• Title/Summary/Keyword: 교정치료 후

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Biomechanical changes in lower quadrant after manipulation of low back pain patients with sacroiliac joint dysfunction (요통환자의 엉치엉덩관절 기능부전에 대한 도수교정 후에 하지의 생체역학적인 변화)

  • Oh, Seung-Gil;Yoo, Seung-Hee
    • Journal of Korean Physical Therapy Science
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    • v.8 no.1
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    • pp.893-906
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    • 2001
  • The purposes of this study were to compare pelvic tilt. range of motion(ROM) of hip rotation, and leg length difference before and after manipulation and to investigate correlation between changes of each variables after manipulation of sacroiliac pint in 31 low back pain patients(11 males, 20 females) with sacroiliac pint dysfunction. The sacroiliac pint of patients was manipulated on the side of anterior pelvic tilt, using the technique described by Stoddard(1962) and Greenmann (1996). I used this technique because it usually eliminated sacroiliac Pint dysfunction in one treatment session. SPSS for window computer system was used to analyze the data. Also t-test was performed for comparison of the variables before and after manipulation, and Pearson product-moment correlation analysis and regression analysis were performed for changes of each variables after manipulation. The result were as follows: 1. The pelvic tilt after manipulation was significantly decreased(mean=$2.79^{\circ}$) compared with the pelvic tilt before manipulation(p=.001). 2. The PROM of hip internal rotation ipsilateral to anterior pelvic tilt after manipulation significantly decreased (mean = $1.88^{\circ}$) compared with hip internal rotation before manipulation (p=.008). The PROM of hip internal rotation ipsilateral to posterior pelvic tilt after manipulation significantly increased(mean = $1.29^{\circ}$) compared with hip internal rotation before manipulation (p=.029). 3. The PROM of hip external rotation ipsilateral to anterior pelvic tilt after manipulation significantly increased(mean=$2.42^{\circ}$) compared with the hip external rotation before manipulation(p=$2.42^{\circ}$) compared with the hip external rotation ipsilateral to posterior pelvic tilt after manipulation significantly decreased(mean = $1.84^{\circ}$) compared with the hip external rotation before manipulation (p=.008). 4. Leg length difference after manipulation significantly decreased(mean=2.15 mm) compared with leg length difference before manipulation (p=.008). Regression analysis revealed that a fair correlation was found between change in leg length difference and change in anterior pelvic tilt after manipulation(p=.009). 5. Pearson product-moment correlation coefficient was used to assess differences of the variables after manipulation. A fair correlation was found between change in leg length difference and change in anterior pelvic tilt after manipulation(r=.462, p<.01). A fair correlation was found between change in anterior pelvic tilt and change in hip internal rotation ipsilateral to anterior pelvic tilt(r=.397, p<.05) and between change in anterior pelvic tilt and change in hip external rotation ipsilateral to anterior pelvic tilt(r=.516, p<.01). A fair correlation was found between change in posterior pelvic tilt and changes in hip internal rotation ipsilateral to posterior pelvic tilt (r=.441, p<.05) and between change in posterior pelvic tilt and change in hip external rotation ipsilateral to posterior pelvic tilt(r=.361, p<.05). A fair correlation was found between change in hip internal rotation ipsilateral to anterior pelvic tilt and change in hip external rotation ipsilateral to posterior pelvic tilt(r=.388, p<.05) and between change in hip internal rotation ipsilateral to posterior pelvic tilt and change in hip internal rotation ipsilateral to anterior pelvic tilt(r=.426. p<.05).

