• Journal of Yeungnam Medical Science
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• 제36권3호
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• pp.163-182
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• 2019

The primary function of intraoperative frozen consultation is to provide an as accurate and prompt diagnosis as possible during surgery and to guide the surgeon in further management. However, the evaluation of frozen section (FS) is sometimes difficult because of suboptimal tissue quality and frozen artifacts compared with routinely processed tissue section. The pathologist responsible for the FS diagnosis requires experience and good judgment. Ovarian tumors are a heterogeneous group of tumors including primary surface epithelial tumors, germ cell tumors and sex cord-stromal tumors, secondary tumors, and other groups of tumors of uncertain histogenesis or nonspecific stroma. Intraoperative FS is a very important and reliable tool that guides the surgical management of ovarian tumors. In this review, the diagnostic key points for the pathologist and the implication of the FS diagnosis on the operator's decisions are discussed.

• Archives of Plastic Surgery
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• 제50권2호
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• pp.220-221
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• 2023

Microsurgical peripheral nerve repair is a technical and challenging procedure that requires thorough training prior to a real-life operating theater scenario. While the gold standard in training remains training on biological living peripheral nerve specimen, various inanimate models of nerve repair simulation have been described in the past years. The textile elastic band (TEB) obtained from a surgical mask was either covered with a fine silicone sheath or was left bare and was used afterward for end-to-end coaptation. The average diameter of the TEB was 2 mm, similar with the nerves in the distal hand and can be easily crafted out of accessiblematerials such as a surgicalmask and silicone sealant. The silicone that covers the TEB offers more fidelity to the simulation for microsurgical nerve coaptation. The TEB model offers an affordable, available, and easy-to-craft alternative to the existing models for peripheral nerve repair simulation and serves as a good initiation tool before moving on to biological specimens.

• 한국정보처리학회:학술대회논문집
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• 한국정보처리학회 2009년도 춘계학술발표대회
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• pp.155-156
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• 2009

In this paper we present 3D image analysis of liver and blood vessels using MDCT. The purpose is to enhance the performance of clinician in assessing anatomical information of liver and blood vessels. The system consists of two parts: 3D image reconstruction and analysis of the 3D liver and blood vessel image. The central vein of the liver is the most important blood vessel for the liver transplantation. We will find the central vein's location and characteristic, and will scheme out a computer assistant liver transplantation planning. It will be an effective tool for interventional radiology, surgical planning, and quantitative diagnosis.

• Journal of Trauma and Injury
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• 제36권4호
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• pp.411-415
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• 2023

An odontoid process fracture is a serious type of cervical spine injury. This injury is categorized into three types based on the location of the fracture. Severe or even fatal neurological deficits can occur due to associated cord injury, which can result in complete quadriplegia. Computed tomography is the primary diagnostic tool, while magnetic resonance imaging is used to evaluate any associated cord injuries. These injuries can occur either directly from the injury or during transportation to the hospital if mishandled. There are two main treatment approaches: surgical fixation or external nonsurgical fixation, with various types and models of fixation devices available. In this case study, computed tomography follow-up confirmed that external fixation can yield successful results in terms of complete healing, even in cases complicated by other factors that may impede healing, such as pregnancy.

• 간호행정학회지
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• 제1권1호
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• pp.132-146
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• 1995

