• The Journal of Korean Academy of Prosthodontics
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• v.46 no.4
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• pp.381-395
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• 2008

Purpoose: For decades dental implants have been used widely in the field of prosthetic dentistry. However there is confusion when establishing treatment plans in cases where some teeth are remained but an insufficient number of implants can be used due to limited anatomical status and ecomomical problems. Many clinicians have tried to connect natural teeth and implants, and it still has controversy. But, there have been few studies on mechanical analysis of connecting natural teeth and implants with konus telescopic removable partial dentures. The purpose of this study was to analyze the stress distribution of prosthesis, abutment and alveolar bone when teeth and implants were connected with the konus telescopic denture, by means of 3-dimensional finite element analysis. Material and methods: The assumption of this study was that there were 2 mandibular canine (11 mm in length, 4 mm in diameter) and 2 implants(10 mm in length, 4 mm in diameter) which are located in the second premolar region. The mandible, teeth, implants, abutments, and connectors are modeled, and analyzed with the commercial software, ANSYS Version 8.1(Swanson, Inc., USA). The control group used implants instead of natural teeth. 21038 elements, 23544 nodes were used in experimental group and 107595 elements, 21963 nodes were used in control group, Stress distribution was evaluated under 150 N vertical load on 3 experimental conditions - between teeth and implants (Load case 1), posterior to implants (Load case 2), between natural teeth (Load case 3). Results: 1. In all load cases, higher von mises stress value was observed in the experimental group. 2. Maximum von miss stress observed in all load cases and all locations were as follows ; a. 929.44 Mpa in the experimental group, 640.044 Mpa in the control group in outer crown and connector - The experimental group showed 1.45 times high value compared with the control group. b. 145,051 Mpa in the experimental group, 142.338 Mpa in the control group in abutment - The experimental group showed 1.02times high value compared with the control group. c. 32.489 Mpa in the experimental group, 25.765 Mpa in the control group in alveolar bone - The experimental group showed 1.26times higher value compared with the control group. 3. All maximum von mises stress was observed in load case 2, and maxim von mises stress in alveolar bone was 32.489 Mpa at which implant failure cannot occur. 4. If maximum von mises stress is compared between two groups, the value of the experimental group is 1.02 times higher than the control group in abutment, 1.26 times higher than the control group in alveolar bone. Conclusion: If natural teeth and implants are connected with the konus telescopic denture, maximum stress will be similar in abutment, 1.26 times higher in alveolar bone than the control group. With this result, there may be possible to make to avoid konus telescopic dentures where natural teeth and implants exist together.

• The korean journal of orthodontics
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• v.36 no.5
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• pp.339-348
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• 2006

Objective: With development of the skeletal anchorage system, orthodontic mini-implant (OMI) assisted on masse sliding retraction has become part of general orthodontic treatment. But compared to the emphasis on successful anchorage preparation, the control of anterior teeth axis has not been emphasized enough. Methods: A 3-D finite element Base model of maxillary dental arch and a Lingual tipping model with lingually inclined anterior teeth were constructed. To evaluate factors influencing the axis of anterior teeth when OMI was used as anchorage, models were simulated with 2 mm or 5 mm retraction hooks and/or by the addition of 4 mm of compensating curve (CC) on the main archwire. The stress distribution on the roots and a 25000 times enlarged axis graph were evaluated. Results: Intrusive component of retraction force directed postero-superiorly from the 2 mm height hook did not reduce the lingual tipping of anterior teeth. When hook height was increased to 5 mm, lateral incisor showed crown-labial and root-lingual torque and uncontrolled tipping of the canine was increased.4 mm of CC added to the main archwire also induced crown-labial and root-lingual torque of the lateral incisor but uncontrolled tipping of the canine was decreased. Lingual tipping model showed very similar results compared with the Base model. Conclusion: The results of this study showed that height of the hook and compensating curve on the main archwire can influence the axis of anterior teeth. These data can be used as guidelines for clinical application.

