• Archives of Plastic Surgery
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• 제40권3호
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• pp.198-202
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• 2013

Background Marjolin's ulcer is known to present a high proportion of recurrence and poor prognosis compared to other kinds of skin cancer. Based on our experience, Marjolin's ulcer patients who have received reconstructive surgery present a higher proportion of recurrence when there was disturbed wound healing after surgery. The impact of disturbed wound healing after surgery on the prognosis was examined in this study. Methods A retrospective study was carried out on 26 patients who were diagnosed with Marjolin's ulcer and received surgery in this hospital from 1996 to 2011. Histologic grading, lymph node metastasis at diagnosis, and the wound healing process were evaluated and chi-squared analysis applied in order to determine the correlation with recurrence. Results The proportion of recurrence increases in patients with a low histologic grade or lymph node metastasis at diagnosis. The proportion of recurrence is even higher when the problem occurs during the wound healing process after surgery. Conclusions Disturbed wound healing after surgery could be used as a sign to quickly identify the recurrence of carcinoma. Therefore, in the event a problem occurs in the wound healing process after surgery, one should keep in mind that this could be a sign of the possibility of recurrence and proceed with careful observation and active diagnosis through additional physical examinations, general X-ray tests, computed tomographys, magnetic resonance imagings, and so on, to obtain an early diagnosis of recurrence.

• Journal of Korean Medical Science
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• 제33권50호
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• pp.326.1-326.10
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• 2018

Background: This retrospective study analyzed the causes of failure in the management process from the identification of brain-dead potential organ donors to actual donation in Korea over the past 5 years. Methods: Data of 8,120 potential brain deaths reported to the Korea Organ Donation Agency were used, including information received at the time of reporting, donation suitability evaluation performed by the coordinator after the report, and data obtained from interviews of hospital medical staff and the donor's family. Results: From January 2012 to December 2016, the total number of brain-dead potential organ donors in Korea was 8,120, of which 2,348 (28.9%) underwent organ procurement surgery with designated recipients. While the number of transplant donors has increased over time, the ratio of transplant donors to medically suitable brain-dead donors has decreased. The common causes of donation failure included donation refusal (27.6%), non-brain death (15.5%), and incompatible donation (11.6%); 104 potential donors (7.8%) were unable to donate their organs because they were not pronounced brain dead. Conclusion: The rate of successful organ donation may be increased by analyzing the major causes of failure in the brain-dead organ donation management process and engaging in various efforts to prevent such failures.

• 대한불안의학회지
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• 제15권2호
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• pp.68-76
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• 2019

Objective : The goal of this study was to investigate the characteristics of early maladaptive schemas (EMSs), and associated neurocognitive functions as seen in visitors for military designation process. Methods : This retrospective study included 111 males aged 18 to 24 years among three groups: 41 visitors for military designation process (VMD), 21 patients with obsessive-compulsive disorder (OCD), and 49 healthy subjects. We collected the results of the Young Schema Questionnaire, Symptom Checklist-90-Revised, three neurocognitive tests as well as their clinicodemographic data. We analyzed the differences in EMSs between these three groups, and the correlations among the identified EMSs and neurocognitive performances within the VMD group. Results : Compared with both the OCD and healthy groups, the evaluation of the VMD group showed significantly higher scores in mistrust/abuse (F=6.4, p=0.002), vulnerability to harm (F=6.6, p<0.0001) and negativity/pessimism schema (F=7.3, p<0.0001), even when controlling for depression scores and levels of education. These three schemas also exhibited significant negative correlations with the score of Stroop test with r ranging from -0.34 to -0.44. Conclusion : These findings suggest that people who are likely to have difficulties adjusting to living in a military life may have psychological vulnerabilities related to certain EMSs. Further studies are warranted to test the clinical potentials of these findings, such as a treatment target and a predictor factor.

