• Journal of Korean Neurosurgical Society
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• v.52 no.2
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• pp.98-102
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• 2012

Objective : To study the clinical significance and relevant factors of radiation-induced intratumoral necrosis (RIN) and peritumoral edema (PTE) after Gamma knife radiosurgery (GKRS) for intracranial meningiomas. Methods : We retrospectively analyzed the data of 64 patients who underwent GKRS for intracranial meningioma. The mean lesion volume was 4.9 cc (range, 0.3-20), and the mean prescription dose of 13.4 Gy (range, 11-18) was delivered to the mean 49.9% (range, 45-50) isodose line. RIN was defined as newly developed or enlarged intratumoral necrosis after GKRS. Results : RIN and new development or aggravation of PTE were observed in 21 (32.8%) and 18 (28.1%) cases of meningioma, respectively during the median follow-up duration of $19.9{\pm}1.0$ months. Among various factors, maximum dose (>25 Gy) and target volume (>4.5 cc) were significantly related to RIN, and RIN and maximum dose (>24 Gy) were significantly related to the development or aggravation of PTE. In 21 meningiomas with development of RIN after GKRS, there was no significant change of the tumor volume itself between the times of GKRS and RIN. However, the PTE volume increased significantly compared to that at the time of GKRS (p=0.013). The median interval to RIN after GKRS was $6.5{\pm}0.4$ months and the median interval to new or aggravated PTE was $7.0{\pm}0.7$ months. Conclusion : A close observation is required for meningiomas treated with a maximum dose >24 Gy and showing RIN after GKRS, since following or accompanying PTE may deteriorate neurological conditions especially when the location involves adjacent critical structures.

• Journal of Korean Neurosurgical Society
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• v.48 no.3
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• pp.263-267
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• 2010

Although cerebellar hemangioblastomas are histopathologically benign, they yield a degree of malignant clinical behavior in long-term follow-up. We present two cases of long-term progression of renal cell carcinoma, which had been diagnosed as renal cysts during treatment for cerebellar hemangioblastoma. A 14-year-old male with von Hippel-Lindau disease was admitted for a cerebellar hemangioblastoma with multiple spinal hemangioblastomas and a renal cyst. After primary total resection of the cerebellar hemangioblastoma, the patient required two further surgeries after 111 and 209 months for a recurrent cerebellar hemangioblastoma. Furthermore, he underwent radical nephrectomy as his renal cyst had progressed to renal cell carcinoma 209 months after initial diagnosis. A 26-year-old male presented with multiple cerebellar hemangioblastomas associated with von Hippel-Lindau disease and accompanied by multiple spinal hemangioblastomas and multiple cystic lesions in the liver, kidney, and pancreas. He underwent primary resect'lon of the cerebellar hemangioblastoma in association with craniospinal radiation for multiple intracranial/spinal masses. Unexpectedly, a malignant glioma developed 83 months after discovery of the cerebellar hemangioblastoma. At the same time, renal cell carcinoma, which had developed from an initial renal cyst, was diagnosed, and a radical nephrectomy was performed. In the view of long term clinical course, cerebellar hemangioblastoma associated with von Hipple-Lindau disease may redevelop even after primary total resection. In addition, associated lesions such as renal cysts may also progress to malignancy after the passing of a sufficient length of time.

• The Journal of Korean Academy of Prosthodontics
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• v.40 no.1
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• pp.79-87
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• 2002

The purpose of this study was to investigate the color stability of composite resins used widely as esthetic restorative material. Surefil(Dentsply, U.S.A.), Esthet X(Dentsply, U.S.A.), Filtek P60(3M, U.S.A.) , Filtek Z250(3M, U.S.A.), Synergy Compact(Coltene, Switzerland), and Synergy Duo(Coltene, Switzerland) were chosen for this study. Thirty six specimens($7mm{\times}2mm$) of each composite resin were fabricated and polished after polymerization. Treatment conditions designed for this study were thermocycling, methylene blue staining, and filtered coffee staining. The color changes before and after treatment were measured by colorimeter(colorimeter, Model Tc-6Fx, Tokyo Denshoku Co.) and analyzed. The followings were drawn from this study: 1. The color changes of Filtek Z250, Surefil, Filtek P60 and Esthet X after thermocycling for 3 weeks were greater than those of the others. 2. The color changes of Surefil and Esthet X after methylene blue stainig and those of Surefil, Filtek Z250 and Filtek P60 after coffee staining were great. 3. The color changes or Synergy Duo and Synergy Compact after thermocycling and coffee staining were relatively lesser than those of other composite resins.

