• Title/Summary/Keyword: 과학교실

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Radiosurgery with Linac Based Photon Knife in Cerebral Arteriovenous Malformation (선형가속기를 이용한 Photon Knife 방사선수술에 의한 뇌동정맥기형의 치료)

  • Kim, Jin-Hee;Choi, Tae-Jin
    • Radiation Oncology Journal
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    • v.21 no.1
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    • pp.1-9
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    • 2003
  • Purpose : The purpose of this study was to analyze the effect of a Linear accelerator based Photon Knife Radiosurgery System developed by the staff of Keimyung University Dongsan Medical Center for the treatment of cerebral arterlovenous malformation Material and Methods : Between December 1993 and October 2000, 30 patients with cerebral arteriovenous malformation (AVM) were treated with the Linac based Photon knife Radlosurgery System In the Department of Therapeutlc Radiology at Keimyung University Dongsan Medical Center. The median age was 34, ranging from 7 to 63 years, with a 2 : 1 male to female ratio. The locations of the AVM nidi were the frontal lobe (motor cortex), parletal lobe, and the thalamus, In that order. The diameters of the AVM nidi ranged 1.2 to 5.5 cm with a mean on 2.9 cm, and target volumes of between 0.5 and 20.5 cc, with a mean of 5.8 cc. The majority of patients received radiation doses of between 1,500 and 2,500 cGy, w14h a mean of 2,000 cGy, at 80% the isodose line. Twenty-five patients were treated with one isocenter, 4 with two, and 1 with four. The follow-up radiological evaluations were peformed with cranial computed tomogram (CT) or MRI between 6 month and one year interval, and if the AVM nidus had completely disappeared in the CT or MRI, we confirmed thls was a complete obliteration, with a cerebral or magnetic resonance angiogram (MRA). The median iollow-up period was 39 months with a range of 10 to 103 months. Results : Twenty patients were radloiogicaiiy followed up ior over 20 months, with complete obliteration observed in 14 (70%). According to the maximal diameter, all four of the small AVM (<2 cm) completely obliterated, 8 of the 10 patients with a medium AVW (2~3 cm) showed a complete obliteration, and two showed partial obliteration. Among the patients with a large AVM (>3 cm), only one showed complete obliteration, and S showed partial obliteration, but 3 oT these underwent further radiosurgery 3 years later. One who followed up for 20 months fellowing further radiosurgery eventually showed complete obliteration. Ten patients with seizure symptoms had no recurrent seizure due to radiosurgery and medication. One of the eleven patients who suffered intracranlal bleeding developed further bleeding at 9 and 51 months fellowing the radiosurgery although complete obliteration was eventually observed and the patient was managed in hospital then recovered. No patient suffered severe complications fellowing the radiosurgery. Conclusion : The radiosurgery with Linac-based Photon knife radiosurgery system, developed by the staff at our hospital, is a safe and effective treatment for AVM patients having diameters or volumes of less than 3 cm or 10 cm$^{3}$, respectively, located In Inoperable areas or who refused neurosurgery. We suggest that staged AVM radiosurgery may initially be considered, if the AVM target volume is above 10 cm$^{3}$

Surgical Treatment of the Congenital Esophageal Atresia (선천성 식도 폐쇄증의 외과적 치료)

