• 제목/요약/키워드: Primary Head

검색결과 710건 처리시간 0.028초

Copula 함수를 이용한 이변량 가뭄 지역빈도해석 모형 개발 (A development of bivariate regional drought frequency analysis model using copula function)

  • 김진국;김진영;반우식;권현한
    • 한국수자원학회논문집
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    • 제52권12호
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    • pp.985-999
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    • 2019
  • 전 세계적으로 극심한 가뭄현상이 반복적으로 발생하고 있으며, 이러한 가뭄을 분석하기 위한 연구가 다수 진행되고 있다. 최근 코플라 함수를 활용한 이변량 가뭄빈도해석에 대한 연구가 다수 진행된 바 있으나, 대부분 지점빈도해석에 국한되어 진행되었으며, 통계적으로 부족한 자료의 기간을 보완하기 위한 대안으로 지역빈도해석 개념을 도입한 연구는 미진한 실정이다. 이러한 점에서 본 연구에서는 기존의 베이지안 기법과 코플라 함수를 연계한 이변량 지역빈도해석 모형을 개발하였다. 최종적으로 이변량 코플라 가뭄 지역빈도해석 모형을 한강유역에 적용하여 2013-2015년에 발생한 가뭄 사상을 평가하였으며, 기존에 개발된 이변량 지점빈도해석 결과와 비교를 통해 모형의 해석결과에 대한 신뢰성을 확보하였다. 결과적으로 이변량 지점빈도해석에 비해 가뭄사상에 대한 결합재현기간의 불확실성 구간이 약 3배 가까이 감소하였으며, DIC 통계량 산정결과 약 15 이상 개선된 것을 확인하였다. 본 연구를 통해 제안된 베이지안 코플라 기반 이변량 가뭄 지역빈도해석 모형은 가뭄자료의 분포특성 및 자료간의 상관성을 효과적으로 재현하는데 유리할 뿐만 아니라, 지역적인 가뭄특성을 효과적으로 평가할 수 있는 장점을 확인할 수 있었다.

거대세포종의 치료시 관절 기능의 보존 (The Preservation of Joint Function in Treatment of Giant Cell Tumor of Bone)

  • 배대경;한정수;선승덕;백창희;이재훈
    • 대한골관절종양학회지
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    • 제1권2호
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    • pp.145-153
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    • 1995
  • Giant cell tumor is most frequently found in juxtaarticular region, and difficult to treat because of local recurrence. Although primary resections reduce recurrence, the joint function will be markedly impaired. Techniques involving physical adjuncts(high speed burr and electric cauterization), acrylic cement or en bloc resection with VFG(vascularized fibular graft) have been employed to reduce local recurrence. From October 1984 to April 1994, twenty-nine patients diagnosed as giant cell tumor were treated at department of Orthopaedic Surgery, School of Medicine, Kyung Hee University. There were eleven men and 18 women, ranging in age from 17 to 52 years(mean: 34 years). The average follow-up period was four years and five months. The location of the lesion was around the knee in 15, distal radius in three, femoral head in three, and others in eight patients. Fifteen patients around the knee joint were treated with several modalities; curettage with bone graft in five, curettage with cement filling in three, curettage with bone graft and physical adjuncts in five, en bloc resection with VFG in one and en bloc resection with arthroplasty in one patient. The functional results, according to the Marshall's knee score, were excellent in one, good in two, and fair in two after the curettage with bone graft, good in three after the curettage with bone cement filling, excellent in one, good in four after the curettage with bone graft and physical adjuncts, and good in two after the en bloc resection with VFG or arthroplasty. Three patients had local recurrence among 15 patients with giant cell tumor around knee. Vascularized fibular graft around wrist joint provided good functional restoration without local recurrence in all three patients who had giant cell tumor in distal radius. Although there is no statistical significance, it seems that curettage with bone graft using physical adjuncts or acrylic cement reveals better results than simple curettage with bone graft. Excellent functional result were obtained without local recurrence by using vascularized fibular graft after en bloc resection.

