• 대한불안의학회:학술대회논문집
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• 2004.06a
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• pp.185-213
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• 2004

우리는 살아가면서 흔히 개인적으로 극심한 스트레스를 겪거나 불행히도 어떤 뜻밖의 재난이나 큰 사고를 경험할 수 있다. 이런 외상적 사건들을 겪고 대부분의 사람들은 잘 극복할 수 있으나 일부 사람들은 심각한 의상 후 스트레스 반응을 보여 그런 외상이 지나감에도 불구하고 괴로운 기억 속에서 그것을 회상시키는 활동과 상황을 피하며 늘 불안한 마음으로 몸은 현재에 살고 있지만 마음은 실상 과거에 매달려 있고 과거의 고통 속에서 헤어 나오지 못하고 있다. 외상 후 스트레스 장애는 다른 불안 장애, 우울증처럼 흔한 질환으로 사회생활에 큰 지장을 주며 삶의 질을 손상시킨다. 그렇지만 외상을 당한 당사자들이 이런 이야기를 하기 꺼려하고, 이런 사람들을 진료실에서 종종 만날 수 있는 임상가들도 외상의 심각성과 외상 후 스트레스 장애에 대한 인식이 부족하여, 우리 주위에 많은 사람이 외상 후 스트레스 장애로 고생하고 있지만 외상 후 스트레스 장애로 진단되는 경우가 실제보다 훨씬 적다. 따라서 외상 후 스트레스 장애에 대한 평가를 배움으로써 더 많은 환자들을 정확히 진단하며 다른 질환과의 감별을 쉽게 할 수 있고, 환자들의 고통과 어려움이 과연 무엇인지 잘 알 수 있으며, 치료 표적과 치료 전략을 정하고, 치료 계획을 세우는 데 도움을 얻을 수 있다. 평가 방법으로는 구조화된 면담, 평가 척도, 정신 생리적 측정법, 치료자의 임상적인 결정 등이 있다. 향후에는 외상 후 스트레스 장애의 증상 정도뿐만 아니라 일상생활, 사회적 관계, 직업적, 사회적 적응 및 기능에 미치는 영향도 같이 평가하는 도구들이 개발되고, 현재 개발된 많은 평가 척도들이 새로이 수정되고 표준화되어, 이런 평가 척도들을 통해 외상 후 스트레스 장애의 경과와 외상 후 스트레스 장애로 인한 정신 사회적 영향을 더 잘 알 수 있는 자료들이 많이 수집되길 바란다. 대칭이, 작은대칭이, 펄조개는 저질이 니질인 곳에서 주로 서식하고 있었고 귀이빨대칭이는 사니질과 사질에 주로 서식하고 있었다. 특히 삽교호 수계 채집된 귀이빨대칭이는 사니질과 사질의 저질에서 출현하였다.및 내장낭 조직들이 중요한 에너지 저장소이며, 영양 공급 기관임을 알 수 있었으며, 폐각근 조직과 내장낭 조직들의 영양물질 함량 변화는 생식소의 에너지 요구에 따라 변하고 있음을 알 수 있었다.. 따른 신장 기능에 대한 영향을 평가해 보아야 한다.하를 조사한 결과, 연간 진동해역으로 유입되는 오염부하량은 부유물질 기준으로 전체 37,316 ton/yr로 추정되었고, 이중 육지기원 부하량이 9,809 ton/yr (26.3%) 였고, 해역의 침강량 23,576 ton/yr (63.2%), 양식생물의 배설량이 3,932 ton/yr (10.5%) 로 대부분이 해역의 침강량에 의한 것으로 조사되었다. 육지오염부하량이 변동이 없다는 전제 조건 아래, 진동만의 피조개 채묘장을 미더덕 양식장으로 품종전환시킬 경우, 전체 부하량은 산술적으로 약 196%가 증가한 72,998 ton/yr 가 되고, 양식생물의 배설량은 10배 정도 증가하게 되어 진동만의 오염부하를 가중하게 된다. 진동만은 여름철 빈산소수괴 및 적조가 빈번하게 발생하고 있으므로 미더덕 양식장을 새로이 시설할 경우 오염부하가 가중될 것으로 판단되어, 앞으로 진동만의 양식장 수용능력을 파악하여 적정량의 양식물량이 시설되어야 할 것이다.25 psu에서 가장 높게 나타났다.인 단백뇨는 진행성 경과의 위험성을 동시에 암시해 주는 매우 유용한 지표이다. 본 연구 결과 학교 신체 검사상에서 발견된 단독 단백뇨의 주된 원인은 기립성 단백뇨로 81.8%를 차지하였다. 그러나 지속성 단백뇨의 경우 비록 9.1%의 빈도를 보였지만, 신장 조직검사를 시행한 결과 진행성 경과를 취할 수 있는