  • 최필조;전희재;이용훈;조광조;성시찬;우종수
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.567-572
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    • 1999
  • Background: Surgical correction of the full spectrum of esophageal atresia with tracheoesophageal fistula has improved over the years, but the mortality and morbidity assoiated with repair of these anomalies still remains high. Material and Method: We retrospectively analyzes 27 surgically treated patients with esophageal atresia and tracheoesophageal fistula at Dong-A University Hospital between January 1992 and March 1997. Result: There were 21 male and 6 female patients. Mean birth weight was 2.62$\pm$.385 kg(2.0~3.4 kg). Twenty- four(88.9%) had esophageal atresia with distal tracheoesophageal fistula, and 3(11.1%) had pure esophageal atresia. Four(14.8%) infants were allocated to Waterston risk group A, 18(66.7%) to group B, and 5(18.5%) to group C. In eighteen(66.7%) infants with associated anomalies, cardiovascular anomalies were the most common. Three had a gap length of 3.5 cm or greater(ultra-long gap) between esophageal segments, 7 had 2.0 to 3.5 cm(long gap), 8 had 1.0 to 2.0 cm(medium gap), and 9 had 1 cm or less(short gap) gap length. Among 27 neonates, 3 cases underwent staged operation, late colon interposition was done in 2, and all other 24 cases underwent primary esophageal anastomosis. Oerative mortality was 2/27(7.4%). Causes of death included acute renal failure(n=1), empyema from anastomotic leak(n=1), necrotizing enterocolitis(n=1), sepsis(n=1), insulin-dependent diabetus mellitus(n=1 . There were 4 anastomosis- related complications including stricture in 3, leakage in 1. Mortality was related to the gap length(p<.05). Conclusion: Although the complication rate associated with surgical repair of these anomalies is high, this does not always implicate the operative mortality. The overall survival can be improved by effective treatment for combined anomalies and intensive postoperatve care.

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Evaluation of the Surgical Treatment for Mitral Stenosis (승모판협착증의 외과적 치료에 대한 평가)

  • Sin, Dong-Geun;Kim, Min-Ho;Jo, Jung-Gu;Kim, Gong-Su
    • Journal of Chest Surgery
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    • v.29 no.10
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    • pp.1095-1101
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    • 1996
  • From July 1983 to June 1995, 95 consecutive patients with mitral stenosis were treated surgically in the Department of Thoracic and Cardiovascular Surgery, Chonbuk national University Hospital, mitral valve replacement(MVR) in 62 patients and open mitral commissurotomy(OMC) in 33 patients. Mitral stenosis combined with coronary artery disease, with aortic valve disease, or wish mitral valvular Insufficiency, were excluded from this study. Surgical procedures for mitral stenosis were evaluated, according to complication, reoperation, mor- tality, nd functional change at mid- and long-term postoperative period. Cardiothoracic ratio in the MVR group was greater than the OMC group(0.59 $\pm$0.07 in MVR, 0.53 $\pm$0. 07 in OMC, p<0.05), but other variables(age, sex, MYHA functional classification, EKG finding, echocardiographic finding) did not show significant difference between two groups in the preoperative periods. Even though pathologic valvular lesion(Sellor's pathologic type m: 35 in MVR, 13 in OMC) and valvular calcification(35 in MVR, 11 in OMC) were severe in the MVR group(p=0.001) at intraoperative observation, OMC was possible in 11 patients(23.9%) among 46 patients with valvular calcification and in 13 patients(27.1 %) among 61 patients with Sellor's pathologic type IH . There was no significant difference in early and late mortality, actuarial survival(75% in MVR, 87.6% in OMC at 12 year), but early and late hemorrhagic, thromboembolic complications in the MVR group were greater than in the OMC. Functional changes in NYHA functional classification, EKG lEnding, cardiothoraclc ratio, and echocardiographic finding(EF, LVIDS, LWDd, LAD) did not differ between two groups in mid- and long-term postoperative periods. We conclude that our efforts for preservation of the native valve would be continued, because hemorrhagic and thromboembolic complications in the MVR were greater than in the OMC, and OMC was possible even in patients with severely stenotic and calcified mitral valve, although there was no sis-nificant difference in the functional change, mortality, and survival between the M VR and OMC.

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Transmission Dose Estimation Algorithm for Tissue Deficit (조직 결손에 대한 투과선량 계산 알고리즘 보정)

  • Yun Hyong Geun;Chie Eui Kyu;Huh Soon Nyung;Lee Hyoung Koo;Woo Hong Gyun;Shin Kyo Chul;Ha Sung Whan
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.186-192
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    • 2002
  • Purpose : Measurement of transmission dose is useful for in vivo dosimetry. In this study, previous algorithm for estimation of transmission dose was modified for use in cases with tissue deficit. Materials and Methods : The beam data was measured with flat solid phantom in various conditions of tissue deficit. New algorithm for correction of transmission dose for tissue deficit was developed by physical reasoning. The algorithm was tested in experimental settings with irregular contours mimicking breast cancer patients using multiple sheets of solid phantoms. Results : The correction algorithm for tissue deficit could accurately reflect the effect of tissue deficit with errors within ${\pm}1.0\%$ in most situations and within ${\pm}3.0\%$ in experimental settings with irregular contours mimicking breast cancer treatment set-up. Conclusion : Developed algorithm could accurately reflect the effect of tissue deficit and irregularly shaped body contour on transmission dosimetry.

