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Treatment Outcome and Prognosis of the Outpatients with Orofacial Pain (구강안면통증 환자의 치료결과와 예후에 관한 연구)

  • Choi, Sea-Hun;Kim, Ki-Suk;Kim, Mee-Eun;Lee, Dong-Ju;Jin, Sang-Bae
    • Journal of Oral Medicine and Pain
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    • v.31 no.2
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    • pp.155-165
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    • 2006
  • The purpose of this study was to evaluate treatment outcome and prognosis of the patients with orofacial pain disorders who visited for treatment in the Department of Oral Medicine, Dankook University Dental Hospital from January 2002 to December 2004. Orofacial pain disorders were categorized into TMD(myogenous, arthrogenous and muscle-joint combined TMDs), neuropathic pain disorder, oral soft tissue disease and complex condition simultaneously having more and two aforementioned categories and treatment period, method and treatment outcome were evaluated. The results of this study were as follows; 1. Average longevity of treatment period was the longest in the neuropathic pain, followed by soft tissue disease, complex conditions, arthrogenous TMD, muscle-joint combined TMD and myogenous TMD in order. 2. When treatment methods were largely categorized into pharmacologic, physical and oral appliance therapy, pharmacologic therapy was used the most frequently for the patients with neuropathic pain or oral soft tissue diseases, oral appliance therapy for those with arthrogenous TMD and physical therapy for those with myogenous TMD. 3. Of physical therapeutic methods used in our clinic, EAST and microwave was employed the most frequently in the patients with myogenous TMD, ultrasound for those with arthogenous TMD and LLLT for those with neuropathic pain or oral soft tissue disease. 4. In comparison with change of pain after treatment, there existed a tendency that pain from neuropathic pain disorders persisted while pain from TMD was getting better or totally disappeared. 5. Concerning the change of mouth opening range in the TMD subgroups, there was no significant difference among the subgroups but significant difference existed among opening ranges, indicating comfortable maximum mouth opening increased the most following treatment. Improvement of active range of mouth opening was the most considerable in those with disc displacement without reduction. It can be said on the basis of the findings from this study that various treatments currently used for the orofacial pain showed good results with TMD in regards with pain control and improvement of function, suggestive of favorable prognosis, while neuropathic pain or soft tissue disease was the clinical conditions difficult to resolve, requiring a long and persistent treatment.

Comparison of Radiation Dose in the Measurement of MDCT Radiation Dose according to Correction of Temperatures and Pressure, and Calibration of Ionization Chamber (MDCT 선량측정에서 온도와 압력에 따른 보정과 Ionization Chamber의 Calibration 전후 선량의 비교평가)

  • Lee, Chang-Lae;Kim, Hee-Joung;Jeon, Seong-Su;Cho, Hyo-Min;Nam, So-Ra;Jung, Ji-Young;Lee, Young-Jin;Lee, Seung-Jae;Dong, Kyung-Rae
    • Progress in Medical Physics
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    • v.19 no.1
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    • pp.49-55
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    • 2008
  • This study aims to conduct the comparative analysis of the radiation dose according to before and after the calibration of the ionization chamber used for measuring radiation dose in the MDCT, as well as of $CTDI_w$ according to temperature and pressure correction factors in the CT room. A comparative analysis was conducted based on the measured MDCT (GE light speed plus 4 slice, USA) data using head and body CT dosimetric phantom, and Model 2026C electrometer (RADICAL 2026C, USA) calibrated on March 21, 2007. As a result, the $CTDI_w$ value which reflected calibration factors, as well as correction factors of temperature and pressure, was found to be the range of $0.479{\sim}3.162mGy$ in effective radiation dose than the uncorrected values. Also, under the routine abdomen routine CT image acquisition conditions used in reference hospitals, patient effective dose was measured to indicate the difference of the maximum of 0.7 mSv between before and after the application of such factors. These results imply that the calibration of the ion chamber, and the correction of temperature and pressure of the CT room are crucial in measuring and calculating patient effective dose. Thus, to measure patient radiation dose accurately, the detailed information should be made available regarding not only the temperature and pressure of the CT room, but also the humidity and recombination factor, characteristics of X-ray beam quality, exposure conditions, scan region, and so forth.

