• Journal of the korean academy of Pediatric Dentistry
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• v.49 no.2
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• pp.228-233
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• 2022

Arteriovenous malformations (AVMs) are rare congenital anomalies characterized by direct communication between arteries and veins that bypass the capillary bed. AVMs may not manifest clinically until late infancy or childhood. In particular, facial AVMs can cause urgent life-threatening dental events. A 5-year-old girl without a medical history visited the hospital because of spontaneous gingival bleeding around the posterior gingival area of the lower left 2nd primary molar. Angiography through the femoral approach under general anesthesia was performed for differential diagnosis and therapeutic option. The blood flow was effectively reduced after arterial embolization alone, and there was no evidence of recurrence at the 5-month follow-up. The present study reports that embolization of the affected vessels can be a more effective and safe method than surgical resection for the treatment of AVM during the growth period.

• Journal of Medicine and Life Science
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• v.19 no.2
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• pp.46-56
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• 2022

The incidence of fever complicating percutaneous coronary intervention (PCI) is rare. However, little is known regarding the cause of fever after PCI. Therefore, this study aimed to determine the clinical characteristics of patients with acute myocardial infarction (AMI), with or without fever, after PCI. We enrolled a total of 926 AMI patients who underwent PCI. Body temperature (BT) was measured every 4 hours or 8 hours for 5 days after PCI. Patients were divided into two groups according to BT as follows: BT<37.7℃ (no-fever group) and BT ≥37.7℃ (fever group). The 2 years clinical outcomes were compared subsequently. Fever after PCI was associated with higher incidence of major adverse cardiac events (MACE) (hazard ratio [HR], 1.56; 95% confidence interval [CI], 1.07-2.28; P=0.021), all-cause death (HR, 2.32; 95% CI, 1.18-4.45; P=0.014), cardiac death (CD) (HR, 2.57; 95% CI, 1.02-6.76; P=0.049), and any revascularization (HR, 1.69; 95% CI, 1.02-2.81; P=0.044) than without fever. In women, prior chronic kidney disease, lower left ventricular (LV) ejection fraction, higher LV wall motion score index, white blood cell count, peak creatine kinase-myocardial band level, and longer PCI duration were associated with fever after PCI. Procedures such as an intra-aortic balloon pump, extracorporeal membrane oxygenation, continuous renal replacement therapy, central and arterial line insertion, and cardiopulmonary resuscitation were related to fever after PCI. Fever after PCI in patients with AMI was associated with a higher incidence of MACE, all-cause death, CD, and any revascularization at the 2 years mark than in those without fever.

• The Journal of the Petrological Society of Korea
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• v.14 no.2 s.40
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• pp.116-126
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• 2005

The Precambrian quartzite and calc-schist layers experienced multi-1310ing events are distributed along the two kinds of U-shaped 1310 (Fold I and II) with $N10^{\circ}E-directed$ fo1d axis in Wollong-myeon, Gwangtan-myeon, Jori-myeon of Paju city, the northeastern part of Gyeonggido. Occurrence of 10 layers of quartzite and 4 layers of calc-schist is not clear whether quartzite and schist layers were deposited sequentially each other or one to two layers of quartzite and schist were distributed repeatedly by isoclinal folding and thrusting, because of lack of sedimentary structures. In this paper, we tried to clarify the correlative relationship among the quartzite beds which are distributed along the U-shaped folds using geochemical tools such as rare earth element (REE) patterns and Nd isotope ratio. Quartzites have characteristics of LREE-flattened, HREE- slightly depleted patterns. They also show Ce negative anomaly whereas there are no Eu anomalies. As a result, quartzite beds occurred along the bilateral sides of fold axis show very similar REE patterns from outer side to inner side of 1314. The Nd model age of quartzite layers shows a trend that the inner part of fold is younger than the outer part of it. Such geochemical characteristics suggest that bilateral quartzite beds occurred along the fold axis were derived from the cogenetic source materials. The REE patterns and trace element geochemistry of mica schist intercalated within quartzite indicate that the quartzite and mica schist may be derived from different source materials. Our results suggest that REE and Nd isotope geochemistries may be very useful in clarifying the relationship of sedimentary deposits which do not show stratigraphical and structural connections in the field.

