• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제29권5호
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• pp.338-345
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• 2003

Purpose : This study was intended to perform cephalometric comparison between the patients with and without obstructive sleep apnea (OSA). The factors influencing the OSA in the lateral cephalogram was also investigated. Patient and Method : Twenty four patients who visited Sleep Disorder Clinic in Dongsan Medical Center, Keimyung University and evaluated with polysomnograph(PSG) and cephalogram were included in the study. The patients had apnea-hypopnea episode(AHI) over 10 times per hour was diagnosed as OSA after overnight PSG. To evaluate hard and soft tissue profile, cephalometric radiogram were taken at maximal intercuspation(P1) and mandibular protruding position(P2). The diffefence between the OSA and normal group were evaluated statistically and the stepwise regression analysis was applied to analyse the cephalometric influencing factors to OSA. Result : The OSA Group(n=14) had significantly higher Body Mass Index(BMI) than control group(n=10). Lower facial height(ANSGn) was longer in OSA group. However statistically significant difference was not detected in other anteroposterior craniofacial measurements. The soft palate lenth (PNS-P), hyoid position (MP-Hyoid) had positive correlation between AHI (r=0.496, r=0.413, respectively, p<0.05). However, the measurements of oropharyngeal airway was not different between the two groups. The hypothesis, the antero-posteriorly narrow oropharyngeal airway might aggravate the airway resistance and can give rise to higher AHI, was not accepted in the study. This can be attributed by inclusion of the patients performed uvulopalatopharyngoplasty because of the tonsilar or soft palate hypertrophy in the present study. The results of regression analysis revealed that PNS-P, upper airway width(Nph1), upper facial heght(N-ANS), and lower facial height(ANS-Gn) could influence the degree of AHI (F value < 0.0001, $R^2$ = 0.829). Conclusion : We suggest lateral cephalogram may utilized as a useful method to evaluate OSA. The patient with long soft palate, narrow upper airway width, long upper & lower facial height can be expected to have high risk of OSA. However, it should be emphasized the comphrehensive intraoral inspection including soft palate and tonsilar hypertrophy because lateral cepahlogram cannot visualize oropharyngeal status completely.

• 대한임상검사과학회지
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• 제52권3호
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• pp.278-283
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• 2020

중추성 수면 무호흡은 수면 중 상기도 저항이 없을 때 흉부와 복부의 호흡 노력 없이 10초 이상의 호흡부전을 보이는 것이 특징이다. 본 증례에서 뇌자기공명영상 확산 강조 영상검사를 통해 외측 연수 경색의 진단을 받은 환자가 수면다원검사를 통해 중추성 수면 무호흡 진단 기준에 미치지 못하는 호흡부전과 중추성 수면 무호흡이 관찰되었다. 호흡부전과 중추성 수면 무호흡에 대한 일차 치료는 CPAP을 사용하였다. CPAP을 사용한 후 수면다원검사와 이전의 수면다원검사를 비교한 결과 무호흡-저호흡 지수(42.5/hr→82.8/hr)와 각성 지수(21.7/hr→40.8/hr)는 악화되었다. 이에 이차 치료로 ASV를 사용하여 적정압력검사를 시행하였다. 이전의 수면다원검사와 비교한 결과 무호흡-저호흡 지수(42.5/hr→8.6/hr)가 상당히 호전되었다. 이러한 결과로 ASV는 중추성 수면 무호흡과 호흡부전에 대한 좋은 치료방법이 될 수 있다.

• 한국콘텐츠학회논문지
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• 제18권10호
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• pp.134-144
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• 2018

본 연구는 고관절 수술 환자에게 섬망 예방프로그램을 적용하여 그 효과를 검증하기 위한 비동등성 대조군 사후설계를 이용한 유사실험연구이다. 연구대상은 일 종합병원에서 고관절 수술후 외과계중환자실에 입실한 65세 이상 노인 환자였으며 실험군 33명, 대조군 31명이었다. 실험군에게 섬망 예방프로그램을 적용하였으며 구체적 내용은 오리엔테이션 중재, 활동 중재, 생리적 중재, 영양 중재, 수면 중재, 환경 중재로 구성되었다. 자료분석은 ${\chi}^2-test$, independent t-test로 분석하였다. 연구결과 실험군은 대조군 보다 섬망 발생률이 낮은 것으로 나타났다(${\chi}^2=7.048$, p=.008). 실험군은 대조군 보다 중환자실 재실일수와 재원일수가 적었으나 통계적으로 유의하지 않은 것으로 나타났다. 본 연구에서 적용한 섬망 예방프로그램은 고관절 수술환자의 섬망을 예방하는데 효과적임을 확인하였으며 향후 고관절 수술환자 섬망 예방을 위해 실무에 적용할 수 있을 것으로 기대한다.

