• Title/Summary/Keyword: Clinical observation

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A STUDY OF SHEAR BOND STRENGTH OF ER:YAG LASER-IRRADIATED PRIMARY DENTIN (Er:YAG 레이저를 조사한 유치 상아질의 전단결합강도에 관한 연구)

  • Lee, Jin-Hwa;Kim, Jong-Soo;Yoo, Seung-Hoon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.34 no.4
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    • pp.569-578
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    • 2007
  • This study was performed to compare the shear bond strength of self etching system and two bottle bonding system with or without laser preparation. Group I was prepared with high speed rotary instrument and $Prompt^{TM}$ L-$Pop^{TM}$, group II with Er:YAG laser and $Prompt^{TM}$ L-$Pop^{TM}$, group III with Er:YAG laser, 37% phosphoric acid and Single bond, group IV with Er:YAG laser and Single bond and group V with high speed, etching and Single bond. And also observation of the prepared and etched dentin surface were performed under scanning electro-microscope. The possibility of clinical application of laser preparation which might have an advantage to reduce pain for children with less unfavorable noise were evaluated. The results obtained are as follows; 1. Group V showed significantly higher bond strength than other groups. And group IV showed significantly lower bond strength than other groups. 2. There was no significant difference between group I and group III. 3. Group II showed significantly lower bond strength than group I, III, V, but showed significantly higher bond strength than group IV. 4. Under scanning electro-microscope, laser-preparated dentin surface showed high irregularity and no smear layer. The surface showed less irregularities and more exposed dentinal tubules with etching. Laser preparation has many advantages over conventional tooth preparation. But this method showed lower resin bonding strength. Laser preparated tooth surface differed from the conventionally preparated tooth surface. More researches are needed on suitable methods for laser preparated dentin surface.

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Surgical Treatment for Chronic Peptic Ulcer with Gastric Outlet Obstruction (만성 소화성 궤양에 합병된 위출구 폐색의 수술적 치료)

  • Lee, Jei Hee;Yang, Shi Joon;Jeon, Young Woong;Park, Sei Hyeog;Kim, Jong Heung;Park, Jong Min
    • Journal of Gastric Cancer
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    • v.8 no.3
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    • pp.160-165
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    • 2008
  • Purpose: With the introduction of H. pylori eradication and proton pump inhibitor, the operative treatments for the acute or chronic complications of peptic ulcer, such as perforation, bleeding and stricture, have decreased. Also owing to the development of non-operative treatment such as interventional endoscopic treatment, the surgical approach to the acute complications, like perforation and bleeding, has diminished. The non-operative treatments for the stricture and obstruction of chronic peptic ulcer in part related to discontinuation of medication have not been satisfactory. We analyzed the clinical outcomes of the patients who underwent operative treatment for outlet obstruction with peptic ulcer. Materials of Methods: From January 1994 to December 2007, we reviewed 31 patients who had been operated on at the National Medical Center for peptic ulcer obstruction. We excluded the cases of adhesive obstructions that were caused by a former ulcer operation and also the cases of obstructions found during emergency operations for treating perforation and bleeding. We classified the surgical treatment group into the bypass operation group and the surgical resection group. We evaluated the effects of the operations by the Visick score. The recurrences were confirmed only by the endoscopic observation of peptic ulcer. Results: The number of patients in the bypass operation group was 6 (19.4%) and that of resection group was 25 (80.6%). The mean age was 57.5 (25~81) years. The number of male patients was 29 (93.5%) and the number of females was 2 (6.5%). The mean symptom duration was 29.6 months. There were 19 smokers (61.3%), 6 NSAID users (19.4%) and 7 H. pylori positive patients (22.6%). Two patients underwent endoscopic balloon dilatation with no success. The locations of lesion were the stomach, the duodenum and both in 9, 20 and 2 cases, respectively. There were operative complications in 13 cases (41.9%), recurrent ulcers in 2 cases (6.5%), and reoperations in 4 cases. The mean Visick score was 1.8 (1~4). There were no statistically significant clinicopathologic differences between the bypass operation group and the resection group. The two groups had 1 case each of recurrence. Although the bypass group had a greater complication rate (83.3%) than the resection group (32%), this was not statistically meaningful (P=0.175). The mean Visick score was 3.0 in the bypass group and 1.6 in the resection group, so the resection group was better (P=0.001). Conclusion: For a case of chronic peptic ulcer with outlet obstruction, even though it has been reported that endoscopic balloon dilatation worked well, surgery is still regarded as an important treatment. If you consider the patients' satisfaction and the difficulty of diagnosing malignant ulcers, surgical resection should be recommended more often than a bypass operation.

