• 한국임상수의학회지
• /
• 제32권4호
• /
• pp.363-365
• /
• 2015

반달가슴곰 (Ursus thibetanus)은 국제적 멸종위기종으로, 국립공원관리공단에서 종복원 프로그램을 진행 중이다. 하지만 자연방사가 어려운 개체들은 제한된 사육 시설로 인해 곰 개체수 관리가 필요하여 수컷에서 고환절제술을 시행하였다. Tiletamine-zolazepam 2 mg/kg과 medetomidine $40{\mu}g/kg$ 합제를 이용하여 곰을 포획하고, 기관 삽관을 통해 isoflurane으로 전신마취를 유지하였다. 고환절제술은 전음낭 절개를 통해 closed method로 시행되었으며, LigaSure를 사용하여 정삭을 소락 절단였다. 절개면 피하조직은 흡수성 봉합사로 연속봉합 하였으며, 피부는 조직접착제로 봉합하였다. 별다른 부작용 없이 전신마취에서 회복되었으며, 총 마취 시간은 58분(곰 A)과 53분(곰 B)이었다. 수술시간은 26분(곰 A)과 24분(곰 B)이었으며, 술 후 부종이나 합병증은 관찰되지 않았다. 본 연구는 반달가슴곰에서 LigaSure를 이용한 최초의 고환절제술 증례이다.

• 한국임상수의학회지
• /
• 제31권6호
• /
• pp.515-518
• /
• 2014

배뇨실금, 변비를 보이는 중성화된 수컷 요크셔테리어가 내원하였다. 신체검사에서 배뇨곤란 증상이 확인되었고 신경학적 이상은 발견되지 않았다. 또한 요검사에서 세균이 확인 되지 않았으며 직장 검사에서 정상 크기의 전립선을 확인 할 수 있었다. 요도 카테터는 저항감 없이 삽입 되었으며 비뇨기계 조영 촬영에서 골반강 내에 위치한 방광이 확인 되었다. 이소성 요관과 같은 선천적 이상은 확인 되지 않았으며 골반강 내 방광을 동반한 요도 조임근 기능 부전증이 진단 되었다. 방광을 복강내 정상 위치로 환납하기 위한 방광 고정술이 결정 되었다. 와욕 봉합을 이용 방광목 부분을 복벽 및 치골 앞 인대에 고정하였으며 추가적으로 방광 외측 부분을 복벽에 고정하였다. 방광 상단 부위는 복벽 절개창 부위에 고정 하였다. 수술 후 배뇨를 돕기 위해 방광내 카테터를 장착하였으며 수술 후 3일 째 제거하였다. 카테터 제거 후 3 일째 정상 배뇨가 확인되었으며 수술 후 2 달째 방광 조영 촬영을 통해 방광이 복강 내에 정상적으로 위치한 것을 확인하였다. 보호자와의 지속적인 전화 통화를 통해 수술 후 3년 11개월까지 정상 배뇨를 확인하였다.

• 대한족부족관절학회지
• /
• 제26권2호
• /
• pp.95-102
• /
• 2022

Purpose: This study was based on the Korean Foot and Ankle Society (KFAS) member survey and aimed to report the current trends in the management of syndesmotic injuries over the last few decades. Materials and Methods: A web-based questionnaire containing 36 questions was sent to all KFAS members in September 2021. The questions were mainly related to the preferred techniques and clinical experiences in the treatment of patients with syndesmotic injuries. Answers with a prevalence ≥50% of respondents were considered a tendency. Results: Seventy-six (13.8%) of the 550 members responded to the survey. The results showed that the most preferred method to diagnose a syndesmotic injury was magnetic resonance imaging (MRI). Intraoperatively, the external rotation stress test and the Cotton test were most frequently used to confirm syndesmotic diastasis. The reduction was usually done by a reduction clamp. One 3.5-mm screw was used most frequently over three cortices at 2~4 cm above the ankle joint. The preferred ankle position during fixation was 0° dorsiflexion. Removal of the syndesmotic screw was routinely done by most surgeons, mainly because of the limitation of movement and risk of screw breakage. Factors that affect suture button selection included non-rigid fixation which enables adequate fixation, early weight-bearing, and an infrequent need to remove the hardware. Inadequate reduction was considered the main factor that affects poor prognosis. Conclusion: This study proposes updated information about the current trends in the management of syndesmotic injuries in Korea. Consensuses in both the diagnostic and therapeutic approach to patients with syndesmotic injury were identified in this survey study. This study may raise the awareness of the various possible approaches toward the injury and should be used to further establish a standard protocol for the management of syndesmotic injuries.