Evaluation of Importance and Performance for Students and Employees about Sanitary Characteristics for High School Foodservice in Busan (부산지역 고등학교 학생과 급식종사자의 급식위생에 대한 중요도와 수행도 평가)

  • Kim, So-Hee
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.34 no.9
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    • pp.1414-1426
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    • 2005
  • The evaluation of students and employees on the importance and the performance for sanitary characteristics in high school foodservices, was investigated. The questionnaires were administered to 379 students and 141 employees in 13 high school, in Busan and then the data evaluated by 5 scales method of Likert were statistically analyzed. The mean scores of the importance and the performance evaluated by students (4.26/3.24) were significantly (p<0.01) lower than those by employees (4.71/4.51). Both the students and the employees percepted that, among sanitary characteristics, cleanliness of meals was most important. The student assessed the performance of withdrawal of plate waste as lowest scores, however the employees assessed student's hygiene as lowest scores, among sanitary characteristics. The gap score of the student (-1.02) between the importance and performance for sanitary factor was higher than that of the employees (-0.02) in high school foodservice. The importance grid of students and employees revealed that the items of tray cleanliness, dining table cleanliness, restaurant cleanliness, and handwashing before serving were high scores to the students, but low scores to the employees. The performance grid of students and employees revealed that the items of tray cleanliness, dining table cleanliness, restaurant cleanliness, the sanitation of treatment process of Plate waste, cleanliness of utensils of platewaste, not touch utensils before serving, handwashing before serving, handwashing before eating and not touch inside of tray were low scores to both the students and the employees. Therefore, it is suggested that the sanitary operations for dining place, treatment process of plate waste and the student's hygiene might have to increase in high school foodservice.

Influence of Environmental Living Standards on Helicobacter pylori Infection in Korean Elementary School Children (서울 지역 초등학생의 생활환경과 Helicobacter pylori 양성률)

  • Kim, Je-Woo;Kim, Hyo-Shin;Chung, Ki-Sup
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.1
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    • pp.10-17
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    • 2001
  • Purpose: We measured anti-H. pylori IgG in Korean elementary school children living in Shinchon area of Seoul, Korea to evaluate the influence of environmental living standards on H. pylori infection. Methods: IgG antibodies to H. pylori were measured in plasma using a commercial ELISA kit (GAP IgG Helicobacter pylori, Bio-Rad Laboratories Inc., Hercules, CA, USA). Information on environmental status such as place of birth, parental income, type of housing, number of persons in the household, parents' occupation, family history of peptic ulcer disease and gastric cancer was obtained. Statistical analysis was done by Chi-square and logistic regression test using SPSS $7.0^{TM}$ for Windows. Results: Study subjects consisted of 571 children, and the age distribution ranged from 6.0 to 13.6 years with a mean of $9.6{\pm}1.8$ years. Male-to-female ratio was 1.1:1. The seropositive rates of H. pylori infection ranged from 10.4% in children aged 6 years to 30.9% in 12 year-old group, overall 16.8%. The prevalence of H. pylori infection progressively increased with age, but there was no significant difference in seropositive rates among children in different age groups (p=0.06). Seropositive rates of anti-H. pylori IgG on the basis of gender, place of birth, parental income, type of housing, parents' occupation, family history of peptic ulcer disease and gastric cancer showed no statistically significant difference. Interestingly, however, seropositive rate of anti-H. pylori IgG showed statistical significance in relation to number of persons in the household (p=0.003; Odds ratio 1.50 by logistic regression test). Conclusion: These results suggest that number of persons in the household is the most important factor among environmental living standards, and that risk of H. pylori infection increases by increment of 1.5 times as the number of persons in the household increases by one.

