• The Korean Journal of Pain
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• v.33 no.2
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• pp.166-175
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• 2020

Background: The effect of dexmedetomidine as an adjuvant in the adductor canal block (ACB) and sciatic popliteal block (SPB) on the postoperative tramadol-sparing effect following spinal anesthesia has not been evaluated. Methods: In this randomized, placebo-controlled study, ninety patients undergoing below knee trauma surgery were randomized to either the control group, using ropivacaine in the ACB + SPB; the block Dex group, using dexmedetomidine + ropivacaine in the ACB + SPB; or the systemic Dex group, using ropivacaine in the ACB + SPB + intravenous dexmedetomidine. The primary outcome was a comparison of postoperative cumulative tramadol patient-controlled analgesia (PCA) consumption at 48 hours. Secondary outcomes included time to first PCA bolus, pain score, neurological assessment, sedation score, and adverse effects at 0, 5, 10, 15, and 60 minutes, as well as 4, 6, 12, 18, 24, 30, 36, 42, and 48 hours after the block. Results: The mean ± standard deviation of cumulative tramadol consumption at 48 hours was 64.83 ± 51.17 mg in the control group and 41.33 ± 38.57 mg in the block Dex group (P = 0.008), using Mann-Whitney U-test. Time to first tramadol PCA bolus was earlier in the control group versus the block Dex group (P = 0.04). Other secondary outcomes were comparable. Conclusions: Postoperative tramadol consumption was reduced at 48 hours in patients receiving perineural or systemic dexmedetomidine with ACB and SPB in below knee trauma surgery.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.5
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• pp.442-446
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• 2010

Purpose: The purpose of this study was to compare the clinical efficacy of popular bone graft materials mineralized allograft and deproteinized bovine bone mineral. Materials and Methods: One hundred seven implants of 78 patients, accompanied by sinus lift using the lateral window technique and simultaneous implantation, were sampled. In addition, some patients with severe systemic conditions were excluded. The initial bone heights of all patients ranged from 3-6 mm. All of the sample cases were treated at our hospital from January 2005 to January 2008. Techniques other than the lateral window technique were excluded, and only one graft material ($Tutoplast^{(R)}$ or Bio-$Oss^{(R)}$) was accepted for inclusion. $Tutoplast^{(R)}$ was used in 63 implants of 41 patients, whereas Bio-$Oss^{(R)}$) was chosen for the remaining 44 implants of 37 patients. The diameters of the particles used ranged from 0.25-1.0 mm, and the volume was 0.5-2 cc (mean, 1.5 cc). Results: The survival rate of the implant fixtures was 99.07% when the lateral window technique was used. Among all of the cases, cases in which $Tutoplast^{(R)}$ was used demonstrated a survival rate of 98.4%, whereas Bio-$Oss^{(R)}$) resulted in 100% survival. With respect to the alveolar bone height, no significant differences were detected between the two graft materials that failed. Conclusion: According to the result reported above, the two common materials for sinus augmentation do not have clinically significant difference. Rather, host factors, such as the height of residual bone, which could be disclosed during questioning patients' systemic conditions, might have greater effects on the prognosis.

• Research in Plant Disease
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• v.25 no.4
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• pp.173-178
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• 2019

From our field investigation from 2017 to 2018, five diseases and four insect pests have been identified as the primary biotic stressors of fruit-producing mulberry, which include popcorn disease and mulberry sucker, respectively. In this study, we examined the relative control effects of selected agro-chemicals against the popcorn disease and mulberry sucker. Our systemic treatment methods to simultaneously control the popcorn disease and the mulberry sucker indicated that an integrated control method showed a superior result with the control efficacy of 89.3%, while a conventional control method resulted in 66.7%. As a result, we concluded that it is much efficient to control both disease and insect pest in mid-April while sequentially applying chemicals only for the popcorn disease from February. By considering the ecological aspects of the popcorn disease and mulberry sucker, this systemic treatment will be able to reduce the labor of growers required for the control.

