• The Transactions of The Korean Institute of Electrical Engineers
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• v.60 no.8
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• pp.1606-1616
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• 2011

The blood pressure measuring equipment, which is being supplied and used most widely by being recognized convenience and accuracy now generally, is oscillometric blood pressure monitor. However, a change in blood pressure is basically influenced by diverse elements such as each individual's physiological status and physical condition. Thus, the measurement of blood pressure, which used single element called oscillation in blood pressure of being conveyed to cuff, is not considered on physiological elements such as cardiovascular system status and blood vessel stiffness index, and on external elements, thereby being quite in error. Accordingly, this study detected diverse bio-signals and body informations in each individual as the measurement subject such as ECG, PPG, and Korotkoff Sound in order to enhance convenience and accuracy of measuring blood pressure in the complex measurement equipment, thereby having extracted regression method for compensation in error of oscillometric blood pressure measurement on the wrist, and having improved accuracy of measuring blood pressure. To verify a method of improving accuracy, the blood pressure value in each of SBP, DBP, MAP was acquired through 4-stage experimental procedure targeting totally 51 subjects. Prior to experiment, the subjects were divided into two groups such as the experimental group for extracting regression method and the control group for verifying regression method. Its error was analyzed by comparing the reference blood pressure value, which was obtained through the auscultatory method, and the oscillometric blood pressure value on the wrist. To reduce the detected error, the blood pressure compensation regression method was calculated through multiple linear regression analysis on elements of blood pressure, individual body information, PTT, HR, K-Sound PSD change. Verification was carried out on improving significance and accuracy by applying the regression method to the data of control group. In the experimental results, as a result of confirming error on the reference blood pressure value in SBP, DBP, and MAP, which were acquired through applying regression method, the results of $-0.47{\pm}7.45$ mmHg, $-0.23{\pm}7.13$ mmHg, $0.06{\pm}6.39$ mmHg could be obtained. This is not only the numerical value of satisfying the sphygmomanometer reference of AAMI, but also shows the lower result than the numerical value in SBP : $-2.5{\pm}12.2$ mmHg, DBP : $-7.5{\pm}8.4$ mmHg, which is the mean error in the experimental results of Brram's research for verifying accuracy of Omron RX-M, which shows relatively high accuracy among wrist sphygmomanometers. Thus, the blood pressure compensation could be confirmed to be made within significant level.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.4
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• pp.301-307
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• 2004

The flap considered at first for the reconstruction of large maxillary defect, especially mid-face defect, is scapular free flap, because it provides ample composite tissue which can be designed 3-dimensionally for orbital, facial and oral reconstruction. In case of maxillary defect involving hard palate, however, this flap has some limitations. First, its bulk prevents oral function and physio-anatomic reconstruction of nasal and oral cavity. Second, mobility and thickness of cutaneous paddle covering the alveolar area reduce retention of tissue-supported denture and give rise to peri-implantitis when implant is installed. Third, lateral border of scapula that is to reconstruct maxillary arch and hold implants is straight, not U-shaped maxillary arch form. To overcome these problems, new concept of step prefabrication technique was provided to a 27-year-old male patient who had been suffering from a complete hard palate and maxillary alveolar ridge defect. In the first stage, scapular osteomuscular flap was elevated, tailored to fit the maxillary defect, particulated autologous bone was placed subperiosteally to simulate U-shaped alveolar process, and then wrapped up with split thickness skin graft(STSG, 0.3mm thickness). Two months later, thus prefabricated new flap was elevated and microtransferred to the palato-maxillary defect. After 6 months, 10 implant fixtures were installed along the reconstructed maxillary alveolus, with following final prosthetic rehabilitation. The procedure was very successful and patient is enjoying normal rigid diet and speech.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.3
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• pp.431-438
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• 2004