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Hedgehog Oral Viral Papilloma (고슴도치 구강유두종)

  • Elfadl, Ahmed K.;Lee, Eun-Joo;Kim, Hyeong-Mi;Kim, Yong Deuk;Chung, Myung-Jin;Park, Jin-Kyu;Kim, Tae-Hwan;Kim, Shin-Yoon;Ghim, Soong-Gu;Kim, Jun Young;Jeong, Kyu-Shik
    • Journal of Life Science
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    • v.27 no.5
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    • pp.575-578
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    • 2017
  • Here we describe the histological lesion of a viral fibro-papilloma in a hedgehog. After surgical removal from maxilla, the solitary swollen mass was round to oval, yellowish with rough surface and measuring $6{\times}3{\times}2mm$ approximately. The tumor mass was submitted to the laboratory of pathology, college of veterinary medicine, Kyungpook National University for pathological diagnosis. Pathological examination of the tumor was established, the tumor was described grossly and sample was trimmed, sectioned and routinely prepared for histopathological evaluation. The tumor mass was diagnosed as viral fibro-papilloma, as the histological picture showed characteristic features of warts caused by papillomaviruses. The tumor characterized by thickening of the stratum spinosum (acanthosis) and basale, koilocytosis, intra-nuclear inclusion bodies in keratinocytes and fibrosis of submucosa. Further, viral inclusion bodies were demonstrated by Machiavello stain giving red color to the nuclei. No lymphocytes that responsible for regression of the wart could be detected, suggesting the poor possibility of spontaneous regression of the tumor. Papillomatosis is a disease of young animals, but in our case the infected Hedgehog was 5 years old, that maybe due to an impaired immune system, which is also shown by absence of lymphocytes. To the best knowledge of the author, this case presents the first report of viral fibropapillomatosis in Hedgehog.

Ultrasonographic Evaluation in Patients with Inguinal Hernia (서혜부 탈장에서의 초음파 조영술)

  • Kwon, Oh-Kyoung;Jung, Jin-Hyang;Park, Jin-Young;Chang, Soo-Il
    • Advances in pediatric surgery
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    • v.8 no.1
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    • pp.16-22
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    • 2002
  • Between March 1999 and January 2000, 82 boys with the diagnosis of inguinal hernias (12 bilateral and 70 unilateral hernias), underwent Ultrasound (US) examination of both sides of the groin, a total of 164 inguinal imaging prior to surgery. The patients ages ranged from 3 days to 12 years with a mean of 32.6 months. Ninty four examinations were on the clinically symptomatic side and 70 were on the asymptomatic side. The US criteria for the diagnosis of an inguinal hernia were as follows: 1) visceral hernia, the presence of bowel loops, or omentum in the inguinal canal, 2) communicating hydrocele, the presence of fluid in the processus vaginalis, 3) widening of patent processus vaginalis at the level of internal inguinal ring. The width of patent processus vaginalis at the level of internal inguinal ring over 4 mm is considered an occult hernia. Among the 94 symptomatic groins, US findings showed 31 (33%) visceral hernias, 18 (19%) communicating hydroceles, and 38 (41%) widening of the internal inguinal ring, and 7 (7%) groins without abnormalities. In 70 asymptomatic groins, there were 4 (6%) visceral hernias, 5 (7%) communicating hydroceles, 11 (16%) widening of the internal inguinal ring, and 50 (70%) groins without abnormalities. Among the 70 asymptomatic groins there were US abnormalities in 20 (28%). One hundred and seven groins with positive US findings were surgically explored. Among 107 operated sites, the operative findings were compatible with the US diagnosis in 104, a sensitivity for US of 97.2%. In patients with US findings of widening of internal inguinal ring (>4 mm), there was patent processus vaginalis in 36 out of 38 symptomatic groins and 10 of 11 asymptomatic groins. The sensitivity of US to the operative findings in widening of internal inguinal ring was 93.8%. For visceral hernia and communicating hydrocele, the sensitivity of positive US findings was 100%. Ultrasonography for inguinal hernias appears to be a rapid, reliable, and noninvasive screening diagnostic tool with high positive specificity. Therefore, we recommend the use of US as a routine diagnostic tool in pediatric patients with inguinal hernias and hydroceles.

