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The Effect of Transcranial Direct Current Stimulation over the Primary Somatosensory Cortex in Patients with Chronic Stroke on Somatosensory and Upper Limb Function for Improving Life Care (만성 뇌졸중 환자를 대상으로 한 일차 체성 감각 피질을 자극한 경두개 직류 전류 자극이 라이프 케어 증진을 위한 체성감각과 상지기능에 미치는 영향)

  • Kim, Sun-Ho
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.6
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    • pp.269-277
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    • 2020
  • The purpose of this study is to investigate the recovery of sensation and the restoration of upper limb function according to transcranial direct current stimulation over the primary somatosensory cortex in patients with chronic stroke with sensory deficit. 20 patients with chronic stroke divided into 10 experimental groups and 10 control groups. Patients received transcranial direct current stimulations over the primary somatosensory cortex on the side of the stroke lesion, and The control group applied sham tDCS to the same location. Intervention was conducted 5 times a week, 20 minutes per session for a total of 2 weeks. Assessment was performed using the Erasmus MC modifications to the Nottingham Sensory Assessment(EmNSA), Semmes-Weinstein monofilament examination(SWME) for somatosensory, and Fugle-Meyer Assessment(FMA), Motor Activity Log(MAL), and accelerometer for upper extremity function. Assessment was conducted before and after the intervention. As a result of the study, the experimental group showed a significant improvement in the overall tactile sense, proprioception, cortical sense, and perception sensitivity than the control group, and showed a statistically significant difference in the usage amount of the upper limb. Based on the results of this study, it is thought that the possibility of effective clinical application of transcranial direct current stimulation for recovery of somatosensory and upper extremity function is thought to be increased.

Gingival pigmentation treatment using Er;YSGG laser (Er;YSGG 레이저를 이용한 치은 색소침착 제거 증례보고)

  • Kim, Hyunjong
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.30 no.2
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    • pp.53-58
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    • 2021
  • The attractiveness of the gingiva is determined by its color, shape, and the shape and location of the boundary between the teeth and the gingival tissue. The standards beauty, balance, and health of the gingiva are all different, but the general public would agree that a coral pink gingiva is more beautiful than black or brown gingiva. Hence, one would be able to smile more confidently in public if he or she receives a gingival pigmentation removal surgery that changes the color of black or brown gums to a beautiful pink color with relative simplicity. The color of one's gingiva varies from pale pink to deep bluish purple, depending on many health components. The most prominent among these include the vascular supply, epithelial thickness, the degree of keratinization, and the presence of pigment in the epithelium. Melanin, carotene, reduced hemoglobulin, and oxyhemoglobulin are the main pigments contributing to the normal color of the oral mucosa. The health of one's gingival tissue are essential for an attractive smile. Excessive melanin deposits in the basal and early basal layers of the epithelium stored in the form of melanosomes frequently cause pigmentation. Although there are many different procedures to remove this pigmentation, the it was removed using the Er;YSGG laser. It is my wish that, through this case study, many people

Development and Feasibility Evaluation of CsPbBr3 Dosimeter for Brachytherapy (근접방사선치료용 CsPbBr3 선량계 제작 및 적용가능성 평가)

  • Yang, Seung-Woo;Park, Sung-Kwang
    • Journal of the Korean Society of Radiology
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    • v.16 no.4
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    • pp.405-410
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    • 2022
  • In brachytherapy, a radiation source is inserted into the body to kill tumor tissue. Therefore, it is important to accurately measure the location of the source and the dose distribution. In this study, a dosimeter that can be used for brachytherapy was developed using CsPbBr3 which is cheaper than the existing detector materials and has a simpler manufacturing process. The CsPbBr3 dosimeter performance was evaluated by analyzing reproducibility, linearity, and distance dependence in 192Ir source. As a result of reproducibility evaluation, the RSD was 1.36%, which satisfies the standard value of 1.5%. As a result of the linearity evaluation, the R2 value was 0.9993, which satisfies the standard R2 of 0.9990. The distance dependence evaluation showed a signal value that decreased exponentially as the distance increased. The evaluation results show that the CsPbBr3 dosimeter satisfies the evaluation criteria and can be used as a brachytherapy quality assurance dosimeter.