• Journal of Periodontal and Implant Science
• /
• 제51권6호
• /
• pp.398-408
• /
• 2021

Purpose: In this study, we aimed to evaluate the clinical validity of the modified tunneling technique using minimal soft tissue harvesting and volume-stable collagen matrix in the anterior mandible. Methods: In total, 27 anterior mandibular teeth and palatal donor sites in 17 patients with ≥1 mm of gingival recession (GR) were analyzed before and after root coverage. For the recipient sites, vertical vestibular incisions were made in the interdental area and a subperiosteal tunnel was created with an elevator. After both sides of the marginal gingiva were tied to one another, a prepared connective tissue graft and volume-stable collagen matrix were inserted through the vestibular vertical incision and were fixed with resorbable suture material. The root coverage results of the recipient site were measured at baseline (T₀), 3 weeks (T₃), 12 weeks (T₁₂), and the latest visit (T_l). For palatal donor sites, a free gingival graft from a pre-decided area avoiding the main trunk of the greater palatine artery was harvested using a prefabricated surgical template at a depth of 2 mm after de-epithelization using a rotating bur. In each patient, the clinical and volumetric changes at the donor sites between T₀ and T₃ were measured. Results: During an average follow-up of 14.5 months, teeth with denuded root lengths of 1-3 mm (n=12), 3-6 mm (n=11), and >6 mm (n=2) achieved root coverage of 97.01%±7.65%, 86.70%±5.66%, and 82.53%±1.39%, respectively. Miller classification I (n=12), II (n=10), and III (n=3) teeth showed mean coverage rates of 97.01%±7.65%, 86.91%±5.90%, and 83.19%±1.62%, respectively. At the donor sites, an average defect depth of 1.41 mm (70.5%) recovered in 3 weeks, and the wounds were epithelized completely in all cases. Conclusions: The modified tunneling technique in this study is a promising treatment modality for overcoming GR in the anterior mandible.

• 대한족부족관절학회지
• /
• 제26권1호
• /
• pp.22-29
• /
• 2022

Purpose: Despite continuous updates of standard treatment guidelines for acute ankle sprain and chronic ankle instability (CAI), in practice preferred treatment protocols vary widely. Based on a Korean Foot and Ankle Society (KFAS) member survey, this study reports current trends in the management of ankle ligament injuries. Materials and Methods: A web-based questionnaire containing 34 questions was sent to all KFAS members in September 2021. Questions mainly addressed clinical experience and preferences for the diagnosis and treatment of ankle ligament injuries. Answers with a prevalence of ≥50% among respondents were considered to reflect tendencies. Results: Eighty-four of the 550 members (15.3%) responded. Answers that showed a tendency were as follows: commonest additional image study (ultrasound), conservative treatment modality (immobilization, oral medication), frequency of surgical treatment (<5 cases per annum), most important factor when deciding on surgical treatment (activity level, e.g., occupation or sport), and commonest surgical procedure (open ligament repair). Answers that showed a tendency for CAI were as follows: most important symptom (repeated sprain, giving way), radiological factors (talar tilt, osteochondral lesion, anterior talar translation), and patient factors (occupation, sports activities, recurrent instability after surgery, etc.). For decision making regarding surgical treatment and method, the most preferred surgical procedure was the modified Broström procedure, and the most common repair technique was suture anchor technique. The following were considered poor prognostic factors; generalized laxity, failed previous surgery, cavovarus, severe mechanical instability, heavy work, obesity, and dissatisfaction after surgery because of residual pain. Conclusion: This study updates information regarding current trends in the management of ankle ligament injuries in Korea, and reveals consensus opinions and variations in approaches to patients with an acute or chronic injury. The divergence of approaches identified indicates the need for further studies to determine standard guidelines and long-term results.