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Effect of Toothbrushing Facilities on PHP Index and Oral Health-Related Behaviors in Middle Schools (양치시설 설치여부에 따른 중학생의 구강환경관리능력 및 구강건강관리 행태 변화)

  • Kim, Soo-Hwa;Hwang, Yoon-Sook;Kim, Kwang-Soo;Jung, Jae-Yeon;Yoo, Young-Jae;Lim, Mi-Hee
    • Journal of dental hygiene science
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    • v.13 no.3
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    • pp.271-280
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    • 2013
  • This study aims to analyze the effects of tooth-brushing facilities (TBF) at middle schools that installed TBF in 2012 as part of the oral health project in Seongdong-gu, Seoul. The subjects were the first graders at A middle school that installed TBF previously and B middle school that installed TBF in 2012. The results are as follows: DMFT, DMFS and CPI didn't show significant difference by schools (p>0.05), but code (0) was higher and code (2) was lower in female students than male students (p<0.05). As to PHP index, the students at A school with TBF indicated better oral hygiene (p<0.01). In the research on before and after installing TBF, the oral hygiene was improved significantly more after the installation than before (p <0.01). In the comparison on the oral health-related behavior, the percentage of not brushing after lunch was higher B school than A school and the frequency of toothbrushing after lunch was higher A school than B school (p<0.01). About the reasons why not to brush after lunch, there was difference in 'lack of the place' as A school showed 2.6% while B school without TBF indicated 14.2% (p<0.01). About the changes of the oral health-related behavior before and after TBF installation, the percentage of not brushing after lunch increased from 78.7% to 83.8% after the installation. The average frequency of tooth-brushing after lunch for one week also decreased from 0.50 to 0.34 (p>0.05). Among the reasons why not to brush after lunch, 'lack of the place' significantly reduced, but 'because other friends don't do it' increased greatly after the installation (p <0.05). Only with the improvement of oral health knowledge, we cannot expect either clinical or behavioral significance. Not only schools but policies of governmental agencies and financial support, cooperation of community-related groups for program development and evaluation will contribute altogether to helping teenagers to habitualize proper oral health management.

Effect of Health Belief Factor on Oral Health Related Behavior in Pregnant Woman (임신부의 건강신념요인이 구강건강관련행위에 미치는 영향)

  • Kim, Mi-Na;Lim, Do-Seon;Kim, Myoung-Hee;Kim, A-Reum;Kim, Sung-Im;Ahn, Yong-Soon
    • Journal of dental hygiene science
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    • v.15 no.2
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    • pp.129-137
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    • 2015
  • This study is conducted with the aim of providing basic data for oral health improvement of pregnant woman and development of oral health education program by analyzing factors influencing the oral health related behavior of pregnant woman applying health belief model which is theoretical model of explaining individual's behavior change. For 217 expectant mothers who visited 8 obstetrics and 1 maternity class located in Seoul, Gyeonggi and Incheon from August 1 to 31, 2014, data analysis was implemented using self-administered questionnaire. Before the completion of self-administered questionnaire, the subjects were fully informed of explanatory note and consented on taking part in the research for the consideration of ethical aspect. Collected materials were treated by PASW Statistics ver. 18.0 program and following results were acquired. Health belief factor which infuences oral health related behavior of pregnant woman resulted that perceived severity influences on oral examination during pregnancy and dental treatment during pregnancy, and perceived benefits influences on oral examination during pregnancy, and perceived barriers on toothbrushing after having a snack, toothbrush with rotation method and oral examination during pregnancy, and self-efficacy influences on use of oral hygiene products after toothbrushing and oral examination during pregnancy. With these research results, I suggest that perceived severity of health belief factor, perceived benefits, perceived barrier and self-efficacy influence oral health related behavior of pregnant woman. And specific oral health education program for pregnant woman is necessary to increase perceived severity of pregnant woman, perceived benefits and self-efficacy and to reduce perceived barriers.