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Comparison of Infective Endocarditis between Children and Adults with Congenital Heart Disease: A 16-Year, Single Tertiary Care Center Review (선천성 심장병을 가진 소아와 성인에서 발생한 감염성 심내막염의 비교: 1개 3차 병원의 16년간 경험)

  • Kwon, Jung Eun;Kim, Yeo Hyang
    • Pediatric Infection and Vaccine
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    • v.23 no.3
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    • pp.209-216
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    • 2016
  • Purpose: This study aimed to evaluate and compare the characteristics of infective endocarditis (IE) between children and adults with congenital heart disease (CHD) at a single tertiary care center. Methods: In this retrospective medical record review, we extracted the demographic characteristics, diagnostic variables, and outcomes of patients diagnosed with IE and CHD between 2000 and 2016. Results: We identified a total of 14 pediatric patients (nine male; median age at diagnosis, 3 years). Of the 14 patients, six had a history of previous open heart surgery, while four had undergone tetralogy of Fallot repair, with transannular patch or Rastelli procedure. Among the 10 children with positive blood cultures, the most common isolated organism was Staphylococcus spp. (8/10, 80%). Eleven adult patients had IE and CHD. Among the adult patients, only four were diagnosed with CHD before IE, and ventricular septal defect was the most common CHD. The most common isolated organism was Streptococcus spp. (6/11, 55%). Compared with adult patients, pediatric patients had a higher incidence of previously diagnosed CHD (P=0.001), with Staphylococcus spp. as the causative organism (P=0.027). The median duration between the onset of symptoms and diagnosis of IE was 9 days in children and 42 days in adults (P=0.012). Conclusions: Significant differences with regard to the diagnosis and progress of IE were observed between children and adults. Age-adjusted and systematic reassessment may be necessary for the diagnosis and management of IE.

Treatment of Grade IV Medial Patellar Luxation by Femoral Shortening Osteotomy in Three Small-Breed Dogs (세 마리의 소형견에서 대퇴 단축 절골술에 의한 4단계 내측 슬개골 탈구의 치료 증례)

  • Kang, Byung-Jae;Rhew, Daeun;Kim, Yongsun;Lee, Seunghoon;Yoon, Daeyoung;Kim, Wan Hee;Kweon, Oh-Kyeong
    • Journal of Veterinary Clinics
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    • v.31 no.5
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    • pp.421-424
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    • 2014
  • Three small-breed dogs with grade IV medial patellar luxation were presented. In all cases, patellar luxation could not be reduced by conventional surgical techniques. Femoral shortening osteotomy was performed in all dogs to correct patellar luxation. In all the dogs, the clinical condition was remarkably improved, and following surgical procedures, no complication or recurrence was presented. Femoral shortening osteotomy is an effective treatment in small-breed dogs with medial patellar luxation associated with severe skeletal deformity.

Maintenance of Platelet Counts with Low Level QC Materials and the Change in P-LCR according to Hemolysis with XN-9000 (XN-9000장비에서 Low Level QC물질에서의 혈소판 수 관리와 용혈에 따른 P-LCR의 변화)

  • Shim, Moon-Jung;Lee, Hyun-A
    • Korean Journal of Clinical Laboratory Science
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    • v.50 no.4
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    • pp.399-405
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    • 2018
  • The platelet count in clinical laboratories is essential for the diagnosis and treatment of hemostasis abnormalities, and accurate platelet counting in the low count range is of prime importance for deciding if a platelet transfusion is needed and for monitoring after chemotherapy. Quality control is designed to reduce and correct any deficiencies in the internal analytical process of a clinical laboratory prior to the release of patient results. Fragmented erythrocytes are the major confusing factors for platelet counting because of their similar size to platelets. The authors found that the low range QC values were out of 2SD with a Sysmex automatic analyzer in internal quality control process. Thus far, there has been little discussion on the relationship between hemolysis and the platelet parameters. Therefore, this study focused on the performance of automated platelet counts, including the PLT-F, the PLT-I, and PLT-O methods at the low platelet range using the low level QC materials and compared the 5 platelet parameters with the hemolyzed samples. The results showed that the CV was the smallest with PLT-F and P-LCR increased from 18.4 to 31.9% in the hemolysis samples. These results indicate that a more accurate estimation of the platelet counts can be achieved using the PLT-F method than the PLT-I method at the low platelet range. The use of the PLT-F system improves the confidence of results in low platelets samples in a routine hematology laboratory. The results suggest that P-LCR is a new parameter in assessing samples when the specimen is suspected of hemolysis and deterioration. Nevertheless, further studies will be needed to establish the relationship with P-LCR and hemolysis using human blood specimens.

