• 기본간호학회지
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• 제6권3호
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• pp.359-368
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• 1999

Background : The purpose of this study was to determine whether cleansing the perineum and urethral meatus and using midstream urine affect the rate of bacterial contamination of urine specimens, and to determine the optimum urine collection method. We studied 41 asymptomatic healthy nursing school students. Women who were menstruating were not excluded from this study. Method : The first and midstream urine samples were collected during consecutive urinationsby each woman. The first sample was not a clean-catch specimen, and the second one was a clean-catch specimen. Both specimens were studied by urinalysis and bacterial culture with standard methods. Results : 41 women met the study criteria and 39 successfully completed the study. None of the urine cultures were positive. 68.3% of the non clean-catch first urine cultures, 53.7% of the non clean-catch midstream cultures, 33.3% of the first clean-catch urine culteres and 30.8% of the midstream clean-catch urine were found to be contaminated. There was a significant difference in the bacterial contamination rates between the first and midstream urine, and the clean-catch and non clean-catch urine(p=0.035, p =0.001 respectively). On urinalysis, 7.3% of the non clean-catch first urine, 7.3% of the non clean-catch midstream urine, 2.6% of the clean-catch first urine and 2.6% of clean-catch midstream urine were found to be above grade 2. Conclusions : According to our results, the bacterial contamination rate was the lowest in midstream and clean catch urine specimens. Threrfore it is recommended that the midstream clean-catch technique is the standard practice for collecting urine specimens for bacterial culture in women.

• Journal of Korean Neurosurgical Society
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• 제60권2호
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• pp.165-173
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• 2017

Objective : To explore and analyze the influencing factors of facial nerve function retainment after microsurgery resection of acoustic neurinoma. Methods : Retrospective analysis of our hospital 105 acoustic neuroma cases from October, 2006 to January 2012, in the group all patients were treated with suboccipital sigmoid sinus approach to acoustic neuroma microsurgery resection. We adopted researching individual patient data, outpatient review and telephone followed up and the House-Brackmann grading system to evaluate and analyze the facial nerve function. Results : Among 105 patients in this study group, complete surgical resection rate was 80.9% (85/105), subtotal resection rate was 14.3% (15/105), and partial resection rate 4.8% (5/105). The rate of facial nerve retainment on neuroanatomy was 95.3% (100/105) and the mortality rate was 2.1% (2/105). Facial nerve function when the patient is discharged from the hospital, also known as immediate facial nerve function which was graded in House-Brackmann : excellent facial nerve function (House-Brackmann I-II level) cases accounted for 75.2% (79/105), facial nerve function III-IV level cases accounted for 22.9% (24/105), and V-VI cases accounted for 1.9% (2/105). Patients were followed up for more than one year, with excellent facial nerve function retention rate (H-B I-II level) was 74.4% (58/78). Conclusion : Acoustic neuroma patients after surgery, the long-term (${\geq}1year$) facial nerve function excellent retaining rate was closely related with surgical proficiency, post-operative immediate facial nerve function, diameter of tumor and whether to use electrophysiological monitoring techniques; while there was no significant correlation with the patient's age, surgical approach, whether to stripping the internal auditory canal, whether there was cystic degeneration, tumor recurrence, whether to merge with obstructive hydrocephalus and the length of the duration of symptoms.

• Archives of Plastic Surgery
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• 제40권5호
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• pp.536-541
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• 2013