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.3
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• pp.280-285
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• 2016

Mandible defects could be caused by congenital malformations, trauma, osteomyelitis, tumor resection. If large areas are included for reconstruction, those are primarily due to tumor resection defects. The large jaw defect results in a problem about mastication, swallowing, occlusion and phonetics, and poor esthetics causes a lot of inconvenience in daily life. It is almost impossible to be a part underwent mandibular resection completely reproduced, should be rebuilt artificially. This case is of a patient who was diagnosed with squamous cell carcinoma pT1N0M0, stage I in February 2004 and received surgery (combined mandibulectomy and neck dissection operation (COMMANDO) in oromaxillofacial surgery) in March 2004, by implant assisted removable partial denture. We could obtain good retention and stability through sufficient coverage and implant holding. Follow up period was about four years. Mandibular left third molar regions have been observed to have resorption of surrounding bone, and periodic check-ups are necessary conditions.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.11
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• pp.454-458
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• 2017

Fibroadenoma are one of the most common benign tumors of the breast in young women. Fibroadenoma may be associated with fibrocystic change, proliferative epithelial changes, and extremely rarely with carcinoma. We report here two cases of malignancy arising from a breast fibroadenoma. The patients were 19 and 51 years old and presented with a lump of recent onset. A 19-year-old female patient was diagnosed with mass excision at another hospital, and re-excision was performed at the hospital. Ultrasonography and cytologic examination revealed fibroadenoma and malignancy in a 51-year-old female patient, who was treated with wide excision. The pathological report of the two cases was revealed as DCIS in a fibroadenoma. Because carcinoma arising within a fibroadenoma is so rare, there are few reports of its characteristics or guidelines for treatment. Careful analysis of the unusual carcinoma arising within a fibroadenoma of the breast led to appropriate diagnosis and treatment of various types of lesions. Herein, we report two cases of DCIS arising within a fibroadenoma of the breast and provide a review of the literature.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.2
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• pp.484-492
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• 2017

This study assessed female occupational therapist job stress and musculoskeletal pain, and examines the problems caused by sexual harassment, family, and marriage policy. The results provide information to improve work environments, reduce job stress, yield data needed for sexual harassment prevention education, examine women occupational therapists' economic activities, and broadly improve the quality of life through participation. The study subjects were currently employed female occupational therapists. Initially 200 subjects were recruited, of whom 185 returned the study questionnaire. Questions addressing job stress included, 'There are times when one feels that the salary is worth less than the job effort', 'Feel tired due to work.', 'That it is time to pay attention to other therapy.', answered positively in that order. Musculoskeletal pain in the wrist and hand (90%), shoulder (86%), neck (69.7%) and waist (68.6%) were the order of the wrist and hand (63%), shoulder (62.2%) and waist (51.9%) pain resulted in interference with daily life. Verbal harassment was reported by 71.4% and 48.6% reported physical and visual harassment. The most common topics in workplace relations were 'Must choose whether to focus on the individual or work (61.1%).', 'Need for understanding and someone who can share their feelings (54.6%).', and 'Colleagues are willing to listen to my story (73%)'.

• Journal of Chest Surgery
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• v.38 no.12 s.257
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• pp.844-848
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• 2005

Background: Thoracic outlet syndrome(TOS) is caused by the compression of neurovascular structures that supply to the upper extremities. Only a few reports have been published in Korea, and this study attempts to investigate the clinical aspects and results of the patients who underwent surgical treatment. Material and Method: This study consist of 16 patients who underwent operations for thoracic outlet syndrome from May, 2002 to October, 2004. The surgical indications were confined to patients with: 1) symptom too severe to perform ordinary daily life because of pain, paresthesia, edema of upper extremities, 2) no improvement after proper physical therapy, 3) definite finding of compression confined by radiologic examinations (MRI, angiography, etc), and 4) no other diseases such as cervical intervertebral herniation, myositis, neurologic diseases below the brachial plexus. The surgical approaches were by transaxillary approaches in 12 cases, supraclavicular approaches in 2 cases, and infraciavicular approaches in 2 cases. Result: There were 15 males and one female with an average age of 23.9 years (range:19$\∼$39). Rib anomalies were observed in four cases (25.0$\%$), but the others had no abnormal ribs. Right lesions were found in eight cases (50.0$\%$), left lesions in five cases (31.3$\%$), and bilateral lesions in three cases (18.7$\%$). The follow-up period was 9$\∼$26 months and recurrence rate was 12.5$\%$ (2/16). Complications were one case of ulnar nerve palsy, one case of persistent pain despite radiologic improvement and three cases of wound dehiscence due to fat necrosis and hematoma. Conclusion: Although the choice of treatment in patients with TOS has been disputed, patients who have no response with proper physical therapies can benefit from the surgical treatment which may help patients to return to normal daily activity in shorter period of time.