• 대한치과교정학회지
• /
• 제54권1호
• /
• pp.48-58
• /
• 2024

Objective: To quantify the effects of midline-related landmark identification on midline deviation measurements in posteroanterior (PA) cephalograms using a cascaded convolutional neural network (CNN). Methods: A total of 2,903 PA cephalogram images obtained from 9 university hospitals were divided into training, internal validation, and test sets (n = 2,150, 376, and 377). As the gold standard, 2 orthodontic professors marked the bilateral landmarks, including the frontozygomatic suture point and latero-orbitale (LO), and the midline landmarks, including the crista galli, anterior nasal spine (ANS), upper dental midpoint (UDM), lower dental midpoint (LDM), and menton (Me). For the test, Examiner-1 and Examiner-2 (3-year and 1-year orthodontic residents) and the Cascaded-CNN models marked the landmarks. After point-to-point errors of landmark identification, the successful detection rate (SDR) and distance and direction of the midline landmark deviation from the midsagittal line (ANS-mid, UDM-mid, LDM-mid, and Me-mid) were measured, and statistical analysis was performed. Results: The cascaded-CNN algorithm showed a clinically acceptable level of point-to-point error (1.26 mm vs. 1.57 mm in Examiner-1 and 1.75 mm in Examiner-2). The average SDR within the 2 mm range was 83.2%, with high accuracy at the LO (right, 96.9%; left, 97.1%), and UDM (96.9%). The absolute measurement errors were less than 1 mm for ANS-mid, UDM-mid, and LDM-mid compared with the gold standard. Conclusions: The cascaded-CNN model may be considered an effective tool for the auto-identification of midline landmarks and quantification of midline deviation in PA cephalograms of adult patients, regardless of variations in the image acquisition method.

• The Journal of Advanced Prosthodontics
• /
• 제16권4호
• /
• pp.244-254
• /
• 2024

PURPOSE. This study aimed to evaluate the reliability and validity of a four-item questionnaire using a face rating scale to measure dental trait anxiety (DTA), dental trait fear (DTF), dental state anxiety (DSA), and dental state fear (DSF). MATERIALS AND METHODS. Participants were consecutively selected from patients undergoing scaling (S-group; n = 47) and implant placement (I-group; n = 25). The S-group completed the questionnaire both before initial and second scaling, whereas the I-group responded on the pre-surgery day (Pre-day), the day of implant placement (Imp-day), and the day of suture removal (Post-day). RESULTS. The reliability in the S-group was evaluated using the test-retest method, showing a weighted kappa value of DTA, 0.61; DTF, 0.46; DSA, 0.67; DSF, 0.52. Criterion-related validity, assessed using the State-Trait Anxiety Inventory's trait anxiety and state anxiety, revealed positive correlations between trait anxiety and DTA/DTF (DTA, ρ = 0.30; DTF, ρ = 0.27, ρ: correlation coefficient) and between state anxiety and all four items (DTA, ρ = 0.41; DTF, ρ = 0.32; DSA, ρ = 0.25; DSF, ρ = 0.25). Known-group validity was assessed using the initial data and Imp-day data from the S-group and I-group, respectively, revealing significantly higher DSA and DSF scores in the I-group than in the S-group. Responsiveness was gauged using I-group data, showing significantly lower DSA and DSF scores on post-day compared to other days. CONCLUSION. The newly developed questionnaire has acceptable reliability and validity for clinical use, suggesting its usefulness for research on dental anxiety and fear and for providing patient-specific dental care.