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A COMPARATIVE STUDY ON THE PHYSICAL PROPERTIES OF ORTHODONTIC PLIERS ACCORDING TO TYPES OF STERILIZATION (멸균 방법에 따른 교정용 플라이어의 물성 변화에 대한 비교 연구)

  • Cho, Il-Je;Son, Woo-Sung
    • The korean journal of orthodontics
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    • v.28 no.2 s.67
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    • pp.329-341
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    • 1998
  • Sterilization has received much attention in orthodontic practices over the past several years. The present study was undertaken to investigate the effects of sterilization on the physical properties of orthodontic pliers-AEZ, Unitek, and Dentronix ligature cutters. This study was designed to examine the tips of ligature cutters before and after 200 and 400 sterilization cycles using the Bowmar RHT-1000, the Dentronix DDS-5000, and the Eschmann SES-2000. The tip surface and the fracture surface were observed with a scanning electron microscope. The microstructure was observed with an optical microscope. The hardness test was carried out with the mic개-Vickers hardness tester and the Rockwell C Scale hardness tester. The chemical composition was analyzed by energy dispersive X-ray spectrometer. The results of this study were as follows : 1. The number and the size of corrosion products on the tip surface and the proportion of cleavage planes in fractured specimen increased, but the hardness of the tip decreased in proportion to sterilization cycles. From these observations, it was considered that mechanical properities decreased in proportion to sterilization cycles. 2. The number and the size of chromium carbides increased in proportion to sterilization cycles. Coarse microstructure decreased mechanical properities. 3. The AEZ and Unitek ligature cutters were Fe-Cr stainless steels, but the Dentronix ligature cutter was Co-Cr alloy. There were many differences among manufactures, but the chemical composition was .not changed after sterilization cycles. 4. The tip edge of ligature cutter used in a clinic revealed microcracks with the SEM observation. Clinical experience confirmed that ligature cutters were gradually degraded by sterilization.

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The Correlation Between Sensory Integration Function and Scholar Achievement in the Lower Classes Children (저학령기 아동의 감각통합 기능과 학업성취도간의 상관관계)

  • Shin, Joong-Il;Choi, Yung-Gun;Jang, Woo-Heuk;Kim, Kyeong-Mi
    • The Journal of Korean Academy of Sensory Integration
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    • v.6 no.1
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    • pp.1-12
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    • 2008
  • Objective : The purpose of this study is to provide reference to functional level of sensory integration of in the low-grads school age, based on the Clinical Observation of Motor and Postural Skills (COMPS) and to examine correlation between the function of sensory integration and academic achievement. Method : Two schools ("J" and "S") have been selected indiscriminately among 56 elementary schools located in Gimhae-si, GyeongNam and then one class from each school was voluntarily chosen among all second-grade classes of the schools. The total number of students in those two classes was 69 (34 boys and 35 girls). Subjects had no developmental problem and no history of referral regarding neurological conditions. Three skilled researchers administrated the COMPS together, and each researcher executed two sub-items of the COMPS. As result of the academic achievement, score data of midterm- and final-exam in the spring semester were collected. The scores of 'Korean language' and 'Math', common examination subjects in both schools, were utilized for data analysis in this study. Results : Statically, there was no significant correlation between the COMPS Weighted Scores and any academic achievements. In a dispersion graphic analysis, however, the total achievement showed significant negative-correlation with the area of 'Rapid Forearm Rotation' and significant positive-correlation with the area of 'Supine Flexion'. In terms of the Math achievement, there are significant negative-correlation with rapid forearm rotation and asymmetrical tonic neck reflex, and significant positive-correlation with the area of 'Supine Flexion'. Students with higher score of the Korean language showed a tendency to get higher Weighted Score and Minus Adjustment Score, and those with lower score of the Math showed a tendency to get higher COMPS scores in all area except the area of 'Supine Flexion'. There was a statically significant difference in the COMPS scores depend on the age among general characteristics. As student older, all COMPS scores, except those in the area of 'Slow Motion' and 'Supine Flexion, were higher. Conclusions : There is somehow reliable correlation between sensory integration function and academic achievement although no statistical significance found in this study. The information from this study may contribute to initiate developing a normative-reference to screen earlier and more alertly sensory integration dysfunctions for school-age children. Further study is recommended trying to find out more reliable matter regarding low grade- schooler's academic achievement.

