• Title/Summary/Keyword: Adult cases

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THE EFFECT OF THE BIORESORBABLE COLLAGEN MEMBRANE ON THE REGENERATION OF BONE DEFECT BY USING THE MIXTURE OF AUTOGRAFT AND XENOGRAFT BONE

  • Lee Jung-Min;Kim Yung-Soo;Kim Chang-Whe;Han Jung-Suk
    • The Journal of Korean Academy of Prosthodontics
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    • v.41 no.3
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    • pp.325-341
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    • 2003
  • Statement of problem: In cases where bony defects were present, guided bone regenerations have been performed to aid the placement of implants. Nowadays, the accepted concept is to isolate bone from soft tissue by using barrier membranes to allow room for generation of new bone. Nonresorbable membranes have been used extensively since the 1980's. However, this material has exhibited major shortcomings. To overcome these faults, efforts were made to develop resorbable membranes. Guided bone regenerations utilizing resorbable membranes were tried by a number of clinicians. $Bio-Gide^{(R)}$ is such a bioresorbable collagen that is easy to use and has shown fine clinical results. Purpose: The aim of this study was to evaluate the histological results of guided bone regenerations performed using resorbable collagen membrane($Bio-Gide^{(R)}$) with autogenous bone, bovine drived xenograft and combination of the two. Surface morphology and chemical composition was analyzed to understand the physical and chemical characteristics of bioresorbable collagen membrane and their effects on guided bone regeneration. Material and methods: Bioresorbable collagen membrane ($Bio-Gide^{(R)}$), Xenograft Bone(Bio-Oss), Two healthy, adult mongrel dogs were used. Results : 1. Bioresorbable collagen membrane is pure collagen containing large amounts of Glysine, Alanine, Proline and Hydroxyproline. 2. Bioresorbable collagen membrane is a membrane with collagen fibers arranged more loosely and porously compared to the inner surface of canine mucosa: This allows for easier attachment by bone-forming cells. Blood can seep into these spaces between fibers and form clots that help stabilize the membrane. The result is improved healing. 3. Bioresorbable collagen membrane has a bilayered structure: The side to come in contact with soft tissue is smooth and compact. This prevents soft tissue penetration into bony defects. As the side in contact with bone is rough and porous, it serves as a stabilizing structure for bone regeneration by allowing attachment of bone-forming cells. 4. Regardless of whether a membrane had been used or not, the group with autogenous bone and $Bio-Oss^{(R)}$ filling showed the greatest amount of bone fill inside a hole, followed by the group with autogenous bone filling, the group with blood and the group with $Bio-Oss^{(R)}$ Filling in order. 5. When a membrane was inserted, regardless of the type of bone substitute used, a lesser amount of resorption occurred compared to when a membrane was not inserted. 6. The border between bone substitute and surrounding bone was the most indistinct with the group with autogenous bone filling, followed by the group with autogenous bone and $Bio-Oss^{(R)}$ filling, the group with blood, and the group with $Bio-Oss^{(R)}$ filling. 7. Three months after surgery, $Bio-Gide^{(R)}$ and $Bio-Oss^{(R)}$ were distinguishable. Conclusion: The best results were obtained with the group with autogenous bone and $Bio-Oss^{(R)}$ filling used in conjunction with a membrane.

Acute Respiratory Failure Treated with Veno-venous Extracorporeal Membrane Oxygenation (정-정맥 체외막형산소화요법을 이용한 급성호흡부전의 치료)