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Association of Plasma Eotaxin with Asthma Exacerbation and Severity (혈장 eotaxin과 천식의 급성악화 및 중증도와의 연관성)

  • Song, So-Hyang;Lee, So-Young;Kim, Chi-Hong;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.1
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    • pp.35-43
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    • 2001
  • Background : The eosinophil chemotactic and activating effects of eotaxin and the known association of eosinophils with asthma suggest that eotaxin expression is increased during an asthma attack. This study was aimed to determine whether the plasma eotaxin levels are higher in patients during an asthma attack and to correlate the eotaxin levels with the disease activity, severity and response to therapy. Method : A case-control study of the plasma eotaxin levels was performed in 100 patients with exacerbated asthma and 48 age- and sex-matched subjects with stable asthma. Results : The plasma eotaxin levels were significantly higher in the 100 patients with exacerbated asthma($233{\pm}175\;pg/mL$) than in the 48 subjects with stable asthma($169{\pm}74\;pg/mL$). A trend toward higher eotaxin levels was observed in asthmatic subjects who were taking oral steroids ($332{\pm}225\;pg/mL$) than in those who were not ($214{\pm}159\;pg/mL$) and higher levels were found in those admitted to the hospital ($275{\pm}212\;pg/mL$) than in those discharged after receiving only emergency treatment ($190{\pm}115\;pg/mL$). The eotaxin levels inversely correlated with the $FEV_$ (r=-0.25, p<0.01). The eotaxin levels were higher in moderate persistent ($323{\pm}256\;pg/mL$) and severe persistent asthmatics ($276{\pm}170\;pg/mL$) than in mild intermittent asthmatics ($l60{\pm}60\;pg/mL$). Conclusion : Eotaxin expression is directly associated with asthma exacerbation, impaired pulmonary function and the disease severity.

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The Study of New Reconstruction Method for Brain SPECT on Dual Detector System (Dual detector system에서 Brain SPECT의 new reconstruction method의 연구)

  • Lee, Hyung-Jin;Kim, Su-Mi;Lee, Hong-Jae;Kim, Jin-Eui;Kim, Hyun-Joo
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.1
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    • pp.57-62
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    • 2009
  • Purpose: Brain SPECT study is more sensitive to motion than other studies. Especially, when applying 1-day subtraction method for Diamox SPECT, it needs shorter study time in order to prevent reexamination. We were required to have new study condition and analysing method on dual detector system because triple head camera in Seoul National University Hospital is to be disposed. So we have tried to increase image quality and make the dual and triple head to have equivalent study time by using a new analysing program. Materials and Methods: Using IEC phantom, we estimated contrast, SNR and FWHM. In Hoffman 3D brain phantom which is similar with real brain, we were on the supposition that 5% of injected doses were distributed in brain tissue. To compare with existing FBP method, we used fan-beam collimator. And we applied 15 sec, 25 sec/frame for each SEPCT studies using LEHR and LEUHR. We used OSEM2D and Onco-flash3D reconstruction method and compared reconstruction methods between applied Gaussian post-filtering 5mm and not applied as well. Attenuation correction was applied by manual method. And we did Brain SPECT to patient injected 15 mCi of $^{99m}Tc$-HMPAO according to results of Phantom study. Lastly, technologist, MD, PhD estimated the results. Results: The study shows that reconstruction method by Flash3D is better than exiting FBP and OSEM2D when studied using IEC phantom. Flowing by estimation, when using Flash3D, both of 15 sec and 25 sec are needed postfiltering 5 mm. And 8 times are proper for subset 8 iteration in Flash3D. OSEM2D needs post-filtering. And it is proper that subset 4, iteration 8 times for 15sec and subset 8, iteration 12 times for 25sec. The study regarding to injected doses for a patient and study time, combination of input parameter-15 sec/frame, LEHR collimator, analysing program-Flash3D, subset 8, iteration 8times and Gaussian post-filtering 5mm is the most appropriate. On the other hands, it was not appropriate to apply LEUHR collimator to 1-day subtraction method of Diamox study because of lower sensitivity. Conclusions: We could prove that there was also an advantage of short study time effectiveness in Dual camera same as Triple gamma camera and get great result of alternation from existing fan-beam collimator to parallel collimator. In addition, resolution and contrast of new method was better than FBP method. And it could improve sensitivity and accuracy of image because lesser subjectivity was input than Metz filter of FBP. We expect better image quality and shorter study time of Brain SPECT on Dual detector system.