• 대한간호학회지
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• 제2권1호
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• pp.49-61
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• 1971

The purpose of this study is to observe the administering of analgesics and sedatives to cases of surgery, the influence of the patients'situational variables on the use of these drugs, and the required number of recovery days in relation to the patients'situational variables and general conditions. Fifty patients in the age range of 15 through 65 who had undergone general surgery at Seoul national University Hospital. Woo Sok University Hospital and Koryo Hospital between May and August of 1971 were chosen for this study. They were observed with regard to the frequency of postoperative uses of analgesics and sedatives age, the required period of recovery in comparison with the situational variables of patients such as sex, age, marital status, the type and duration of anesthesia, experience of previous operation, history of other diseases, preoperative period of hospitalizations and the general conditions of patients such as sleep, stomach condition, bowel condition, urination, interest in surroundings, strength and energy, self-assistance and appetite. The study results were reviewed in a statistical method to obtain the following findings: 1. There was a significant decrease in the frequency of analgesic uses according to the number of days passed after operation. 2. The mean postoperative recovery days were 5.31 days and mote than half of the patients have never used analgesics until recovery. 3. There was a significant decrease in the frequency of sedative uses according to the number of days passed after operation. 4. The rank-order correlation between the frequency of analgesic use and that of sedative use following surgery observes in relation to the number of postoperative days was a low and negative one. 5. All of the patients except one hate used sedatives only once a day for the whole recovery period. 6. The longer they stayed in the hospital before surgery, the less have they used analgesics after surgery. 7. There were significant differences in use of analgesics after surgery by age groups; the 25-44 age group used more analgesics than the 15-24 and 45-65 age groups. 8. There were no significant differences in use of analgesics after surgery by all situational variables except the number of days of hospitalization and age. 9. The longer they stayed in the hospital before surgery, the earlier have they recovered from the surgery. 10. There were no significant differences in the number of required recovery days by all situational variables except the length of preoperative hospitalization. 11. There were no significant differences in the number of required postoperative recordedly days by the general conditions of patients.

• 항공우주의학회지
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• 제31권2호
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• pp.31-32
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• 2021

In Vol. 31, No. 2, our journal prepared a review article, two original papers, and three case reports. First, autonomous systems are increasingly being introduced in aircraft systems. Therefore, it is crucial that flight crews are trained to adapt and handle these autonomous systems better. Consequently, we discussed crew resource management for handling autonomous systems. The fatigue of aviation workers is one of the biggest threats to aviation safety. Therefore, we analyzed the degree of fatigue in commercial aircraft pilots and evaluated the relationship between fatigue and their workload and the effect of fatigue on sleep. Since obesity has a significant impact on the health of aviation workers, we also comparatively analyzed the prevalence of obesity in Korea and Japan based on the data from the National Health and Nutrition Examination Survey. We defined cases that are difficult for aviation medical examiners to evaluate. This issue included cases of peripheral dizziness and tinnitus, cases of atopic dermatitis treated with biological agents, and cases of malignant tumors.

• 동의생리병리학회지
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• 제22권4호
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• pp.930-942
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• 2008

Following conclusions were derived from researching various consumption caused after surgical operation. The meaning of surgery in HyungSang medical point of view is a big flaw of the original configuration. Therefore meaning, the loss of container to store something. Changes of the body after surgery can be formation of stagnated blood and abnormal cyst of the removed part and entangled undigested food and stagnant blood. After surgery when the symptoms become chronic or the patients develop side effects as they age, consumption and aging process begins. HyungSang medical treatments of consumption caused after surgery are the followings. We should prevent aging of the framework by using appropriate medication to make up for faults in Gall Bladder, Bladder type and six meridian type by considering its form, color, pulse and symptoms. Stability of emotion that can endure various mental stimulation is needed. Prevent stagnation, indigestion, obstruction and numbness by smoothing up the constructive energy and the defensive energy in the operated part. The Heart and Kidney should be under control and Stomach and Spleen should be reinforced so that food intake is accelerated and produce vital substances and Ki and blood. Eum blood and Yang Ki should circulate around the body well. Examine daily life and if small changes in skin complexion, appetite, sleep and excretion occur, also difference in adaptation of external stimulation and mental health occurs immediate treatment and care is necessary. Treatment of side-effects caused from both aging process and post-surgery in HyungSang's view point is considered better than other ways of treatment and will contribute in expanding the field of medical science.

