• The Korean journal of helicobacter and upper gastrointestinal research
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• v.18 no.4
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• pp.264-270
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• 2018

Gastrointestinal stromal tumor (GIST) is a mesenchymal tumor derived from Cajal cells originating from the myotonic plexus. The expression of tyrosine kinase (KIT) membrane receptors that are active on KIT is inhibited by the KIT inhibitor imatinib mesylate. GISTs are resistant to conventional chemotherapy, and radiation therapy is not significantly beneficial for GISTs. With the development of imatinib mesylate, approximately 81.6% of patients with advanced and metastatic GIST exhibit an effect above the stabilization response, thereby increasing the survival time. However, imatinib mesylate alone is unlikely to cure metastatic GISTs. Even with a partial or stable response, imatinib mesylate may be used for a longer time period. However, resection of grossly visible lesions should be considered for patients with a stable response during surgical treatment. In this study, we present a case of GIST with liver metastasis after imatinib mesylate treatment, which was followed up without recurrence after partial resection.

• Journal of Trauma and Injury
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• v.34 no.2
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• pp.81-86
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• 2021

Purpose: This study investigated the clinical outcomes of trauma patients with blunt thoracic aortic injuries at a single institution. Methods: During the study period, 9,501 patients with traumatic aortic injuries presented to Trauma Center of Gil Medical Center. Among them, 1,594 patients had severe trauma, with an Injury Severity Score (ISS) of >15. Demographics, physiological data, injury mechanism, hemodynamic parameters associated with the thoracic injury according to chest computed tomography (CT) findings, the timing of the intervention, and clinical outcomes were reviewed. Results: Twenty-eight patients had blunt aortic injuries (75% male, mean age, 45.9±16.3 years). The majority (82.1%, n=23/28) of these patients were involved in traffic accidents. The median ISS was 35.0 (interquartile range 21.0-41.0). The injuries were found in the ascending aorta (n=1, 3.6%) aortic arch (n=8, 28.6%) aortic isthmus (n=18, 64.3%), and descending aorta (n=1, 3.6%). The severity of aortic injuries on chest CT was categorized as intramural hematoma (n=1, 3.6%), dissection (n=3, 10.7%), transection (n=9, 32.2%), pseudoaneurysm (n=12, 42.8%), and rupture (n=3, 10.7%). Endovascular repair was performed in 71.4% of patients (45% within 24 hours), and two patients received surgical management. The mortality rate was 25% (n=7). Conclusions: Traumatic thoracic aortic injuries are life-threatening. In our experience, however, if there is no rupture and extravasation from an aortic injury, resuscitation and stabilization of vital signs are more important than an intervention for an aortic injury in patients with multiple traumas. Further study is required to optimize the timing of the intervention and explore management strategies for blunt thoracic aortic injuries in severe trauma patients needing resuscitation.

• Journal of Korean Biological Nursing Science
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• v.23 no.2
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• pp.138-150
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• 2021

Purpose: This retrospective study aimed to investigate nursing interventions in patients with severe thoracic injury in trauma bay of a regional trauma center. Methods: Of the 1,780 patients admitted to the trauma bay of a regional trauma center in a university hospital in the Gyeonggi Province between January 1, 2019 and December 31, 2019, 120 adult patients with severe thoracic injury who met the inclusion criteria were enrolled. Participants' clinical characteristics and nursing interventions were collected from electronic medical records after receiving ethical approval. Nursing interventions were classified using the terminology in the Nursing Intervention Classification. Results: The mean age of participants was 52.25 years and 72.5% of participants were male. The main areas of thoracic injury included lung parenchyma and pleura (95.8%). The mean Abbreviated Injury Scale (AIS) for thoracic injury was 3.13 and the mean Injury Severity Score (ISS) was 17.81. Fluid resuscitation, invasive hemodynamic monitoring, chest tube care, respiratory monitoring, artificial airway management, gastrointestinal tube care, mechanical ventilation management: airway insertion and stabilization, blood product administration, allergy management, and surgical preparation were performed significantly more frequently in thoracic injury patients with unstable vital signs or a higher AIS score. Conclusion: This study is significant as it investigated the types of nursing interventions given to patients with severe thoracic injury in the trauma bay. These results would contribute to developing more detailed educational materials for initial nursing interventions in trauma bay.

