• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.3
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• pp.296-301
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• 2008

Actinomyces is a part of the normal oral flora, but under certain circumstances it may become pathogenic. Actinomycosis is a chronic granulomatous infective disease caused by microaerophilic Gram-positive bacteria of the genus actinomyces. It can involve almost any system, but principally affects the head and neck. Because the lesions in the submandibular region and the angle of the jaw give the face a swollen, indurated appearance, actinomycosis of mandible can be easily misdiagnosed in its acute or early state of infection. In these cases the disease usually presented as a swelling suggestive of an abscess or mimicking a neoplasm. The yield from standard cultures was poor and repeated sampling and anaerobic culture may be needed to obtain a positive culture. So actinomycosis should always be considered in a differential diagnosis of all infections of the cervicofacial area. Diagnosis of actinomycosis is made based on the histopathology, the clinical presentation and past dental history. We experienced a case of actinomycosis in the masseter muscle and present the case with review of literature.

• Archives of Reconstructive Microsurgery
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• v.9 no.2
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• pp.158-163
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• 2000

Over the past several years, countless patients have benefitted from the use of leeches in microsurgery. As we know, leeches are used to overcome the problem of venous congestion by creating prolonged localized bleeding uniquely characteristics of leech bite. Venous congestion, a common complication of digital replantation, often has been treated through surgical repair like arteriovenous anastomosis. The leech produces a number of important substances which contribute to the special property of the bite, including an anticoagulant, a local vasodilator and local anesthetics. The bite usually bleeds for 1 to 2 hours and under special circumstances may bleed for up to 24 hours. So venous congestion is relieved. However, leeches increase the possibility of infection through their gut content. Infection associated medical leech application is significant risk. Other risk include allergic reaction, adverse psychologic reaction and blood loss requiring transfusion. The 65 cases of medical leech application were performed between August, 1997 and May, 2000 according to an established protocol. The complication were 18 cases ; infection (13 cases), hemorrhage (2 cases), allergic reaction (1 case), psychologic problem (1 case) and hypochromic anemia (1 case). Then our study was performed on the base of indication. As a result, Aeromonas hydrophilia was cultured from gut of medical leech and Klebsiella, Staphylococcus and Pseudomonas were cultured from media. We present the clinical risk-benefit of the medical leech therapy through several cases following digital replantation.

• Journal of Oriental Neuropsychiatry
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• v.23 no.3
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• pp.161-174
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• 2012

Objectives : The purpose of this study is to study as reference for practical application in clinics, examine the procedure of historical changes and compare components and their doses of herb medicines, which are recorded in the chapter, Sinmun Jeonkwang of "Donguibogam". Methods : I examined 19 Herb Medicines (Ed note: no need to capitalize the 'h' and 'm') in Chapter Sinmun Jeonkwang of "Donguibogam". Fourteen books, which were noted in Chapter Sinmun Jeonkwang of "Donguibogam" and 16 books in Jeonkwang part of "The Eastern Medical Textbook of neuropsychiatry" and 25 books were mentioned in same part of "Uibujeonrok", were selected as reference. Results and Conclusions : Fourteen documents were referred to the 19 Herb Medicines in Chapter Sinmun Jeonkwang of "Donguibogam". Seventeen Herb Medicines were recorded in the source book but 2 Herb Medicines were not recorded. Fourteen Herb Medicines among 19 were recorded in the source book, which were directly quoted from the firstly appeared books, and 3 Herb Medicines were re-quoted from the other books that succeeded the source books. I suspect that the components and dosages of the Herb Medicines were revised, according to the author's clinical experience and circumstances.