A 10-year retrospective study on the risk factors affecting the success rate of internal connection implants after prosthetic restoration (내부연결 임플란트의 보철 수복 후 성공률에 미치는 위험요소에 관한 10년간의 후향적 연구)

  • Seoin Lee;Min-Jeong Kim
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.2
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    • pp.113-124
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    • 2023
  • Purpose. The purpose of this study is to help increase the success rate by analyzing the types and characteristics of implant prosthesis and the survival rate. Materials and methods. Among implants placed between 2011 and 2020 at Sanbon Dental Hospital, College of Dentistry, Wonkwang University, a case restored by a prosthetic surgeon was investigated for the characteristics and correlation of failure. The causes of failure were classified as failure of osseointegration, peri-implantitis, fixture fracture, abutment fracture, screw fracture, screw loosening, prosthesis fracture, and loss of prosthesis retention. Prosthetic method, cantilever presence, placement location, etc. were analyzed for their correlation with implant failure. Results analysis was derived through Chi-square test and Kaplan-Meier survival analysis using SPSS ver 25.0 (IBM, Chicago, IL, USA). Results. A total of 2587 implants were placed, of which 1141 implants were restored with Single Crown and 1446 implants with Fixed Partial Denture, and the cumulative survival rate was 88.1%. The success rate of SC was 86.2% (984) and the success rate of FPD was 89.6% (1295), showing statistically significant differences, among which factors that had significant differences were abutment fracture, screw fracture, and screw loosening (P < .05). Conclusion. As a result of the 10-year follow-up, more failures occurred due to biomechanical factors than biological factors. Further studies on the success of implants will be needed in the future.

Effects of Home-Visit Program with Cognitive-Stimulating Activities on Cognitive Function and Memory Self-efficacy of an Elderly with Dementia Special Rating : Single Subject (가정방문 인지자극 활동이 치매특별등급(5등급) 노인의 인지기능 및 기억 자기효능감에 미치는 효과 : 개별대상연구)

  • Son, Bo-Young;Bang, Yo-Soon
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.5
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    • pp.247-262
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    • 2019
  • This study involved the effects of home-visit program with cognitive-stimulating activities on cognitive function and memory self-efficacy of an elderly with dementia special rating(5rates). The study was conducted from February 11 to April 26, 2019 using a 65-year old woman residing in G Metropolitan City. The individual subject study used an A-B-A design. The subject performed activities that required thinking and resolving in order to stimulate both her body and cognition. The activities chosen were easily accessible to those having a form of mild dementia, rates 5 dementia special rating, and repetitively stimulated the subject's intellectual capacity in an attempt to increase her degraded cognitive functioning. Specifically, the activities exercised both short-term memory and recollection using familiar letters, numbers, and bodily movements frequently encountered in daily life. The program positively affected the subject's memory and concentration. In addition, the program was found to be feasible for home use by those with mild dementia, obviating the need to travel to a location like a welfare center. The author presents specific activities for stimulating cognition that can effectively intervene to positively influence the cognitive functioning and memory of those with rates 5 dementia special rating.