• Journal of Trauma and Injury
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• v.35 no.1
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• pp.12-18
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• 2022

Purpose: Pedicle screw fixation provides 3-column stabilization, multidimensional control, and a higher rate of interbody fusion. Although computed tomography (CT) is recommended for the postoperative assessment of pedicle screw fixation, its use is limited due to the radiation exposure dose. The purpose of this preliminary retrospective study was to assess the clinical usefulness of low-dose mobile cone-beam CT (CBCT) for the postoperative evaluation of pedicle screw fixation. Methods: The author retrospectively reviewed postoperative mobile CBCT images of 15 patients who underwent posterior pedicle screw fixation for spinal disease from November 2019 to April 2020. Pedicle screw placement was assessed for breaches of the bony structures. The breaches were graded based on the Heary classification. Results: The patients included 11 men and four women, and their mean age was 66±12 years. Of the 122 pedicle screws, 34 (27.9%) were inserted in the thoracic segment (from T7 to T12), 82 (67.2%) in the lumbar segment (from L1 to L5), and six (4.9%) in the first sacral segment. Although there were metal-related artifacts, the image of the screw position (according to Heary classification) after surgery could be assessed using mobile CBCT at all levels (T7-S1). Conclusions: Mobile CBCT was accurate in determining the location and integrity of the pedicle screw and identifying the surrounding bony structures. In the postoperative setting, mobile CBCT can be used as a primary modality for assessing the accuracy of pedicle screw fixation and detecting postoperative complications.

• Journal of Korean Foot and Ankle Society
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• v.28 no.1
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• pp.8-14
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• 2024

Purpose: Ankle fracture fixation is the gold standard of treatment but it does have its own complications. There is inadequate data regarding the comparative effectiveness of early vs. delayed fixation for open ankle fracture outcomes. This study compares the clinical and functional outcomes of open ankle fractures treated by early or delayed definitive fixation and identifies the limitations of both methods. Materials and Methods: All 73 patients enrolled in the study underwent surgical intervention within 24 hours of injury. The early fixation group (group A) consisting of 39 patients underwent definitive fixation as an index procedure, while the delayed fixation group (group B) consisted of 34 patients who underwent debridement and external fixator application as an index procedure and definitive fixation when soft tissue condition was conducive. All patients were evaluated at 2, 6, and 12 weeks postoperatively and then three monthly for a year. Results: Enneking and American Orthopaedic Foot and Ankle Society scores were markedly higher in the early fixation group at 6 months postoperatively (p-values <0.001 and 0.011, respectively). However, no discernible intergroup difference was evident at 12 months postoperatively. Between 6 and 12 months, group functional outcome scores were significantly different. At 6 months, there was a substantial difference in dorsiflexion between the two groups (p-values 0.001 and <0.001, respectively), but no difference was observed at 12 months postoperatively. At 6 and 12 months, group average plantar flexions were non-significantly different. Conclusion: Early definitive fixation of complex ankle fractures using a targeted approach produced promising results for lower grade open fractures (grades 1 and 2), and delayed definitive fixation, after initial external fixation to allow for soft tissue stabilization, produced promising results for higher grade open fractures (grades 3A and 3B). At 12-month follow-ups, clinical and functional outcomes achieved using these strategies were equivalent.

• Journal of Korean Ophthalmic Optics Society
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• v.19 no.1
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• pp.31-42
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• 2014

Purpose: The present study was conducted to investigate the effect of the physical properties of RGP lens induced by lens polishing on the actual wearer's subjective comfort, the tear film break-up time and the blinking rate as a follow-up study that revealed the relationship between the lens physical properties during lens manufacturing and lens wearer's factors. Methods: RGP lenses made from the three different polishing conditions (25, 50 and 100 seconds) were applied on 28 eyes of 17 subjects, aged 20 to 29 years, without any known disease and surgical history in the eyes. While the subjects were asked to wear the RGP lenses longer than a week, the questionnaire for the comfortability was administered everyday. Subjective and objective tear break-up time and blinking rate of the wearers were further measured. Results: The wearer's subjective comfortability showed some difference in the type of discomfort and satisfaction score according to the polishing status when wearing RGP lenses made from different polishing conditions longer than a week, and a bigger difference in satisfaction score induced by polishing condition was especially shown in experienced RGP lens wearer rather than un-experienced wearer. In the case of RGP lens wearer compared with the ones without the wearing experience, as the wearing time increased subjective and objective tear break-up time were increased and the blinking rate was decreased. However, subjective and objective tear break-up time were tended to decrease with even longer wearing time when wearing the RGP lens made from the polishment for 100 seconds. Conclusions: These results confirmed that the optimization of physical properties of the lens may not give the same effect on the wearer's subjective and objective symptoms and other factors when actual wearing. From the results, it can suggest that the success rate of RGP lens wear may be changed by physiological factors such as the stabilization of wearer's tear film, comfortability and lens wearing experience when wearing RGP lens based on 'The manufacturing standard for soft contact lens/hard contact lens' provided by Korea Food and Drug Administration.