Postoperative Pulmonary Vein Stenosis (PVS) in Patients with TAPVR (전 폐정맥 환류 이상의 수술 후 폐정맥 협착에 대한 분석)

  • Jung Sung-Ho;Park Jeong-Jun;Yun Tae-Jin;Jhang Won-Kyoung;Kim Young-Hwue;Ko Jae-Kon;Park In-Sook;Seo Dong-Man
    • Journal of Chest Surgery
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    • v.39 no.5 s.262
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    • pp.347-353
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    • 2006
  • Background: Despite recent advances in surgical technique and perioperative care of total anomalous pulmonary venous return (TAPVR), post-repair pulmonary vein stenosis (PVS) remains as a serious complication. We thought that the most important factors of TAPVR repair to prevent PVS were good exposure, proper alignment, and sufficient stoma size. We analyzed our experience retrospectively. Material and Method: Between Jan. 1995 and Feb. 2005, we studied 74 patients diagnosed with TAPVR suitable for biventricular repair. Supra-cardiac type (n=41, 55.4%) was the most common. Mean CPB time, ACC time, and TCA (40.5%, 30/74) time were $92.1{\pm}25.9\;min,\;39.1{\pm}10.6\;min$, and $30.2{\pm}10.7\;min$, respectively. Mean follow-up duration was $41.4{\pm}29.1$ months and follow-up was possible in all patients. Result: The median age and body weight at operation were 28.5 days ($0{\sim}478$ days) and 3.4 kg $(1.4{\sim}9\;kg)$. Early mortality was 4.1% (3/74). Causes of death were pulmonary hypertensive crisis, sepsis, and sudden death. There was PR-PVS in 2 patients (early: 1, late: 1). Both patients were cardiac type TAPVR drained to coronary sinus. Re-operations were done but only one patient survived. Cumulative survival rate in 5 year and percent freedom from PVS were $94.5{\pm}2.7%\;and\;97.2{\pm}2.0%$, respectively. Conclusion: There was no PVS in patients who underwent extra-cardiac anatomosis between LA and CPVC. Therefore it could be said that our principle might be effective in preventing PR-PVS in patients suitable two-ventricle.

THE FISSURE PENETRATION AND MICROLEAKAGE OF PIT AND FISSURE SEALANT WITH MECHANICAL PREPARATION (기계적 삭제방법을 이용한 치면열구전색제의 열구 침투도 및 미세누출)

  • Kim, Ji-Yeon;Lee, Jae-Ho;Park, Ki-Tae;Kim, Seong-Oh;Choi, Byung-Jai;Son, Heung-Kyu
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.1
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    • pp.164-173
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    • 2005
  • Mechanical preparation has been introduced to provide the sealant retention. The objective of this study was to compare the fissure penetration and the microleakage of pit and fissure sealant using mechanical preparation(mechanical preparation + acid etching) and acid etching only. An additional objective of this study was to compare the fissure penetration and the microleakage of unfilled and filled sealant in both methods. Sixty human premolars extracted for orthodontic purpose were selected. Thirty teeth were acid etched alone and remaining thirty teeth were prepared with a $\frac{1}{4}$ round bur and then acid etched. One-half of teeth in each surface treatment method were sealed with unfilled sealant and the other half were sealed with filled sealant. All of the teeth were thermocycled for 1200 cycles at $5^{\circ}C\;and\;55^{\circ}C$ and immersed in 5% methylene blue for 24 hours. Each tooth was sectioned bucco-lingually at mesial pit and distal pit and examined under a Measurescope. In the case of mechanical preparation, fissure penetration of sealant was significantly increased compared with the case of acid etching only(P < 0.05). The filled and unfilled sealant using mechanical preparation showed significantly decreased microleakage when compared with the unfilled sealant using acid etching only(P < 0.05). No differences were found in fissure penetration and microleakage between unfilled and filled sealant in both methods. Taken together, the results of this study suggest that mechanical preparation and filled sealant are recommended when placing pit and fissure sealant. However, further clinical studies should be performed in regard to microleakage.