• Journal of the Korean Dietetic Association
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• v.13 no.4
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• pp.357-367
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• 2007

This research was performed to evaluate the effects of nutrition education on food waste reduction at school food service. A dietitian conducted nutrition education on environmental protection and proper eating attitude and poor eating habits for 3rd and 5th graders at an elementary school in Seoul. The effectiveness of the education was evaluated by surveying the students before and after the education; 375 responses were analyzed. A questionnaire was designed to compare changes of the students' attitudes and plate waste before and after education. Plate wastes of boiled black rice(p<0.05), potato soup(p<0.05), amaranthus herb salad(p<0.01), and cabbage kimchi(p<0.05) decreased significantly after education. Students' eating attitudes improved significantly(t= -6.22, p<0.01) after nutrition education. Major reasons the students did not eat all foods they were served were large portion sizes (30.59%), low menu preference (29.79%), and tastes (17.82%). The menus with high plate waste rates were cooked vegetable items (35.64%) and soup items (26.6%). After education, students' attitudes on ‘food waste pollutes the Earth(p=0.013)’, ‘food preparation for birthday parties(p<0.01)’, and ‘restaurant selection for eating out (p<0.01)’ changed significantly. After education, plate waste and portion sizes that the students perceived were not negatively correlated. In conclusion, nutrition education on proper eating habits and source reduction is an effective method to reduce food waste generation and to improve students' eating attitudes and awareness on environment.

• Archives of Plastic Surgery
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• v.40 no.4
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• pp.341-347
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• 2013

Background Intractable chronic scalp ulcers with cranial bone exposure can occur along the incision after cranioplasty, posing challenges for clinicians. They occur as a result of severe scarring, poor blood circulation of the scalp, and focal osteomyelitis. We successfully repaired these scalp ulcers using a vascularized bipedicled pericranial flap after complete debridement. Methods Six patients who underwent cranioplasty had chronic ulcers where the cranial bone, with or without the metal plate, was exposed along the incision line. After completely excising the ulcer and the adjacent scar tissue, subgaleal dissection was performed. We removed the osteomyelitic calvarial bone, the exposed metal plate, and granulation tissue. A bipedicled pericranial flap was elevated to cover the defect between the bone graft or prosthesis and the normal cranial bone. It was transposed to the defect site and fixed using an absorbable suture. Scalp flaps were bilaterally advanced after relaxation incisions on the galea, and were closed without tension. Results All the surgical wounds were completely healed with an improved aesthetic outcome, and there were no notable complications during a mean follow-up period of seven months. Conclusions A bipedicled pericranial flap is vascularized, prompting wound healing without donor site morbidity. This may be an effective modality for treating chronic scalp ulcer accompanied by the exposure of the cranial bone after cranioplasty.

• Archives of Plastic Surgery
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• v.39 no.6
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• pp.655-658
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• 2012

Squamous cell carcinoma infrequently occurs at the soft palate. Although various methods can be used for reconstruction of soft palate defects that occur after resecting squamous cell carcinoma, it is difficult to obtain satisfactory results from the perspective of the functional restoration of the soft palate. A combination of bilateral palatal mucomuscular flap for the oral side and superiorly based posterior pharyngeal flap for the nasal side were performed on two patients who were diagnosed with squamous cell carcinoma of the soft palate in order to reconstruct the soft palate defects after surgical resection. After surgery, the patients were followed-up for a mean period of 11 months. The flaps were well maintained in both patients. The donor site defects were epithelialized and completely recovered. Additionally, no recurrence of the primary sites was shown. Slight hyponasality was observed in the voice assessments that were conducted 6 months after surgery. No food regurgitation or aspiration was observed in the swallowing tests. We used a combination of bilateral palatal mucomuscular flap and superiorly based posterior pharyngeal flap to reconstruct the soft palate defects that occurred after resecting the squamous cell carcinomas. We reduced the donor site complications and achieved functionally satisfactory outcomes.