The purpose of present study was to compare the sedative effect of intranasal and oral midazolam treatment. The study was conducted on twenty eight child patients who required at least two visits. All the patients showed a good physical status (ASA-I). The patient was randomly assigned to receive midazolam either intranasal (Group I, 0.25 mg/kg) or oral (Group II, 0.5mg/kg) route at each visit. Treatment procedure was divided into six stages. In each stage, sleep score, crying score, movement score and overall behavior score were evaluated. The overall results can be summarized as follows: 1. Through all treatment procedures, no significant difference was observed between Group I and Group II in terms of sleep, crying, movement and overall behavior index. 2. In a questionnaire to the parents, 67.8% of parents answered that the child suffered at intranasal administration, while only 17.7% of parents responded the same way at oral administration. 3. In a questionnaire regarding patients' behavior at home after midazolam treatment, 'Similar to normal behavior' was 78.6% in Group I and 57.1% in Group II, indicating that intranasal treatment of midazolam may be more effective for the recovery.

• The Korean Society of Law and Medicine
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• v.15 no.1
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• pp.211-237
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• 2014

Because of unpredictability and high possibility of abnormal results by clinical trials compared to general medical behaviors, a procedure for ensuring with sufficient explanations by investigators must be secured. Therefore, in a sequence of clinical trials, what kinds of scope, stage, and method of explanations provided by investigators, including doctors or researchers, to trial subjects are closely related to the compensation for damages by violation of liability for explanation. In case of application of clinical trials to patients who have critical illness such as cancer, issues of "Quality of Life" regarding trial subjects, cancer patients, should be discussed. Especially, in case of clinical trials for terminal cancer patients, the right of subjects' self-determination, which is a fundamental principle in medical behaviors, should be discussed. The right of self-determination includes participation in clinical trials for the possibility of life-sustaining even a little bit, or no participation in clinical trials in order to have a time for completing the rest of his life. Like this, if the extent and scope of explanations related to the issues of "Quality of Life" are raised as main issues, the evaluation of "Quality of Life", should be a prerequisite. In many occasions, realistically, despite bad results such as deaths or serious adverse drug reactions after clinical trials, it may not be easy for compensating to trial subjects or their survivors, who requested civil compensation for damage. Futhermore, in abnormal results after concealment of clinical trials or performance of clinical trials without permission, and in the case of trial subjects' failures of proving proximate cause between the clinical trials and abnormal results, problematic results such as no protection to the trial subjects could be occurred. In performing clinical trials, investigators should provide sufficient explanations for trial subjects and secure voluntary informed consents from the trial subjects. Therefore, clinical trials without trial subjects' permissions and the informed consent process violate trial subjects' rights of self-determination, and the investigators shall be liable for compensation for damages. Then, issues might be addressed are what are essential contents of patients' "rights of self-determination" infringed by clinical trials without subjects' permissions. Two perspectives about patients' rights of self-determination might be considered. One perspective regards physical distress of patients (subjects) from therapies without sufficient explanations as the crux of the matter. The other perspective regards infringement of human dignity caused by being subjects without permission as the crux of the matter irrespective of risks' big and small influences. This research follows perspective of the latter. Forming constant fiduciary relation between investigators (doctors) and subjects (patients) pursuant medical contracts, and in accordance with this fiduciary relation, subjects, who are patients, have expectations of explanations and treatments by the best ways. If doctors and patients set this forth as a premise, doctors should assume civil liability when doctors infringe patients' expectations.

• Archives of Plastic Surgery
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• v.40 no.5
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• pp.510-516
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• 2013