• Clinical and Experimental Pediatrics
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• v.48 no.7
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• pp.737-744
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• 2005

Purpose : Infants and children with cardiovascular diseases often present with respiratory symptoms. However, missed or delayed evaluation for potential airway problem may complicate overall prognosis. The aim of this study is to determine the clinical characteristics of these patients and explore the cause of airway problem. Methods : We reviewed the medical records of 64 patients(M : F=33:31, mean age : $6.3{\pm}7.5$ months) whose airway problems were proven by computed tomography or bronchoscopy in perioperative periods at the Asan Medical Center from January 1997 to June 2004. Patients were divided into two groups based on the duration of ventilator care : ${\leq}7$ days(group 1 : 23 cases, M : F=10 : 13) and >7 days(group 2 : 41 cases, M : F=23 : 18). Results : The patients in group 2 significantly developed more post-operative respiratory symptoms than group 1(P<0.001) and had more airway problems including extrinsic obstruction, intrinsic anomaly, and combined problem than group 1 although not significantly different(P=0.082). Among underlying diseases, the most common diseases were vascular anomaly(26.2 percent) and aortic arch anomaly(26.2 percent) in group 1 and pulmonary atresia with ventricular septal defect(22.4 percent) in group 2. The most frequent respiratory symptoms were recurrent wheezing pre-operatively and failure of ventilator weaning post-operatively. The major types of airway anomaly were tracheomalacia and tracheal stenosis(in each case 18.2 percent). Nineteen patients with persistent airway problems underwent aortopexy or other vascular correction. Of the 19 patients, 13(68.4 percent) were improved, but 2 failed in weaning ventilator and 4 died of non-airway problems. Conclusion : Early evaluation and treatment for potential airway problems may affect natural or surgical prognosis in patients with cardiovascular diseases presenting with respiratory symptoms.

• Journal of the Korean Society of Radiology
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• v.14 no.3
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• pp.203-209
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• 2020

The purpose of this study is to assess the mechanical stability and alignment of the patient positioning system (PPS) of Leksell Gamma Knife Perfexion(LGK PFX). The alignment of the PPS of the LGK PFX was evaluated through measurements of the deviation of the coincidence of the Radiological Focus Point(RFP) and the PPS Calibration Center Point(CCP) applying different weights on the couch(0, 50, 60, 70, 80, and 90 kg). In measurements, a service diode test tool with three diode detectors being used biannually at the time of the routine preventive maintenance was used. The test conducted with varying weights on the PPS using the service diode test tool measured the radial deviations for all three collimators 4, 8, and 16 mm and also for three different positions of the PPS. In order to evaluate the alignment of the PPS, the radial deviations of the correspondence of the radiation focus and the LGK calibration center point of multiple beams were averaged using the calibrated service diode test tool at three university hospitals in Busan and Gyeongnam. Looking at the center diode for all collimators 4, 8, and 16 mm without weight on the PPS, and examining the short and long diodes for the 4 mm collimator, the means of the validation difference, i.e., the radial deviation for the setting of 4, 8, and 16 mm collimators for the center diode were respectively measured to 0.058 ± 0.023, 0.079 ± 0.023, and 0.097 ± 0.049 mm, and when the 4 mm collimator was applied to the center diode, the short diode, and the long diode, the average of the radial deviation was respectively 0.058 ± 0.023, 0.078 ± 0.01 and 0.070 ± 0.023 mm. The average of the radial deviations when irradiating 8 and 16 mm collimators on short and long diodes without weight are measured to 0.07 ± 0.003(8 mm sd), 0.153 ± 0.002 mm(16 mm sd) and 0.031 ± 0.014(8 mm ld), 0.175 ± 0.01 mm(16 mm ld) respectively. When various weights of 50 to 90 kg are placed on the PPS, the average of radial deviation when irradiated to the center diode for 4, 8, and 16 mm is 0.061 ± 0.041 to 0.075 ± 0.015, 0.023 ± 0.004 to 0.034 ± 0.003, and 0.158 ± 0.08 to 0.17 ± 0.043 mm, respectively. In addition, in the same situation, when the short diode for 4, 8, and 16 mm was irradiated, the averages of radial deviations were 0.063 ± 0.024 to 0.07 ± 0.017, 0.037 ± 0.006 to 0.059 ± 0.001, and 0.154 ± 0.03 to 0.165 ± 0.07 mm, respectively. In addition, when irradiated on long diode for 4, 8, and 16 mm, the averages of radial deviations were measured to be 0.102 ± 0.029 to 0.124 ± 0.036, 0.035 ± 0.004 to 0.054 ± 0.02, and 0.183 ± 0.092 to 0.202 ± 0.012 mm, respectively. It was confirmed that all the verification results performed were in accordance with the manufacturer's allowable deviation criteria. It was found that weight dependence was negligible as a result of measuring the alignment according to various weights placed on the PPS that mimics the actual treatment environment. In particular, no further adjustment or recalibration of the PPS was required during the verification. It has been confirmed that the verification test of the PPS according to various weights is suitable for normal Quality Assurance of LGK PFX.