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Colonization Rate and Control of Vancomycin-Resistant Enterococci in the Neonatal Intensive Care Unit (일개 신생아중환자실 반코마이신 저항 장구균(VRE)의 유행 양상과 조절)

  • Seo, Jung Ho;Nam, Ga Yeon;Park, Kyung Hee;Byun, Shin Yun;Park, Su Eun
    • Pediatric Infection and Vaccine
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    • v.17 no.1
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    • pp.1-8
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    • 2010
  • Purpose : Recently, vancomycin-resistant enterococci (VRE) have become one of the major nosocomial pathogens in Korea. However, there have been few studies on the epidemiology of VRE colonization among neonates. In this study, we investigated the prevalence of VRE colonization, risk factors for VRE, and how to control the spread of VRE infection in the Neonatal Intensive Care Unit (NICU) of Pusan National University Hospital (PNUH). Methods : We retrospectively reviewed medical records of 192 neonates who were admitted to the NICU of PNUH from March 2006 to March 2007. Surveillance cultures from rectal swabs for detecting VRE were obtained weekly during the study period. We analyzed the prevalence of VRE and various risk factors. Results : The rate of VRE colonization among NICU patients was 25% (48/192). Thirty five of these VRE colonized patients were transferred to the NICU from other local hospitals. Compared with the non-VRE group, the risk factors associated with VRE colonization were lower birth weight, congenital heart disease, applied mechanical ventilation, use of a central venous catheter, chest tubing, a history of surgery, and use of antibiotics. Conclusion : VRE colonization among patients admitted to the NICU is rapidly increasing. Monitoring and managing premature neonates from the beginning of the birth process, avoiding many invasive procedures, avoiding antibiotics such as vancomycin and third generation cephalosporin are important for preventing the emergence and spread of VRE colonization in the NICU.

Bloodstream Infections in Children with Cancer between 2005 and 2008 in a Single Center (2005-2008년 단일 기관의 소아 혈액 종양 환자에서의 균혈증 양상: 소아 혈액 종양 환자에서의 균혈증)

  • Kim, Ji Hye;Kim, Hyung Jin;Lim, Yeon Jung;Lee, Young Ho;Oh, Sung Hee
    • Pediatric Infection and Vaccine
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    • v.17 no.1
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    • pp.36-48
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    • 2010
  • Purpose : In children on anticancer chemotherapy, bloodstream infections (BSIs) are a major cause of morbidity and mortality. We investigated febrile episodes and bloodstream infections in pediatric cancer patients to guide proper selection of empiric antibiotics for febrile pediatric hemato-oncologic patients. Methods : All febrile episodes treated in the division of hematology-oncology, the department of pediatrics, Hanyang University Hospital, between July 2005 and June 2008 were reviewed. Episodes with and without bloodstream infections were compared. Results : Forty cases (18.9%, 25 patients) of BSI occurred in 212 febrile episodes (63 patients). Thirty-seven cases (23.6%, 22 patients) of BSI occurred in 157 febrile episodes with neutropenia (54 patients). Microorganisms identified in BSI corresponded to 23 gram-positive bacteria (51.2%), 20 gram-negative bacteria (44.5%), and 2 fungi (4.4%). Rates of BSI between those who had received umbilical cord blood transplantation and those who had received transplantation from other source were significantly different (55.0% vs. 7.7%, P =0.001). No differences in mortality rate were observed among organisms in BSI patients. For febrile episodes the rate of BSI was higher among those with Chemoport than those with Hickman catheter (P =0.029) and gram-positive pathogens were more likely to be associated with Chemoport (P =0.001). Conclusion : The study showed the rate of BSI, distribution of pathogens with regard to neutropenia, transplantation, central venous catheters, and antimicrobial susceptibility of pathogens in order to help guide in the choice of optimal empiric antibiotics in pediatric febrile neutropenic hemato-oncologic patients.

