• Archives of Plastic Surgery
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• 제35권6호
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• pp.692-697
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• 2008

Purpose: Gluteal perforator flap has evolved to one of the standard tools for coverage of pressure sore. We used this flap to cover the defect adjacent to the buttock. Methods: From September 2004 to August 2006, gluteal perforator flaps were performed in 3 patients with sore and 9 patients with tumor. We made the rule for free style design of the flap. First, the defect should be covered fully regardless of the shape or area. Second, the location of perforators was decided to maximize flap mobility. Third, the donor-site should be closed directly. Results: Successful reconstruction was fulfilled. In 2 cases, initial flap congestion was observed but medical leech was applied and it was resolved. Partial flap loss occurred in one case. Infection was observed in one case. But there were no major complications. Conclusion: Gluteal perforator flap is very good option for the reconstruction of the defects adjacent to the buttock.

• 대한불안의학회지
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• 제8권2호
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• pp.141-145
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• 2012

Objective : The purpose of this study was to describe and compare trends in suicidal ideation, suicidal attempt and suicide in Republic of Korea from 2006 to 2011. Such data are needed to guide policies to reduce suicidal behaviors. Methods : Data came from the 2006-2010 Korea National Health and Nutrition Examination Survey, Korea National Statistical Office and 2006-2011 Korean Epidemiologic Catchment Area Study Replication and 2007-2011 National Emergency Department Information System. Results : No change occurred between 2006-2011 in suicidal ideation, suicidal attempt, whereas suicide rate increased annually. Suicidal attempt events was decreased in age over 50. Suicidal attempts by poisoning and hanging have increased, although suicide caused by poisoning of insecticide have decreased. Especially, suicides caused by hanging have gradually increased in both sex. Conclusions : These finding suggest that fatal suicidal methods may influence increased suicidal rate. Instead of traditional suicidal process, investigation of other pathway about suicidal behaviors should be needed.

• Tuberculosis and Respiratory Diseases
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• 제70권4호
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• pp.307-314
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• 2011

Background: Chronic obstructive pulmonary disease (COPD) is a major cause of death and disability worldwide and one of the most prevalent diseases in Korea. We examined trends and risk factors of health care utilization for COPD in Korea. Methods: We retrospectively analyzed the database of Patient Surveys from 1990 through 2008, which were nationwide surveys of health services utilization through outpatient department (OPD) visits and hospitalization. Physician-diagnosed COPD patients whose ages were 45 years and older were included. Results: OPD visits and hospitalization of COPD patients between 1990 and 2008 were estimated to be 68,552 and 17,774 persons, respectively. Trends in OPD visits and hospitalization for COPD significantly increased from 1990 through 2008 (p=0.019, p=0.001, respectively). The increment rate for OPD visits was 2.0 fold over those years; for hospitalization it was 3.3 fold. Risk factors for OPD visits for COPD were male gender (odd ration [OR], 1.41; 95% confidence interval [CI], 1.39~1.43), those aged 65 years and older (OR, 1.50; 95% CI, 1.47~1.53), residential area other than a metropolis (OR, 1.08; 95% CI, 1.07~1.010) and access to a physician's office (OR, 1.17; 95% CI, 1.14~1.21). Risk factors for hospitalization were male gender (OR, 2.15; 95% CI, 2.07~2.23), those aged 65 year and older (OR, 2.86; 95% CI, 2.72~3.00), residential area other than a metropolis (OR, 1.98; 95% CI, 1.90~2.07) and access to a hospital (OR, 2.88; 95% CI, 2.59~3.22) (p<0.001, both). Conclusion: Health care utilization for COPD subjects increased from 1990 to 2008. Risk factors for the utilization were male gender, older age, and residential area other than a metropolis.