• Journal of Chest Surgery
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• v.43 no.6
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• pp.663-668
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• 2010

Background: Spontaneous pneumomediastinum is an uncommon disorder with few cases reported. It usually occurs in young males and has benign self-limiting course without any apparent concomitant factor. It is seen after intrathoracic pressure changes leading to alveolar rupture. The clinical experiences of two medical centers were reviewed to aid in optimal management. Material and Method: Retrospective review between March 2003 and August 2010 with spontaneous pneumomediastinum patients was performed. Result: 24 patients were identified with a diagnosis of spontaneous pneumomediastinum. These 24 patients were comprised of 18 men and 6 women with mean age 18.9 years (range 10 ~ 33). The major initial complaints were chest pain (79.2%), throat pain (62.5%), and subcutaneous emphysema (41.7%). The triggering events were exercise (16.7%), coughing (12.5%) and vomiting (12.5%). No apparent triggering event was noted in 54.2% of patients. In all cases, chest radiograph and computed tomography was done. Diagnostic computed tomography was required in 25%. White blood cell counts and C-reactive protein (CRP) were checked, and their initial mean values were $9,790{\pm}3,240/{\mu}L$ Land $1.31{\pm}1.71mg/dL$, final mean values were $5,440{\pm}1,665/{\mu}L$ Land $0.72{\pm}0.73mg/dL$, respectively. 23 patients were admitted (average $5.0{\pm}1.8$) and the symptoms were self-limiting in all cases without complications. Conclusion: Spontaneous pneumomediastinum is a benign condition with mild inflammatory signs that often presents with chest or throat pain. Secondary causes must be ruled out to avoid an unfavorable outcome with less invasive study. Because of very rare complications and recurrence, outpatient basis and shortened hospitalization may be feasible.

• Journal of Chest Surgery
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• v.48 no.5
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• pp.328-334
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• 2015

Background: There have been a number of studies on mitral valve replacement and repeated percutaneous mitral balloon valvotomy for mitral valve restenosis after percutaneous mitral balloon valvotomy. However, studies on mitral valve repair for these patients are rare. In this study, we analyzed postoperative outcomes of mitral valve repair for mitral valve restenosis after percutaneous mitral balloon valvotomy. Methods: In this study, we assessed 15 patients (mean age, $47.7{\pm}9.7years$; 11 female and 4 male) who underwent mitral valve repair between August 2008 and March 2013 for symptomatic mitral valve restenosis after percutaneous mitral balloon valvotomy. The mean interval between the initial percutaneous mitral balloon valvotomy and the mitral valve repair was $13.5{\pm}7years$. The mean preoperative Wilkins score was $9.4{\pm}2.6$. Results: The mean mitral valve area obtained using planimetry increased from $1.16{\pm}0.16cm^2$ to $1.62{\pm}0.34cm^2$ (p=0.0001). The mean pressure half time obtained using Doppler ultrasound decreased from $202.4{\pm}58.6ms$ to $152{\pm}50.2ms$ (p=0.0001). The mean pressure gradient obtained using Doppler ultrasound decreased from $9.4{\pm}4.0mmHg$ to $5.8{\pm}1.5mmHg$ (p=0.0021). There were no early or late deaths. Thromboembolic events or infective endocarditis did not occur. Reoperations such as mitral valve repair or mitral valve replacement were not performed during the follow-up period ($39{\pm}16months$). The 5-year event-free survival was 56.16% (95% confidence interval, 47.467-64.866). Conclusion: On the basis of these results, we could not conclude that mitral valve repair could be an alternative for patients with mitral valve restenosis after percutaneous balloon mitral valvotomy. However, some patients presented with results similar to those of mitral valve replacement. Further studies including more patients with long-term follow-up are necessary to determine the possibility of this application of mitral valve repair.