• 대한공업교육학회지
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• v.38 no.2
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• pp.48-67
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• 2013

This study tried to suggest implications about operation direction of specialized high schools (SHS) by researching awareness of middle school students (MSS), school parents (SP), human resources directors in industrial institutions (HRDII) who will be the main users of SHS education, about entering SHS and career after graduating from SHS. Seniors of middle school, SP and HRDII in Asan, Chungnam were the subject of this survey research. The summary of the result of this study is as follow: First, MSS and SP usually hoped to enter general high schools rather than vocational education schools such as SHS, meister high schools, and MSS considered school records and SP considered aptitude and talent for the factors to choose high school. Second, MSS, SP, and HRDII recognized purposes of SHS as improvement of talent and aptitude, and getting a job. As for positive images of SHS, they recognized it as applying talent and aptitude to life early, getting good jobs easily, fast independence after graduation, and learning excellent technologies, and as for negative images of SHS, they recognized it as social prejudices and discrimination, students with bad school records enter them, disadvantages about promotion and wages, and being unfavorable for entering universities. They also recognized education of SHS as being effective for improvement of basic and executive ability and key competency, development of creative human resources, and improvement of right personality and courteous manners. Third, many MSS and SP showed intention to enter SHS if it is established in Asan. They wished to enter SHS because they would like to apply their aptitude and talent to life early, learn excellent skill, and hope for early employment, on the other hand, they did not wish to enter SHS because it was not suited for their aptitude and talent, awareness about SHS is low, it is unfavorable to enter universities, and there were social prejudices and discrimination. They also similarly hoped for getting jobs and entering universities after graduating from SHS. And the reason they wanted to get a job was usually because they want to be successful by advancing into society early, or because it is still hard to get a job even after graduate from the university, on the other hand, the reason they want to enter university is because is usually in-depth education about major and social discrimination about level of education. The ability to perform duties forms the greatest part of the employment standard that MSS, SP, and HRDII aware. MSS and SP usually hoped for industrial, home economics and housework and commercial majors in SHS, and considered aptitude and talent, the promising future, and being favorable for employment for choosing major. The reason HRDII hire SHS student was to develop student into talent of industrial institution, ability of student, and need for manpower with high school graduation level, and there were also partial answer that they can hire SHS student if they have ability to perform duties. The proposals about operation direction of SHS according to the results above are as follow: SHS should diversify major and curriculum to meet various requirements of student and parents, establish SHS admission system based on career guidance, and improve student's ability to perform duties by establishing work-based learning. The Government should organize work-to-school policy to enable practical career development of students from SHS, and promote relevant policy to reinforcing SHS education rather than quantitative evaluation such as employment rate, and cooperative support from each government departments is required to make manpower with skill related to SHS to get proper evaluation and treatment.

• Journal of Chest Surgery
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• v.37 no.1
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• pp.27-34
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• 2004