• Journal of Oral Medicine and Pain
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• 제45권4호
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• pp.97-109
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• 2020

Purpose: Cervicogenic headache (CGH) is pain referred to the head/ face from the structures in vicinity of upper cervical spinal nerves via trigeminocervical pathway. Ponticulus Posticus (PP) and Elongated Styloid Process (ESP) are anatomical structures that cause compression of vasculature present around upper cervical nerve plexus. Recently, computational fluid dynamics (CFD) has shown to play an essential role in identification of these high-pressure zones in the brain. The aim of this research is to study the association of ESP and PP in patients with CGH and to develop a hypothesis by CFD to analyse vertebrobasilar insufficiency as a contributing factor in occurrence of CGH. Methods: Retrospective analysis of 4500 full skull CBCT scans was done for the presence of partial or complete PP and length of Styloid Process (SP). Research was divided into two phases; In first Preliminary Phase, 150 scans that showed the presence of PP and ESP were analysed, and only 134 patients gave consent to fill the questionnaire containing 96 question items pertaining to symptoms associated with CGH. In the second phase, simulation of Vertebral and Carotid Artery was done using Fluent 14.5 Software and by CFD, pressure distribution on arteries was obtained that helped to identify high pressure regions. Results: Both PP and ESP showed a statistically significant association with CGH (p<0.001). By CFD analysis, both steady and transient phases of simulation showed drop in pressure due to constriction of internal carotid and vertebral artery by ESP and PP respectively and were found to decrease the volume of blood reaching the brain, 0.12 /0.13 mL and 0.06 mL respectively. Conclusions: Our analysis proves ESP and PP as contributing factors towards CGH. Hence for proper diagnosis and management of headache disorders, clinicians should have adequate knowledge about these anatomical structures and their resulting clinical symptoms.

• Archives of Plastic Surgery
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• 제36권5호
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• pp.623-628
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• 2009

Purpose: In cases where nasal fractures involve frontal process of maxilla or perpendicular plate of ethmoid, 4 - 5 days of nasal packing may not provide sufficient support for avoiding displacement after packing removal. Therefore a single Kirschner - wire(K - wire) is used as an internal splint when nasal fractures involve the above two areas. Methods: Thirty five patients during the last 3 practical years were treated with a K -wire pinning according to the anatomic locations of nasal fractures. We performed a retrospective study using 13 nasal fractures out of total 35 patients. Among 13 cases, 10 patients involved frontal process of maxilla, and 3 patients were diagnosed as bilateral nasal side wall fractures accompanied with fractures of perpendicular plate of ethmoid. One patient of the last three cases had been augmented with dorsal silicone implant long before the trauma. We analyzed the anteroposterior displacement of key stone area and the width between both lateral walls by comparing immediate postoperative radiographs with 2 month follow - ups. To reduce the errors, the same measurements were taken by two different inspectors, and the mean of each inspector's measurements was compared. Patient satisfaction was analyzed using a questionnaire regarding the esthetic and functional outcomes. Results: Ten patients underwent a longitudinal K - wire fixation in submucoperiosteal plane underneath the frontal process of maxilla. And three patients underwent a transverse K - wire fixation from the one side of lateral wall to the perpendicular plate of ethmoid and to the other side of lateral wall. The mean postoperative anteroposterior displacement of the key stone area measured by two inspectors were 1.84% and 3.06%; mean narrowing of bony pyramid were 1.33% and 1.48%, respectively. Subjective satisfaction scores regarding the esthetic appearance and the maintenance of nasal shape compared with immediate post - operative state with the long term ones were not different (p>0.05). Conclusion: K - wire pinning after closed reduction is a reliable and useful method for the treatment of nasal fractures involving frontal process of maxilla or perpendicular plate of ethmoid. This is because it achieves longer intranasal support after reduction. This method also leaves conspicuous external scar, and minimal soft - tissue injury.

• Radiation Oncology Journal
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• 제31권2호
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• pp.88-96
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• 2013

Purpose: This study identifies accident sequences from the past accidents in order to help the risk analysis application to the external radiotherapy. Materials and Methods: This study reviews 59 accidental cases in two retrospective safety analyses that have collected the incidents in the external radiotherapy extensively. Two accident analysis reports that accumulated past incidents are investigated to identify accident sequences including initiating events, failure of safety measures, and consequences. This study classifies the accidents by the treatments stages and sources of errors for initiating events, types of failures in the safety measures, and types of undesirable consequences and the number of affected patients. Then, the accident sequences are grouped into several categories on the basis of similarity of progression. As a result, these cases can be categorized into 14 groups of accident sequence. Results: The result indicates that risk analysis needs to pay attention to not only the planning stage, but also the calibration stage that is committed prior to the main treatment process. It also shows that human error is the largest contributor to initiating events as well as to the failure of safety measures. This study also illustrates an event tree analysis for an accident sequence initiated in the calibration. Conclusion: This study is expected to provide sights into the accident sequences for the prospective risk analysis through the review of experiences.