• 성인간호학회지
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• 제25권1호
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• pp.24-32
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• 2013

Purpose: The aim of the study was to identify the most appropriate fall-risk assessment tool for neurological patients in an acute care setting. Methods: This descriptive study compared the reliability and validity of three fall-risk assessment tools (Morse Fall Scale, MFS; St Thomas's Risk Assessment Tool in Falling Elderly Inpatients, STRATIFY; Hendrich II Fall Risk Model, HFRM II). We assessed patients who were admitted to the Department of Neurology, Neurosurgery, and Rehabilitation at Asan Medical Center between July 1 and October 31, 2011, using a constructive questionnaire including general and clinical characteristics, and each item from the three tools. We analyzed inter-rater reliability with the kappa value, and the sensitivity, specificity, predictive value, and the area under the curve (AUC) of the three tools. Results: The analysis included 1,026 patients, and 32 falls occurred during this study. Inter-rater reliability was above 80% in all three tools. and the sensitivity was 50.0% (MFS), 84.4%(STRATIFY), and 59.4%(HFRM II). The AUC of the STRATIFY was 82.8. However, when the cutoff point was regulated as not 50 but 40 points, the AUC of the MFS was higher at 83.7. Conclusion: These results suggest that the STRATIFY may be the best tool for predicting falls for acute neurological patients.

• Tuberculosis and Respiratory Diseases
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• 제69권3호
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• pp.184-190
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• 2010

Background: The purpose of this study was to determine the prognostic significance of chest computed tomographic (CT) parameters in acute submassive pulmonary embolism (PE). Methods: Between January 2006 and December 2009, 268 consecutive patients with acute submassive PE that was confirmed by chest CT with pulmonary angiography in emergency room were studied. One experienced radiologist measured CT parameters and judged the presence of right ventricular dysfunction. CT parameters were analyzed to determine their ability to predict a major adverse event (MAE). Results: There were 220 patients included and 61 (27.7%) had MAE. Left ventricular and right ventricular maximum minor axis ($36.4{\pm}8.0$ vs. $41.7{\pm}7.4$, p<0.01; $45.7{\pm}9.4$ vs. $41.5{\pm}7.6$, p<0.01), superior vena cava diameter ($19.2{\pm}3.4$ vs. $18.0{\pm}3.4$, p=0.02), azygos vein diameter ($10.0{\pm}2.2$ vs. $9.2{\pm}2.3$, p=0.02), septal displacement (19 vs. 18, p<0.01) were significantly higher in MAE group than in no MAE group. Patients with MAE had high right ventricular/left ventricular dimension ratio (RV/LV ratio) compared to patients without MAE ($1.34{\pm}0.48$ vs. $1.03{\pm}0.28$, p<0.01). The most useful cut-off value of RV/LV ratio for MAE was 1.3 and the area under the curve was 0.71 (0.62~0.79). Conclusion: RV/LV ratio on chest CT was a significant predictor of submassive PE related shock, intubation, in-hospital mortality, thrombolysis, thrombectomy within 30 days.

• Korean Journal of Radiology
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• 제24권7호
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• pp.681-689
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• 2023

Objective: Three-dimensional rotational angiography (3D-RA) is increasingly used for the evaluation of intracranial aneurysms (IAs); however, radiation exposure to the lens is a concern. We investigated the effect of head off-centering by adjusting table height on the lens dose during 3D-RA and its feasibility in patient examination. Materials and Methods: The effect of head off-centering during 3D-RA on the lens radiation dose at various table heights was investigated using a RANDO head phantom (Alderson Research Labs). We prospectively enrolled 20 patients (58.0 ± 9.4 years) with IAs who were scheduled to undergo bilateral 3D-RA. In all patients' 3D-RA, the lens dose-reduction protocol involving elevation of the examination table was applied to one internal carotid artery, and the conventional protocol was applied to the other. The lens dose was measured using photoluminescent glass dosimeters (GD-352M, AGC Techno Glass Co., LTD), and radiation dose metrics were compared between the two protocols. Image quality was quantitatively analyzed using source images for image noise, signal-to-noise ratio, and contrast-to-noise ratio. Additionally, three reviewers qualitatively assessed the image quality using a five-point Likert scale. Results: The phantom study showed that the lens dose was reduced by an average of 38% per 1 cm increase in table height. In the patient study, the dose-reduction protocol (elevating the table height by an average of 2.3 cm) led to an 83% reduction in the median dose from 4.65 mGy to 0.79 mGy (P < 0.001). There were no significant differences between dose-reduction and conventional protocols in the kerma area product (7.34 vs. 7.40 Gy·cm², P = 0.892), air kerma (75.7 vs. 75.1 mGy, P = 0.872), and image quality. Conclusion: The lens radiation dose was significantly affected by table height adjustment during 3D-RA. Intentional head off-centering by elevation of the table is a simple and effective way to reduce the lens dose in clinical practice.

