• 제목/요약/키워드: Clinical variable

검색결과 917건 처리시간 0.024초

이하부에 발생한 침습성 섬유종증이 하악체에 침범한 증례 보고 (A CASE OF AGGRESSIVE FIBROMATOSIS INVADED MANDIBULAR BODY ON THE PAROTID REGION)

  • 김영조;이동근;엄인웅;민승기;정창주;김은철
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제16권2호
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    • pp.186-195
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    • 1994
  • Fibromatosis is benign fibroblastic proliferative lesion with abundant collagenous neo-formation located principally in the abdominal wall and in the upper and lower extremities (Masson & Soule, 1966). Wilkins and Waldron, in 1975, suggested that the title aggressive fibromatosis was a more appropriate term, reflecting the invasive characteristics of the disease. Synonyms listed were extra-abdominal desmoid, juvenile fibromatosis, aggressive infantile fibromatosis and congenital fibrosarcoma. A total of 12% of all fibromatosis arise in head and neck. Fibromatosis of the oral cavity is uncommon and is even more rare when in involve the mandibule. It is a locally aggressive fibrous tissue tumor, generally does not metastasize, but may cause considerable morbility and even death due to local infiltration. The degree of microscopic cellularity is variable, not only from tumor to tumor but also from area to area in the same tumor. Some tumors present with proliferation of mature fibroblasts and a dominating collagenous component : others may show a lack of the tumor in both types. The common histologic denominator appears to be cellular interlacing bundles of elongated fibroblasts, showing little or no mitotic activity and no pleomorphism. Mitosis are not a consistent index of malignancy when found in younger age groups. Fibromatosis still posses difficult problems of diagnosis and treatment. It is frequently recurrent and infliltrates neighbouring tissues. These lesion infliltrate widely and replace muscle, fat, and even bone with fibrous tissue of varying cellularity. Lesion representing fibromatosis in the oral cavity must be carefully evaulated by both surgeon and pathologists to ensure proper diagnosis and treatment planning. When these lesions involve bone, surgeon must be aware of the lesion's potential to perforate the cortex and expand while remaining hidden from the surgeon's view. Careful and precise clinical correlation with histologic appearance is essential to preclude misdiagnosis of fibrosarcoma yet provide surgical treatment plan that provides adequate local excision and long-term follow up. As regards cause, little is known. It is attributed to trauma or alteration in the sex hormone(Carlos, et al, 1986). Clinially, the lesion is reported to be not painful in most cases, but capable of rapid growth. The treatment is essentially surgical excision with wide margin of adjacent uninvolved tissue. Radiotherapy, hormone treatment or chemotherapy are of no use (WIkins et al, 1975 ; Majumudar and Winiarkl, 1978). We report a case of aggressive fibromatosis of 15-year-old with a lesion in the soft tissue of the parotid area that invaded the underlying bone of the mandibular body.

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전치부 영역 임플란트의 식립 시기에 따른 심미적 평가 (Comparative esthetic evaluation of anterior zone with immediate, early, and delay implantation)

  • 김정화;서성용;김나홍;유정현;이동운
    • 대한심미치과학회지
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    • 제26권1호
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    • pp.17-23
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    • 2017
  • 임플란트 식립시기가 심미적인 부분에 영향을 미치는 것에 대한 연관성을 평가하기 위해 전치부 영역에 식립된 34개의 임플란트 (27명 환자)를 후향적으로 조사했다. 즉시, 조기 및 지연식립으로 시기별로 그룹을 나누고 모든 환자를 보철완료 1년후에 연조직 평가를 시행했다. 통계적으로 그룹별 유의한 의미는 없었다. 식립 시기에 상관없이 만족할 만한 최종결과를 위해 다양한 골이식술과 연조직 이식술이 이루어졌다. 즉, 식립시기로 그 결과를 결정지을 수 없다는 점은 다각적인 면에서 고려사항이 요구된다는 점을 시사한다.