  • Kim, Hyoung-Soo;Han, Sang-Jin;Hong, Kyung-Soon;Yoon, Duck-Hyoung;Lee, Chang-Youl;Lee, Myung-Goo;Hong, Won-Ki;Lee, Sun-Hee;Kim, Kun-Il;Lee, Hee-Sung;Cho, Sung-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.68 no.2
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    • pp.62-66
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    • 2010
  • Background: Extracorporeal membrane oxygenation (ECMO) during severe acute respiratory failure helps to recover the pulmonary function. This study evaluated our experience with veno-venous ECMO in adult patients with acute respiratory failure. Methods: From January 2007 to July 2009, ECMO was used on 54 patients. Of these 54 patients, 7 were placed on veno-venous ECMO for acute respiratory failure. The indications of ECMO were based on the lung dysfunction measured as a $PaO_2/FiO_2$ ratio <100 mm Hg on $FiO_2$ of 1.0, or an arterial blood gas pH <7.25 due to hypercapnia despite the optimal treatment. $EBS^{(R)}$, $Bio-pump^{(R)}$, and Centrifugal Rotaflow $pump^{(R)}$ were used and all cannulations were performed percutaneously via both femoral veins. When the lung function was improved, an attempt was made to wean on ECMO at moderate ventilator settings followed by decannulation. Results: Five of the 7 patients were male and the mean age was $46.3{\pm}18.3$. The causes of acute respiratory failure were 3 cases of pneumonia, 2 near-drownings, 1 pulmonary hemorrhage due to acute hepatic failure and 1 mercury vapor poisoning. The mean support time of ECMO was $17.3{\pm}13.7$ days. Of the 7 patients implanted with ECMO, 5 patients (71%) were weaned off ECMO and 3 patients (43%) survived to hospital discharge after a mean 89.6 hospital days. Conclusion: The early use of ECMO for acute respiratory failure in adults due to any cause is a good therapeutic option for those unresponsive to the optimal conventional treatments.

Surgical Treatment with Extracorporeal Circulation for Acute Dissection of Descending Thoracic Aorta (체외순환을 이용한 흉부 하행대동맥의 급성 박리증 수술)

  • 최종범;정해동;양현웅;이삼윤;최순호
    • Journal of Chest Surgery
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    • v.31 no.5
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    • pp.481-487
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    • 1998
  • The surgical management of acute type B dissection is controversial. The complexity of the repair usually requires a period of aortic cross-clamping exceeding 30 minutes, which can cause ischemic injury of the spinal cord. Several forms of distal perfusion have been considered for use to prevent this injury. To determine the safety and efficacy of a graft replacement with cardiopulmonary bypass in reparing acute dissection of descending thoracic aorta, we retrospectively reviewed our surgical experience treating 8 patients who had aortic dissection secondary to atherosclerosis, trauma, and carcinoma invasion. Cardiopulmonary bypass was performed with two aortic cannulas for simultaneous perfusion of the upper and lower body and one venous cannula for draining venous blood from the right atrium or inferior vena cava. Although aortic cross-clamp time was relatively long (average, 117.8 minutes; range, 47 to 180 minutes) in all cases, there was no neurologic deficit immediately after graft replacement for the aortic lesion. Two patients(25%) of relatively old age died on the postoperative 31st and 41st days, respectively, because of delayed postoperative complications, such as pulmonary abscess and adult respiratory distress syndrome. Although any of several maneuvers may be appropriate in managing dissection of the descending aorta, graft replacement with cardiopulmonary bypass during aortic cross-clamping may be a safe and effective method for the treatment of acute dissection of the descending thoracic aorta.

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A Basic Study for Development of Clinical Practice Guidelines of Korean Medicine in Autism Spectrum Disorder -Based on Pre-existing Clinical Practice Guidelines of Autism Specturm Disorder- (자폐스펙트럼장애의 치료에 대한 한의 임상 가이드라인 개발을 위한 기초연구 -기존에 개발된 자폐스펙트럼장애 가이드라인을 중심으로-)