• 한국콘텐츠학회:학술대회논문집
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• 한국콘텐츠학회 2017년도 춘계 종합학술대회 논문집
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• pp.111-112
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• 2017

MRI는 부분 영역을 자세히 영상화하는 검사임에도 인체에 위해한 RF를 전신에 주고 있다. 이러한 문제점을 개선하기 위해 저자들은 RF차단 방호복을 자제제작하여 적용한 결과 적용 전보다 적용 후가 95% 이상 RF를 차단하였다. 따라서 MRI 검사 시 본 연구의 방호복이 인체의 위해를 줄일 수 있는 최적의 대안임을 알 수 있다.

• Korean Journal of Radiology
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• 제2권2호
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• pp.117-120
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• 2001

We report a case of adult granulosa cell tumor arising in the scrotal tunics. The patient was a 34-year-old man who presented with right scrotal swelling, first noticed four months previously. Under the initial clinical impression of epididymo-orchitis, antibiotic treatment was instituted but there was no response. The paratesticular nodules revealed by ultrasound and magnetic resonance imaging mimicked intratesticular lesion, and radical orchiectomy was performed. Although several cases of adult testicular granulosa cell tumor, have been reported, the occurrence of this entity in the paratesticular area has not, as far as we are aware, been previously described.

• Journal of Periodontal and Implant Science
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• 제39권2호
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• pp.139-148
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• 2009

Purpose: Ultrasonic scalers have been widely used for removing biofilm which is considered as major etiologic factor of periodontal disease. The purpose of this study was to evaluate the effect of working parameters of piezoeletric ultrasonic scaler with scaler tip (No. 1 tip) on casting gold alloy removal. Methods: Type III dental casting gold alloy (Firmilay$^{circledR}$, Jelenko Inc, CA, USA) was used as substitute for tooth substance. Piezoeletric ultrasonic scaler and No.1 scaler tip (P-Max$^{circledR}$, Satelec, France) were selected. The selected working parameters were mode (P mode, S mode), power setting (2, 4, 8) and lateral force (0.5 N, 1.0 N, 2.0 N). The effect of working parameters was evaluated in terms of ablation depth, ablation width and ablation area. Results: Mode influenced ablation depth and ablation area. Power also influenced ablation depth and ablation area. Especially, Power 2 and power 8 showed statistically significant difference. Lateral force had influence on ablation width, and 0.5 N resulted significant increase compared with 1.0 N and 2.0 N. Ablation depth was influenced by mode, power and lateral force and defect width was influenced by lateral force. Ablation area was influenced by mode and power. Conclusions: It can be concluded that the use of piezoelectric ultrasonic scaler with No. 1 scaler tip in S mode and high power may result in significant loss of tooth substance.

• 대한디지털의료영상학회논문지
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• 제14권2호
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• pp.47-56
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• 2012

Amount of radiation exposure by seeing through fluoroscopy examination while is many patient exposure administration and unprepared misgovernment be. In this study, abdominal fluoroscopy during the scan, the dose and image quality change according to the use of grid and added filter optimized by measuring the test condition is proposed. Uses seeing through fluoroscopy examination equipment of Image Intensifier of Easy Diagnost Eleva (Philips), under tube type and uses Human phantom and measures average area dose according to grid insertion existence and nonexistence and added filter kind change. Measure sum of 29 organ dose and effective dose through PCXMC imagination simulation program and image J program through noise, SNR, image distortion was measured. Resolution, sharpness, and analyzed using the MTF curves. Fluorography the grid to insert the filter thickness and thickening and increased the average area dose and organ doses and effective dose. In the case of spot examination, when inserted grid, average area dose and organ dose and effective dose increased. Filter thickens the average area dose decreased, but the organ doses and effective dose were increased when use 0.2mmCu+1mmAl filter, decreased slightly. Noise and SNR measurements without inserting the gird, if you do not use the added filter was the lowest and when measure the distortion, 0.1mmCu+1mmAl filter was no difference of image quality in case insert grid was judged that when did not use occasion added filter that do not use grid, difference of image quality does not exist. Did not show a big difference, according to the grid and uses of the added filter sharpness, and resolution. Patient dose increases with factors that reduce the quality of the image so reckless grid and the use of the added filter when abdominal fluoroscopy examination should be cautious in using.