성인 상악 전치 형태에 따른 치은의 임상적 소견 (Clinical features of the gingiva according to maxillary anterior teeth form in adult)

  • 안치현;허수례;조익현;김형섭
    • Journal of Periodontal and Implant Science
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    • 제35권2호
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    • pp.359-369
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    • 2005
  • It has been suggested that morphologic characteristics of the periodontium are partly related to the shape and form of the teeth. Furthermore, the severity of symptoms of periodontal disease have been proposed to differ among these various morphologic entities or "biotypes". The purpose of the present study was to examine the relationship between the form of the crowns in the maxillary anterior tooth segment and (1) a group of morphological characteristics and (2) the thickness of the gingiva. The thickness of gingiva was measured by ultrasonic device(SDM). 100 subjects devoid of symptoms of destructive periodontal disease were examined regarding, e.g., probing depth, gingival recession, width of keratinized gingiva, thickness of the keratinized gingiva. From maxillary study cast, the width(at the apical third-CW) and the length(CL) of the crowns of the 6 anterior teeth were determined. A CW/CL-ratio was calculated for each tooth and averaged for each tooth region. The individual mean CW/CL-ratio values for the central incisors were ranked. The 10 subjects ranked highest and the 10 ranked lowest were selected as having either a long-narrow(group N) or a short-wide(group W) form of the crown of the tooth. The data for each of the examined parameters were averaged for each tooth region in each subject and mean values for subjects in groups W and N were compared using the Student t-test. Stepwise multiple regression analysis, including data from the whole sample, was performed for each tooth region with the thickness of the free gingiva as the dependent variable. The results from the analyses demonstrated that individuals with a long-narrow form of the central incisors displayed, compared to individuals with a short-wide crown, form (l) a narrow zone of keratinized gingiva, (2) a pronounced "scalloped" contour of the gingival margin. There was no significant difference between groups N and W with respect to the thickness of the keratinized gingiva. The CW/CL-ratio data revealed that a certain form of the crowns in the central incisors was accompanied by a similar form in the lateral incisors and canine tooth region. The regression analyses demonstrated that the thickness of the keratinized gingiva in central, lateral incisors and canines was significantly related to the width of the keratinized gingiva.

비기허증(脾氣虛證) 환자의 식사 전후 주관적 식욕과 Gut Hormone 혈중 농도에 대한 탐색적 연구 (Exploratory Study on the Pre-and Post-Prandial Subjective Appetite and Plasma Gut Hormone Levels in Spleen Qi Deficiency (SQD) Syndrome)

  • 오혜원;이지원;김제신;이준희
    • 사상체질의학회지
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    • 제27권1호
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    • pp.125-137
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    • 2015
  • Objectives The aim of this study was to investigate clinical factors of SQD syndrome by tracking plasma gut hormone (active ghrelin, active Glucagon-like peptide-1(GLP-1), pancreatic polypeptide(PP), total peptide YY(PYY)) profiling of pre-post prandial standard meal between SQD group and normal group. Methods A total of 24 adult participants were consecutively recruited on April 2014. They were diagnosed as either by SQD syndrome or normal by Spleen Qi Deficiency Questionnaire (SQDQ). On the experimental day, blood samplings of 2 ml were repeatedly collected at 6 points from 2 groups for measuring plasma levels of gut hormones. At every point, subjective appetite sensations were self-registered. Results & Conclusions 1. There were significantly lower subjective 'Appetite' (p=0.012) and higher 'Satiety' (p=0.012) in SQD group. At each time point, subjective 'Appetite' was significantly lower at 60 min after breakfast (p=0.034) and 'Satiety' were significantly higher at 15 min (p=0.020) and 120 min (p=0.044) after breakfast in SQD group. 2. There were no significant differences in plasma levels of gut hormones (active ghrelin, active GLP-1, PP, total PYY) between SQD and normal group. Also at each time point, there were no significant differences of plasma levels of gut hormones between SQD and normal group. 3. Changes in plasma levels of gut hormones compared to baseline were not significantly different at each time point between SQD and normal group. Plasma PYY levels compared to baseline increased in SQD group following 15 min and 30 min after breakfast but decreased in normal group. 4. Further investigation is needed to construct gut hormone profiling and in this perspective, we can approach evaluation tool on variable appetite in Traditional Korean Medicine (TKM) syndrome in the future.

생화학적 표식자에 따른 성인들의 골밀도 분석 (Analysis of Bone Mineral Density According to the Biochemical Variable Markers in Adults)