Background Pathogens in the nasal cavity during nasal surgery could lead to a systemic infectious condition, such as bacteremia, nosocomial infection, or toxic shock syndrome. However, there is no research about the prevalence of nasal carriage in patients with nasal bone fracture. Methods This was a prospective, double-blind, randomized study about the rate of nasal carriage in 200 patients with nasal bone fracture in Korea. Nasal secretions were taken from both the middle nasal meatus and colonized. All analyses were carried out using SPSS software. Results Pathogens were identified in 178 of the 200 cases. Coagulase-negative staphylococci (CNS) were the most cultured bacteria in 127 (66.84%) of the 190 total patients after excluding 10 cases of contaminated samples, and methicillin-resistant coagulase-negative staphylococci (MRCNS) were found in 48 (25.26%). Staphylococcus aureus was the second most identified pathogen, found in 36 (18.95%), followed by 7 cases (3.68%) of methicillin-resistant Staphylococcus aureus (MRSA). The prevalence rate of MRSA in the females was higher than that in the males (RR=4.70; 95% CI, 1.09-20.18), but other demographic factors had no effect on the prevalence rate of MRSA and MRCNS. Conclusions The prevalence rate of these pathogens in patients with nasal bone fracture in Korea was similar to other reports. However, few studies have addressed the prevalence rate of CNS and MRCNS in accordance with risk factors or the change in prevalence according to specific prophylaxis against infectious complications. Additional research is needed on the potential connections between clinical factors and microbiological data.

• Archives of Plastic Surgery
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• 제37권4호
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• pp.443-446
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• 2010

Purpose: Tragus is one of the key structure of the normal shape of auricle. We experienced several cases of hypoplastic tragus with preauricular appendage. This article describes the methods of reconstruction of atypical tragus using accessory tragus or macrotragus to make better aesthetic results rather than simple excision. Methods: From April, 2004 to March, 2009, 21 patients got operations by our method. Seven patients had bilateral deformity of tragus. Mean age was 12.7 years. For 17 cases of accessory tragus, simple excision, z-plasty and interpolation flap was performed. For 11 cases of macrotragus, debulking and z-plasty was performed. Mean follow-up period was 9.4 months. Results: Reconstructed tragus looked symmetric with the opposite side in contour, size, direction and partial coverage of auditory meatus. There was no enlargement of remnant appendage for the follow up period and there was no complication such as hematoma, infection and chondritis. Conclusion: In cases of small and deformed tragus, preauricular tissue such as accessory tragus and macrotragus could be a good source of tragal reconstruction.

• Journal of Korean Neurosurgical Society
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• 제38권3호
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• pp.202-205
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• 2005

Objective : The purpose of this study is to measure the dimensions of foramen ovale and to localize the zygomatic point using computed tomography[CT] in Korean adults with idiopathic trigeminal neuralgia. Methods : Facial axial CT scans using the orbitomeatal plane were performed in 67patients [39males and 28females; mean age 58.8years] with idiopathic classic trigeminal neuralgia. We measured the size of the foramen ovale and localized the zygomatic point which was a skin marker over the ipsilateral zygoma that approximates the lateral projection of a straight line joining the centers of the two foramen ovale. Results : The axial dimensions of the foramen ovale on the orbitomeatal plane were of average length : $8.18{\pm}0.82mm$ [range $6.9{\sim}11.5mm$]. width : $4.06{\pm}0.86mm$ [$2.5{\sim}5.7mm$]. The average distance between the external acoustic meatus and the zygomatic point was $21.64{\pm}1.99mm$ [$16.3{\sim}25.0mm$] and the average distance of anterior margin of condylar process of mandible to zygomatic point was $4.29{\pm}1.19mm$ [$1.0{\sim}7.0mm$]. Conclusion : The anatomical understandings including the size of the foramen ovale and localization of the zygomatic point could be helpful in determining a plan of percutaneous approaches to foramen ovale.

• 대한방사선기술학회지:방사선기술과학
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• 제45권6호
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• pp.483-489
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• 2022

This study proposes a new skull lateral examination, and provides an improved examination environment for patients and radiologists. The study was divided into three groups. One group was divided into the SID (source to image receptor distance) 110 ㎝ and 180 ㎝ in the skull lateral posture, the other group The other group was divided into an position in contact with the detector and an position without contact with the detector, and the other group was divided into male and female groups, considering that the difference in shoulder width between adult males and females would affect the dose and image quality. For dose evaluation, the ESD (entrance surface dose) was measured at the EAM (external auditory meatus), and the conditions were applied equally at 70 ㎸p, 200 ㎃, and 10 ㎃s. For image quality evaluation, SNR (signal to noise ratio) and CNR (contrast to noise ratio) were measured in frontal sinus, EAM, and sella turcica. As a result of ESD comparison, when sid 110 ㎝ to sid 180 ㎝ was changed among the three groups, ESD values decreased the most to 729.18±4.62 μ㏉ and 224.18±0.74 μ㏉ at 180 ㎝ (p<0.01). The values of SNR and CNR were statistically significant (p<0.01), but there was no qualitative difference. This shows that when the SID is 180 ㎝, it is possible to reduce the dose without lowering the image quality. So, It is suggested that the SID 180 ㎝ is used without contacting the detector when examining the skull lateral.