  • Kim, Sang Min;Lee, Jin Yong;Lee, Sun Haeng;Chang, Gyu Tae
    • The Journal of Pediatrics of Korean Medicine
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    • v.31 no.1
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    • pp.52-62
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    • 2017
  • Objectives The purpose of this study is to review pre-existing clinical practice guidelines for autism spectrum disorders, and refer those in developing a new practice guideline. Methods A total of 9 existing clinical practice guidelines for autism spectrum disorder developed from 2010 to 2016 were searched by Google scholar and Pubmed, and were reviewed those literatures in three parts: general, diagnosis & evaluation, and intervention. Results There were no consistency in the recommendation methods of 9 clinical care guidelines (such as the method of rating and recommendation intensity for diagnosis, evaluation, and treatment). However, in the diagnosis and evaluation section, frequently used evaluation and diagnostic tools are mentioned in most clinical practice guidelines, and the types of pharmacologic and non-pharmacological treatments that are mainly recommended in treatment are equally mentioned in most clinical practice guidelines could confirm. Conclusions 1. Some guideline recommendations are graded according to each criterion. Recommendations presented in various databases were based on systematic reviews or other literatures. The most utilized database were PsycINFO, CINAHL, Cochrane. 2. DSM-5 and ICD-10 were the most common used diagnostic criteria, and DSM-IV was used as a diagnostic standard in the guideline published before 2013. The tools used for diagnosis and evaluation were also varied. However, most recommended ones were ADI-R, ADOS-G, and DISCO. 3. Treatment was largely divided into pharmacological intervention and non-pharmacological intervention. In some guideline, the interventions were divided into pediatric and adult. Most of the pharmacological interventions were not recommended due to lack of evidence, but in cases in which specific symptoms were aimed, they recommended to seek professional help. 4. In addition to interventions, each guideline referred to supportive interventions that may be helpful in the daily life of patients with ASD, which may need to be addressed in future clinical guidelines.

Subjective Recognition Type of Entrepreneurship Education in Korea: Comparison to the European Union and OECD - Using Q methodology - (유럽연합과 OECD의 기업가정신교육 비교를 통한 한국 기업가정신교육의 주관적 인식 유형 연구 - Q방법론을 사용하여 -)

  • Do, Hyewon;Kim, Kyong-hwan
    • International Area Studies Review
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    • v.22 no.1
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    • pp.188-211
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    • 2018
  • This study examined the problem of entrepreneurship education in Korea, which equate entrepreneurship with startups, unlike the global trend of approaching entrepreneurship with a broad concept. On the basis of overseas cases such as European Union and OECD, this study derived the need for entrepreneurship education from the perspective of thinking and behavioral patterns. In addition, Q methodology was used to reason out various recognition patterns and approach solutions for problems of entrepreneurship education in Korea, such as awareness of the need for entrepreneurship education in concepts separate from start-ups, reasons for infertility, and why it is difficult to activate. This approach was conducted for educators and educatees that carries out entrepreneurship education in Korea. In conclusion, there were four types of subjective perceptions about the difference of entrepreneurship education and startup education, and three types were recognized for the need to differentiate entrepreneurship education from startup education, and the two types that made up the upper majority strongly supported the need for entrepreneurship education to be implemented individually. According to the conclusion, this study proposed the development and spread of common teaching materials made by the Ministry of Education and Ministry of SMEs and Startups, which is the competent Ministry, to train professional teachers, training methods, and continuous refresher education. It also proposed that there should be a social atmosphere for eliminating rejection of entrepreneurship not only among the youth but also the adult population, and for continuous awareness of concepts that can be applied within the organization and the community, and that a policy basis is required to do so.

Satisfaction and Experience of the Elderly with Dementia for the Service Provided by the Dementia Day Care Center (치매주간보호센터에서 제공하는 서비스에 대한 치매노인의 만족도와 경험)

  • Kim, Hwasoon;Lee, Young-Whee;Jung, Da-Woe;Lee, Jee-Yeon
    • The Journal of the Korea Contents Association
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    • v.19 no.7
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    • pp.609-627
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    • 2019
  • The purpose of this study was to explore service satisfaction of the elderly using dementia day care center and the meaning of day care experience. The subjects for this methodological triangulation study were 67 dementia elderly for 1:1 interview and 15 dementia elderly for focus group interview. All subjects were using dementia day care center. The mean age was $79.95{\pm}5.90$ for quantitative study and $80.07{\pm}5.78$ for qualitative study subjects. The mean scores of service satisfaction were ranged from $2.86{\pm}0.41$ to $2.96{\pm}0.30$. The lowest score domain was 'help and assistance', and the highest score domain was 'food and environment'. In 14 questions, satisfaction score was 3 point. According to content analysis, the experiences of dementia day care center were described with 20 themes such as 'mutual respect and understanding', 'pleasure and upset feelings about participation', etc. and 35 sub-themes. The overall satisfaction scores were high and in most cases the positive experiences with dementia day care service were described. Therefore it is recommended for mild dementia elderly to use dementia day care service and to be expanded.