Even though Korean medical law stipulates that number of patients attended by a nurse is 2.5 for hospitalization and 30 for ambulatory care, the number of patients cared by a nurse per day is much greater than the standard prescribed by the medical law. Current productivity of nurses is not desirable unless the quality of care is considered. And nursing manpower staffing based on neither current nurses' productivity nor standard of medical law cannot respond properly to dynamic situation of the medical services. Under this background, the necessity of more efficient management of nursing manpower occupying 1/3 of total hospital workers has been recognized by many nursing administrators. Many nursing researchers have studied to foretell the nursing manpower objectively on the basis of measured nursing workload according to patient classification as well. Most of These researches, however, have been conducted in the tertiary hospitals, so it is imperative to conduct other researches to predict necessary nursing manpower in the secondary and the primary hospitals. The study was performed to measure nursing workload and predict pertinent nursing manpower to a secondary hospital with 400beds. Nursing workload was surveyed using measuring tool for direct and indirect care hours in a surgical unit and a medical unit. Survey was conducted from Sep.10 to Sep.16 and from Oct.5 to Oct.11, 1994 respectively by two skilled nurses, Subjects were patients, patients' family members and nursing personnels. Results are follows : 1. Patient classification distributed as 22% of class I (mildly ill patient), 57% of class II (moderately ill patient), and 21% of class III (acutely ill patient) in the medical nursing unit, while 23% of class I, 29% of class II, 12% of class III, and 36% of classIV (critically ill patient) in the surgical nursing unit. There was no difference of inpatient number between weekday and weekend. Bed circulation rate was 89% in both units and average patients number per day was 37.4 (total 42beds) in the medical nursing unit, 32.9 (total 37beds) in the medical nursing unit. 2. Direct care hours per day measured as 2.8hrs for class I, 3.3hrs for class II, and 3.5hrs for class III in the medical nursing unit, while 3.1hrs for class I, 3hrs for class II, 2.7hrs for class III, and 2.2hrs for classIV in the surgical nursing unit. Meanwhile, hours for nursing assistant activities per patient by patients' family members were 11mins and 200mins respectively. Direct care hour rate by shift was day 36%, evening 25%, and night 39% in the medical nursing unit, while 40%, 29%, and and 31% respectively in the surgical nursing unit. 3. Measurement and observation activity held 44.2% of direct care activities of nurses and medication 36.7%, communication 11.7%, exercise 1.8%, treatment 1.3%, hygiene 1.3%, elimination and irrigation 1.1%, suction 1%, nutrition 0.5%, thermotherapy 0.3%, oxygen therapy 0.1% in order. 4. Indirect care hours per day were 294.2mins in the medical nursing unit, and 273.9mins in the surgical nursing unit. By shift, evening was the highest in both units. Indirect care hours for each patient were 44.5mins in the medical nursing unit and 46mins in the surgical nursing unit. 5. checking activities including doctor's order, medication, and delivering patients to the next shift occupied 39.7% of indirect care activities, and preparation 26%, recording 23.8%, communication and conference 6.7%, managing equipments 2.1%, messenger activity 1.7% in order. 6. On the ground of these results, nursing manpower needed in a secondary hospital was estimated ; 27 nursing personnels for the medical nursing unit of 37beds, and 20 nursing personnels for the surgical nursing unit of 33beds.

• 대한임상검사과학회지
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• 제41권1호
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• pp.1-5
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• 2009

The Platelet Function Analyzer (PFA)$^{(R)}$-100 measures the ability of platelets activated in a high-shear environment to occlude an aperture in a membrane treated with collagen and epinephrine (CEPI) or collagen and ADP (CADP). The time taken for the flow across the membrane to stop (closure time, CT) is recorded. The aim of this study was to assess the potential of the PFA$^{(R)}$-100 as a primary clinical screening tool using the wide spectrum of clinical samples assessed for platelet function as well as to perform the optimal algorithm for the use of PFA$^{(R)}$-100. We established the reference interval in 460 hospital inpatients defined as having normal platelet function based on classical laboratory tests. The reference interval by using the range $5^{th}$ and $95^{th}$ percentile was 84~251 seconds for males CEPI-CT and 85~249 seconds for females CEPI-CT. A total of 1,200 inpatients were enrolled to identify impaired hemostasis before surgical interventions. The abnormal group showing prolonged CEPI-CT was 303 cases (18.9%). Only 3 cases had both abnormal CEPI-CT and CADP-CT. Several factors including sample errors, drugs, hematologic abnoralities were contributed to unexpected prolonged CEPI-CT for screening test. The von Willebrand factor (vWF:Ag) assay was performed only in one patient to verify the algorithm for the use of PFA$^{(R)}$-100. The PFA$^{(R)}$-100 was sensitive and rapid method for primary screening test of platelet dysfunction, so we can substitute it for the bleeding time in routine clinical practice.

• 대한두경부종양학회지
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• 제16권1호
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• pp.46-51
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• 2000

Objectives: Primary malignant tumors in the salivary glands are relatively rare. Because of the rarity and the different histopathologic patterns, it is difficult to establish a uniform treatment strategy. The prime treatment of salivary gland malignancy is the surgery, but the role of radiotherapy has been under debate. Radiation therapy combined with conservative surgical procedures may be as successful and perhaps more rational treatment than radical surgery alone. The aim of this study is to evaluate clinical pattern, incidence, treatment modality and outcome of the salivary gland maligancy. Materials and Methods: The medical records of 32 patients with malignant neoplasm of salivary gland who treated at the Keimyung university Dongsan hospital were analyzed retrospectively. Results: The overall 5 year survival rate was 77.9% stage I : 100%, stage II : 75%, stage III : 66.7%, stage IV : 55.6%). The 5 year survival rate according to tumor grade was 100% in low grade malignancy, 71.8% in high grade malignancy. The 5 year survival rate according to treatment modalities was as follows: Surgery only group was 83.3%, combined treatment group with surgery and posoperative radiation was 74.6%. Conclusion: The factors affecting prognosis is variable, but the stage at the time of diagnosis, site of lesion, tumor grade, histologic subtype were important factors. Surgery was the prime treatment tool and postoperative radiotherapy was also imperative in higher stage patient, high grade tumor, or patients with positive surgical margin.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제38권
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• pp.47.1-47.8
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• 2016