• Journal of Veterinary Clinics
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• v.30 no.1
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• pp.49-52
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• 2013

A wild black-crowned night heron (Nycticorax nycticorax) with dehydration and a non-weight bearing lameness of the left leg was rescued. On physical examination, the left knee was displaced laterally at almost a $90^{\circ}$ angle with firm swelling and crepitus in the area of the coxofemoral joint. Radiographs confirmed cranio-dorsal coxofemoral luxation. A closed reduction attempt failed. The coxofemoral joint luxation was reduced surgically by placement of the femoral neck next to the pelvis with a suture. Ten days after surgery, radiographs and computed tomography showed the femoral neck and head were positioned well within the acetabulum. At 20 days, the bird was using the affected limb normally, and could hunt and forage for food in a rehabilitation housing unit with a small pond. The bird was successfully released into the wild. The placement of the femoral neck adjacent to the pelvis with a suture can be successfully performed for cases of avian coxofemoral joint luxation. Furthermore, this procedure can provide sufficient stabilization of the coxofemoral joint and acceptable limb function.

• Neonatal Medicine
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• v.16 no.1
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• pp.64-70
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• 2009

Congenital diaphragmatic hernia (CDR) with severe pulmonary hypoplasia is associated with significant mortality. Recently, several new therapeutic methods have been suggested, such as high-frequency oscillatory ventilation and inhaled nitric oxide. For hypoxemic respiratory failure unresponsive to these advanced medical treatment options, extracorporeal membrane oxygenation (ECMO) serves as the last potentially effective treatment. An understanding of the pathophysiology of pulmonary hypertension associated with CDH led to a strategy involving preoperative stabilization and delayed surgical intervention with ECMO. We describe four cases of ECMO, including the first report of ECMO for neonatal CDH in Korea.

• The Journal of Korean Academy of Prosthodontics
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• v.36 no.2
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• pp.203-244
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• 1998

The human mandible is always under the condition of loading by the various forces extorted by the attached muscles. The loading is an important condition of the stomatognathic system. This condition is composed of the direction and amount of forces of the masticatory muscles, which are controlled by the neuromuscular system, and always influenced by the movement of both opening and closing. Mandible is a strong foundation for the teeth or various prostheses, nevetheless it is a elastic body which accompanies deformation by the external forces on it. The elastic properties of the mandible is influenced by the various procedures such as conventional restorative treatments, osseointegrated implant treatments, reconstructive surgical procedures and so forth. Among the treatments the osseointegrated implant has no periodontal ligaments, which exist around the natural teeth to allow physiologic mobility in the alveolar socket. And so around the osseointegrated implant, there is almost no damping effect during the transmission of occlusal stress and displacements. If the osseointegrated implants are connected by the superstructure for the stabilization and effective distribution of occlusal stresses, the elastic properties of mandible is restricted according to the extent of 'splinting' by the superstructure and implants. To investigate the change of elastic behaviour of the mandible which has osseointegrated implant prosthesis of various numbers of implant installment and span of superstructre, a three dimensional finite element model was developed and analyzed with conditions mentioned above. The conclusions are as follows : 1. The displacements are primarily developed at the area of muscle attachment and distributed all around the mandible according to the various properties of bone. 2. The segmentation in the superstructure has few influence on the distribution of stress and displacement. 3. In the load case of ICP, the concentration of tensional stress was observed at the anterior portion of the ramus($9.22E+6N/m^2$) and at the lingual portion of the symphysis menti($8.36E+6N/m^2$). 4. In the load case of INC, the concentration of tensional stress was observed at the anterior portion of the ramus($9.90E+6N/m^2$) and the concentration of tensional stress was observed at the lingual portion of the symphysis menti($2.38E+6N/m^2$)). 5. In the load case of UTCP, the relatively high concentration of tensional stress($3.66E+7N/m^2$) was observed at the internal surface of the condylar neck.

• Journal of Veterinary Clinics
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• v.32 no.3
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• pp.231-234
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• 2015

This study measured the tibial plateau angle (TPA), a value that predicts cranial cruciate ligament rupture (CCLR) and a prerequisite for dynamic stabilization, in small breed dogs. The cadavers of 32 skeletally mature small breed dogs without CCLR were used to measure TPA. Differences were evaluated between males and females, left and right limbs, and among breeds. The mean TPA of all dogs was $26.13^{\circ}{\pm}2.33^{\circ}$. The mean TPAs of left and right limbs were $26.00^{\circ}{\pm}2.23^{\circ}$ and $26.26^{\circ}{\pm}2.45^{\circ}$, respectively, which was not a significant difference. The mean TPAs of male and female dogs were $26.01^{\circ}{\pm}1.57^{\circ}$ and $26^{\circ}.22{\pm}2.80^{\circ}$, respectively, which was also not significant difference. The mean TPAs in Maltese, Poodle, Shih Tzu, and Yorkshire terrier were $26.06^{\circ}{\pm}2.96^{\circ}$, $25.21^{\circ}{\pm}1.38^{\circ}$, $26.65^{\circ}{\pm}2.96^{\circ}$, and $26.27^{\circ}{\pm}1.61^{\circ}$, respectively. Differences in these means were not statistically significant. The TPA measured from this study could provide important information for further investigation of the pathogenesis of and surgical techniques for CCLR in small breed dogs.