• Radiation Oncology Journal
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• v.37 no.4
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• pp.302-308
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• 2019

The abscopal effect is a term that has been used to describe the phenomenon in which localized radiation therapy treatment of a tumor lesion triggers a spontaneous regression of metastatic lesion(s) at a non-irradiated distant site(s). Radiation therapy induced abscopal effects are believed to be mediated by activation and stimulation of the immune system. However, due to the brain's distinctive immune microenvironment, extracranial abscopal responses following cranial radiation therapy have rarely been reported. In this report, we describe the case of 42-year-old female patient with metastatic melanoma who experienced an abscopal response following her cranial radiation therapy for her brain metastasis. The patient initially presented with a stage III melanoma of the right upper skin of her back. Approximately 5 years after her diagnosis, the patient developed a large metastatic lesion in her upper right pectoral region of her chest wall and axilla. Since the patient's tumor was positive for BRAF and MEK, targeted therapy with dabrafenib and trametinib was initiated. However, the patient experienced central nervous system (CNS) symptoms of headache and disequilibrium and developed brain metastases prior to the start of targeted therapy. The patient received radiation therapy to a dose of 30 Gy delivered in 15 fractions to her brain lesions while the patient was on dabrafenib and trametinib therapy. The patient's CNS metastases improved significantly within weeks of her therapy. The patient's non-irradiated large extracranial chest mass and axilla mass also shrank substantially demonstrating the abscopal effect during her CNS radiation therapy. Following radiation therapy of her residual chest lesions, the patient was disease free clinically and her CNS lesions had regressed. However, when the radiation therapy ended and the patient continued her targeted therapy alone, recurrence outside of her previously treated fields was noted. The disease recurrence could be due to the possibility of developing BRAF resistance clones to the BRAF targeted therapy. The patient died eventually due to wide spread systemic disease recurrence despite targeted therapy.

• The Journal of the Korea Contents Association
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• v.15 no.9
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• pp.662-669
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• 2015

The purpose of this study is to explore plan for increasing the analysis and understanding skills of literary works by using systemic thinking technique. This study used a literatures analysis method. The concrete study contents are as follows; First, it is centered on presenting values of literary education through analysing fairy tales conditions in Korean textbooks in relation to national curriculum for elementary and middle school. Second, it is to explore the features of systemic thinking technique. Third, it is to draw the instruction design model and application. Main expected effects of this study are breakaway from habitual routine, developing comprehensive and logical thinking ability, expanding fancy and imagination, cultivating innovative problem solving skill, inducing interest in literature, and increasing linguistic skills. That is, it is to be effective instruction strategy to enhance creativity and to cultivate character in classroom.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.6
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• pp.672-676
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• 2000

One of the current treatment methods for chronic osteomyelitis is removal of the infected and necrotic tissue to reduce the bacterial concentration as much as possible. This is performed concomitantly with antibiotic therapy. Chronic osteomyelitis(C.O.) implies chronic ischemia of the diseased bone. Thus, the treatment for C.O. requires high systemic level of antibiotics. In some cases, however, inherent undesirable adverse effects(for example, nephrotoxicity, ototoxicity, and others) may render this course of treatment difficult. Knowing that residual monomers are released from hardened bone cement, installation of antibiotic-impregnated PMMA(polymethyl-methacrylate) beads in situ have been one of treatment methods of C.O. When introduced into the wound, they established an exceedingly high level of local antibiotics for prolonged period without high systemic level of antibiotics. We experienced favorable results with vancomycin-impregnated PMMA beads for the treatment of C.O. of the mandible. So, we report it with literature reviews.

• Proceedings of the KSME Conference
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• 2000.11b
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• pp.371-376
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• 2000