  • 김순근;권대철;송운흥
    • 대한방사선기술학회지:방사선기술과학
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    • 제32권4호
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    • pp.411-418
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    • 2009
  • 성인들의 생화학적 표식자를 검사해 골밀도에 직접 관여할 수 있는 중요한 유전적 또는 생화학적 인자들을 규명하고 성인들의 골다공증 병태생리에 관련된 정보를 제공하고 골다공증의 위험인자 등과의 관련요인을 분석하였다. 2007년 9월 12일부터 2008년 3월 18일까지 대학병원 건강증진센터에 내원한 남성 568명 여성 430명으로 총 998명 수진자를 대상으로 양 에너지 엑스선 골밀도 측정기를 이용하여 대퇴경부 및 척추의 골밀도를 측정하였다. 골밀도에 직접 관여하는 혈액의 생화학적 표식자는 인, 칼슘, 관절염, 헤모글로빈, 글루코오스, 간 기능검사의 GOT, GPT, $\gamma$-GTP를 측정하여 성인들의 골다공증 병태생리에 관련된 정보를 제공하여, 골다공증의 진단과 치료 및 예방에 생화학적 위험인자를 분석하여 관련요인을 조사하였다. 남성은 대퇴경부 및 척추의 골밀도는 20대에서 가장 높았고, 60대에서 대퇴경부와 척추의 골밀도가 가장 낮았다. 여성은 대퇴경부의 골밀도가 20대에서 가장 높았으나 척추는 40대에서 골밀도가 가장 높았고, 60대에서 대퇴경부와 척추의 골밀도가 가장 낮았다. 여성들 중 폐경 후의 여성들보다 폐경 전의 여성들이 골밀도가 유의하게 높았으며, 남성의 생화학적 표식자 인에서 정상 기준치 이상 군에서 대퇴경부와 척추에서 골밀도가 높았으며 여성은 정상치군일 때가 대퇴경부와 척추에서 골밀도가 높게 나타났다. 나이가 많아짐에 따라 골밀도는 낮아지고 체중이 높아지면 골밀도는 높아졌다.

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물리치료학에서의 PBL 학습교재 개발 및 적용 (The Development and Implementation of Problem-Based Learning Package in Physical Therapy)

  • 황현숙;정진우;임종수
    • 대한물리치료과학회지
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    • 제9권4호
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    • pp.83-94
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    • 2002
  • Within physical therapy education, there has been increased attention to curricula and course that emphasize problem solving, clinical reasoning, and synthesis of information across traditional discipline-specific boundaries. This article describes the development implementation, and outcomes of a problem-based learning course in Physical therapy. The course was designed to help students to integrate the various elements of a physical therapy curriculum and to enhance their abilities to respond to an ever-changing health care environment. An evaluation of the course by the first 50 students who completed it revealed both strengths and weaknesses. Students responded that the course enhanced their professional behavior, including interpersonal communication skills, team work, and follow-through with professional responsibilities. The learning package was developed by the authors and implemented to a college students during three weeks of the first semester of 2001. Most studies which conducted PBL module development were short period or temporary PBL package application and evaluation rather than a whole semester's. While, this study carried on partial integrated PBL curriculum development and application with recomposing content of the two subjects to one subject Physical therapy which includes four PBL packages. This package was developed from a simple concept to complex and partial integrated PBL curriculum application systematically variable learning methods such as discussion, practice, lecture, video. There are 2 classes, each class has 25 students, in the college. Each class has 5 small groups consisting 5 students. Two tutors proceeded discussion charging each class also, they used multiple methods and materials like tutorials, self-directed learning, lecture, and video. The package is 5 grades and 5 hours per week and the rate of discussion, lecture is 4, 1 respectively. One of the most change is the increase of interaction between students and tutors. Whenever students need information and suggestion, they can visit tutors who provide reading materials and guide for the direction of self learning. Therefore, this study describes the PBL package development process and application during one semester recomposing contents of two subjects to Physical therapy concepts. Besides, it will contribute to active application of existing each subject to tutors who intend to convert as PBL methods. The study has significant meaning to show potentiality of partially integrated PBL application, using systematic PBL package development from two subjects contents. However, when students' need of yearning is over the extent of Introduction of Physical therapy and Rehabilitation medicine, tutors should set learning extent. So, there is limitation to attain completely integrated PBL education within one subject, therefore, it is high lighted to proceed development of integrated curriculum to maximize learning effects of PBL. It is exected that partial integrated PBL package development and application will distribute to prosper excellent physiotherapist in practice.

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복부외상환자의 예후에 영향을 미치는 인자들에 대한 분석 (Analysis of the Prognostic Factors for Abdominal Trauma)