• 대한두개안면성형외과학회지
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• 제24권1호
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• pp.18-23
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• 2023

Background: When performing reduction of zygomatic arch fractures, locating the inward portion of the fracture can be difficult. Therefore, this study investigated the discrepancy between the locations of the depression on the soft tissue and bone and sought to identify how to determine the inward portion of the fracture on the patient's face. Methods: We conducted a retrospective review of chart with isolated zygomatic arch fractures of type V in the Nam and Jung classification from March 2013 to February 2022. For consistent measurements, a reference point (RP), at the intersection between a vertical line passing through the end point of the root of the ear helix in the patient's side-view photograph and a transverse line passing through the longest horizontal axis of the external meatus opening, was established. We then measured the distance between the RP and the soft tissue depression in a portrait and the bone depression on a computed tomography (CT) scan. The discrepancy between these distances was quantified. Results: Among the patients with isolated zygomatic arch fractures, only those with a fully visible ear on a side-view photograph were included. Twenty-four patients met the inclusion criteria. There were four types of discrepancies in the location of the soft tissue depression compared to the bone depression: type I, forward and upward discrepancy (7.45 and 3.28 mm), type II, backward and upward (4.29 and 4.21 mm), type III, forward and downward (10.06 and 5.15 mm), and type IV, backward and downward (2.61 and 3.27 mm). Conclusion: This study showed that discrepancy between the locations of the depressions on the soft tissue and bone exists in various directions. Therefore, applying the transverse and vertical distances measured from a bone image of the CT scan onto the patient's face at the indicated RP will be helpful for predicting the reduction location.

• Investigative Magnetic Resonance Imaging
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• 제24권1호
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• pp.38-45
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• 2020

Background: Differentiation of cerebellopontine angle (CPA) schwannoma from meningioma is often a difficult process to identify. Purpose: To identify imaging features for distinguishing CPA schwannoma from meningioma and to investigate the usefulness of susceptibility-weighted imaging (SWI) in differentiating them. Materials and Methods: Between March 2010 and January 2015, this study pathologically confirmed 11 meningiomas and 20 schwannomas involving CPA with preoperative SWI were retrospectively reviewed. Generally, the following MRI features were evaluated: 1) maximal diameter on axial image, 2) angle between tumor border and adjacent petrous bone, 3) presence of intratumoral dark signal intensity on SWI, 4) tumor consistency, 5) blood-fluid level, 6) involvement of internal auditory canal (IAC), 7) dural tail, and 8) involvement of adjacent intracranial space. On CT, 1) presence of dilatation of IAC, 2) intratumoral calcification, and 3) adjacent hyperostosis were evaluated. All features were compared using Chi-squared tests and Fisher's exact tests. The univariate and multivariate logistic regression analysis were performed to identify imaging features that differentiate both tumors. Results: The results noted that schwannomas more frequently demonstrated dark spots on SWI (P = 0.025), cystic consistency (P = 0.034), and globular angle (P = 0.008); schwannomas showed more dilatation of internal auditory meatus and lack of calcification (P = 0.008 and P = 0.02, respectively). However, it was shown that dural tail was more common in meningiomas (P < 0.007). In general, dark spots on SWI and dural tail remained significant in multivariate analysis (P = 0.037 and P = 0.012, respectively). In this case, the combination of two features showed a sensitivity and specificity of 80% and 100% respectively, with an area under the receiver operating characteristic curve of 0.9. Conclusion: In conclusion, dark spots on SWI were found to be helpful in differentiating CPA schwannoma from meningioma. It is noted that combining dural tail with dark spots on SWI yielded strong diagnostic value in differentiating both tumors.

