• 대한두개안면성형외과학회지
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• 제24권1호
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• pp.37-40
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• 2023

Penetrating wounds to the face are cosmetically devastating and can be life-threatening. If the foreign body causing the penetrating wound is a piece of wood, small remnants might be left behind after the initial treatment. A 33-year-old male patient presented to the emergency center after a piece of lumber pierced his face as a passenger in a traffic accident. The patient's vital signs were stable, and emergency surgery was performed to remove the foreign body and repair the soft tissue. No noteworthy complications were seen after open reduction and internal fixation of the facial bone fractures. Seven months after the accident, the patient underwent scar revision along with full-thickness skin grafting for post-traumatic scars. After the surgery, pus-like discharge which was not previously present was observed, and the graft did not take well. A residual foreign body, which was the cause of graft failure, was found on computed tomography and the remaining foreign body was removed through revision surgery. The patient is receiving outpatient follow-up without any complications 6 months after surgery. This case demonstrates the importance of performing a careful evaluation to avoid missing a residual foreign body, especially if it is of wooden nature.

• 치위생과학회지
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• 제23권1호
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• pp.1-12
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• 2023

Background: This study aimed to identify the present level and needs of clinical dental hygienists and to present the Borich needs assessment and the locus for focus model as integrated priorities. Methods: The participants of this study were dental hygienists working in dental clinics (hospitals). The final data of the 194 participants were analyzed using frequency analysis and a paired sample t-test. To analyze the need for clinical dental hygienists to perform work, the Borich priority determination formula was used. The x-y plane consisting of four quadrants was used to analyze the need using the locus for focus model, which helps to determine the priority while showing visual effects. Results: "Scaling" was the highest required level for clinical dental hygienists, and "panorama taking" was the highest present level. The priorities of educational needs were systematically and visually derived from dental hygienists who were currently working through the Borich needs assessment and the locus for focus model for each task performed in the clinical field. Through the priorities of these two models, a total of 13 items appeared in the common high-level area; "oral health care (disability)," "oral health care (systemic disease)," "applying a rubber dam," "professional mechanical tooth cleaning," "root planing," "taking vital signs," "medication counseling," "wire cutting," "removing cement after removing band/bracket," "delivering bracket," "preparing mini-screw implantation," "dental insurance claim," and "patient reception." Conclusion: Based on the results, the department of dental hygiene should maintain and improve the standardized clinical practice curriculum and clinical dental hygienists' practical skills and contribute to the realization of the legal scope of dental hygienists, reflecting the requirements of clinical fields.

• 대한한방내과학회지
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• 제44권5호
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• pp.1050-1061
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• 2023

This study reported the case of a patient with quadriparesis due to cerebral aneurysm rupture, subarachnoid hemorrhage, and intraventricular hemorrhage (IVH) treated with Korean medicine. The patient was treated with acupuncture, herbal medicine (mainly Tonggyuhwalhyeol-tang-gagam), Western medicine, moxibustion, cupping, and rehabilitative therapy for 75 days, and improved after administration. After treatment, the Manual Muscle Test grade improved from 4/4-/3+/3 to 4+/4+/4+/4+, the Korean version of the modified Barthel Index score improved from 9 to 100, the National Institute of Health's Stroke Scale score improved from 2 to 0, the Global Deterioration Scale score improved from 3 to 2, and the Korean version of the Mini-Mental State Examination score improved from 22 to 30. During administration, the patient did not show seizures, shock, or loss of consciousness, and the vital signs were stable in the normal range. We followed up the brain computed tomography findings for 2 times and found that there was no definite evidence of intracranial hemorrhage or IVH or re-rupture or rebleeding after Korean medicine treatment. This study suggests that Korean medicine treatment with blood-invigorating and stasis-removing herbs could be a safe and effective intervention option for improving quadriparesis due to cerebral aneurysm rupture and subarachnoid hemorrhage.