• Archives of Plastic Surgery
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• 제38권2호
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• pp.207-211
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• 2011

Purpose: Surgery for thyroid gland requires skin incisions that can result in postsurgical neck scar. To overcome this, many surgeons performed a endoscopic thyroidectomy. But, this approach had a some problems. One of postoperative problems, iatrogenic cervical dystonia (CD) may occur. At common, CD is defined as a syndrome characterized by prolonged muscle contraction causing twisting, repetitive movements or abnormal posture. Botulinum toxin A (BTA, Botox$^{(R)}$, Allergan, Irvine, CA, USA) is well known treatment agent in the treatment of CD. So, the authors applied BTA injection in rare case with iatrogenic CD resulting in endoscopic thyroidectomy. Methods: A 43-year-old female had endoscopic subtotal thyroidectomy operation 3 years ago. She had symptoms such as progressive cervical pain, abnormal neck posture, depression, and sleep difficulty. About 1 year later, the patient who had previous myomectomy of the clavicular head of sternocleidomastoid muscle, however, symptoms were not improved. And then the patient received BTA therapy in our department. The 2 units per 0.1 mL solution was administered in a 1 mL tuberculin syringe. Results: The dose of BTA used in the patient was 36 units for vertical platysmal bands, superficially, and 10 units for ipsilateral sternocleidomastoid muscle, intramuscularly. After 2 weeks, additional the dose of BTA used in the patient was 5 points for remained scar bands, superficially. Complications related to injection such as significant swallowing difficulties, neck muscle weakness, or sensory change were not observed. In 9 months follow-up, the patient maintained a good result from the method of BTA injection alone. Conclusion: The basic concept is selective denervation for the hyperactive individual muscles and scar bands. We conclude that BTA is an effective and safe treatment for CD despite the iatrogenic and complex presentation of this complication.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제8권2호
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• pp.252-256
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• 2005

저자들은 청색증, 복부 팽만을 주소로 내원한 생후 2일 된 남아에서 Haddad 증후군, 즉 결장 전체의 무신경절증 형태의 Hirschsprung병을 동반한 선천성 중추성 저환기 증후군 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 한국임상약학회지
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• 제23권3호
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• pp.213-222
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• 2013

Purpose: The aim of this study was to investigate the current state of antidepressant prescriptions in breast cancer patients and factors affecting the prescription of antidepressants. Methods: This study targeted female breast cancer patients who were prescribed antidepressants by a psychiatrist at least once between August 2010 and July 2011 at the Asan Medical Center in Seoul. The prescription history of each study subject was investigated to analyze the current state of antidepressant prescriptions in breast cancer patients. Results: The analysis of the prescription histories of 136 subjects in the antidepressant group determined that escitalopram, mirtazapine, and trazodone were the three most commonly prescribed medications with an average of 1.54 antidepressants prescribed per patient. A logistic regression analysis showed a statistically significant increase in antidepressant prescriptions in patients who were divorced or widowed, had sleep disturbances, or had undergone oncologic surgery for the breast cancer (p<0.050). In contrast, the prescription rate was lower for patients with tumour sizes greater than 50 mm (p<0.050). Conclusion: The sociodemographic factor of marital status, clinical factors of sleep disorders and tumour size, and a treatment-specific factor of the use of surgical therapy were identified as affecting the prescription of antidepressants in female breast cancer patients.

• Archives of Reconstructive Microsurgery
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• 제17권2호
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• pp.120-125
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• 2008

Purpose: Heat therapy by heat lamp after microvascular surgery is being used for preventing blood vessels's contraction and blood-flow's disturbance. As usually, incandescent lamp has been used. But there have been several problems and need for improvement in the existing heat lamp treatment. So we would like to introduce improved heat lamp to keep an appropriate temperature and intensity of illumination. Methods: The existing heat lamps are the ones of general light stands covered with newspaper, having 60 watt light bulb of incandescence and lampshade made of aluminum. We have tried to improve shortcomings of the existing heat lamps by enlarging the size of aluminum lampshade and attaching a curtain that can block heat and light. We conducted a comparative study between the existing and improved heat lamps. Under the assumption that there are several affected parts, we have also measured the distance from heat lamp to patients' eye region and then intensity of illumination. Result: The target temperature of surface was realized in 11 minutes with the maximum temperature reaching at 36.6 degrees C in 28 minutes at the existing heat lamp while the target temperature reached in 7 minutes with the maximum temperature reaching at 39.0 degrees C in 17 minutes at the improved heat lamp. The existing and improved heat lamp showed 38 lx and 0.1 lx of intensity of lumination, respectively. Conclusion: Using improved heat lamps, we can keep an appropriate temperature and we think we can make contribution to patients' treatment by making them and their neighbors able to sleep with minimized disturbance thanks to low intensity of illumination secured by blocking light.