• The Korean Journal of Physiology
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• 제2권1호
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• pp.39-45
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• 1968

Recently, in this department, pressure-displacement curve and breaking tension of dog and human tympanic membrane were studied using intact, fresh or dried tympanic membrane attached to external auditory meatus. However, physical property, proper elasticity-Young Modulus, of the tympanic membrane has not been clarified yet. Present study is attempted to further clarify proper Young Modulus of tympanic membrane, and to distinguish possible difference between layer of stratum radiatum and layer of stratum circulare of tympanic membrane in breaking tension and in Young Modulus. Tympanic membrane was excised from sacrificed dog, and preparation was made into the size of approximately 1 mm in width and 3 mm in length. In fresh or dried tympanic membrane, which was dried at $80^{\circ}C$ for 24 hrs., some preparations were made along the long axis parallel to the fibers of radial direction, and others were made along the long axis perpendicular to the radial fibers-circular direction. Breaking tension and displacement according to loading, were measured and Young Modulus was calculated in tympanic membrane preparations under the different experimental conditions. Results obtained are summarized as follows : 1. Young Modulus of fresh tympanic membrane in radial direction was $6.57{\times}10^8\;dyne/cm^2$, and that of fresh preparation in circular direction was $1.68{\times}10^8\;dyne/cm^2$. The Young Modulus of fresh tympanic membrane in radial direction resembles to that of silk and whale moustache. In dried tympanic membrane, Young Modulus of preparation of radial direction was $30.2{\times}10^8\;dyne/cm^2$ and that of preparation in circular direction was $25.0{\times}10^8\;dyne/cm^2$. 2. Breaking tension of fresh tympanic membrane was 44.9 gm/mm in radial preparation, and 7.9 gm/mm in circular preparation. In dried tympanic membrane, breaking tension was 46.7 gm/mm in preparation of radial direction, and 17.2 gm/mm in preparation of circular direction. 3. Much smaller breaking tension of the circular preparation-one fifth to the radial preparation-seemed to be responsible for the higher incidence of circular fiber breaking in tympanic membrane performation caused by trauma or sudden change in atmospheric pressure. 4. The correlation seemed to be very close between breaking tension and Young Modulus in tympanic membrane.

• 대한방사선기술학회지:방사선기술과학
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• 제40권1호
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• pp.121-126
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• 2017

의료용 디지털 영상 및 통신 표준 영상과 3차원 프린팅을 이용한 보청기 이어 쉘 제작기술을 연구하였다. 이는 기존에 없는 새로운 적용방법이며 보청기 수요자의 안전, 감염, 제작시간, 진행 단계를 줄일 수 있는 적용기술이다. 연구는 의료용 디지털 영상 및 통신 표준 영상으로 스테레오리소그래피 파일을 만들기 위한 0.5 mm, 1.0 mm, 2.0 mm의 볼륨으로 획득한 값을 3차원 프린터로 출력 전과 후의 과정에서 형상표면에 미치는 영향을 실험하였다. 출력 전에는 스테레오리소그래피 파일구조에 대해 상대적 관계를 비교하였고, 출력 후에는 이어 쉘 형상표면의 적층구조 간격을 현미경으로 확대하여 비교하였다. 스테레오리소그래피 파일구조 분석에서 0.5 mm, 1.0 mm, 2.0 mm의 순으로 삼각형 꼭지점, 5개 이상의 교차점, 최대 교차점의 개수가 많았으며 외이도 형상 자체의 굴곡도에 따라 Bending, Angle, Crest 영역 순으로 삼각형 구조가 조밀하게 분포하였다. 디지털 현미경에 의한 이어 쉘 형상표면은 2.0 mm, 1.0 mm, 0.5 mm 순으로 적층구조 간격이 두껍게 나타났다. 이와 같이 스테레오리소그래피 표면구조는 3차원 이어 쉘 형상의 굴곡도가 불규칙하고 스테레오리소그래피 파일을 만들기 위한 의료용 디지털 영상 및 통신 표준 데이터의 볼륨 값이 작을수록 교차하는 스테레오리소그래피 삼각형 구조는 조밀함을 알 수 있었다.