• Journal of Oriental Neuropsychiatry
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• v.23 no.3
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• pp.175-190
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• 2012

Objectives : The purpose of this study is To to study as reference (Ed note: 'study as reference' is awkward and unclear) for practical application in clinics, examine the procedure of historical changes and compare components and their doses of herbal medicines, which are recorded in Chapter Sinmun Jeongan of "Donguibogam". Methods : I examined 23 Herb Medicines in Chapter Sinmun Jeongan of "Donguibogam". Fourteen books, which were noted in Chapter Sinmun Jeongan of "Donguibogam" and 14 books were mentioned in the same part of "Uibujeonrok", which were selected as reference. Results and Conclusions : Fourteen documents were referred to as the 23 Herb Medicines in Chapter Sinmun Jeongan of "Donguibogam". A total of 21 Herb Medicines were recorded in the source book, but 2 Herb Medicines were not recorded. Eleven Herb Medicines among 21 were recorded in the source book, which were directly quoted from the firstly appeared books and 10 Herb Medicines were re-quoted from other books that succeeded the source books. I suspect that the components and dosages of the Herb Medicines were revised, according to the author's clinical experience and circumstances.

• The Korean Journal of Applied Statistics
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• v.23 no.6
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• pp.1081-1091
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• 2010

Clinical trials are often carried out as multi-center studies because the patients enrolled for a trial study are very limited in one particular hospital. In these circumstances, the use of an ordinary Jonckheere (1954) and Terpstra (1952) test for testing trend among several independent treatment groups is invalid. We propose a the stratified Jonckheere-Terpstra test based on van Elteren (1960)'s stratified test of Wilcoxon (1945) statistics and an application of our method is demonstrated through example data. A simulation study compares the efficiency of stratified and unstratified Jonckheere-Terpstra trend tests.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.6
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• pp.634-638
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• 2008

PURPOSE: The application of computer-aided technology to implant dentistry has created new opportunities for treatment planning, surgery and prosthodontic treatment, but the correct selection and combination of available methods may be challenging in times. Hence, the purpose of this case report is to present a combination of several computer-aided tools as approaches to manage complicated implant case. MATERIAL AND METHODS: A 47 year-old female patient with severe dental anxiety, high expectations, financial restrictions and poor compliance presented for a fixed rehabilitation. A CT scan with a radiographic template obtained with software (SimPlant, Materialize, Leuven, Belgium) was used for treatment planning. The surgical plan was created and converted into a stereolithographic model of the maxilla with bone-supported surgical templates (SurgiGuide, Materialise, Leuven, Belgium), that allowed for the precise placement of 7 implants in a severely resorbed edentulous maxilla. After successful osseointegration, an accurate scan model served as the basis for the fabrication of a one-piece milled titanium framework using the Procera (Nobel Biocare, Gothenburg, Sweden) technology. The final rehabilitation of the edentulous maxilla was rendered in the form of a screw-retained maxillary metal-reinforced resin-based complete prosthesis. RESULTS: Despite challenging circumstances, 7 implants could be placed without bone augmentation in a severely resorbed maxilla using the SimPlant software for pre-implant analysis and the SurgiGuide-system as the surgical template. The patient was successfully restored with a fixed full arch restoration, utilizing the Procera system for the fabrication of a milled titanium framework.

• Anxiety and mood
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• v.11 no.2
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• pp.114-119
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• 2015

A conflict of interest is usually defined as a set of circumstances that creates a risk that professional judgments or actions regarding a primary interest will be unduly influenced by a secondary interest. In general, a conflict of interest can be classified as either a financial or a non-financial one. A financial conflict of interest reportedly occurs frequently in medical (and psychiatric) research and practice and is associated with a greater likelihood of reporting results favorable to the intervention being studied. A non-financial conflict of interest may occur in psychiatric research and practice as a result of the so-called "allegiance effect." It is very important that clinicians and researchers in the field of psychiatry be aware that their field is vulnerable to both financial and non-financial conflicts of interest. Considering that it is impossible in modern psychiatry to be completely free from possible conflicts of interest, the best way to manage a conflict of interest is disclosure based on the principles of transparency. Actions that might lead to conflicts of interest should be avoided as much as possible.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.10
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• pp.4953-4958
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• 2012

