatment outside major city centres, and older age. Histological features suggesting a favourable prognosis were often predictive of declining various treatments, although reverse findings also applied with women with positive nodal status being more likely to decline a mastectomy and those with larger tumours more likely to decline chemotherapy. While survival analyses lacked statistical power due to small numbers, higher risks of breast cancer death were suggested, after adjusting for age and conventional clinical risk factors, (1) for women not receiving breast surgery for unstated reasons (RR=2.29; p<0.001); and (2) although not approaching statistical significance $p{\geq}0.200$), for women declining radiotherapy (RR=1.22), a systemic therapy (RR1.11), and more specifically, chemotherapy (RR=1.41). Conclusions: Women have the right to choose their treatments but reasons for declining recommendations require further study to ensure that choices are well informed and clinical outcomes are optimized.

• 대한전기학회:학술대회논문집
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• 대한전기학회 2006년도 심포지엄 논문집 정보 및 제어부문
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• pp.45-47
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• 2006

Cleft palate is a congenital deformity condition with separation of the two sides of the lip resulting in nose deformity. Evaluation of surgical corrections and outcome assessments for nose deformity due to the cleft lip depends mainly on doctor's subjective judgment. An objective method for evaluation of the condition and surgical outcome of nose deformity due to the cleft palate is needed. This study aimed at objective assessment of a cleft palate nose deformity condition by analyzing the following parameters obtained from photographic images of a cleft palate patients: (1) angle difference between two nostril axes. (2) center of the nostril and distance between two centers. (3) overlapped area of two nostrils, and (4) the overlapped area ratio of the two nostrils. A regression equation of doctor's grades was obtained using the eight parameters. Three plastic surgeons gave us the grades for the each photographic image by 10 increments with maximum grade of 100. The average reproducibility of the grades given by the three plastic surgeons and the three laymen using the developed program was $10.8{\pm}4.6%$ and $7.4{\pm}1.8%$, respectively. Kappa values representing the degree of consensus of the plastic surgeons and the three laymen were 0.43 and 0.83. respectively. Correlation coefficient of the grades evaluated by the surgeons and obtained by the neural network was 0.798. In conclusion. the developed neural network model provided us better reproducibility and much better consensus than doctor's subjective evaluation in addition to objectiveness and easy application.

• Archives of Plastic Surgery
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• 제44권6호
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• pp.490-495
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• 2017

Background Cleft lip and palate repair requires a deep and small surgical field and is usually performed by surgeons wearing surgical loupes. Surgeons with loupes can obtain a wider surgical view, although headlights are required for the deepest procedures. Surgical microscopes offer comfort and a clear and magnification-adjustable surgical site that can be shared with the whole team, including observers, and easily recorded to further the education of junior surgeons. Magnification adjustments are convenient for precise procedures such as muscle dissection of the soft palate. Methods We performed a comparative investigation of 18 cleft operations that utilized either surgical loupes or microscopy. Paper-based questionnaires were completed by staff nurses to evaluate what went well and what could be improved in each procedure. The operating time, complication rate, and scores of the questionnaire responses were statistically analyzed. Results The operating time when microscopy was used was not significantly longer than when surgical loupes were utilized. The surgical field was clearly shared with surgical assistants, nurses, anesthesiologists, and students via microscope-linked monitors. Passing surgical equipment was easier when sharing the surgical view, and preoperative microscope preparation did not interfere with the duties of the staff nurses. Conclusions Surgical microscopy was demonstrated to be useful during cleft operations.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제44권1호
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• pp.25-28
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• 2018

Objectives: This study aimed to describe recent patterns in the types of statistical test used in original articles that were published in Journal of the Korean Association of Oral and Maxillofacial Surgeons. Materials and Methods: Thirty-six original articles published in the Journal in 2015 and 2016 were ascertained. The type of statistical test was identified by one researcher. Descriptive statistics, such as frequency, rank, and proportion, were calculated. Graphical statistics, such as a histogram, were constructed to reveal the overall utilization pattern of statistical test types. Results: Twenty-two types of statistical test were used. Statistical test type was not reported in four original articles and classified as unclear in 5%. The four most frequently used statistical tests constituted 47% of the total tests and these were the chi-square test, Student's t-test, Fisher's exact test, and Mann-Whitney test in descending order. Regression models, such as the Cox proportional hazard model and multiple logistic regression to adjust for potential confounding variables, were used in only 6% of the studies. Normality tests, including the Kolmogorov-Smirnov test, Levene test, Shapiro-Wilk test, and $Scheff{\acute{e}}^{\prime}s$ test, were used diversely but in only 10% of the studies. Conclusion: A total of 22 statistical tests were identified, with four tests occupying almost half of the results. Adoption of a nonparametric test is recommended when the status of normality is vague. Adjustment for confounding variables should be pursued using a multiple regression model when the number of potential confounding variables is numerous.

• Journal of Gastric Cancer
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• 제15권1호
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• pp.29-38
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• 2015

Purpose: Before expanding our indications for laparoscopic gastrectomy to advanced gastric cancer and adopting reduced port laparoscopic gastrectomy, we analyzed and audited the outcomes of laparoscopy-assisted distal gastrectomy (LADG) for adenocarcinoma; this was done during the adoptive period at our institution through the comparative analysis of short-term surgical outcomes and learning curves (LCs) of two surgeons with different careers. Materials and Methods: A detailed comparative analysis of the LCs and surgical outcomes was done for the respective first 95 and 111 LADGs performed by two surgeons between July, 2006 and June, 2011. The LCs were fitted by using the non-linear ordinary least squares estimation method. Results: The postoperative morbidity and mortality rates were 14.6% and 0.0%, respectively, and there was no significant difference in the morbidity rates (12.6% vs. 16.2%, P=0.467). More than 25 lymph nodes were retrieved by each surgeon during LADG procedures. The LCs of both surgeons were distinct. In this study, a stable plateau of the LC was not achieved by both surgeons even after performing 90 LADGs. Conclusions: Regardless of the experience with gastrectomy or laparoscopic surgery for other organs, or the age of surgeon, the outcome was quite acceptable; the learning process differ according to the surgeon's experience and individual characteristics.