Background: Infective endocarditis shows higher operative morbidity and mortality rates than other cardiac diseases. The vast majority of studies on infective endocarditis have been made on aortic endocarditis, with little attention having been paid to infective endocarditis on the mitral valve. This study attempts to investigate the clinical aspects and operative results of infective endocarditis on the mitral valve. Meterial and Method: The subjects of this study consist of 23 patients who underwent operations for infective endocariditis on the mitral valve from June 1995 to May 2003. Among them, 2 patients suffered from prosthetic valvular endocarditis and the other 21 from native valvular endocarditis. The subjects were evenly distributed age-wise with an average age of 44.8$\pm$15.7 (11∼66) years. Emergency operations were performed on seventeen patients (73.9%) due to large vegetation or instable hemodynamic status. In preoperative examinations, twelve patients exhibited congestive heart failure, four patients renal failure, two patients spleen and renal infarction, and two patients temporary neurological defects, while one patient had a brain abscess. Based on the NYHA functional classification, seven patients were determined to be at Grade II, 9 patients at Grade III, and 6 patients at Grade IV. Vegetations were detected in 20 patients while mitral regurgitation was dominant in 19 patients with 4 patients showing up as mitral stenosis dominant on the preoperative echocardiogram. Blood cultures for causative organisms were performed on all patients, and positive results were obtained from ten patients, with five cases of Streptococcus viridance, two cases of methicillin-sensitive Staphylococcus aureus, and one case each of Corynebacteriurn, Haemophillis, and Gernella. Operations were decided according to the AA/AHA guidelines (1988). The mean follow-up period was 27.6 $\pm$23.3 (1 ∼ 97) months. Result: Mitral valve replacements were performed on 43 patients, with mechanical valves being used on 9 patients and tissue valves on the other 4. Several kinds of mitral valve repair or mitral valvuloplasty were carried out on the remaining 10 patients. Associated procedures included six aortic valve replacements, two tricuspid annuloplasty, one modified Maze operation, and one direct closure of a ventricular septal defect. Postoperative complications included two cases of bleeding and one case each of mediastinitis, low cardiac output syndrome, and pneumonia. There were no cases of early deaths, or death within 30 days following the operation. No patient died in the hospital or experienced valve related complications. One patient, however, underwent mitral valvuloplasty 3 months after the operation. Another patient died from intra-cranial hemorrhage in the 31st month after the operation. Therefore, the valve-related death rate was 4.3%, and the valve-related complication rate 8.6% on mid-term follow-up. 1, 3-, and 5-year valve- related event free rates were 90.8%, 79.5%, and 79.5%, respectively, while 1, follow-up. 1, 3-, and 5-year valve- related event free rates were 90.8%, 79.5%, and 79.5%, respectively, while 1, 3-, and 5-year survival rates were 100%, 88.8%, and 88.8%, respectively. Conclusion: The findings suggest that a complete removal of infected tissues is essential in the operative treatment of infectious endocarditis of the mitral valve. It is also suggested that when infected tissues are completely removed, neither type of material nor method of operation has a significant effect on the operation result. The postoperative results also suggest the need for a close follow-up observation of the patients suspected of having brain damage, which is caused by preoperative blood contamination or emboli from vegetation, for a possible cerebral vascular injury such as mycotic aneurysm.

• Tuberculosis and Respiratory Diseases
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• v.40 no.2
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• pp.135-146
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• 1993

Background: In acute pulmonary embolism it has been postulated that the constriction of bronchi and pulmonary artery secondary to neurohumoral response plays an important role in cardiopulmonary dysfunction in addition to the mechanical obstruction of pulmonary artery. Serotonin is considered as the most important mediator. Positive end expiratory pressure (PEEP) stimulates $PGI_2$ secretion from the vascular endothelium, but its role in acute pulmonary embolism is still in controversy. Methods: To study the cardiopulmonary effect and therapeutic role of Ketanserin, selective antagonist of 5-HT2 receptor, and PEEP in acute pulmonary embolism experimental acute pulmonary embolism was induced in dogs with autologous blood clot. The experimental animals were divided into 3 groups, that is control group, Ketanserin injection group and PEEP application group. Results: Thirty minutes after embolization, mean pulmonary arterial pressure and pulmonary vascular resistance increased and cardiac output decreased. $PaO_2,\;P\bar{v}O_2$ and oxygen transport decreased and physiological shunt and $PaCO_2$ increased. After injection of Ketanserin, comparing with control group, mean pulmonary arterial pressure, pulmonary vascular resistance and physiological shunt decreased, while cardiac output, $PaO_2$ and oxygen transport increased. All these changes sustained till 4 hours after embolization. After PEEP application pulmonary vascular resistance, $PaO_2$ and $PaCO_2$ increased, while physiological shunt, cardiac output and oxygen transport decreased. After discontinuation of PEEP, mean pulmonary arterial pressure and pulmonary vascular resistance decreased and were lower than control group, while $PaO_2$ and cardiac output increased and higher than control group. $PaCO_2$ decreased but showed no significant difference comparing with control group. Conclusion: It can be concluded that Ketanserin is effective for the treatment of acute pulmonary embolism. With PEEP hemodynamic status deteriorated, but improved better than control group after discontinuation of PEEP. Thus PEEP may be applied carefully for short period in acute pulmonary embolism if the hemodynamic status is tolerable.