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The effect of growth hormone treatment in short children born small for their gestational ages (만삭 부당경량아로 출생한 저신장증 환아에서의 성장호르몬 치료 효과)

  • Seo, Joo Hee;Kim, Duk Hee
    • Clinical and Experimental Pediatrics
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    • v.49 no.3
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    • pp.312-316
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    • 2006
  • Purpose : Growth hormone(GH) has been recognized as an effective treatment for short children born small for their gestational ages(SGA), and nowadays it has been widely used for the treatment of short children born SGA. The aim of this study is to assess the efficacy of GH treatment for the children born SGA. Methods : The study population was made of 40 short children born SGA with GH-treated(n=26) and untreated control group(n=14). In order to evaluate the effect of GH treatment, the changes in standard deviation scores(SDS) of the GH-treated group were compared to the changes in SDS before and after treatment from the control group in the same period. Results : There were no differences between the GH-treated group and the control group in gestational age, birth weight, chronological age, target height and the period of follow-up observation; however, the GH-treated group had lower height SDS($-3.3{\pm}0.9$) than the control group($-2.4{\pm}0.4$) before treatment(P<0.05). The GH-treated group had gained $1.2{\pm}1.0$ height SDS during GH treatment while the control group had gained $0.5{\pm}0.6$ height SDS. In the GH treatment group, HDL-cholesterol increased from $48.5{\pm}9.9mg/dL$ to $56.1{\pm}8.7mg/dL$(P<0.05) and LDL-cholesterol decreased from $88.1{\pm}23.3mg/dL$ to $76.4{\pm}19.4mg/dL$(P<0.05) after treatment. There were no changes in total cholesterol, triglyceride, free fatty acid and fasting blood sugar. IGF-I increased from $224.9{\pm}191.3{\mu}g/L$ to $443.2{\pm}152.5{\mu}g/L$(P<0.05) and IGFBP-3 also increased from $3.7{\pm}1.3mg/L$ to $5.6{\pm}1.2mg/L$(P<0.05). Conclusion : We conclude that growth hormone treatment is effective in the treatment of short children born SGA.

Normative data of penile length in Korean newborns (한국인 신생아 음경 길이에 대한 연구)

  • Kim, Sang Yeob;Jun, Jae Sung;Lee, Sang Geel
    • Clinical and Experimental Pediatrics
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    • v.51 no.9
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    • pp.944-949
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    • 2008
  • Purpose : As modern society has became more open, interest in healthy internal and external growth has increased, including that pertaining to penile length in children. A micropenis is defined as one where penile length is more than 2 SD (standard deviation) below the mean, and it can be traced back to chromosome and endocrine disorders. The authors executed this study to suggest guidelines for the study of the micropenis and standard information for penile length in Korean newborns. Methods : The subjects of this study were 168 male infants between 37 and 42 weeks of gestational age, none of whom had any complications during pregnancy or birth; each had been born in Daegu Fatima Hospital between February and June 2007. Penile length was measured using conventional stretched penile length measurement (CPLM) and syringe methods. Results : Penile length was $3.02{\pm}0.25cm$ (F=36.467, $R^2=0.180$, P<0.001) when measured with CPLM, and $3.29{\pm}0.26cm$ (F=9.149, $R^2=0.052$, P<0.001) with the syringe method. There was no statistically significant difference in the penile length of newborn infants as a result of taking measurements with the two methods, and both methods showed significance at 0.631 in terms of Pearson's correlation coefficient, at the level of P=0.01. Conclusion : In this study, penile length tended to be longer when gestational age was longer, and a micropenis can be assumed to be one less than 2.5 cm using CPLM and less than 2.8 cm using the syringe method. In the case of a concealed penis, the syringe method is helpful. When a micropenis is assumed, close observation by outpatient department personnel, and additional endocrine and chromosome studies should be undertaken after sufficiently consulting the parents.