• Archives of Plastic Surgery
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• v.39 no.6
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• pp.612-617
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• 2012

Background Packing after closed reduction of a nasal bone fracture causes inconvenient nasal obstruction in patients. We packed the superior meatus with Vaseline gauze to support the nasal bone, and packed the middle nasal meatus with a Doyle Combo Splint consisting of an airway tube, a silastic sheet, and an expandable sponge to reduce the inconvenience. In addition, we aimed to objectively identify whether this method not only enables nasal respiration but also sufficiently supports the reduced nasal bone. Methods Nasal ventilation was measured via spirometry 1 day before surgery and compared to 1 day after surgery. To compare support of the reduced nasal bone by the 2 methods, 2 plastic surgeons assessed the displacementon X-rays taken after the surgery and after removing the packing. The extent of nasal obstruction, dry mouth, sleep disturbance, headache, and swallowing difficulty were compared with visual analog scales (VAS) on a pre-discharge survey. Results In the experimental group, the nasal respiration volume 1 day after surgery remained at $71.3%{\pm}6.84%$ on average compared to 1 day prior to surgery. Support of the reduced bone in the experimental group ($2.80{\pm}0.4$) was not significantly different from the control group ($2.88{\pm}0.33$). The VAS scores for all survey items were lower in the experimental group than in the control group, where a lower score indicated a lower level of inconvenience. Conclusions The nasal cavity packing described here maintained objective measures of nasal respiration and supported the reduced bone similar to conventional methods. Maintaining nasal respiration reduced the inconvenience to patients, which demonstrates that this packing method is useful.

• Korean Journal of Health Education and Promotion
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• v.24 no.1
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• pp.63-74
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• 2007

Objectives: This study aimed to evaluate the educational effect of the Field Epidemiology Specialist Training Program for School Nurse which composed of 18hours curriculum. Method: The subjects were 797 who participated in the 2005 training program. Data was collected with structured questionnaires(knowledge on the control of communicable disease 15 items, attitude 15 items, and confidence in practice 14 items, demographic characteristics 4 items) before (January) and after (July to October) programs in 2005. Results: Knowledge on the control of communicable disease was improved from 9.7 points (possible range : 0-15) before program to 11.9 points after program. Attitude was improved from 53.6 points (possible range : 15-60) before program to 55.7 points after program. Confidence in practice was changed from 45.9 points (possible range : 14-56) before program to 50.0 points after program. Even though all three areas were improved after educational program, knowledge showed the largest change among them. Conclusion: We can conclude the educational program was effective because knowledge, attitude, and confidence in practice on the control of communicable were statistically significantly improved after educational program. Further educational program is recommended to be operated to get more improvement in attitude and confidence in practice. And short-term continuing educational program is needed to maintain and refresh the information on the control of communicable diseases in schools.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.3
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• pp.195-199
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• 2013

Pseudoaneurysms are rare complications of orgthognathic surgery, trauma or other surgical procedures in the head and neck regions. Surgical approach is a routine procedure of bleeding control. However, bleeding control using angiography and embolization can also be an excellent method. We experienced pseudoaneurysm of the inferior alveolar artery occurring after surgical curettage of cystic lesion. The 33-year-old man who underwent surgical curettage of keratocystic odontogenic tumor was presented with severe bleeding in the right mandible ramal inner surface 14 days after the surgical curettage. After hemostasis with vaseline gauze packing and pressure, bleeding temporarily stopped. However, bleeding started after 14 days and soon it has been continued. Finally, the patient was diagnosed as pseudoaneurysm of the inferior alveolar artery from the enhanced-computed tomography images, and angiographic embolization was performed successfully. We report a rare case of pseudoaneurysm of the inferior alveolar artery after benign tumor curettage and review of the previewer's literature.

• Restorative Dentistry and Endodontics
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• v.25 no.4
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• pp.550-560
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• 2000

In this study, shear bond strength of two bonding systems were measured and appearance of dentin surfaces were observed with SEM according to the storage time of eugenol on dentin surface, thus evaluated the effect of eugenol on bond strength of two dentin bonding systems. Control groups were directly bonded to dentin surface with One Step, Prime & Bond 2.1. Experimental groups were divided into experimental I and II according to dentin bonding agents. After eugenol application, dentin surfaces were bonded with One Step and Prime & Bond 2.1 according to the each storage time of immediately, 3min, 24hour, 48hour and 1week, and then control and experimental groups were filled with light cured composite resin(Z-100). After 24 hours water storage at $37^{\circ}C$, all samples were subjected to a shear load to fracture at a cross head 1.0mm/min with Instron universal testing machine(No. 4467). Etched dentin surface storaged for each time of immediately, 3min, 24hour, 48hour and 1 week after eugenol application were observed under Scanning Electron Microscope(Hitachi S-2300) at 20kvp. The data were evaluated statistically with two-way ANOVA and Tukey's HSD. The results were as follows; 1. Shear bond strengths were higher in control groups than in the experimental groups. 2. As storage time was increased after eugenol application, the shear bond strengths were decreased in experimental groups. 3. In experimental I, II the shear bond strengths were the lowest in which storage time was 1 week after eugenol application. 4. As storage time was increased after eugenol application, etched dentin surfaces showed obstructed dentinal tubule.