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Surgical Closure of the Patent Ductus Arteriosus in Premature Infants by Axillary Minithoracotomy (액와 소개흉술에 의한 미숙아 동맥관 개존증의 외과적 치료)

  • Cho, Jung-Soo;Yoon, Yong-Han;Kim, Joung-Taek;Kim, Kwang-Ho;Hong, Yung-Jin;Jun, Yong-Hoon;Shinn, Helen Ki;Baek, Wan-Ki
    • Journal of Chest Surgery
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    • v.40 no.12
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    • pp.837-842
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    • 2007
  • Background: Closure of the ductus arteriosus is often delayed in premature infants, which creates a hemodynamically significant left to right shunt that exerts an adverse effect on the normal development and growth of these babies. We reviewed out experience on surgical closure of patent ductus arteriosus via axillary minithoracotomy in premature infants. Material and Method: From April 2002 to October 2006, 20 premature infants whose gestation was under 37 weeks underwent surgical closure of patent ductus arteriosus as a result of complications or contra-indications for the use of indomethacin. Their mean gestational age was 28.8+3.4 weeks, ranging from 25+3 to 34+6 weeks, and the average age at operation was $15.6{\pm}6.3$ days. The mean body weight at operation was $1,174{\pm}416\;g$, ranging from 680 to 2,100g; 16 infants were under 1,500 and 9 infants were under 1,000 g. The procedures were performed in the newborn intensive care unit via $2{\sim}3\;cm$ long axillary minithoracotomy with the infant in the lateral position with left arm abduction. The mean size of the patent ductus arteriosus was $3.8{\pm}0.3\;mm$. For the most part, the ductus was closed with clips; 2 infants in whom the ductus was ruptured while dissection was being performed underwent ductal division. Result: Ten of twelve infants who had been ventilator dependent preoperatively could be successfully weaned from the ventilator at a mean duration of 9.7 days after the operation. There was no procedure-related complication or death. Two infants eventually died of the conditions not related to the operation; one from sepsis at postoperative 131 days and the other from pneumonia at postoperative 41 days, respectively. Conclusion: Surgical closure of the patent ductus arteriosus improved the hemodynamic instability and so promoted the successful growth and normal development of premature infants. Considering the low surgical risk along with the reduced invasiveness, early and aggressive surgical intervention is highly recommended.

A Clinical Review of Acute Respiratory Distress Syndrome (ARDS) Due to Miliary Tuberculosis (급성호흡곤란증후군으로 발현된 속립성 결핵의 임상적 고찰)

  • Ahn, Young-Soo;Lee, Sang-Moo
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.1
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    • pp.17-26
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    • 2002
  • Background : The detection and early elimination of the causes for acute respiratory distress syndrome(ARDS) at the initial stage can result in a more favorable prognosis. Miliary tuberculosis as a cause of the ARDS is quite rare. A diagnosis of miliary tuberculosis is difficult due to the diversity of radiological patterns and non-specific clinical finfings, and low sensitivity of sputum examinations for acid-fast bacilli(AFBs). An analysis of the clinical data is the first step in diagnosing these unusual, rare cases. Materials and Methods : In this study the clinical features, laboratory data, radiological findings and diagnostic methods were analyzed in 9 cases with an initial presentation of ARDS due to miliary tuberculosis. The ARDS was defined by the definition of the American-Europian consensus conference 1992. Results : The mean age of the patients was $67{\pm}18$ years (F:M=7:2). The chief complaints were dyspnea(5/9), coughing (3/9) and fever(5/9). On a physical examination, fine or coarse crackles were noted(6/9). The ARDS developed on average 6.7 days after the initial respiratory symptoms. The mean $PaO_2/FiO_2$ of the patients was $133.5{\pm}53.4$, the number of cases with a WBC<5000/$mm^3$ was 4 out of 9 cases. A platelet count<70,000/$mm^3$ was observed in 2 out of 9 cases, and the serum albumin level was $2.6{\pm}0.6$ g/dL. The initial simple chest PA showed ground glass appearances and consolidation in all cases, However, the miliary nodular densities were observed in only 4 out of the 9 cases. HRCT revealed alveolar densities and a consolidation in 5 out of 6 cases, and miliary nodules in 5 out of 6 cases, The diagnosis of tuberculosis was made by a liver biopsy (4/4, 100% sensitivity), a bone marrow biopsy (1/2, 50% sensitivity), and an open lung biopsy (1/1), the sputum AFB was positive in only 2 out of 9 cases. The patient was treated with INH, RFP, EMB, PZA, and steroids. The survival rate was 55.5%. Conclusion : Miliary tuberculosis should be considered as one of the causes for ARDS in areas where there is a high prevalence of tuberculosis. The chief complaints of the patients on admission are dyspnea, fever and coughing without any specific riskfactors. A liver biopsy is particularly useful in ARDS patients with mechanical ventilation to determine the causes of the ARDS if miliary tuberculosis is suspected as being the underlying disease.