Establishing a Nomogram for Stage IA-IIB Cervical Cancer Patients after Complete Resection

  • Zhou, Hang;Li, Xiong;Zhang, Yuan;Jia, Yao;Hu, Ting;Yang, Ru;Huang, Ke-Cheng;Chen, Zhi-Lan;Wang, Shao-Shuai;Tang, Fang-Xu;Zhou, Jin;Chen, Yi-Le;Wu, Li;Han, Xiao-Bing;Lin, Zhong-Qiu;Lu, Xiao-Mei;Xing, Hui;Qu, Peng-Peng;Cai, Hong-Bing;Song, Xiao-Jie;Tian, Xiao-Yu;Zhang, Qing-Hua;Shen, Jian;Liu, Dan;Wang, Ze-Hua;Xu, Hong-Bing;Wang, Chang-Yu;Xi, Ling;Deng, Dong-Rui;Wang, Hui;Lv, Wei-Guo;Shen, Keng;Wang, Shi-Xuan;Xie, Xing;Cheng, Xiao-Dong;Ma, Ding;Li, Shuang
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.3773-3777
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    • 2015
  • Background: This study aimed to establish a nomogram by combining clinicopathologic factors with overall survival of stage IA-IIB cervical cancer patients after complete resection with pelvic lymphadenectomy. Materials and Methods: This nomogram was based on a retrospective study on 1,563 stage IA-IIB cervical cancer patients who underwent complete resection and lymphadenectomy from 2002 to 2008. The nomogram was constructed based on multivariate analysis using Cox proportional hazard regression. The accuracy and discriminative ability of the nomogram were measured by concordance index (C-index) and calibration curve. Results: Multivariate analysis identified lymph node metastasis (LNM), lymph-vascular space invasion (LVSI), stromal invasion, parametrial invasion, tumor diameter and histology as independent prognostic factors associated with cervical cancer survival. These factors were selected for construction of the nomogram. The C-index of the nomogram was 0.71 (95% CI, 0.65 to 0.77), and calibration of the nomogram showed good agreement between the 5-year predicted survival and the actual observation. Conclusions: We developed a nomogram predicting 5-year overall survival of surgically treated stage IA-IIB cervical cancer patients. More comprehensive information that is provided by this nomogram could provide further insight into personalized therapy selection.

Maternal and Child Factors Associated with Early Detection of Cerebral Palsy (뇌성마비아 조기발견과 관련된 모자인자)

  • Bae, Sung-Soo;Park, Jung-Han
    • Journal of Preventive Medicine and Public Health
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    • v.20 no.2 s.22
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    • pp.312-321
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    • 1987
  • To investigate the maternal and child factors associated with early detection of cerebral palsy, 74 mothers of cerebral palsy children who were born since January 1, 1980 and being treated at Taegu Rehabilitation Center for the Handicapped, Rehabilitiation Center of Taegu University, St. Paul Children's House and Pusan Welfare Association of Cerebral Palsy Children were interviewed from February to April 1987. There is no association between age of child when parents noticed the child's abnormality and educational level of father but it tend to be detected earlier when education level of mother is college or above compared with high school or under. There is a trend of earlier detection of child's abnormality although statistically not significant in case father is professional or managerial worker, monthly income of father is over \610,000, child is first-born, age of the parents is 34 years or under, child is a boy, and child has periodic well-baby check-up. The child's abnormality is detected earlier when mothers had 7 prenatal visits or more compared with those who had 6 visits or less (p<0.05). Parents noticed the child's abnormality first in 85.1% of the cases whereas doctors detected it first in 2.7% and this percentage was not different whether the child had periodic well-baby check-up or not. The first physician's diagnosis of the children was cerebral palsy in 36.5% and the rest was normal, need for observation, uncertain, etc. Parents took the child to doctor for diagnosis 2-3 months after they noticed the child's abnormality and after the child was diagnosed as cerebral palsy parents either took no therapeutic measure or brought the child to physiotherapy or acupuncture or gave herb medicine before they started specific rehabilitative therapy. For early detection of the cerebral palsy children, teaching of evaluation method for child development should be reinforced both in medical school and clinical training course and should train the specialist for diagnosis and treatment of crippling conditions. Also, public education is needed for the importance of early detection of crippling conditions and currently available methods for diagnosis and treatment.