Background This paper discusses the treatment protocol for patients with frostbite. Methods We performed a retrospective analysis of a series of 17 patients with second- and higher-degree frostbite who had been treated at our medical institution between 2010 and 2012. Results Our clinical series of patients (n=17) included 13 men and four women, whose mean age was $42.4{\pm}11.6$ years (range, 22-67 years). The sites of injury include the foot in six patients (35.3%), the hand in six patients (35.3%) and the facial region in five patients (29.4%). Seven patients with second-degree frostbite were completely cured with only conservative treatment during a mean period of $12.7{\pm}3.3$ days (range, 8-16 days). Of the five patients with third-degree frostbite, two underwent skin grafting following debridement, and the remaining three achieved a complete cure with conservative treatment during a mean period of $35{\pm}4.3$ days (range, 29-39 days). Five patients with fourth-degree frostbite were treated with surgical procedures including amputation. Conclusions With the appropriate conservative management in the early stage of onset, surgeons should decide on surgery after waiting for a sufficient period of time until the demarcation of the wound. Continuous management of patients is also needed to achieve functional recovery after a complete cure has been achieved. This should also be accompanied by patient education for the avoidance of re-exposure to cold environments.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.27-35
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• 1999

Background: Fibromyalgia is a common syndrome of musculoskeletal pain and fatigue. Lacking distinctive histological or laboratory abnormality in diagnosis, it has often been considered a form of "psychogenic rheumatism". Fibromyalgia causes much distress to the affected patients and often frustrates physicians, who are unable to start rational therapy on any logical disease pathology. Methods: Growth hormone is essential for muscular homeostasis. In the present study, the notion that the stage-4 sleep anomaly typically seen in the fibromyalgia syndrome may disrupt growth hormone secretion was tested. Because growth hormone has a very short half-life, serum levels of somatomedin C were measured; somatomedin C is the major mediator of growth hormone's anabolic actions and is a prerequisite for normal muscle homeostasis. Serum levels of somatomedin C using acid-extraction procedure and two-site immunoradiome-tric assay (IRMA) and number of tender points were measured in 27 female patients with fibromyalgia from 40 to 60 years old and 27 healthy controls. Results: There were no differences in the concentration of somatomedin C between fibromyalgia patients and controls ($mean{\pm}SD$: $178.3{\pm}75.5$ ng/ml versus $166.3{\pm}76.6$ ng/ml; p=0.55). And there were no correlations between number of tender point and serum somatomedin C level by linear regression analysis. Conclusions: These findings did not support that there is a distinctive disruption of the growth hormone-somatomedin C neuroendocrine axis in a fibromyalgia syndrome. But we can not discard the hypothesis that disturbed sleep predispose to muscle pain.

• Journal of the Korea institute for structural maintenance and inspection
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• v.16 no.5
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• pp.112-120
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• 2012

A numerical model considering the internal vaporization and the creep effect, in the form of a analytical program, for tracing the behavior of high strength concrete(HSC) members exposed to fire is presented. The two stages, i.e., spalling procedure and fire resistance time, associated with the thermal, moisture flow, creep and structural analysis, for the prediction of fire resistance behavior are explained. The use of the analytical program for tracing the response of HSC member from the initial pre-loading stage to collapse, due to fire, is demonstrated. Moisture evaporates, when concrete is exposed to fire, not only at concrete surface but also at inside the concrete to adjust the equilibrium and transfer properties of moisture. Finite element method is employed to facilitate the moisture diffusion analysis for any position of member, so that the prediction method of the moisture distribution inside the concrete members at fire is developed. The validity of the numerical model used in this program is established by comparing the predictions from this program with results from others fire resistance tests. The analytical program can be used to predict the fire resistance of HSC members for any value of the significant parameters, such as load, sectional dimensions, member length, and concrete strength.

• Journal of Gifted/Talented Education
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• v.23 no.1
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• pp.67-87
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• 2013