Comparison of pediatric injury patterns before and during the COVID-19 pandemic in Korea: a retrospective study

  • Geom Pil Nam;Woo Sung Choi;Jin-Seong Cho;Yong Su Lim;Jae-Hyug Woo;Jae Ho Jang;Jea Yeon Choi
    • Journal of Trauma and Injury
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    • v.36 no.4
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    • pp.343-353
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    • 2023
  • Purpose: The COVID-19 pandemic led to significant changes in the lifestyle patterns of children and affected the patterns of pediatric injuries. This study analyzed the changing patterns of pediatric injury overall and by age groups, based on the datasets before and during the COVID-19 pandemic. Methods: This study is based on the data of patients who presented with injuries at 23 hospital emergency departments participating in the Emergency Department-based Injury In-depth Surveillance (EDIIS) conducted by the Korea Disease Control and Prevention Agency. The surveillance data was categorized by injury mechanism, location, activity, and severity. We analyzed the injury patterns of pediatric patients aged 0 to 15 years. Subgroup analysis was conducted by age group in children aged 7 to 15 years, 1 to 6 years, and <1 year. Results: When comparing the COVID-19 pandemic period to the pre-COVID-19 period, the total number of pediatric patients with injuries decreased by 38.7%, while the proportions of in-home injuries (57.9% vs. 67.9%), and minor injuries (38.9% vs. 39.7%) increased. In the 7 to 15 years group, bicycle riding injuries (50.9% vs. 65.6%) and personal mobility device injuries (2.4% vs. 4.6%) increased. The 1 to 6 years group also showed an increase in bicycle accident injuries (15.8% vs. 22.4%). In the <1 year group, injuries from falls increased (44.5% vs. 49.9%). Self-harm injuries in the 7 to 15 years group also increased (1.6% vs. 2.8%). Conclusions: During the COVID-19 pandemic period, the overall number of pediatric injuries decreased, while injuries occurring at home and during indoor activities increased. Traffic accidents involving bicycles and personal mobility devices and self-harm injuries increased in the 7 to 15 years group. In the <1 year group, the incidence of falls increased. Medical and societal preparedness is needed so that we might anticipate these changes in the patterns of pediatric injuries during future infectious disease pandemics.

Predictive Factors for Symptomatic Dislodgement of Percutaneous Transhepatic Biliary Drainage Catheter in Patients with Malignant Biliary Obstruction (악성 담관 폐쇄 환자에서 경피경간 담도 배액술의 유증상 이탈 발생의 예측 인자)

  • Hee Jeong Yu;Jung Gu Park;Gyoo Sik Jung;Kwang Il Seo;Hyun Joon Park;Jong Hyouk Yun
    • Journal of the Korean Society of Radiology
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    • v.84 no.6
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    • pp.1350-1360
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    • 2023
  • Purpose To evaluate the factors that predict symptomatic dislodgement of a percutaneous transhepatic biliary drainage (PTBD) catheter in patients with malignant biliary obstruction. Materials and Methods This retrospective study included 572 patients with malignant biliary obstruction who underwent 733 PTBD catheter insertions between January 2010 and February 2015. The duration of catheter placement, approach site, location of the catheter tip, insertion angle, presence of a closed-loop pigtail, and tube diameter were evaluated. Results During the follow-up period, 224 PTBD catheter dislodgements (30.56%) were observed in 157 patients. Among them, 146 (19.92%) were symptomatic. The mean duration from catheter insertion until dislodgement was 32 days (range: 1-233 days). Male (odds ratio [OR]: 1.636, 95% confidence interval [CI]: 1.131-2.367, p = 0.009), right-sided approach (OR: 1.567, 95% CI: 1.080-2.274, p = 0.018), increased insertion angle (OR: 1.015, 95% CI: 1.005-1.026, p = 0.005), and incomplete closed-loop pigtail formation (OR: 1.672, 95% CI: 1.098-2.545, p = 0.016) were independent factors predictive of symptomatic dislodgement of a PTBD catheter. Conclusion Factors predictive of symptomatic catheter dislodgement included male sex, a right-sided approach, increased insertion angle, and incomplete closed-loop pigtail formation.