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The Role of Chest CT Scans in the Management of Empyema (농흉에서 전산화 단층촬영의 의의)

  • Heo, Jeong-Suk;Kwun, Oh-Yong;Sohn, Jeong-Ho;Choi, Won-Il;Hwang, Jae-Seok;Han, Seung-Beom;Jeon, Young-June;Kim, Jung-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.4
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    • pp.397-404
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    • 1994
  • Background: To decide the optimal antibiotics and application of chest tube, examination of pleural fluid is fundamental in the management of empyema. Some criteria for drainage of pleural fluid have been recommended but some controversies have been suggested. Recently, newer radiologic methods including ultrasound and computed tomography scanning, have been applied to the diagnosis and management of pleural effusions. We undertook a retrospective analysis of 30 patients with pleural effusion who had CT scans of the chest in order to apply the criteria of Light et al retrospectively to patients with loculation and to correlate the radiologic appearance of pleural effusions with pleural fluid chemistry. Method: We analyzed the records of 30 out of 147 patients with pleural effusion undergoing chest CT scans. Results: 1) Six of the pleural fluid cultures yielded gram negative organisms and three anaerobic bacterias and one Staphylococcus aureus and one non-hemolytic Streptococci. No organism was cultured in ninteen cases(63.0%). 2) The reasons for taking chest CT scans were to rule out malignancy or parenchymal lung disease(46.7%), poor response to antibiotics(40.0%), hard to aspirate pleural fluid(10.0%) and to decide the site for chest tube insertion(3.3%). 3) There was no significant correlations between ATS stages and loculation but there was a tendency to loculate in stage III. 4) There was a significant inverse relationship between the level of pH and loculation(p<0.05) but there appeared to be no relationship between pleural fluid, LDH, glucose, protein, loculation and pleural thickening. 5) In 12 out of 30, therapeutic measures were changed according to the chest CT scan findings. Conclusion: We were unable to identify any correlations between the plerual fluid chemistry, ATS stages and loculations except pH, and we suggest that tube thoracotomy should be individualized according to the clinical judgement and serial observation. All patients with empyema do not need a chest CT scan but a CT scan can provide determination of loculation, guiding and assessing therapy which should decrease morbidity and hospital stay.

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An Observation of the Chief Complint and a Weak Child of Prediatric outpatinets (소아과(小兒科) 외래(外來) 환자(患者)의 주소증(主訴症) 및 허약아(虛弱兒)에 관(關)한 연구(硏究))