• Journal of Chest Surgery
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• v.38 no.7 s.252
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• pp.489-495
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• 2005

In the surgical treatment of aortic dissection, aortic arch replacement under total circulatory arrest is often performed after careful inspection to determine the severity of disease progression. Under circulatory arrest, antegrade or retrograde cerebral perfusion is required for brain protection. Recently, antegrade cerebral perfusion has been used more, because of the limitation of retrograde cerebral perfusion. This study is to compare these two methods especially in the respect to neurological complications. Material and Method: Forty patients with aortic dissection involving aortic arch from May 2000 to May 2004 were enrolled in this study, and the methods of operation, clinical recovery, and neurological complications were retrospectively reviewed. Result: In the ACP (antegrade cerebral perfusion) group, axillary artery cannulation was performed in 10 out of 15 cases. In the RCP (retrograde cerebral perfusion) group, femoral artery Cannulation was performed in 24 out of 25 cases. The average esophageal and rectal temperature under total circulatory arrest was $17.2^{\circ}C\;and\;22.8^{\circ}C$ in the group A, and $16.0^{\circ}C\;and\;19.7^{\circ}C$ in the group B, respectively. Higher temperature in the ACP group may have brought the shorter operation and cardiopulmonary bypass time. However, the length of period for postoperative clinical recovery and admission duration did not show any statistically significant differences. Eleven out of the total 15 cases in the ACP group and thirteen out of the total 25 cases in the RCP group showed neurological complication but did not show statistically significant difference. In each group, there were 5 cases with permanent neurological complications. All 5 cases in the ACP group showed some improvements that enabled routine exercise. However all 5 cases in RCP group did not show significant improvements. Conclusion: The Antegrade, cerebral perfusion, which maintains orthordromic circulation, brings moderate degree of hypothermia and, therefore, shortens the operation time and cardiopulmonary bypass time. We concluded that Antegrade cerebral perfusion is safe and can be used widely under total circulatory arrest.

• Journal of Oral Medicine and Pain
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• v.31 no.3
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• pp.199-210
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• 2006

The epidemiological researches on the inpatients hospitalized at the oral medicine ward have been continuously carried out since 1970, and most researches have been performed by centering around the oral medicine wards of college hospitals. Numerous specialists have been produced after the establishment of oral medicine, and they have been active in various fields. As dental clinics have gotten bigger, the function of oral medicine in the secondary clinics is being brought out. As admissive channel, case features, case composition and otherwise have not been researched for a long time, the related researches should be carried out from now on. Hereupon, this study was carried out by targeting the 100 inpatients hospitalized at the oral medicine ward of Sun Hospital located in Daejeon Korea, through questionnaire. As the result, the following results were derived. 1. The ages of the inpatients in Sun Hospital were $29.21{\pm}11.31$ on the average; 71 females' mean average was $29.63{\pm}11.29$ and 29 males' mean average was $28.17{\pm}11.48$. In regard of school career, the patients who finished high-school course or higher accounted for 78%; the patients' school career seemed to be relatively high. The patients who complained of temporomandibular pain accounted for the highest proportion with 65%. In motivation to visit this hospital, internet surfing was 11%, mass media was 10%, acquaintance's introduction was 38%. The patients, who were hospitalized at another hospital due to the same symptom, accounted for 56%. The dental clinics, which made the patients visit this hospital, accounted for 20%. The patients, who were previously aware that the present symptom should be treated by oral medicine, accounted for 38%. The patients, who were not aware of the fact in advance, were 62%. The respondents of 51% answered that they were aware of the fact one month or below before hospitalization. 2. The patients, who complained of craniocervical ache, accounted for 58%; the patients, whose ache aches affect dailylife, were 22%. Continuous ache was 14% and intermittent ache was 68%, and dull pain was 23%. 3. Life variations were compared with each other by using SRRS (Social Readjustment Rating Scale). In consequence, the variation within 3 years indicated a significant difference in the both groups but the variation within 6 months did not indicate any differences. 4. In regard of the questionnaire on the incidents happened for a week, the ache-group was compared with the group free from the ache. As the result, the number of strain arisen for a week, the decrease of favorite works and sudden fear indicated a significant difference. Pleasant feeling and the decrease of interests in looks did not indicate a significant difference, but came close to the significance. 5. In the questionnaire on impatience, the ache-group indicated higher value but there was not a significant difference. 6. In the questionnaire on the symptoms caused by stress, the two groups indicated significant differences in the item of 'the teethridge itches and feels a tooth rising' and 'the occiput or the nape is stiff.' In the item 'the inside of the cheek or the teethridge are widely peeled off, accompanied with ache and hemorrhage', 'the face has acne or pimple' and 'headache frequently attacks', a significant difference was not observed but the two groups came close to the significance.