Recurrence Analysis after Video-assisted Thoracic Surgery for the Treatment of Spontaneous Pneumothorax (자연기흉의 비디오흉강경수술 후 재발에 대한 분석)

  • Kim, Sung-Wan;Kim, Duk-Sil;Lim, Chang-Young;Lee, Hyeon-Jae;Lee, Gun;Kong, Joon-Hyuk
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.710-715
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    • 2010
  • Background: Video-assisted thoracic surgery (VATS) became common in the treatment of spontaneous pneumothorax (SP). Therefor we've reviewed the recurrence rate after VATS and analysed the factors affecting recurrent pneumothorax after VATS on this study. Material and Method: This retrospective analysis was performed on 321 patients of SP who had undergone VATS from Jan. 2001 to Dec. 2008. The two groups were divided as follow: group A, non-recurrent group (298 patients: 93%); and group B, recurrent group (26 patients: 7%); the two groups were analysed retrospectively. Result: The average age of the study groups were $20.9{\pm}4.3$ years old in recurrent group vs. $25.9{\pm}11.7$ years old in non-recurrent group with statistical significance (p < 0.05). There were no statistical significance in male to female ratio, height/weight ratio, location of pneumothorax, smoking history, operative time, duration of drain, hospital stay, indication of opertion and incidence rate. Average length of duration in recurrence was 12.9 months. There was 22 (95.7%) recurrent patients after VATS within 4 year period among recurrent group. Treatment methods in 23 of recurrent patients were, 8 (VATS), 2 (Axillary thoracotomy) with 15% or more in amount of pneumothorax and 7 (7 Fr. chest tube), 6 (nasal 02) with 15% or less in amount of pneumothorax. Among 10 cases of reoperation, there were 3 cases of over looking type and 7 cases of new growing type. There was no additional recurrence after these procedures were given. Conclusion: There was higher recurrence rate in younger age after VATS thus for those under 20 yrs old, detailed and possible preoperative warning for recurrence is warranted. Most recurrence occured within 4 year period, thus for this reason, regular interval based follow up with chest x-ray study is suggested during this period.

Analysis of the Work of the Head Nurse and a Work Model for the Head Nurse in University Hospitals in Korea (대학종합병원 수간호사의 업무분석과 모형연구)

  • 김인숙
    • Journal of Korean Academy of Nursing
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    • v.19 no.2
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    • pp.212-222
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    • 1989
  • When the head nurse who is pivotal in the nursing service administration of the hospital performs efficiently as a first-line manager, the effectiveness of the nursing unit, which includes the quality of nursing care, the jab satisfaction of staff members, and the cohesiveness of staff members is increased. With this point of view in mind, the researcher carried out a study to determine the actual work (the content of the work, the work process, the role of the head nurse, the activity media, and the purpose of the work) of the head nurse in a university hospital in Korea. In addition, this study was also carried out for the purpose of preparing an ideal model for the work of the head nurse. The research subjects were 39 head nurses. This included all the head nurses in two university hospitals except those who were working in outpatient care, operating rooms, central supply, nursing administration, in-service education and emergency care. Data were collected from September 24th to October 21th, 1987 and April 4th to 12th, 1988. A work activity record on which the head nurse recorded directly in a chronological narrative form, was used as the research instrument. The 234 work activity records, 39 head nurse's continuous recording over 6 days(from Monday to Saturday) were collected and analysed. The results were as follows ; 1. With regard to the work content for the total daily work of the head nurse, 45.2% of the activities were managerial activities but 58.1% of the head nurse' s time was spent in direct patient care. 2. With regard to the work process of the head nurse, specifically the location, the size and membership of groups contacted, the results were as follows : 1) Of the total daily work activities 92.4% were carried out in the nursing unit and this occupied 84.5% of total daily work time. Direct patient care was generally performed on the nursing unit and managerial work was performed in other areas. 2) Of the total daily work activities, 73% was with one or more persons and 51.2% of total daily work time was spent in groups. 3) A total of 51 persons, working in different capacities were contacted. These included 21 persons giving patient care, 19 persons working in nursing unit management, and 7 persons working in human resource management. 3. With regard to the head nurse's role in work activity, 53.3% of total daily work activities involved the informational role, 26.9%, the interpersonal role and 19.9%, the decisional role. With regard to time, 57.7% was spent in the informational role, 23.9%, in the interpersonal role and 18.3%, in the decisional role. When the head nurse performed managerial work, she gave nearly equal emphasis to all three roles when she gave direct patient care the informational role was increased. 4. With regard to the activity media, the number of unscheduled activities accounted for 27.1% of the activities, scheduled activities, 24.3%, desk work activity, 22.1%, rounds, 12.5% and telephone calls, made or received, 14.0%. In daily total work time managerial work related to desk work and scheduled activities were high, ranging from 29.8% to 29.9% but for direct patient care time, scheduled activities and unscheduled activities were high, ranging from 23.6% to 35.3%. 5. With regard to the purpose of the work performed, 54.4% of the total daily work was concerned with the team and 41.4% was concerned with the agency. The managerial work was concerned mainly with the team and the direct patient care was concerned mainly with the patient. When the frequency of an activity and time were compared no significant difference was found between the days for which the work was recorded for any of the variables : the work content, the work process, the work role, the activity media and purpose of the work. On the basis of this study the following are proposed as an ideal model for head nurse work in Korea : The managerial work should be increased to 70%. The decisional role activities should be increased to 40%. Twenty percent of the work activity should be allocated to agency, community and profession. It is believed that this model for the head nurse's work can contribute to guidelines for job description development. Finally, educational programs, organizational and structural devices, and administrative support are needed for the proper function of the head nurse in this proposed model.