  • Shin Ji-Na;Shin Youn-Guo
    • The Journal of Pediatrics of Korean Medicine
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    • v.14 no.2
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    • pp.149-168
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    • 2000
  • The Purpose of this study was to investigate the new effective oriential medicine tretments in pediatric disease and its clinical applicability The study was composed of 1245 new patients who had been treated at the all unit in the Dong-Seo oriential Medicine Hospitial for 1 year, from 1 April 1999 to 31 March 2000, and aged between 0 and 18 years. The chief complaint was mainly categorized by oral examination on patients and their care-givers. Result 1. The numbers of children who involved in this study is total 1245: Male children are 668 and female children are 577 children. The sex rate between male and female is 1.15 to 1. 2. Most of the above patients came to the hospital at first time from diseases such as musculoskelectal disease, weakness, asthma, cough, anorexia, common cold, rhiorrhea, sweating, dyspepsia, dematitis, night terror, obesity, stomach, short stature, Besides, they also came to the hospital at first time from various diseases such as epistasxis, pyrexia. Bell's palsy, nocturia, contipation, cerebral palsy, disorder, CVA. diarrhea. stress disease, Allergic disease, Tic disorder. Visual disorder, Kawasaki disease, Pierre Robin's syndrom, hematuria, edema and so on. 3. Looking at the frequent diseases, Respiratory dis. children including asthma, cough, rhiorrhea, sweating, common cold, pyrexia covers 36%, in 399 numbers. digestive dis. children including anorexia, dyspepsia, stomach, diarrhea, constipation, indigestion covers 19%, in 211 numbers. cadiovasculary disease children including arrthymia, terror in frequency, night crying, sediation, Tic disorder covers 8%, in 85 numbers. Hepatobiliary disease children including short stature, dizziness, visual difficulty, sprain, disorder of nail covers 21%, in 238 numbers. renal disease. children including nocturia, hematuria, hemation, disorder of hair, menorrhea, cerebral palsy, edema in 44 numbers. Fatigue children covers 13%. in 143 numbers. 4. In case of respatory disease children. total number is 399 children. dematitis children are 108 numbers and asthma children are 96 numbers. These show that children seem to the best have dematitis and asththma. The age from 0 to 6 is 290 numbers, covering 73 percentage. The others are covering 27 percentage. These data demonstrate that the age from 0 to 6 age could easily get these kinds - of diseases. The 29 percent of children had these kinds of diseases in spring. The 28 percent of children had these kinds of diseases in autumn. These show that children seem to frequently have these kinds of diseases in both spring and autumn season.(inter-season) 5. In case of digestive disease, anorexia covers 39%, in 83 numbers, dyspepsia covers 28%, in 59 numbers, anorexia and dyspepsia were the lagest group in digestive disease and the age from 0 to 6 covers 59%, in 125 numbers and the other age covers 39%. According to these data, infant seems to be vulnerable to these kinds of diseases. The 24 percent of children had these kinds of diseases in spring and summer. The 33 percent of children had these kinds of diseases in winter, which means that children mostly had winter. but decreased significant in autumn. 6. In case of cadiovasculary diseases, it can be divided into two categories: night covers 73% and nervous characteristics covers 27%. The age from 0 to 6 occupies 75%, and the other age occupies 25%. These data also show that infants can easily infected with these kinds of diseases. Analyzing by the season, summer could be the most frequent season that children have these kinds of diseases. but decreased in autumn. 7. In case of hepatobiliary children, sprains covers 166 numbers, fatigue covers 32 numbers, epistasxia covers 24 members, the reasion which sprain occupyied most of % were sprain covered ages. The age from 0 to 14 covers 59% and from 15 to 18 covers 41%. In the conclusion the adolescent seems to be vulnerable to sprains. In spring 29%, insummer 31%, in autumn 23%, and in winter 28% of children got these kinds of diseases, which show that children seems to have this kinds of disease in summer season. and decreased in autumn. 8. In case of renal disease. nocturia and hematuria covers 52%(occupied overhalf). The age from 0 to 6 covers 52%(occupied overhalf). Analyzing by season, in spring increased in summer(59%), decreased in autumn(45%) Conclusion 1. The chief complant in pediatric diseases that needed an oriental medical tretment was mainly the disease that tends to take iong time and the weakness. and appeared frequency in respiratory disease : 2. The oriential medical tretment was still preferred as a way to improve the weakness by patients, rather than a way to overcome their disease. In paticular, the study shows that the oriental medical tretment should be emphasized in terms of preventing the disease 3, The new disease, which were developed with the change of human life and envir oment(just like seual disorder, short stature, obesity, dynamic disorder, examinee disease), should be in vestigated as a new field of oriental medical tretment.

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