• 문화기술의 융합
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• 제9권5호
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• pp.909-917
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• 2023

기호학 이론은 현실주의 영화의 해석에 있어 매우 중요한 역할을 수행한다. 현실주의 영화는 현실 생활의 사건과 상황을 반영하는데 집중하며, 사실적인 묘사를 통해 관객에게 현실의 문제를 생각하도록 한다. 이 과정에서, 기호학 이론은 영화 속의 상징적인 요소와 그 배후에 함축되어 있는 깊은 의미를 해석할 수 있도록 유도한다. 본 연구는 리얼리즘 영화에 나타난 기호학적 특징을 소쉬르의 기의와 기표의 개념을 통해 접근하고, 특히 영화의 기호에 나타난 임의성과 2급 기호 체계(언어체계+신화 체계)가 영화의 기호적 함의와 영화의 문화적 의의에 작용하는 과정을 분석하고자 하였다. 그리고 <도가니>의 사례에서 적용되는 과정을 살펴봄으로써 영화 속의 함축적인 서사 구조, 의미 구조, 이데올로기가 사회를 반영하는 대중문화 속에서 드러내는 영향과 효과를 연구하고자 하였다. 연구를 통해 영화의 기호가 전달하고자 하는 잠재적 정보의 다채로운 가능성을 볼 수 있었으며, 기호학을 통해 창의적 견해와 해석을 가능성을 볼 수 있었다.

• 대한영상의학회지
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• 제82권1호
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• pp.244-249
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• 2021

52세 여자 환자가 호흡곤란을 주소로 내원하였다. 환자는 2개월 전에 침습성 흉선종으로 광범위 흉선절제술을 받았다. 전산화단층촬영에서는 양측 폐에 수많은 소결절들이 발견되었다. 급성 호흡곤란 증후군이 악화되어 혈관외과의는 정맥-정맥 체외막산소공급(extracorporeal membrane oxygenation; 이하 ECMO)을 계획하였다. 왼쪽 대퇴동맥을 통해 경피적 삽관술을 시행하는 도중에 혈관외과의는 혈관 손상을 의심하였고 환자의 활력 징후가 불안정해졌다. 8일 전에 촬영한 복부 컴퓨터단층촬영에서 May-Thurner 증후군이 있었고, 이후 시행한 혈관조영술에서 좌측 총장골정맥의 파열이 발견되어 stent-graft를 삽입하여 출혈을 멈추었다. 8일 전 시행된 복부 전산화단층촬영을 확인해 보니 May-Thurner 증후군이 있었다. 이에 May-Thurner 증후군 환자에서 ECMO 삽관으로 인한 혈관 손상이 발생하여 스텐트 삽입술을 시행하였던 드문 증례를 보고하고자 한다.

• Journal of Veterinary Science
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• 제25권3호
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• pp.38.1-38.16
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• 2024

Importance: Deaths due to neonatal calf diarrhea are still one of the most critical problems of cattle breeding worldwide. Determining the parameters that can predict diarrhea-related deaths in calves is especially important in terms of prognosis and treatment strategies for the disease. Objective: The primary purpose of this study was to determine mortality rates and durations, survival status, and predictive prognosis parameters based on vital signs, hematology, and blood gas analyses in neonatal diarrheic calves. Methods: The hospital automation system retrospectively obtained data from 89 neonatal diarrheic calves. Results: It was found that 42.7% (38/89) of the calves brought with the complaint of diarrhea died during hospitalization or after discharge. Short-term and long-term fatalities were a median of 9.25 hours and a median of 51.50 hours, respectively. When the data obtained from this study is evaluated, body temperature (℃), pH, base excess (mmol/L), and sodium bicarbonate (mmol/L) parameters were found to be lower, and hemoglobin (g/dL), hematocrit (%), lactate (mmol/L), chloride (mmol/L), sodium (mmol/L) and anion gap (mmol/L) parameters were found to be higher in dead calves compared to survivors. Accordingly, hypothermia, metabolic acidosis, and dehydration findings were seen as clinical conditions that should be considered. Logistic regression analysis showed that lactate (odds ratio, 1.429) and CI^- (odds ratio, 1.232) concentration were significant risk factors associated with death in calves with diarrhea. Conclusions and Relevance: According to the findings obtained from this study, the determination of lactate and Cl^- levels can be used as an adjunctive supplementary test in distinguishing calves with diarrhea with a good prognosis.