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부적절한 일차 처치와 연관된 이하선 종양 2례 (Tumors of the Parotidomasseteric Area Associated with Inadequate Primary Treatment: Report of 2 Cases)

  • 송진우;최환준;김미선;안형식;김준혁;이영만
    • Archives of Plastic Surgery
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    • 제33권6호
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    • pp.764-768
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    • 2006
  • Purpose: Parotid neoplasia are relatively frequent, representing approximately 3% of all tumors in the head and neck regions. But incomplete resection and misdiagnosis of parotid gland is followed by multiple tumor invasion, tumor recurrence, and other iatrogenic tumor formation. In patients undergoing parotidectomy for confirmed or suspected malignancy, the traditional or modified rhytidectomy incision may prove suboptimal because it does not easily lend itself to a continuous neck dissection. Similarly, patients with tumors of the anterior accessory lobe or patients with large anterior tumors may also require the modified Blair incision for adequate surgical exposure. This report serves to revisit the topic of accessory and parotid gland neoplasms to emphasize proper management, particularly the surgical aspects, so that consequences of recurrence are avoided. Methods: This is a retrospective review of our experience with two cases of parotid tumors; one accessory parotid gland neoplasm and one parotid gland neoplasm. We report the case of parotid tumor and epidermal cyst in a 54-year old male patient and the case of case of recurrent parotid tumor with local invasion in 30-year old male patient. Results: All were removed through a modified Blair incision. Pathologic report notified that One was found pleomorphic adenoma and epidermal cyst, and the other one pleomorphic adenoma with subcutenous invasion. The patients recovered well without any complication such as infection, hematoma, facial nerve palsy, and necrosis of skin flap. Patients were discharge POD#7. Patients were followed up to for 1 year and they have no sign of recurrence. Conclusions: A high index of suspicion, prudent diagnostic skills(including fine-needle aspiration biopsy, CT, US), and meticulous surgical approach are the keys to a successful management of these lesions. We experienced two cases of parotid neoplasia, in the treatment of tumor reccurence & iatrogenic tumor arising from the parotid gland and are presented with the review of literatures.

일 병원에서의 병원감염관리활동 사례연구 (A Case Study on Nosocomial Infection Control Activities in A General Hospital in Pusan)

  • 배영순
    • 한국의료질향상학회지
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    • 제2권2호
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    • pp.156-171
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    • 1996
  • Background: Nosocomial infection control is one of important means to assure the quality of medical care in the hospital, however, it has been neglected by most of the hospital personnels. Of nosocomial infections, urinary tract infection is the highest incidence, which is related to the indwelling catheter. It is, therefore, necessary to pay primary attention to the patients with the indwelling catheter in intensive care unit in order to control nosocomial Infection and to improve the quality of medical care in the hospital. Methods : The subjects of this study were patients with indwelling catheter who were admitted to the ICU of Pusan Paik Hospital from March 1994 to May 1995. The author calculated UTI rate among the subjects through the cultivation of the urine, identified the related factors of the UTI through brain storming of study team and head nurses working at ICU, and analized the effectiveness of the proposed approaches through comparing the infection rates of before and after activities. Results : The major activities carried out by the study team were to conduct in-service education programs for the staffs working at ICU about the importance of the nosocomial infection control in QA, and nursing intervention to reduce the UTI rate among the patients with indwelling catether. 1. The major nursing interventions that the study team had implemented were as follows ; 1) Drainage system was changed from partial open system to completely closed system. 2) Bladder irrigation which was routinely practised in all patients stopped among the noninfected patients. 3) Bladder irrigation set was changed to the disposable one. 4) Catheter was inserted under the anesthesia for patients to be operated. 5) Male patient receiving wrapped with gauze after perineal care was not wrapped. 6) Clamp which had not been before was newly attached to drainage tube. 7) Urine bag which had been packed into a lot of pieces was done into each piece. 8) The interval of change of indwelling catheter had regularly been four weeks, however it was used continously until it worked well. 9) Catheter was attached well at the defined site. 10) Paper towel was used instead of cotton towel. 11) Mats at the entrance were removed and cleansing of wards was enhanced. 2. The UTI rate by month was 34.4% in maximum and 9.8% in minimum during the period of this study, however it had gradually decreased. After 6 months from initiating infection control activities, the trend of rates was relatively stable. It was identified that UTI rate was different by season 12.5% in winter and 27.2% in summer. 3. Utilization rate of indwelling catheter was maintained at under 50%, but it was increased above 57% from April 1995. 4. The number of bladder irrigation sets used per day was 33.3 sets in maximum and 2.8 sets in minimum. The number used per day were also remarkably deceased. Conclusion : It was found that a program to control UTI could contribute to nosocomial infection control, and it was, in turn, a mean to assure the quality of medical care in the hospital. The nursing interventions which this study team had implemented were effective in the reduce of UTI rates.