• The Journal of the Korean bone and joint tumor society
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• v.20 no.1
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• pp.14-21
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• 2014

Purpose: To analyze the clinical features and treatment outcome of Langerhans' cell histocytosis. Materials and Methods: From August 1996 to June 2013, 28 patients who histologically proven with LCH were analyzed of medical records, radiography, pathologic character retrospectively. Results: A total of 28 cases of LCH including 22 child has been reported. Onset age was 0.6 to 51 years old, occurred in the average age was 14.8 years. Follow-up period was 6 months to 134 months average was 44.6 months. The M:F ratio was 2.5:1. The initial symptoms was pain in 18 cases, 5 cases of pathologic fracture, 3 case of palpable mass, 1 case of discovered by accident in radiography, 1 case of torticollis. In radiological examination osteolysis was seen all cases, 7 cases showed a periosteal reaction, 1 case showed soft tissue extension. Clinical type of all cases were eosinophilic granuloma. 25 cases were classified as unifocal disease and 3 cases were multifocal single systemic diseases. In all cases, incisional biopsy was performed. After histologic confirmed, 14 cases was treated with curettage or surgical excision of the lesion and the other 14 cases were followed up without treatment. There is no death during follow up period. 11 cases has no radiological improvement after 3-6 months observation, intralesional steroid injection was performed. Conclusion: Patients with LCH who has rapid systemic onset is very rare, so if you meet the young children who suspected LCH, you shoulder avoid the examination which cause excessive radiation exposure to the young patient. In order to confirm the diagnosis of disease, biopsy is needed. Close observation after confirmed by histological method will bring the satisfactory results. But the patients who had pathologic fracture or wide bone destruction already may need curettage and bone grafting to lesion or internal fixation. The lesion which has no radiological improvement after 3-6 months observation or appear with pain interferes daily life may need local steroid injection as a good treatment.

• Neonatal Medicine
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• v.18 no.2
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• pp.328-336
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• 2011

Purpose: An association between very low birth weight infants(VLBWI) and hearing loss has long been recognized. Early identification and intervention for hearing loss benefits language and speech/cognitive development. We investigated the risk factors and clinical outcomes of hearing loss among VLBWI. Methods: We analyzed the results of auditory brainstem response (ABR) testing of VLBWI. These infants were admitted to the neonatal intensive care unit (NICU) of Pusan National University Yangsan Hospital between December 2008 and February 2011. A follow-up was conducted subsequently. Results: ABR evaluations were performed on 65 infants, and 31 showed abnormal results (47.7%). Among the 31 infants, 10 were classified with moderate/severe/profound hearing loss (15.4%). The infants with abnormal ABR had a higher incidence of low birth weight, prolonged ventilator care, cumulative dose of furosemide, and the lowest $PaO_2$ (P<0.05). Those with moderate/severe/profound hearing loss had a higher incidence of low Apgar scores at 5 minutes (odds ratio[OR],0.34; 95% confidence interval[CI],0.13-0.89), prolonged ventilator care (OR,1.06; 95% CI,1.01-1.12), and mild hearing loss compared to those without profound hearing loss. Follow-up evaluations on eight infants with ABR reveled improvements 5.6${\pm}$3.9 months later. One infant, who had profound hearing loss in both ears, used a hearing aid. Conclusion: Factors influencing hearing loss at the first VLBWI hearing screening test included lower Apgar scores at 5 min and prolonged use of a ventilator. Most VLBWI with hearing losses were expected to recover after several months of follow-up.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.1
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• pp.84-92
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• 2003

Purpose: To report two cases of bone tumors other than osteoid osteoma in the proximal femur and treated with percutaneous high frequency radioablation method. Cases: We reviewed two cases with intracortical chondroma and enchondroma in the femoral head retrospectively. The patient with intracortical chondroma was a thirty one year old woman and had suffered right hip pain of 1 year duration. The lesion was located in the head of right femur and treated with CT guided percutaneous high frequency radioablation after needle biopsy under general anesthesia. The symptom was gone immediately after the procedure and was discharged postop. 1 day. 15 months has passed without symptom recurrence. Second case having enchondroma, was 56 year old woman complaining of gluteal area pain for 3 months. Radiologic evaluation showed osteolytic lesion with sclerotic rim on the inferior portion of the left femoral head. She received a same therapy with CT guided radiofrequency ablation following needle biopsy. She reported dramatic pain relief after the procedure and was discharged postop. 1 day. No symptom has occurred for 3 months until now. Conclusion: We present 2 cases of bone tumor occurred in the hip joint area other than osteoid osteoma which were treated with CT guided radiofrequency ablation.