The Change of Vascular Reactivity in Rat Thoracic Aorta 3 Days after Acute Myocardial Infarction (흰쥐에서 급성심근경색 3일 후 흉부 대동맥 혈관 반응성의 변화)

  • Lee, Sub;Roh, Woon-Seok;Jang, Jae-Seok;Bae, Chi-Hoon;Park, Ki-Sung;Lee, Jong-Tae
    • Journal of Chest Surgery
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    • v.42 no.5
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    • pp.576-587
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    • 2009
  • Background: The up-regulation of the nitric oxide (NO)-cGMP pathway might be involved in the change of vascular reactivity in rats 3 days after they suffer acute myocardial infarction. However, the underlying mechanism for this has not been clarified. Material and Method: Acute myocardial infarction (AMI) was induced by occluding the left anterior descending coronary artery (LAD) for 30 min (Group AMI), whereas the sham-operated control rats were treated similarly without LAD occlusion (Group SHAM), The concentration-response relationships for phenylephrine (PE), KCl, acetylcholine (Ach) and sodium nitroprusside (SNP) were determined in the endothelium intact E(+) and endothelium denuded E(-) thoracic aortic rings from the rats 3 days after AMI or a SHAM operation. The concentration-response relationships of PE in the E(+) rings from the AMI rats were compared with those relationships in the rings pretreated with nitric oxide synthase (NOS) inhibitor $N{\omega}$-nitro-L-arginine methyl ester (L-NAME) or the cyclooxygenase inhibitor indomethacin. The plasma nitrite/nitrate concentrations were checked via a Griess reaction. The cyclic GMP content in the thoracic aortic rings was measured by radioimmunoassay and the endothelial nitric oxide synthase (eNOS) mRNA expression was assessed by real time PCR. Result: The mean infarct size (%) in the rats with AMI was $21.3{\pm}0.62%$. The heart rate and the systolic and diastolic blood pressure were not significantly changed in the AMI rats. The sensitivity of the contractile response to PE and KCl was significantly decreased in both the E(+) and E(-) aortic rings of the AMI group (p<0.05). L-NAME completely reversed these contractile responses whereas indomethacin did not (p<0.05). Moreover, the sensitivity of the relaxation response to Ach was also significantly decreased in the AMI group (p<0.05). The plasma nitrite and nitrate content (p<0.05), the basal cGMP content (p<0.05) and the eNOS mRNA expression (p=0.056) in the AMI rats were increased as compared with the SHAM group. Conclusion: Our findings indicate that the increased eNOS activity and the up-regulation of the NO-cGMP pathway can be attributed to the decreased contractile or relaxation response in the rat thoracic aorta 3 days after AMI.

Nursing Professor's inspection and Status of Patient's Records and Informed Consent for Clinical Practice of Nursing Student in Korea and Japan (한·일 간호대학생의 임상실습 시 환자의 설명동의 및 기록관리와 지도실태)

  • Cho, Yooh-Yang;Kim, In-Hong;Yamamoto, Fujie;Yamasaki, Fujiko
    • Journal of agricultural medicine and community health
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    • v.31 no.1
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    • pp.35-46
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    • 2006
  • Objectives: In recently. the management and protection on individual information in patient's medical & nursing records have been very important, and that need a guideline. The purpose of this study was to investigate the status of using the patient's nursing records of nursing students in clinical practice, to find and discuss the patient's informed consent, and status of education and management concerned to patient's nursing records. Methods: This study used a mailing survey. data collected from September 24th to October 31th in 2002. The subject were 333 professors who are major in adult nursing, pediatric nursing, psychological nursing of 111 university of nursing department and nursing college. And then we received the survey mail from 103 professors that respondent rate was 30.9%. Results: The characteristics of study subjects showed 49.0% of university. 51.0% of college of nursing. 50.0% of the subjects practiced point the patient by oral approval in clinical practice. But when the decision of the patient was very difficult, 21.6% of the subjects take to informed consent from his or her families. During the clinical practice, 49.0% of the subjects were explain to patient about clinical practice and contents of the nursing student, only 7.8% of the subjects were explain to patient with nursing records. 52.0% of the subjects were took out records from the hospital, only 17.6% of the subjects had standard of the patient's informed consent and standard of handling practice records. 17.6%-92.2% of the subjects that educate and manage concern to patient's nursing records.