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경주 서악리 삼층석탑의 훼손상태 및 보존처리 (Deterioration and Conservation Treatment of the Three Storied Stone Pagoda in Seoak-ri, Gyeongju)

  • 이명성;정민호;정영동;이찬희
    • 보존과학회지
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    • 제18권
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    • pp.63-74
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    • 2006
  • 경주서악리 삼층석탑의 모든 부재는 정동이 잘 발달된 중립질의 회백색 알카리 화강암으로 구성되어 있다. 이 석탑은 이미 보수되어 전체적으로 안정감을 주며 상륜부를 제외하면 거의 원형을 보존하고 있다. 그러나 석탑에 직접적인 영향을 가하는 주변의 수목과 지반에 서식하는 잔디의 영향으로 지대석과 기단부 및 옥개석의 상부에는 지의류를 비롯한 미생물의 서식이 심각한 상태이다. 따라서 보존처리는 일차 건식세정을 실시하였고 이차로 습식세정을 실시하였다. 이때 잘 제거되지 않는 지의류 및 오염물 등은 고온스팀을 이용하여 제거하였다. 또한 이미 보수에 사용되었던 콘크리트와 에폭시 수지를 제거를 하고 에폭시계 합성수지에 탈크와 알카리 화강암 파우더 등의 충전제를 혼합하여 복원하였다. 부재들의 질감을 맞추기 위해 합성수지와 충전제의 혼합과정에서 색 맞춤을 하였다. 또한 석탑의 동쪽에 있는 사면으로부터 흘러내리는 빗물의 유입을 최소화하기 위해 배수로를 설치하였으며, 석탑주변에 서식하고 있는 수목 및 잔디를 제거하여 습기 발생을 최소화함으로서 향후지의류의 발생을 억제시키고자 하였다.

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구강 결손부에 적용된 요골 유리전완 피부피판 적용례 분석 (Clinical Cases Analysis of Forearm Free Fasciocutaneous Flaps on Oral Cavity Defect Area)

  • 김욱규;이광호;송원욱;황대석;김용덕;신상훈;김종렬;정인교
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제32권4호
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    • pp.324-331
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    • 2010
  • The radial forearm free flap (RFFF) has become a workhorse flap as a means of reconstructing surgical defects in the head and neck region. We have transferred 12 RFFFs with fasciocutaneous type on oral cavity defects in 12 patients after cancer resection and submucous fibrotic lesion ablation from 2005 to 2007 at Department of oral and maxillofacial surgery, Pusan National University Hospital. We reviewed retrospectively patients' charts and followed up the patients. Clinical analysis on the cases with RFFFs focusing on flap morbidity, indications and available vessels was done. The results of study are follows: 1. RFFF could be applied for all kind of defects after resection of tongue, floor of mouth, buccal mucosa, denuded bone of palate, maxilla, and mandible. 2. All free flaps could be used for primary reconstruction. The survival rate of 12 RFFFs was 92%. Partial marginal loss of the flaps was shown as 3 cases among 12 cases. Large size-vessels like superior thyroid artery, facial artery, internal jugular vein were favorable for microvascular anastomosis. 3. Parenteral nutrition instead of nasal L-tube also can be favorable for postoperative a week for better healing of the flap if the patients couldn't be tolerable with nasal tubing. 4. Donor sites with thigh skin graft were repaired with wrist band for 2 weeks. The complications included scarring, abnormal sensation on hand, and reduced grip strength in few patients, but those didn't induce major side effects. 5. Most RFFFs were well healed even if mortality rate of cancer patients was shown as 50% (5/10 persons). The mortality of patients was not correlated with morbidity of the flaps. We could identify the usefulness of RFFF for restoration of oral function, esthetics if the flap design, tissue transfer indications, and well controlled operation are proceeded.