• Journal of Acupuncture Research
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• 제41권2호
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• pp.107-114
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• 2024

Background: Low back pain (LBP) is a common musculoskeletal disorder worldwide, with a lifetime prevalence of up to 80%. Among nonsurgical treatments for chronic LBP, Korean medicine treatments are highly preferred, and pharmacopuncture therapy combining acupuncture and herbal medicine is widely used. However, no evidence-based study has focused on the use of various types of pharmacopuncture. Methods: The pragmatic randomized controlled clinical trial will include 44 participants; recruitment will start in July 2023. All participants will receive integrated Korean medicine treatment including acupuncture, cupping, and infrared therapy, and the intervention group will also receive pharmacopuncture. After 16 treatment sessions, twice a week for 8 weeks, follow-up assessments will be performed at week 9. As a pragmatic randomized controlled clinical protocol, the type, dose, and acupoints of acupuncture and pharmacopuncture are not determined in advance but are selected and recorded according to the clinical judgment of the Korean medicine doctor. Results: The primary outcome will be measured using a visual analog scale score, and the secondary outcomes include the Oswestry disability index, patient global impression of change, no worse than mild pain, and range of motion. Safety will be assessed by examining participants' self-reported adverse events and vital signs and conducting blood tests before and after the test. Conclusion: This study aims to provide clinical evidence of the effectiveness and safety of pharmacopuncture for chronic LBP.

• 대한두개안면성형외과학회지
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• 제25권2호
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• pp.71-76
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• 2024

Background: The rising incidence of dialysis-dependent end-stage renal disease (ESRD) has underscored the need for collaboration between plastic surgeons and nephrologists, particularly concerning preoperative and postoperative management for facial reconstruction. This collaboration is essential due to a scarcity of comprehensive information in this domain. Methods: A study initiated in January 2015 involved 10 ESRD cases on dialysis undergoing Mohs micrographic surgery for facial skin cancer, followed by reconstructive surgery under general anesthesia. To ensure surgical safety, rigorous measures were enacted, encompassing laboratory testing, nephrology consultations, and preoperative dialysis admission. Throughout surgery, meticulous control was exercised over vital signs, electrolytes, bleeding risk, and pain management (excluding nonsteroidal anti-inflammatory drugs). Postoperative assessments included monitoring flap integrity, hematoma formation, infection, and cardiovascular risk through plasma creatinine levels. Results: Adherence to the proposed guidelines yielded a notable absence of postoperative wound complications. Postoperative plasma creatinine levels exhibited an average decrease of 1.10 mg/dL compared to preoperative levels, indicating improved renal function. Importantly, no cardiopulmonary complications or 30-day mortality were observed. In ESRD patients, creatinine levels decreased significantly postoperatively compared to the preoperative levels (p< 0.05), indicating favorable outcomes. Conclusion: The consistent application of guidelines for admission, anesthesia, and surgery yielded robust and stable outcomes across all patients. In particular, the findings support the importance of adjusting dialysis schedules. Despite the limited sample size in this study, these findings underscore the effectiveness of a collaborative and meticulous approach for plastic surgeons performing surgery on dialysis-dependent patients, ensuring successful outcomes.

• 대한소아치과학회지
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• 제35권3호
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• pp.427-436
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• 2008