The Effect of Regular Exercise on anxiety Level of Older People (노인들의 규칙적인 체육활동이 노후불안 수준에 미치는 영향)

  • Jeon, Ik-Gi;Lee, Sun Hee
    • 한국노년학
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    • v.28 no.4
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    • pp.953-968
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    • 2008
  • This research was performed to recognize anxiety level of older people, to find out anxiety level after or before regular exercises, and to find out how much anxiety level could be lowered by the sports activities. This research selected a population among the students who enrolled at sport activity classes (e, g., physical exercises, gate ball, volume dance) at L, S, J, Y (a), Y (b), D older people college located in Seoul and Gyoenggi area. 200 of the population were chosen as candidates by convenience sampling, nonprobability sampling. Considering the age of the candidates, total 200 cases were collected by using two methods (survey and interview) simultaneously. The data assessment was made by SPSS 12.0 Version. Error tolerance in statistics is .05. The data was analyzed by using frequency analysis, paired t-test and independent t-test. After analyzing anxiety awareness level after and before regular exercises, anxiety of older people are classified by four factors. First, anxiety for loss is 3.756 (M=3.756) before exercises, while 1.942 (M=1.942) after exercises. Second, fear for aging is 3.443 before exercises and 2.243 after exercises. Third, anxiety for physical appearance is 3.253 before exercises and 2.310 after exercises. Finally, anxiety caused by psychological insecurity is 3.060 before exercises, while 1.666 after exercises. Error of tolerance for all factors falls within .001. Anxiety score after exercises is lower than that of before exercises for every factor as well. As a result, regular physical exercises appeared to reduce anxiety level of older people.

Changes in the Treatment Strategies for Helicobacter pylori Infection in Children and Adolescents in Korea

  • Jun, Jin-Su;Seo, Ji-Hyun;Park, Ji-Sook;Rhee, Kwang-Ho;Youn, Hee-Shang
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.5
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    • pp.417-430
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    • 2019
  • The policies developed for the treatment of Helicobacter pylori infection in adults may not be the most suitable ones to treat children and adolescents. Methods used to treat children and adolescents in Europe and North America may not be appropriate for treating children and adolescents in Korea due to differences in epidemiological characteristics of H. pylori between regions. Moreover, the agreed standard guidelines for the treatment of H. pylori infection in children and adolescents in Korea have not been established yet. In this study, the optimal treatment strategy for H. pylori infection control in children and adolescents in Korea is discussed based on these guidelines, and recent progress on the use and misuse of antimicrobial agents is elaborated. Non-invasive as well as invasive diagnostic test and treatment strategy for H. pylori infection are not recommendable in children aged less than ten years or children with body weight under 35 kg, except in cases of clinically suspected or endoscopically identified peptic ulcers. The uncertainty, whether enough antimicrobial concentrations to eradicate H. pylori can be maintained when administered according to body weight-based dosing, and the costs and adverse effects outweighing the anticipated benefits of treatment make it difficult to decide to eradicate H. pylori in a positive noninvasive diagnostic test in this age group. However, adolescents over ten years of age or with a bodyweight of more than 35 kg can be managed aggressively as adults, because they can tolerate the adult doses of anti-H. pylori therapy. In adolescents, the prevention of future peptic ulcers and gastric cancers is expected after the eradication of H. pylori. Bismuth-based quadruple therapy (bismuth-proton pump inhibitor-amoxicillin/tetracycline-metronidazole) with maximal tolerable doses and optimal dose intervals of 14 days is recommended, because in Korea, the antibiotic susceptibility test for H. pylori is not performed at the initial diagnostic evaluation. If the first-line treatment fails, concomitant therapy plus bismuth can be attempted for 14 days as an empirical rescue therapy. Finally, the salvage therapy, if needed, must be administered after the H. pylori antibiotic susceptibility test.