• 영어어문교육
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• 제17권2호
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• pp.219-245
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• 2011

This case study aims to investigate how a primary English teacher's professional development was pursued through novice teacher mentoring after the six-month intensive in-service teacher training program(IIETTP). The teacher was involved in mentoring two novice teachers working at the same school. They observed each other's classes and exchanged their views on the classes, focusing on areas to be improved. The observation was done within a framework that consisted of pre-, during- and post-observation sessions. Data was gathered through retrospective entries kept after the post-observation meetings. The entries were categorized according to their saliency, frequency and recurring patterns identified. The findings reveal that learning from the training course could be applied professionally and could serve to bridge the gap between training and teaching. It is also shown that the mentee teachers' professional development was enhanced and the mentor teacher herself benefited from the collaborative learning process involved with working with the novice teachers. Some suggestions are made for the effective implementation of school-based teacher development programs after the IIETTP.

• Advances in pediatric surgery
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• 제13권1호
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• pp.1-12
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• 2007

Biliary atresia (BA) is the result of fibrosing destructive inflammatory process affecting intrahepatic and extrahepatic bile ducts, which lead to cirrhosis and portal hypertension. Kasai portoenterostomy has been the standard operative procedure in biliary atresia. Recently, there has been remarkable increase in the survival rate in cases of BA. However, long-term survivors are not clearly evaluated in Korea. To define long-term prognosis factors of patients who underwent surgery for BA, a retrospective study was undertaken of 10 (37 %) patients surviving more than 10 years among 27 patients who underwent one of Kasai procedures between 1981 and 1995. Hepatomegaly was present in 4 and splenomegaly in 7 patients. Serum bilirubin was normalized at 1 year after operation. Aspartate aminotransferase (AST, GOT), Alanine aminotransferase(ALT, GPT) were normalized at 12 years and alkaline phosphatase(ALP) was normalized at 13.5 years. Cholangitis developed mainly within 5 years after operation so close follow up is needed. Life long follow-up is needed because of progressive deterioration of liver function even after 10 years.

• 한국과학교육학회지
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• 제32권8호
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• pp.1269-1280
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• 2012

The purpose of this study is to analyze the verbal interaction during elementary students' hypothesis generation learning. For this study, 32 6th graders were selected and were assorted into heterogeneous small-groups by achievement levels. The topics of hypothesis generation learning were developed by analyzing the current elementary school curriculum. Each group's verbal interactions were audio/video taped and transcribed. After coding the protocol and having student retrospective interview, types and frequency of verbal interaction were analyzed. The frequency of verbal interaction during observation was highest and that of questioning situation identification was lowest. Regarding to the quality of verbal interactions, low level interactions were significantly frequent during observation. On the other hand, hypothetical explicans generation revealed high frequency of high level interactions. The results revealed that elementary students can make high level verbal interactions through hypothesis generation learning.

• Nuclear Engineering and Technology
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• 제33권6호
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• pp.626-637
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• 2001

A series of study on energy dependence in chemiluminescence dosimetry with sugar and sorbite produced in two different countries was carried out administering a dose of 5 Gy to the samples at six different mean photon energies of 30, 50, 80, 130, 662 and 1250 keV. The results revealed distinct energy dependence of chemiluminescence(CL) output of sugar and sorbite. Although the energy dependence, in general, could be fitted by a polynomial of (os E, with I being radiation energy, up to cubic term, we reached a conclusion that the adoption of a fitting function, $y_{R}$$^{=a}$.(1-e $^{-b.logE}$)$^{c}$ +d, deduced from theoretical energy response curve calculated as the ratio of the mass energy absorption of the samples of interest to the soft tissue is more reasonable and rational. Herecoefficients $y_{R}$ is CL intensity, and a, b, c and d are constants to be determined in the fitting process. Energy dependence of relative sensitivities of one sample to the other, discrepancy in sensitivities of the samples from the two countries, and prominent grain size effect in Sorbitol were also shown.shown.