  • 김희준;김형수;서경원;주재균;류성엽;김정철;김형록;박영규;김동의;김영진;김신곤
    • Journal of Trauma and Injury
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    • 제20권1호
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    • pp.12-18
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    • 2007
  • Purpose: Recently, trauma is more frequent due to the increases in the population, the number of traffic accident, and the incidence of violence. Especially, abdominal trauma is a leading cause of morbidity and mortality. We analyzed the clinical features and the factors associated with morbidity and mortality. Methods: We analyzed 136 patients of abdominal trauma who were admitted at the Department of Surgery, Chonnam National University Hospital, from January 2003 to June 2005. We analyzed the cause of trauma, the injured organ, combined injuries, mental status, blood pressure, laboratory findings, morbidity, and mortality. The relationships between by variable were assesed by using the independent samples test and the Kruskal?Wallis test. Results: The causes of trauma were traffic accidents (98 cases, 72%), falling accidents (9 cases, 6.6%), violence (6 cases, 4.4%), and stab injuries (6 cases, 4.4%). The injured organs were the small intestines (47 cases, 34.6%), the liver (35 cases, 25.7%), the spleen (26 cases, 19.1%), the mesentery (17 cases, 12.5%), the large intestines (15 cases, 11.0%), the pancreas (14 cases, 10.3%), etc. The most common combined injury was chest injury (53 cases, 39%). Comatose or semicomatose mental status and shock on admission (<60 mmHg in systolic) were related to high mortality (85.7%). In laboratory findings, decreased hemoglobin (<8 g/dL), and platelet count (<$50,000/mm^3$), and increased creatinine level (>1.6 mg/dL) were significant prognostic factors. The incidence of postoperative complications was 40.4%, and frequent complications were wound infection (8.1%) and re-bleeding (8.1%). The overall mortality rate was 18.4%, and most common cause was hypovolemic shock (18 cases, 13.2%), however, there was no statistical difference according to injurd organ. Conclusion: In the multivariate analysis, mental status, hemoglobin, and serum creatinine level were the most significant prognostic factors. When an abdominal trauma patient arrives at the emergency room, a rapid and accurate evaluation of the patient's status and risk factors, and resuscitation, if necessary, have to be performed to lower the morbidity and mortality.

신생자돈의 콕시듐증에 대한 Baycox(Bay Vi 9142) 현탁액의 효능 (Efficacy of Baycox(Bay Vi 9142) Suspension against Coccidium Isospora suis in piglets)

  • 김병기
    • 한국임상수의학회지
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    • 제12권1호
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    • pp.917-924
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    • 1995
  • I suis cocciosis in piglets seems to occur in the majority of Korean sow herds. Cocci야osis is characterized by a pasty diarrhea in piglets appearing at 5 to 11 days old. Morbidity is variable, Mortality is usually low but piglets growth is always retarded. And, the principal source of infection is the environment because of the high resistance of oocysts. Control of coccidiosis is usually frustrated since the majority of treatment have not constant results. Mundt et al(1990) developed a new strategy by administrating toltrazuril as an oral suspension. This new anticoccidial drug reduced clinical signs and mortality. Therefore, we will try to medicate piglets with Baycox(Bay Vi 9142) suspension in a sow herd, having a problem of I suis coccidiosis. The incidences of coccidiosis in suckling piglets in C and D bleeding stock farm were from 28.6 to 42.3 and 21.1~57.9 % during 3 to 21 day-old. The body weights of suckling piglets in treated groups were higher than those of control groups at 11 and 18 day-old. Also, those of C breeding stock firm were higher than those of D farm. The body weight gains of suckling piglet of treated groups were higher than those of control groups. Also, those of C breeding stock firm were higher than those of D farm. There was no dead piglet in all experimental groups. Some atrophic piglets were done away with. In C breeding stock farm, the incidences of diarrhea in treatment groups were significantly lower an those of control groups. Also, the degrees of diarrhea in treated groups were significantly lower than those in control groups. In D breeding stock farm, the incidences of diarrhea in treated groups were a little lower than those in control groups. Also the degrees of diarrhea in treated groups were a little lower than those in control groups. In the treated groups, the incidences and degrees of diarrhea were reduced at the 4th day and increased at the 13th day after treatment. The number of litters excreted oocysts in treated groups wert lower than those in control groups after treatment. Also, the OPG in treated groups were lower than those in control groups. According to above results, the effect of Baycox suspension against swine coccidiosis was very good. If we will treat with Barcox suspension swine coccidiosis in swine stock farms, we can get good effects of the improvement of body weight gains and diarrhea and e reduce of excreted costs in faeces.