20-Year Experience of Surgical Treatment for Postpneumonectomy Empyema (전폐절제술 후 사강에 발생한 농흉의 치료)

  • 김형렬;김영태;성숙환;김주현
    • Journal of Chest Surgery
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    • v.35 no.7
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    • pp.542-547
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    • 2002
  • Background: Postpneumonectomy empyema(PPE) is an infrequent but potentially life-threatening complication. To date, various surgical efforts have been made to manage this complication. We reviewed our 20-year surgical experience of PPE and long-term follow-up data. Material and Method: Total of 37 patients who were treated for PPE between fan, 1980 and Jun, 2000 were included. Various clinical factors such as micro-organism, operative method and timing, presence of bronchopleural fistula(BPF), underlying disease and fate of empyema cavity were retrospectively reviewed and analyzed. Result: Majority of patients(34) underwent Eloesser operation for effective drainage. There was only one operative mortality. The causative organisms were Staphylococcus species and Pseudomonas species in 46% BPF was found in 20 cases, among which spontaneous closures took place in 4 cases. The chest wall was closed in 40%(8/20) of patients with BPF, compared to 59%(10/17) without BPF. The closure rate was statistically better in patients without BPF(p=0.006). Even though the patients with benign disease showed higher closure rate(50%) than those with lung cancer (31%), the difference was not significant(p=0.25). Conclusion: Eloesser procedure was an effective method for initial drainage of PPE cavity with low operative mortality. Given the findings of low spontaneous closure rate of BPF, aggressive approach to close the BPF is mandatory to achieve the final goal of chest wall closure. It was found that majority of patients still left their chest cavity opened, even after controlling the active inflammation of the empyema cavity. More aggnessive approach for chest wall closure is recommended in all patents with benign disease and in selective patients with lung cancer if there is no evidence of recurrence at several years after the initial operation.

ERUPTION DISTURBANCE ASSOCIATED WITH A DEVELOPING ODONTOMA (발육중인 치아종으로 인한 맹출 장애)

  • Ryu, Jae-Ryang;Kim, Young-Jin;Kim, Hyun-Jung;Nam, Soon-Hyeun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.4
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    • pp.505-511
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    • 2010
  • Odontoma represents 22% of all odontogenic tumors, which is characterized by slow growth pattern. Most of the odontomas usually develop during dental follicle proliferation. The growth of odontoma is limited and lesion is generally asymptomatic. It is frequently diagnosed during assessments for delayed eruption of permanent tooth and is usually founded in the second decade of life. Odontoma is usually diagnosed through radiographic views and is difficult to diagnose at the early developmental stage of odontoma. But an uncalcified developing odontoma can disturb the eruption of the tooth, so it is important to perform periodic radiographic examinations. Treatments are surgical removal and observation of odontoma followed by surgical opening or orthodontic traction of impacted tooth according to the tooth development and the location of impacted tooth. In this case, we found the radiopaque calcified odontoma in the radiographic view meanwhile follow up of the impacted tooth showing idiopathic eruption disturbance. This suggests that a developing odontoma is the cause of eruption disturbace.