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Cell study on the Magnesium ion implanted surface with PSII (PSII를 이용한 마그네슘 이온 주입 임플란트에 대한 MC3T3-E1 골모양 세포 반응 연구)

  • Shin, Hyeong-Joo;Kim, Dae-Gon;Park, Chan-Jin;Cho, Lee-Ra;Lee, Hee-Su;Cha, Min-Sang
    • Journal of Dental Rehabilitation and Applied Science
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    • v.25 no.4
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    • pp.361-374
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    • 2009
  • For successful osteogenesis around the implants, interaction between implant surface and surrounding tissue is important. Biomechanical bonding and biochemical bonding are considered to influence the response of adherent cells. But the focus has shifted surface chemistry. The purpose of this study is to evaluate the MC3T3-E1 osteoblast like cell responses of magnesium (Mg) ion implanted titanium surface produced using a plasma source ion implantation method. Commercially pure titanium disc was used as substrates. The discs were prepared to produce four different surface, A: Machine turned surface, B: Mg implanted surface, C: sandblasted surface, D: sandblasted and Mg implanted surface. MC3T3 El osteoblastic like cells were cultured on the disc specimens. Cell adhesion, proliferation, differentiation, and synthesis of extracellular matrix were evaluated. The cell adhesion morphology was evaluated by SEM. RT PCR assay was used for assessment of cell adhesion, proliferation and differentiation. ALP activity was measured for cell differentiation. The results of this study were as follows: 1. SEM showed that cell on Mg ion groups was more proliferative than that of non Mg ion groups. On the machine turned surface, cell showed some degree of contact guidance in aligning with the machining grooves. 2. In RT PCR analysis, osteonectin and c-fos mRNA were more expressed on sandblasted and Mg ion implanted group. 3. ALP activity was not significantly different among all groups. Within the limitations of this study, the following conclusions were drawn: It might indicate Mg ion implanted titanium surface induce better bone response than non Mg ion groups.

Clinical Characteristics of Neonatal Status Epilepticus (신생아 간질 중첩증의 임상 특성)

  • Jung, Kyeong Hun;Kim, Yun Hee;Kwon, Young Se;Jun, Yong Hoon;Kim, Soon Ki;Son, Byong Kwan
    • Clinical and Experimental Pediatrics
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    • v.48 no.12
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    • pp.1342-1347
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    • 2005
  • Purpose : Among perinatal risk factors, neonatal seizures are one of the strongest independent discriminators of adverse outcome, representing high risks of mortality and neurologic morbidity. This study was undertaken to evaluate the neurologic outcome of neonatal status epilepticus according to underlying etiology, seizure pattern, onset time, and duration. Methods : We reviewed retrospectively 36 neonates(19 males, 17 females) with status epilepticus who were admitted to the neonatal intensive care unit, Inha Hospital between July, 1988 and June, 2003. They were evaluated with neurologic examination, laboratory data, EEG findings, and neuroimaging studies etc. Results : The mean gestational period of the patients was $37.0{\pm}3.6$ weeks and birth weight was $2.70{\pm}0.82$ kilogram. Fifty two point eight percent of the neonates were male and 66.7 percent were born at term. The most common cause of neonatal status epilepticus was hypoxic-ischemic encephalopathy. In preterm babies, intracranial hemorrhages showed an especially high frequency(P=0.034). Gestational age and birth weight did not show a correlation with neurologic complications. The incidence of neurological sequelae were significantly related to prolonged seizures lasting more than 1 hour(P=0.002). Neonates with seizures within the first 72 hours tended to be more frequent among those who developed adverse outcomes(P=0.016). Generalized tonic seizures had the worst prognosis, whereas those children who had subtle seizures had better outcomes than any other type(P<0.05). Generalized tonic seizures were primarily represented on EEG by abnormal background, whereas subtle seizure showed a significantly more normal EEG than any other seizures(P<0.05). Conclusion : Our results indicate that neonatal status epilepticus with early onsets, prolonged durations. And generalized tonic types can predict an increased risk for neurologic sequelae. So, those seizures must be perceived as medical emergencies and treated aggressively with antiepileptic drugs.