Background: The paradigm of tonsillectomy has shifted from a treatment of recurrent throat infection to one of multi-discipline management modalities of sleep-disordered breathing (SDB). While tonsillectomy as a treatment for throat problems has been performed almost exclusively by otorhinolaryngologists, tonsillectomy as a part of the armamentarium for the multifactorial, multidisciplinary therapy of sleep-disordered breathing needs a new introduction to those involved in treating SDB patients. This study has its purpose in sharing a series of tonsillectomies performed at the Seoul National University Dental Hospital for the treatment and prevention of SDB in adult patients. Methods: Total of 78 patients underwent tonsillectomy at the Seoul National University Dental Hospital from 1996 to 2015, and 23 of them who were operated by a single surgeon (Prof. Jin-Young Choi) were included in the study. Through retrospective chart review, the purpose of tonsillectomy, concomitant procedures, grade of tonsillar hypertrophy, surgical outcome, and complications were evaluated. Results: Twenty-one patients diagnosed with SDB received multiple surgical procedures (uvulopalatal flap, uvulopalatopharyngoplasty, genioglossus advancement genioplasty, tongue base reduction, etc.) along with tonsillectomy. Two patients received mandibular setback orthognathic surgery with concomitant tonsillectomy in anticipation of postoperative airway compromise. All patients showed improvement in symptoms such as snoring and apneic events during sleep. Conclusions: When only throat infections were considered, tonsillectomy was a procedure rather unfamiliar to oral and maxillofacial surgeons. With a shift of primary indication from recurrent throat infections to SDB and emerging technological and procedural breakthroughs, simpler and safer tonsillectomy has become a major tool in the multidisciplinary treatment modality for SDB.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제25권4호
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• pp.304-310
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• 1999

This study was designed to find the effect of Minocycline loaded microcapsule applied locally to tissue by measuring drug concentration in tissue and serum by HPLC and to achieve optimal drug delivery system and duration to a specific target site. Control group were administrated minocycline intramuscularly twice a day with $0.2{\mu}g/100g$ for 1 to 10 days. In experimental group, surgical wound was created on Rt. cheek and then minocycline loaded microcapsule was applied into the space between superficial and deep layer of masseter muscle. Animals were sacrificed at 1, 3, 5, 7, 10 days after initial administration, blood was obtained from heart and right masseter muscle was excised. Blood sample was centrifuged at 3000rpm for 15min. Tissue sample was homogenized, left at room temperature for 48hr and centrifuged at 4000g for 5min. Supernatant was completely dried and dissolved in distilled water. Analysis was conducted using a ${\mu}Bondapack$ C18 column. The mobile phase was 0.2M Ammonium Oxalate/0.1M EDTA/DMF=11/4/5 solution, which was injected into the column and detected with photodiode detector at 344nm wavelength. The results were as follows : 1. This method was reliable, could be replicated and suitable for minocycline analysis in tissue as well as serum. 2. In tissue, concentration of minocycline of experimental group was higher than that of control group for 5days. 3. Except 1 day, concentration of minocycline in serum of experimental group was lower than that of control group. 4. Concentration of minocycline in tissue was much higher than that in serum. From these results, minocycline loaded microcapsule might be effective tool for local drug delivery system might be useful for treatment of infections of oral and maxillofacial region and management of infected surgical wound, minimizing systemic effects.

• 한국CDE학회논문집
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• 제17권4호
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• pp.253-261
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• 2012

In order to make dental implant surgery successful, it is important to perform proper planning for dental implant placement. In this paper, we propose a decent approach to dental implant placement planning based on geometric processing of 3D models of jawbones, a nerve curve and neighboring teeth around a missing tooth. Basically, the minimum enclosing cylinders of the neighboring teeth around the missing tooth are properly used to determine the position and direction of the implant placement. The position is computed according to the radii of the cylinders and the center points of their top faces. The direction is computed by the weighted average of the axes of the cylinders. For a cylinder whose axis passes the position along the direction, its largest radius and longest length are estimated such that it does not interfere with the neighboring teeth and the nerve curve, and they are used to select the size and type of an implant fixture. From the geometric and spatial information of the jawbones, the teeth and the fixture, we can construct the 3D model of a surgical guide stent which is crucial to perform the drilling operation with ease and accuracy. We have shown the validity of the proposed approach by performing the finite element analysis of the influence of implant placement on bone stress distribution. Adopted in 3D simulation of dental implant placement, the approach can be used to provide dental students with good educational contents. It is also expected that, with further work, the approach can be used as a useful tool to plan for dental implant surgery.