Characteristics and components of the third place for daily support of the elderly in Korea (한국 노인의 일상 지원을 위한 제3의 장소의 특성 및 구성요소)

  • Choi, Yeonhee;Seo, Hyunbo
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.27 no.1
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    • pp.45-51
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    • 2021
  • Purpose: Problems related to the elderly's daily life, such as social isolation and absence of a place to go, are already widely recognized, but there are few domestic studies or support policies for this, and the elderly leisure welfare facilities provided by the state do not fully support the elderly's daily life. There are studies related to the elderly's neighborhood environment and facilities, which can be seen as the third place for the elderly in Korea, but these are mostly quantitative studies. In order to talk about the third place for daily support for the elderly in Korea, a detailed study of the use cases of the third place in Korea is needed. This study analyzes the third place of the elderly in Korea and discovers the characteristics and components. Based on the detailed analysis of the third place of the elderly, the characteristics of the third place of the elderly in Korea and the elements constituting it are found to be able to represent the specific necessary environment of the third place of the elderly. Methods: The research targets include 'A Mill' (located in Jungnang-gu, Seoul), and 'Roadside in front of Villa B'(located in Dongdaemun-gu, Seoul), 'C-dong roadside park'(located in Dobong-gu, Seoul) within the range of repeated observations and meetings among the places used as a third place for the elderly was selected. The site survey consisted of in-depth interviews, observational surveys, and participatory observations. In-depth interviews were held for a total of 5 months, from October to December 2019 and from April to May 2020. Results: As a result, a total of 11 characteristics (adjacent to the residence, an open place, an independent space, a comfortable place to stay, a pleasant space, safety is guaranteed, a place that has been operated for a long time, a place that can be used autonomously, a place where social exchange occurs, No financial burden, fun activities) was discovered. Implications: This study is significant in that unlike the existing studies focusing on the use behavior of established institutions or facilities, the elderly identified the necessary environment through their own created places.

Analysis of Five Years of US Immigration Medical Exams (5년간의 미국 이민 비자 신체검사 결과 분석)

  • Lim, Juwon
    • Korean journal of aerospace and environmental medicine
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    • v.31 no.3
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    • pp.77-81
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    • 2021
  • Purpose: The United States of America have pre-migration screening program are mandated through legislation. The one of purpose of this program is to prevent the importation of certain communicable diseases. Examinations of migration applicants are performed by panel physicians who are licensed physicians in the countries of origin that have agreements with the government departments of the country of destination to undertake this activity. In recent decades, the number of US migrants has increased, however COVID-19 impacted this trend of international migrants. The Aim of this study is to examine trends of US applicants and outcomes of tuberculosis and sexual transmitted infections (STIs) screening in South Korean applicants for US visa. Methods: A total of 4,442 applicants participated in US visa health check-up in 2016 to 2020. Results: The numbers of applicant for US visa in males and females was 1,814 and 2,628. The positive results in tuberculosis and STIs screening was noted with 0.66% in nontuberculous mycobacteria (NTM), 0.03% in tuberculosis, 0.03% in gonorrhea, 0.08% in syphilis, and 0.74% in chlamydia. The age groups of 2 to 14 years showed higher positive rate (13.89%) in tuberculin skin test (TST) tests compared to the rate of interferon gamma release assay (IGRA) tests (0.44%, P<0.001). The positive ratio of NTM and abnormal chest X-ray (CXR) which required sputum tests among the applicants over 15 years old has trends to increase with age. The age groups of over 70 years showed high positive rate in NTM and abnormal CXR (4.10%, 20.51%). However, ages 15 to 49 years groups showed 0.00% to 0.30% in NTM and 1.08% to 3.91% in abnormal CXR. In the study population, the positive rates of STIs were 0.03%, 0.08%, and 0.74% in gonorrhea, syphilis, and chlamydia, respectively. Among the participants who underwent sputum smears and cultures were just 1 case of active tuberculosis (0.03%) and 25 cases of NTM infection (0.66%). Conclusion: This study found that rate of positivity in tuberculosis and STIs screening among South Korean applicants for US visa in 2016 to 2020. Regarding tuberculosis, the positivity of CXR among the aged 15 to 59 years applicants was lower than that among over 60 years old. Among 2 to 14 years, positivity of IGRA was very low. And IGRA test can reduce effort of further evaluation compared to TST test in South Korea, so IGRA test among young adults can be useful. High positive rates in STI among young adult could result in high active sexuality, especially chlamydia infection is most common. Therefore Chlamydia polymerase chain reaction should be considered formal protocol among the Korean applicant for US visa.