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척수소뇌성 운동실조증 제7형 (Spinocerebellar ataxia 7 (SCA7))

  • 정선용;장석훈;김현주
    • Journal of Genetic Medicine
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    • 제4권1호
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    • pp.22-37
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    • 2007
  • The autosomal dominant spinocerebellar ataxias (SCAs) are a group of neurodegenerative diseases, clinically and genetically heterogeneous, characterized by degeneration of spinocerebellar pathways with variable involvement of other neural systems. At present, 27 distinct genetic forms of SCAs are known: SCA1-8, SCA10-21, SCA23, SCA25-28, DRPLA (dentatorubral-pallidoluysian atrophy), and 16q-liked ADCA (autosomal dominant cerebellar ataxia). Epidemiological data about the prevalence of SCAs are restricted to a few studies of isolated geographical regions, and most do not reflect the real occurrence of the disease. In general a prevalence of about 0.3-2 cases per 100,000 people is assumed. As SCA are highly heterogeneous, the prevalence of specific subtypes varies between different ethnic and continental populations. Most recent data suggest that SCA3 is the commonest subtype worldwide; SCA1, SCA2, SCA6, SCA7, and SCA8 have a prevalence of over 2%, and the remaining SCAs are thought to be rare (prevalence <1%). In this review, we highlight and discuss the SCA7. The hallmark of SCA7 is the association of hereditary ataxia and visual loss caused by pigmentary macular degeneration. Visual failure is progressive, bilateral and symmetrical, and leads irreversibly to blindness. This association represents a distinct disease entity classified as autosomal dominant cerebellar ataxia (ADCA) type II by Harding. The disease affectsprimarily the cerebellum and the retina by the moderate to severe neuronal loss and gliosis, but also many other central nervous system structures as the disease progresses. SCA7 is caused by expansion of an unstable trinucleotide CAG repeat in the ATXN7 gene encoding a polyglutamine (polyQ) tract in the corresponding protein, ataxin-7. Normal ATXN7 alleles contain 4-35 CAG repeats, whereas pathological alleles contain from 36->450 CAG repeats. Immunoblott analysis demonstrated that ataxin-7 is widely expressed but that expression levels vary among tissues. Instability of expanded repeats is more pronounced in SCA7 than in other SCA subtypes and can cause substantial lowering of age at onset in successive generations termed ‘anticipation’ so that children may become diseased even before their parents develop symptoms. The strong anticipation in SCA7 and the rarity of contractions should have led to its extinction within a few generations. There is no specific drug therapy for this neurodegenerative disorder. Currently, therapy remains purely symptomatic. Cellular models and SCA7 transgenic mice have been generated which constitute valuable resources for studying the disease mechanism. Understanding the pathogenetic mechanisms of neurodegeneration in SCAs should lead to the identification of potential therapeutic targets and ultimately facilitate drug discovery. Here we summarize the clinical, pathological, and genetic aspects of SCA7, and review the current understanding of the pathogenesis of this disorder. Further, we also review the potential therapeutic strategies that are currently being explored in polyglutamine diseases.

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구강암과 구인두암의 절제술 후 전완유리피판술을 이용한 재건술 (Reconstruction with Radial Forearm Free Flap after Ablative Surgery for Oral Cavity and Oropharyngeal Cancers)

  • 조광재;천병준;선동일;조승호;김민식
    • 대한두경부종양학회지
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    • 제19권1호
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    • pp.41-46
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    • 2003
  • Background and Objectives: Surgical ablation of tumors in the oral cavity and the oropharynx results in a three dimensional defect because of the needs to resect the adjacent area for the surgical margin. Although a variety of techniques are available, radial forearm free flap has been known as an effective method for this defect, which offers a thin, pliable, and relatively hairless skin and a long vascular pedicle. We report the clinical results of our 54 consecutive radial forearm free flaps used for oral cavity and oropharynx cancers. Materials and Methods: We reviewed the medical records of patients who were offered intraoral reconstruction with a radial forearm free flap after ablative surgery for oral cavity and oropharyngeal cancers from August 1994 to February 2003 and analyzed surgical methods, flap survival rate, complication, and functional results. Among these, 20 cases were examined with modified barium swallow to evaluate postoperative swallowing function and other 8 cases with articulation and resonance test for speech. We examined recovery of sensation with two-point discrimination test in 15 cases who were offered sensate flaps. Results: The primary sites were as follows : mobile tongue (18), tonsil (17), floor of mouth (4), base of tongue (2), soft palate (2), retromolar trigone (3), buccal mucosa (1), oro-hypopharynx (6), and lower lip (1). The paddles of flaps were tailored in multilobed designs from oval shape to tetralobed design and in variable size according to the defects after ablation. This procedures resulted in satisfactory flap success rate (96.3%) and showed good swallowing function and social speech. Eight of 15 cases (53.3%) who had offered sensate flap showed recovery of sensation between 1 and 6 postoperative months (average 2.6 month). Conclusion: The reconstruction with radial forearm free flap might be an excellent method for the maximal functional results after ablative surgery of oral cavity and oropharyngeal cancers that results in multidimensional defect.