The purpose of this study was to determine how nurses recognize the need for supportive care of advanced cancer patients and to provide preliminary data on how adequate circumstances are to be set up and maintained in Korea. For the purpose of this study, we developed a preliminary questionnaire based on a focus group of 8 nurses run by a clinical psychologist and administered it to 228 nurses in a cancer hospital, over a 3-month period. Participants of this study were nurses with more than 5 years' experience of treating advanced cancer patients. The result showed that 207 respondents (90.8%) agreed that a smooth communication system for treatment taking into account the symptoms experienced by patients and rehabilitation issues was needed. More than 80% agreed that the items needed for an integrated management service for advanced cancer patients should include psychological support, an integrated pain and symptom management, and education for the patient and his or her caregivers. These results strongly suggest that a new system distinct from palliative care or hospices is needed for patients with advanced cancer in Korea.

• Journal of Chest Surgery
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• v.26 no.12
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• pp.909-914
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• 1993

Complete and optimal visualization of the mitral apparatus is a prerequisite for accurate repair or replacement of the mitral valve. A vertical left atriotomy just posterior to the interatrial groove is the most commonly used approach. However,exposure can be difficult under certain circumstances,such as small left atrium or reoperation. Other approaches have been advocated to deal with this difficult situations. We used an extended transseptal approach in 10 patients and good clinical results and excellent educational effects were obtained. The extended transseptal approach combines two semicircular atrial incisions circumscribing the tricuspid and mitral annuli anteriorly and superiorly,allowing exposure of the mitral valve by deflecting the ventricular side using stay sutures. The right atrium is opened anteriorly along the atrioventricular sulcus. The atrial septum is incised vertically through the fossa ovalis. Right atrial and septal incisions are joined at the superior end of the interatrial septum and extended across the dome of the left atrium to the left atrial appendage. The mitral valve was replaced in all 10 patients. Four of 10 patients had other simultaneous valve procedure: one had aortic valve replacement: 2 underwent tricuspid annuloplasty: 1 had aortic valve replacement and tricuspid annuloplasty. There was no hospital death and complication. Among the 5 patients who had atrial fibrillation preoperatively,4 had atrial fibrillation postoperatively,1 converted to sinus rhythm. The five patients who were in normal sinus rhythm preoperatively remained in sinus rhythm after replacement. A review of our results with this approach confirms the efficacy and safty of this method. So we recommanded this approach for routine mitral valve procedure,especially difficult situations,such as a small left atrium or the redo operation.

• Archives of Reconstructive Microsurgery
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• v.3 no.1
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• pp.40-44
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• 1994

Microsurgery has advanced beyond its nascent stages reaching success rates of 90% to 95%. However, this means that even in the best circumstances, 5% to 10% of free flaps and replants fail. Almost all failures are due to vessel thrombosis, resulting in ischemia of the transplanted tissue. Many attemps have been undertaken to treat and reverse its effects. Zdeblick and colleagues noted an improvement in the viability of amputated limbs replanted after an extended period of ischemia following intraarterial infusion of urokinase. Subsequent studies have investigated many modalities of urokinase administration in various animal models by differing ischemic periods. These studies, however, have failed to establish a definitive, generally accepted protocol for administration of urokinase in the salvage of tissue subjected to prolonged ischemia. Our clinical observations suggest that a bolus of urokinase delivered under pressure may increase the thromoblytic effect of the drug, probably by means of increased delivery to microvasculature. We intend to investigate the role of selective pressure perfusion of ischemic flaps as a new means for increasing the effectiveness of urokinase in the treatment of the "no-reflow" phenomenon. A total of 32 male New Zealand rabbits were used and divided into the four groups according to the method of infusion. After 12 hours of ischemia the flaps were injected with Hartmann's solution or with urokinase and the percent survival of the flap was determined at 7 days following flap reperfusion. As the result, the flap survival rate was highest in the pressure injection of urokinase group.