진정법을 이용한 소아환자의 치과치료 시 chloral hydrate와 hydroxyzine을 복용 후 추가로 midazolam을 비점막내로 분무하는 것과 구강 점막 하로 주사했을 때 행동 반응과 진정 효과에 대해 비교하고자 하였다. 미국 마취과학회 신체등급 I급 (ASAI)이며, 협조가 안 되는 24-72 개월 소아 환자 중 진정법을 통해 2개 치아 이상의 보존 치료 및 발치 치료를 받은 33명을 대상으로 하였다. 모든 환자는 chloral hydrate 50 mg/kg 와 hydroxyzine 1 mg/kg 복용하였다. 45분 후 한 군은 비강내로 midazolam 0.2 mg/kg 을 추가 투여하였고 다른 군은 구강 점막 하 midazolam 0.2mg/kg 을 주사하였다. 치료하는 동안 두 군 모두 50 % nitrous oxide 를 유지하였다. 맥박 산소 계측기와 호기말 이산화탄소 분압 측정기를 이용하여 산소 포화도, 맥박수, 호흡수, 호기말 이산화탄소 분압을 기록하였다. 행동 반응은 Quiet(Q), Crying(C), Movement(M) 그리고 Struggling(S)를 이용하여 총 40분 동안 매 2분마다 기록하고 모든 진정 치료 과정은 비디오로 촬영하였다. 모든 자료는 chi-sqaure test와 two sample independent t-test를 사용하여 분석하였다. 두 군간의 평균 도입 시간과 최대 치료 시간은 통계학적으로 유의한 차이가 없었다. 또한 활력 생징후도 모두 정상 범위이며 두 군 사이에 통계학적으로 유의한 차이가 없었다. 행동 반응 비교에서는 치료 시작 10분 동안 비강내 투여 군이 점막 하 투여 군보다 개선된 행동 반응을 보였다(P<0.05). 치료 시작 10분 이후에는 두 군사이의 행동 반응에서 유의한 차이가 없었다. 이 연구는 chloral hydrate 와 hydroxyzine 복용 후 nitrous oxide 50%로 유지하는 진정법에 비강내로 midazolam을 추가 투여하는 것은 점막 하로 추가 투여와 유사한 진정 효과를 가진다. 또한 비강내 midazolam 추가 투여하는 것은 구강 점막 하로 추가 투여의 장점을 가지면서도 비침습적이고 상대적으로 통증이 적다는 이점이 있다. 그러므로 비강내 midazolam 추가 투여는 침습적인 구강 점막 하 추가 투여를 대체할 만한 방법이다.

• 한국임상수의학회지
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• 제26권6호
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• pp.568-573
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• 2009

개에서 구강 수술 시에 있어서, xylazine 또는 전침 진통을 적용시의 진통효과를 측정하기 위하여 본 연구를 실시하였다. Glucose (GLU), serum alanine aminotransferase (ALT), 및 blood urea nitrogen (BUN) 혈액화학치의 변화와 Vital signs (호흡수, 맥박수, 심박수) 그리고 통증 반응에 대한 영향을 알아보았다. 8마리의 건강한 2년령의 잡종개를 사용하였으며, 각 4마리씩 무작위로 선별하여 xylazine 또는 전침 군에 배정하였다. Xylazine 군의 개는 체중이 3.6${\pm}$1.0 kg 이었으며, xylazine 1.5 mg/kg을 근육주사 하였으며, 전침 군의 개는 체중이 3.9${\pm}$1.0 kg 이었으며, 최초 5분 동안은 1 volt (10-15 hz)를 적용하였고, 그 이후에는 1-9 Volts (25-30 hz)를 유지시켜서 총 60 분의 전침을 적용하였으며, 사용된 경혈은 삼간 (LI-3), 합곡 (LI-4) 및 하관(ST-7) 이었다. 모든 개들은 약물 처치 또는 전침 실행에 있어서, 투여 전 및 투여 후10, 25, 40, 55 및 120분에 검사하였다. 전침 군의 평균 직장체온은, 투여 후 25, 40 및 55분에 있어서 xylazine 군에 비하여 유의성 있게 높은 결과를 나타내었다 (p < 0.05). 전침군의 평균 심박수는, 투여 후 10, 25, 40 및 55분에 있어서 xylazine 군에 비하여 유의성 있게 높은 결과를 나타내었다 (p < 0.05). 전침 군의 평균 호흡수는, 투여 후 55 및 120분에 있어서 xylazine 군에 비하여 유의성 있게 높은 결과를 나타내었다 (p < 0.05). 전침군의 평균 GLU는, 투여 후 55 및 120분에 있어서 xylazine 군에 비하여 유의성 있게 낮은 결과를 나타내었다. (p < 0.05). 전침 군의 평균 통증지수 총계는, 투여 후 10, 25, 40 및 55분에 있어서 xylazine 군에 비하여 유의성 있게 높은 결과를 나타내었다 (p < 0.05). 전침 군의 진통이 xylazine 군에 비하여 더욱 양호 하였다. 침술 유도된 외과적 진통과 관련된 어떠한 부정적인 생리학적 영향도 나타나지 않았다. 따라서, 허약한 환자에서 구강의 소 수술에 있어서, 이들 경혈을 사용한 전침 진통은 유용할 것으로 생각된다.