In this study, the computational method is presented to simulate the hemodynamics of the patients after the Fontan procedure. The short-term feedback control models are implemented to assess the hemodynamic responses of the patients exposed to the stresses such as gravitational effect or hemorrhage. To construct the base line of the Fontan model, we assume an increase in venous tone, in heart rates, and in systemic resistance that are based on the clinical observations. For the verification of the present method we simulate the LBNP (lower body negative pressure) test for the normal and the Fontan model and we compare these with experimental data. Computational results show that the diastolic ABP(arterial blood pressure) increases but the systolic ABP decreases during LBNP. The increase in heart rate is due to the control system activated by the decreased mean ABP and CVP(central venous pressure). In case of the Fontan model, the increased venous tone is the reason of the diminished CVP change during LBNP. We also simulate 20% hemorrhage stress to the patient after the Fontan procedure and these results are compared with the experimental and the existing computational one. Computational results on the hemodynamics of patients after the Fontan procedure show that the mean ABP and cardiac output decrease. Heart rate and systemic resistance increase to compensate for the decrease in ABP. The sensitivity analysis according to the conduit resistance is also presented to delineate the effects of the local blood flow resistance. The cardiac output decreases according to the increase of the conduit resistance. The 50% increase in the conduit resistance causes about 3% decrease of cardiac output.

• Tuberculosis and Respiratory Diseases
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• v.50 no.3
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• pp.367-372
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• 2001

Bacillus Calmette-Guerin(BCG) has been widely used for the prophylaxis of superficial bladder tumor recurrence and for the treatment of bladder carcinoma in situ. More than 95% of patients who receive BCG instillation tolerate the treatment well and side reactions have been reported in less than 5% of patients. Most side effects are minor and self-limiting. However, a rare occurrence of severe systemic reactions have been reported. Among the severe systemic reactions, hypersensitivity pneumonitis should be considered in patients with pneumonic complications after BCG instillation in cases where the culture for mycobacteria is negative in the sputwn, brochoalveolar lavage and blood specimen. In addition, a fiberoptic bronchoscopy with transbronchial lung biopsy demonstrates a fibrosis of the alveolar septums, where there is and an increased lymphocyte count with out tuberculous inflammatory changes, the and CD4 : CD8 ratio is increased and no symptomatic response to antituberculosis chemotherapy is observed. Here we report a 68 years old man with interstitial pneumonitis following intravesical BCG instillation.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.9 no.2
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• pp.93-113
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• 2014

Objectives : This study aims to evaluate domestic/foreign clinical studies related to the traction therapy and analyse points to consider about cervical/lumbar traction therapy. Methods : Seven databases were searched for related articles about cervical/lumbar traction therapy from 1950 to 2014. Fourteen clinical studies and several systemic reviews were included among 144 studies searched. Out of fourteen clinical studies, four were case series and ten were controlled trials. Results : Most of included studies reported favorable effects of traction group compared to baseline of controlled group. The various mechanical factors most relevant to traction are 1) angle of pull and direction, 2) traction force, 3) duration of traction and frequency of treatment. Conclusions : We found various mistake in the applications of statistical methodologies of traction therapy targeting patients of cervical, lumbar vertebral disease. It is necessary for more randomized controlled trials to evaluate effect of cervical/lumbar traction therapy targeting patients of cervical, lumbar vertebral disease.

• Journal of Korean society of Dental Hygiene
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• v.16 no.6
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• pp.931-941
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• 2016

Objectives: The purpose of this study was to examine the association between depression and poor oral health in Korean elderly using Korean version of the Patient Health Questionnaire-9 (PHQ-9) for assessment of depressive symptoms. Methods: This study used the data from Korean National Health and Nutrition Examination Survey (KNHANES VI-2). The study included 1,454 elderly Korean aged over 65. Variables included demographic characteristics (gender, age), socioeconomic factor (income, education), systemic diseases, oral health related factor (tooth brush, dental products), health related factor (alcohol drinking, smoking), and depression. Logistic regression analysis was used as sequential models. Effects were quantified as odds ratios (OR) and 95% confidence intervals (CI). Results: From frequency analysis, being female, primary school or less, non-alcohol drinking, poor oral health were significantly related to depression. In the multiple logistic regression model, depression was significantly associated with poor oral health (OR=1.96, CI=1.15-3.53) after adjustment for other covariates including demographic characteristics, socioeconomic factor, systemic diseases, oral health related factor, and health related factor (OR=1.91, CI=1.13-3.27). Conclusions: Depression had an influence on the poor oral health after adjustment as confounding variable in the elderly. It should be focused on the health promotion for the elderly vulnerable to depression and poor oral health. The development of the mental health and oral health should be established.