• The Journal of Engineering Geology
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• v.27 no.4
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• pp.489-500
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• 2017

It is not rare that pseudotachylite, dark colored rock with glassy texture, is recognizable in deep core samples drilled up to 900 m from the surface. Pseudotachylite with widths varying few to 20 cm is sharply contacted or interlayered with the host rocks composed of Jurassic granite and Precambrian amphibolite gneiss, showing moderately ductile deformation or slight folding. Pseudotachylite occurring at varying depths in the deep drill core are slightly different in texture and thickness. There is evidence of fault gouge at shallower depths, although brittle deformation is pervasive in most drill cores and pseudotachylite is identified at random depth intervals. Under scanning electron microscope (SEM), it is evident that the surface of pseudotachylite is characterized by a smooth, glassy matrix even at micrometer scale and there is little residual fragments in the glass matrix except microcrystals of quartz with embayed shape. Such textural evidence strongly supports the idea that the pseudotachylite was generated through the friction melting related to strong seismic events. Based on X-ray diffraction (XRD) quantitative analysis, it consists of primary minerals such as quartz, feldspars, biotite, amphibole and secondary minerals including clay minerals, calcite and glassy materials. Such mineralogical features of fractured materials including pseudotachylite indicate that the fractured zone might form at low temperatures possibly below $300^{\circ}C$, which implies that the seismic activity related to the formation of pseudotachylite took place at shallow depths, possibly at most 10 km. Identification and characterization of pseudotachylite provide insight into a better understanding of the paleoseismic activity of deep grounds and fundamental information on the stability of candidate disposal sites for high-level radioactive waste.

• Journal of the Korean Society of Marine Environment & Safety
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• v.22 no.3
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• pp.278-285
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• 2016

The key features of maritime accidents are the change of their attributes by new risks from time to time. To prevent maritime accidents in Korea, the impacts by new risks on domestic safety environments should be identified or predicted. The purpose of this paper is to find the hazard factors by new risks on maritime safety in Korea. The meaning of new risks is the elements of accident hazard which is compiled from new or rare or unprecedented events in the worldwide maritime transportations. The problems of new risks are the lacks of optimum countermeasures to mitigate accident risks. Using the questionnaires with 152 event scenarios classified by 20 accident causes, the hazard identification and risk analysis of new risks was performed based on the Formal Safety Assessment (FSA) by IMO. A total of 22 Influence Diagrams, which is to depict the transit flows between accident causes to consequences, is used in the construction of 152 event scenarios. A total of 20 accidents causes is the same contents as the causation factors represented in Statistical Year Book for Maritime Accidents of Korean Maritime Safety Tribunals. After defining the evaluation equations to the response results of questionnaires by 46 experts, the work for risk analysis is carried out. As results from the analysis of 152 scenarios, it is known that the root cause to affect on maritime safety in Korea is the pressure of business competition and it led to the lacks of well experienced crews, the overload of vessel operations and crew's fatigue. In addition, as results from the analysis of 20 accident causes, the three accident causes are to be candidate as main issues in Korea such as the inadequate preparedness of departure, the neglecting of watch keeping in bridge and the inadequate management of ship operations. All of the results are thought to be as basic hazard factors to safety impediments. It is thus found that the optimum Risk Control Options to remove the hazard factors and to mitigate consequences required are the following two factors: business competition and crewing problems.

• Journal of Korean Neurosurgical Society
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• v.52 no.6
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• pp.534-540
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• 2012