• 기독교교육논총
• /
• 제77권
• /
• pp.107-126
• /
• 2024

연구 목적 : 본 연구는 통일 후 남북한 동류의식 형성을 위한 기독교교육적 과제를 모색하기 위해 시작되었다. 지난 분단 시기 동안 남한과 북한은 정치·경제·사회·문화·교육 등 사회의 거의 모든 요소에서 이질화 되었다. 이질화 된 두 사회가 만나 통일의 과정에서 경험하게 될 다양한 사회 갈등을 고려할 때, 사회 통합의 문제는 더 이상 제도적 통합이나 경제적 통합의 하위 요소가 아니라 그 자체로 필수적 요소가 된다. 연구 내용 및 방법 : 연구를 위해 인간의 욕구가 사회 갈등의 조건이라는 '인간 욕구 이론'을 바탕으로 사회 갈등의 형태를 분석했다. 사회의 갈등은 인간의 다양한 욕구가 충족되지 않은 것으로부터 기인하며 이는 결국 동류의식을 형성하고자 하는 정체성의 갈등으로 확장된다. 사회적 갈등이 정체성 갈등으로 수렴된 통일 독일의 사례에 비추어 통일 한국 시대의 갈등은 곧 정체성 갈등이 될 것이라고 예측했다. 결론 및 제언 : 통일 후 사회의 갈등을 봉합해야 할 기독교교육의 방향을 '기독교교육의 공공성'과 '하나님 나라' 개념에 대한 신학적 성찰로부터 도출하였다. 그리고 사회 통합의 구체적인 교육방안으로 시민과 제자로서의 이중 정체성에 대한 기독교교육을 통해 하나님 사랑과 이웃 사랑의 담론을 제시하는 동시에 신앙 공동체를 통한 재 사회화 교육의 필요성을 강조하였다.

• Journal of Chest Surgery
• /
• 제57권5호
• /
• pp.477-483
• /
• 2024

Background: Torsion of the right middle lobe following right upper lobectomy is a rare but potentially fatal complication. To prevent this, fixation of the right middle lobe has been suggested. This study was performed to examine the impact of right middle lobe fixation on postoperative outcomes and bronchial changes. Methods: We enrolled patients who underwent curative-intent video-assisted thoracic surgery (VATS) right upper lobectomy for lung cancer from 2019 to 2022. Participants were grouped based on whether they did or did not receive right middle lobe fixation. Bronchial angles were measured using preoperative and postoperative chest computed tomography images, and postoperative outcomes and bronchial changes were compared between the 2 groups. Results: The study included a total of 50 patients, with 17 (34%) undergoing right middle lobe fixation. All procedures were performed using VATS. No significant differences between groups were observed in preoperative characteristics or postoperative outcomes. After surgery, both groups exhibited a significant increase in the right bronchus intermedius angle and a significant decrease in the branch angle. The postoperative right bronchus intermedius angle was significantly larger in the group without right middle lobe fixation compared to the group with fixation (47.38°±10.98° vs. 39.41°±9.21°, p=0.014). Three cases of atelectasis occurred in the group that did not undergo fixation while no cases were observed in the fixation group; however, this difference was not statistically significant. Conclusion: Fixation of the right middle lobe reduced postoperative angulation of the right bronchus intermedius, which may help prevent postoperative atelectasis.

• 대한치과교정학회지
• /
• 제30권5호
• /
• pp.657-668
• /
• 2000

본 연구는 골격성 III급 부정교합 환자에서 상악골 전방이동 수술 후 야기되는 코의 형태변화에 대해 연구하고 이를 예측할 수 있는 요소를 찾아 교정-악교정 수술 복합 치료계획의 수립과 결과의 예측에 이용하고자 시행되었다. 부산대학교병원 치과진료처 교정과에 내원하여 골격성 III급 부정교합으로 진단되어 술전 교정치료를 받고 Le Fort I 골절단술로 상악골의 전방 이동시키는 동시에 하악골을 후방 이동시킨 남녀 성인 환자 25명을 대상으로 하였다. 이들의 수술전, 후 측모두부규격방사선사진과 정모 및 측모 안면사진을 계측, 분석하여 다음과 같은 결과를 얻었다. 1. 상악골 전방이동에 따른 비첨의 수직적 위치 변화는 상관성이 높았으며 ANt, SNt에서 A point의 전방이동에 의해 ${\beta}_0$는 각각 0.228, 0.257로 나타났다. 2. 상악골 전방이동에 따른 비첨의 수평적 위치변화는 상관성이 높았으며 ANt, SNt, Sn point에서 A point의 전방이류에 의해 ${\beta}_0$는 각각 0.484, 0.431, 0.806으로 나타났다. 3. 상악골의 전방이동에 따른 비익부의 확장정도는A point의 전방이동에 의해 0.002의 ${\beta}_0$를 나타내었으나, 임상적으로 유의한 변화는 없었다. 4. 수술 후 비첨의 수직적 및 전후방적 위치변화를 예측하는 지표로 사용된 ADV, DRI, Prominence of nose, Pre-Op CA 중 ADV 만이 설명변수로서 유의성이 있었다.