Lung Cancer Knowledge among Secondary School Male Teachers in Kudat, Sabah, Malaysia

  • Al-Naggar, Redhwan Ahmed;Kadir, Samiah Yasmin Abdul
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권1호
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    • pp.103-109
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    • 2013
  • Background: The objective of this study is to determine knowledge about lung cancer among secondary school male teachers in Kudat, Sabah, Malaysia. Materials and Methods: A cross-sectional study was conducted among three secondary schools located in Kudat district, Sabah, Malaysia during the period from June until September 2012. The protocol of this study was approved by ethics committee of Management and Science University, Malaysia. The aims were explained and a consent form was signed by each participant. Respondents were chosen randomly from each school with the help of the headmasters. Self-administrated questionnaires, covering socio-demographic characteristics and general knowledge of lung cancer, were distributed. Once all 150 respondents completed the questionnaire, they passed it to their head master for collecting and recording. All the data were analyzed using Statistical Package for the Social Sciences (SPSS) version 13. ANOVA and t-test were applied for univariate analysis; and multiple linear regression for multivariate analysis. Results: A total of 150 male secondary school teachers participated in this study. Their mean age was $35.6{\pm}6.5$ (SD); maximum 50 and minimum 23 years old. More than half of the participants were Malay and married (52%, 79%; respectively). Regarding the knowledge about lung cancer, 57.3% of the participants mentioned that only males are affected by lung cancer. Some 70.7% mentioned that lung cancer can be transmitted from one person to another. More than half (56.7%) reported that lung cancer is not the leading cause of death in Malaysian males. As for risk factors, the majority reported that family history of lung cancer is not involved. However, 91.3% were aware that cigarettes are the main risk factor of lung cancer and more than half (52%) believed that second-hand smoking is one of the risk factor of lung cancer. More than half (51.3%) were not aware that asbestos, ionizing radiation and other cancer causing substances are risk factors for lung cancer. Quitting smoking, avoiding second-hand smoking and avoiding unnecessary x-ray image of the chest (53.3%, 96.0%, 87.3%; respectively) are the main preventive measures mentioned by the participants. For the factors that influence the participants knowledge, univariate and multivariate analysis showed that only race was significant. Conclusions: Overall, the knowledge of school male teachers about lung cancer was low. However, few items were scored high: cigarettes are the main risk factor; avoiding second-hand smoking; and avoiding x-rays. Interventions to increase lung cancer awareness are needed to improve early detection behavior. Increase the price of pack of cigarettes to RM 20 and banning smoking in public places such as restaurants are highly recommended as primary preventive measures.

3T MRI에서 흡수영역의 변화에 따른 Birdcage Resonator의 개발 (Development of Birdcage Resonator for Various Absorption Regions at 3T)

  • 이정우;최보영;윤성익;이형구;서태석;허순녕
    • 한국의학물리학회지:의학물리
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    • 제15권1호
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    • pp.54-58
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    • 2004
  • 목적: 인체에 비해 크기가 작은 동물의 자기공명영상을 획득하기 위하여 현재 사용되고 있는 Head 코일보다 원통 반지름이 작은 Low-pass Filter 형태의 Birdcage Resonator를 제작하여 보다 큰 신호대잡음비(Signal-to-Noise Ratio: SNR)를 획득함으로써 고해상도의 영상을 얻고자 하였다. 방법: 원통형의 아크릴과 구리테이프를 사용하여 각각 내경 지름이 13 cm, 15 cm이고, 길이 30 cm, 12개의 element를 가진 동물용 Low-pass Filter 형태의 Birdcage Resonator를 각각 제작하였고, 자기공명영상을 얻기 위하여 Spin Echo Pulse Sequence와 Fast Spin Echo Pulse Sequence를 사용하였다. 제작된 Birdcage Resonator는 실험적 수치와 팬톰과 동물에 대한 MR영상으로 그 가치를 평가하였다. 결과: 대상물의 크기에 따른 SNR을 비교하기 위하여 다양한 크기의 코일을 이용하여 각각의 팬톰 영상을 획득하였다. 팬톰 영상으로부터 측정된 SNR의 값을 통해 코일의 크기에 대한 대상물의 크기를 알 수 있었다. 토의 및 결론: 본 연구를 통하여 같은 형태의 Birdcage Resonator일 경우 대상물의 크기에 따라 SNR이 다르며, 특히 대상물의 크기가 코일 크기의 40∼80% 정도일 때 SNR이 더 크다는 것을 알 수 있었다. 따라서 코일의 크기에 비해 촬영하고자 하는 대상물의 부피가 작은 경우 대상물의 부피에 맞추어 코일을 제작하면 SNR이 보다 뛰어난 영상을 얻을 수 있을 것으로 사료된다.