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Early Result of Demineralized Bone Matrix (DBM, Genesis$^{(R)}$) in Bone Defect after Operative Treatment of Benign Bone Tumor (양성 골 종양의 수술적 치료 후 발생한 골 결손에서 탈무기화 골 기질(DBM, Genesis$^{(R)}$)의 단기 결과)

  • Seo, Hyun Je;Chung, So Hak
    • The Journal of the Korean bone and joint tumor society
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    • v.19 no.2
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    • pp.56-63
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    • 2013
  • Purpose: This study was performed to evaluate the efficiency of demineralized bone matrix (DBM, Genesis$^{(R)}$) used for bone defect after operative traetment of benign bone tumors by clinical and radiological methods. Materials and Methods: DBM was used to treat bone defect after operative treatment of benign tumor from February 2012 to May 2013. Total 25 benign bone tumor cases (15 males, and 10 females) with mean age of 30.3 were studied. The diagnoses were solitary bone cyst in 9 cases, non ossifying fibroma in 5, fibrous dysplasia in 5, aneurysmal bone cyst in 3 and enchondroma in 3. In categorization by location of tumor, there were 5 cases of distal femur, 4 of proximal tibia, 3 of proximal femur, 3 of proximal humerus, 3 of phalanx, 2 of distal radius, 2 of hip bone, 2 of calcaneus, and 1 of scapula. Autogenous bone was used with DBM in 6 cases, and only DBM used in 19 cases. Mean periods of follow up were 8.7 months (range: 6 to 14 months). Amount of graft resorption and bone formation was observed with compare of post operation radiograph and the difference was shown by percentage. Resorption level was measured by DBM level which could be observed from simple x-ray, and bone formation level by bone trabecular formation level at impaired site. Results: Twenty three cases of total 25 cases showed bone union. In the 23 cases, more than 98% DBM resorption was observed after mean 4.3 months, and more than 98% bone formation was observed after mean 6.9 months. Lesser bone defect sizes showed faster bone formation and it was statistically significant (p=0.036). But other comparative studies on other factors such as, sex, age of patients and combination of autogenous bone were no statistically significant differences in graft resorption and bone formation. And there was no significant complication in periods of follow-up. Conclusion: Demineralized Bone Matrix (Genesis$^{(R)}$) is thought to be useful treatment for bone defect after operative treatment of benign bone tumor, however longer follow-up periods appears to be needed.