This study explores high school gifted students' perception of cheating in school using the concept mapping method. The map shows the gifted students' concept structure and the different perception between gifted and non-gifted students on cheating. For the purpose, 63 high school gifted students participated at the brainstorming stage to gather the possible related statements. Finally, 64 statements were confirmed and these were divided and evaluated by 13 focus group students. Then, they were analyzed by multidimensional scaling and processed by hierarchical cluster analysis. The results compiled from this procedure show that high school gifted students' perception of cheating is classified into five clusters: "unacceptable cheating behaviors of friends", "an inseparable relation among social structure, giftedness and cheating", "conflict, coping skills, and tolerance related to the cheating", "immorality in one's inner person" and "the judgement based on morality and social justice". In addition, 150 gifted students and 160 non-gifted students checked the degree of agreement to each statement with the likert 6 points scale and the result showed that there was no significant difference in two clusters, "unacceptable cheating behaviors of friends" and "the judgement based on morality and justice", while it turned out that there were significant perception gaps in three clusters, "inseparable relation among social structure, giftedness and cheating", "conflict, coping skills, and tolerance related to the cheating" and "immorality in one's inner person". Implications of the study related to the gifted students' moral behaviors were discussed in depth.

• Archives of Plastic Surgery
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• v.38 no.4
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• pp.339-344
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• 2011

Purpose: The goal of cancer surgery is complete removal of cancer tissue and prevention of recurrence. Surgeons can change the surgical instruments after total resection of the cancer mass. The purpose of this procedure is to prevent dissemination of the cancer cells attached to the surgical instruments. Authors hypothesize the possibility of local recurrence caused by the cancer cells attached to the surgical instruments in the skin cancer cases. Methods: Skin cancers were induced by using DMBA-TPA two-stage carcinogenesis model in 10 of Balb/c mice. In 2-weeks, skin cancer was developed in all 10 mice. cancer cell attached surgical instruments were made by pinching the removed cancer tissue using Adson tissue forcep 10, 20, 30 times each. To count number of cancer cells in each forcep with different number of pinching was done, the forceps were washed in 30 mL of the normal saline and Cytospin preparation was done. To make recurrence models from cancer cell attached surgical instrument, three incisions were made in normal skin of each mouse, and local seeding was done by pinching subcutaneous tissue in 10, 20, 30 times each by using Adson teeth forceps mentioned above as cancer cell attached surgical instrument. Results: All skin cancers were squamous cell carcinoma. Local recurrences were developed in 7 mice (3 in 10 times forceping site, 2 in 20 times forceping and 3 in 30 times forceping). In the cytospin test, the mean number of squamous cells in 100 microscope was 28.6 in 10 times, 47.2 in 20 times, 93.6 in 30 times, respectively. P value was 0.002 in Wilcoxon-Sign test. Conclusion: The number of cell count was significantly increased as number of pinching was increased. And these cells are able to induce local recurrence by local seeding. Considering this result, authors are able to confirm that the minimal handling in cancer surgery is important factor to prevent local recurrence.

• Journal of Chest Surgery
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• v.32 no.3
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• pp.276-280
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• 1999

Background: Post-pneumonectomy empyema(PPE) is an uncommon but a serious complication. The management remains as challenge for general thoracic surgeons. Material and Method: During the period of January 1990 to December 1996, we evaluated the results of 20 patients with post-pneumonectomy empyema. Result: Sex ratio were 15 male and 5 female patients with mean age of 41.5${\pm}$21.5 yrs. The occurrence ratio of left to right side was 8:12. The most common disease for prior pneumonectomy was pulmonary tuberculosis. The duration between pneumonectomy and PPE was variable in 1 month to 6yrs. Fever was the most frequent symptom and S. aureus was the most frequent pathogen. In 13 cases, there were combined with BPF. Four patients underwent trans-sternal closure, and Clagett procedure was performed. There was one recurrence that later underwent muscle plombage and omentopexy later. Nine patients underwent omentopexy, muscle plombage and thoracoplasty. There were 7 cases that were not combined with BPF. All 7 patients underwent thoracoplasty, and two of them were combined with muscle plombage. Mean follow-up duration is 40${\pm}$32.3 months. There were no late deaths nor recurrences of PPE. Conclusion: We conclude that early diagnosis and proper drainage in PPE patients are important in its initial stage of management, and also management is completely achieved in thoracoplasty with muscle plombage or omentopexy.