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Down Regulation of miR-34a and miR-143 May Indirectly Inhibit p53 in Oral Squamous Cell Carcinoma: a Pilot Study

  • Manikandan, Mayakannan;Rao, Arunagiri Kuha Deva Magendhra;Arunkumar, Ganesan;Rajkumar, Kottayasamy Seenivasagam;Rajaraman, Ramamurthy;Munirajan, Arasambattu Kannan
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권17호
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    • pp.7619-7625
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    • 2015
  • Background: Aberrant microRNA expression has been associated with the pathogenesis of a variety of human malignancies including oral squamous cell carcinoma (SCC). In this study, we examined primary oral SCCs for the expression of 6 candidate miRNAs, of which five (miR-34a, miR-143, miR-373, miR-380-5p, and miR-504) regulate the tumor suppressor TP53 and one (miR-99a) is involved in AKT/mTOR signaling. Materials and Methods: Tumor tissues (punch biopsies) were collected from 52 oral cancer patients and as a control, 8 independent adjacent normal tissue samples were also obtained. After RNA isolation, we assessed the mature miRNA levels of the 6 selected candidates against RNU44 and RNU48 as endogenous controls, using specific TaqMan miRNA assays. Results: miR-34a, miR-99a, miR-143 and miR-380-5p were significantly down-regulated in tumors compared to controls. Moreover, high levels of miR-34a were associated with alcohol consumption while those of miR-99a and miR-143 were associated with advanced tumor size. No significant difference was observed in the levels of miR-504 between the tumors and controls whereas miR-373 was below the detection level in all but two tumor samples. Conclusions: Low levels of miR-380-5p and miR-504 that directly target the 3'UTR of TP53 suggest that p53 may not be repressed by these two miRNAs in OSCC. On the other hand, low levels of miR-34a or miR-143 may relieve MDM4 and SIRT1 or MDM2 respectively, which will sequester p53 indicating an indirect mode of p53 suppression in oral tumors.

수지 첨부 절단창의 재접합술 시 원위지 관절 고정과 운동 범위의 관계 (A Comparative Study of Range of Motion With or Without Distal Interphalangeal Joint Fixation in Replantation of the Amputated Fingertips)

  • 한승규;노시영;김진수;이동철;기세휘;양재원
    • Archives of Reconstructive Microsurgery
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    • 제20권1호
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    • pp.18-25
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    • 2011
  • Purpose: In the process of replantation of the amputated fingertips, the primary concern was given to survival of the amputees, while the functional aspect of digits after the surgery has been easily neglected. Although an internal fixation with a K-wire is often a part of replantation of the amputated fingertips, little consideration had been given to the study of relationship between distal interphalangeal joint fixation and post operative range of motion. A comparative study in relation to post operative range of motion was done on two different groups, one group with K-wire insertion and the other group without a K-wire insertion at the distal interphalangeal joint. Materials and Methods: The study was done on the cases of a single digit amputation conducted at our institute (the age in the range of 10 to 60) in about four-year of time span from March of 2005 to March of 2009. The cases with a thumb replantation, osteomyelitis or articular surface injury have been excluded from this study. The cases of both head and shaft fracture, except the insertion site of tendon, of distal phalanx of internal fixation with a single K-wire were reviewed for this study. A group of 24 cases without distal interphalangeal joint fixation in comparison to a group of 22 cases with distal interphalangeal joint fixation was reviewed to assess the postoperative range of motion at distal interphalangeal joint on the 6th week after the surgery. And, on the 30th month after the surgery, a group of 10 cases without distal interphalangeal joint fixation in comparison to a group of 10 cases with joint fixation was reviewed. A K-wire was removed in about 5 weeks after the fracture was reunited under the radiographic image, immediately followed by a physical therapy. Result: The active range of motion for a group without interphalangeal joint fixation was measured $49.0^{\circ}$ on average, while $28.6^{\circ}$ was measured for a group with interphalengeal fixation on the 6th week after the surgery. On the 30th month after the surgery, the active range of motion was measured $52.0^{\circ}$ and $55.0^{\circ}$ on average for a group without and with interphalangeal fixation respectively. Conclusion: In the process of replantation of the amputated fingertips, short-term(on the 6th week) improvement of postoperative active motion of range can be expected in the cases without distal interphalangeal fixation in comparison to the cases of interphalangeal joint fixation with a K-wire. However, there seems to be no difference on motion of range in a long-term (on the 30th month) follow up period.

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