Objective : Brainstem arteriovenous malformation (AVM) is rare and radiosurgical management is complicated by the sensitivity of the adjacent neurological structures. Complete obliteration of the nidus is not always possible. We describe over 20 years of radiosurgical procedures for brainstem AVMs, focusing on clinical outcomes and radiosurgical techniques. Methods : Between 1992 and 2011, the authors performed gamma knife radiosurgery (GKRS) in 464 cerebral AVMs. Twenty-nine of the 464 patients (6.3%) reviewed had brainstem AVMs. This series included sixteen males and thirteen females with a mean age of 30.7 years (range : 5-71 years). The symptoms that led to diagnoses were as follows : an altered mentality (5 patients, 17.3%), motor weakness (10 patients, 34.5%), cranial nerve symptoms (3 patients, 10.3%), headache (6 patients, 20.7%), dizziness (3 patients, 10.3%), and seizures (2 patients, 6.9%). Two patients had undergone a previous nidus resection, and three patients had undergone a previous embolization. Twenty-four patients underwent only GKRS. With respect to the nidus type and blood flow, the ratio of compact type to diffuse type and high flow to low flow were 17 : 12 and 16 : 13, respectively. In this series, 24 patients (82.8%) had a prior hemorrhage. The mean target volume was 1.7 $cm^3$ (range 0.1-11.3 $cm^3$). The mean maximal and marginal radiation doses were 38.5 Gy (range 28.6-43.6 Gy) and 23.4 Gy (range 18-27 Gy), and the mean isodose profile was 61.3% (range 50-70%). Results : Twenty-four patients had brainstem AVMs and were followed for more than 3 years. Obliteration of the AVMs was eventually documented in 17 patients (70.8%) over a mean follow-up period of 77.5 months (range 36-216 months). With respect to nidus type and blood flow, the obliteration rate of compact types (75%) was higher than that of diffuse types (66.7%), and the obliteration rate of low flow AVMs (76.9%) was higher than that of high flow AVMs (63.6%) (p<0.05). Two patients (6.9%) with three hemorrhagic events suffered a hemorrhage during the follow-up period. The annual bleeding rate of AVM after GKRS was 1.95% per year. No adverse radiation effects or delayed cystic formations were found. Conclusion : GKRS has an important clinical role in treatment of brainstem AVMs, which carry excessive surgical risks. Angiographic features and radiosurgical techniques using a lower maximal dose with higher isodose profiles are important for lesion obliteration and the avoidance of complications.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.21 no.1
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• pp.37-41
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• 2010

Background and Objectives : Transient minor voice changes after thyroidectomy are not infrequent complaints even in cases without any evidence of recurrent laryngeal nerve damage. However, clinical course, diagnosis and management of such voice changes are not fully understood. This study aimed to evaluate the clinical characteristics of minor voice changes after thyroidectomy. We also tried to assess the significance and feasibility of superior laryngeal nerve monitoring and to find out the optimal evaluation tools for such voice changes after thyroidectomy. Materials and Method : Nine adult patients who received total thyroidectomy without evidence of recurrent laryngeal nerve injury were enrolled for this prospective study. Voice evaluations were performed preoperatively and 3 months postoperatively ; acoustic analyses including voice range profile, aerodynamic study, stroboscopic evaluation and subjective voice assessment with questionnaires. The external branch of superior laryngeal nerve was monitored by nerve stimulator after ligation of superior thyroidal vessels. Results: Four of nine patients complained their voice change at 3 months after the surgery. Three of them reported complete recovery of their voice at 6 months after the surgery. Acoustic analysis revealed significant decrease in their phonatory range especially with high tone loss. Questionnaires related to singing was more sensitive than previously well-known "voice handicap index". Stimulation of the superior laryngeal nerve was feasible in most of the cases (94.4%), but it failed to show any correlation with minor voice changes after thyroidectomy. Conclusion : Minor voice changes were not rare events during the first 6 month after thyroidectomy. Decrease in phonatory range with high tone loss and therefore, discomfort in singing was the most common finding. Superior laryngeal monitoring was feasible but it was not a sensitive tool for the prediction of minor voice change after thyroidectomy.

• Journal of the Korean Society of Marine Environment & Safety
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• v.22 no.7
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• pp.791-799
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• 2016

The purpose of this work is to analyse the impact of new accident risks on maritime safety in Korea. The new accident risks have been induced from new/rare or unprecedented events in world maritime transportation, as identified by 46 experts in the previous study. To measure the impact of these new accident risks on maritime safety in Korea, the statistical accident data reported by the Korean Maritime Safety Tribunals (KMST) has been used for calculation, and the concept of Risk Index (RI) = Frequency Index (FI) + Severity Index (SI)established in a Formal Safety Assessment (FSA) by the IMO has also been introduced. After calculating two kinds of weight for FI and SI from the statistical accident data, high ranked scenarios were identified and their relationships between new risks and these scenarios were analysed. The results from this analysis showed, the root cause of the top-ranked scenario to be "developing high technology", which leads to "shorten cargo handling time". These results differed from optimum RCOs such as "business competition" and "crewing problems" which were identified in the previous study.