• Archives of Reconstructive Microsurgery
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• 제21권1호
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• pp.50-55
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• 2012

Purpose: We reviewed 66 cases of the glomus tumors in the hands. The purpose of this study was to review the characteristic signs and symptoms of glomus tumors and the surgical outcomes. We made hypothesis that (1) our guideline for surgical excision are reliable and (2) our surgical technique is efficient and less harmful to the nail root. Materials and Methods: The clinical diagnosis was made with occasional radiological studies and surgical excision was performed according to our indications. Patients with electrical shock-like pain by touching (the essential symptom) and at least 2 of 4 clinical signs and symptoms (cold hypersensitivity, paroxysmal pain that radiated proximally, blue discoloration, nail deformity for dorsal tumor or a palpable nodule for pulp tumor) underwent surgical excision. Results: The duration of symptoms of the patients was about 5.3 years. No difference of prevalence was found in both hands, but the thumb and the middle finger were more affected than the other fingers. The mean follow up period was 2.4 years and none of the patients complained the same characteristic pain at the last visit. Conclusion: To the best of our knowledge, this report is the largest case series about glomus tumors in the finger tip. The clinical signs and symptoms are important to make a diagnosis of glomus tumors, and surgical excision is the treatment of choice.

• 대한치과교정학회지
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• 제49권6호
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• pp.413-426
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• 2019

This study was performed to describe the longitudinal management of recurrent temporomandibular joint (TMJ) ankylosis from infancy to adulthood in perspective of surgical and orthodontic treatment. A 2-year-old girl was referred with chief complaints of restricted mouth opening and micrognathia due to bilateral TMJ ankylosis. For stage I treatment during early childhood (6 years old), high condylectomy and interpositional arthroplasty were performed. However, TMJ ankylosis recurred and symptoms of obstructive sleep apnea (OSA) developed. For stage II treatment during early adolescence (12 years old), gap arthroplasty, coronoidectomy, bilateral mandibular distraction osteogenesis, and orthodontic treatment with extraction of the four first premolars were performed. However, TMJ ankylosis recurred. Because the OSA symptoms reappeared, she began to use a continuous positive airway pressure device. For stage III treatment after completion of growth (20 years old), low condylectomy, coronoidectomy, reconstruction of the bilateral TMJs with artificial prostheses along with counterclockwise rotational advancement of the mandible, genioglossus advancement, and orthodontic treatment were performed. After stage III treatment, the amount of mouth opening exhibited a significant increase. Mandibular advancement and ramus lengthening resulted in significant improvement in the facial profile, Class I relationships, and normal overbite/overjet. The OSA symptoms were also relieved. These outcomes were stable at the one-year follow-up visit. Since the treatment modalities for TMJ ankylosis differ according to the duration of ankylosis, patient age, and degree of deformity, the treatment flowchart suggested in this report could be used as an effective guideline for determining the appropriate timing and methods for the treatment of TMJ ankylosis.

• 한국치위생학회지
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• 제15권1호
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• pp.111-118
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• 2015

Objectives: The aim of the study is to investigate the health belief model affecting the oral health behavior in middle and high school students. Methods: The subjects were 296 middle and high school students in Seoul, Gyeonggi and Incheon from February 15 to March 21, 2014. The students filled out the self-reported questionnaires after receiving informed consents. The instrument was adopted and revised from those of Kim & Hwang, and Choi & Joo. The questionnaire consisted of 4 questions of general characteristics, 9 questions of oral health status including subjective oral health status, frequency of tooth brushing, duration of tooth brushing, method of tooth brushing, use of oral health devices, dental clinic visit, scaling services, snack intake, and smoking. The oral health belief consisted of 25 questions including susceptibility, seriousness, barriers, benefit, and self-efficacy using Likert 5 scale. The reliability of Cronbach's alpha in the study was 0.725. Data were analyzed using SPSS ver 18.0 for frequency analysis, t-test, ANOVA, ${\chi}^2$-test, and Pearson's correlation coefficient, simple regression, and binary logistic regression. Results: Oral health beliefs of middle and high school students affected the oral health behaviors. Susceptibility, barriers and self-efficacy also influenced on the oral health behaviors. In order to provide the best oral health education, susceptibility and self-efficacy are the primary factors to increase motivation because the motivation endows the students with correction of oral health behaviors that improve the knowledge, attitudes, and decrease barriers in oral hygiene. Conclusions: It is important to correct oral health behaviors in the middle and high school students by providing the continuing and systematic oral health education.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제23권5호
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• pp.439-446
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• 2020

Purpose: The evidence for an association between inflammatory bowel disease (IBD) and obesity is conflicting. Therefore, we set out to review the body mass index (BMI) at presentation of IBD to understand if the rise of the obesity rate in the general population, lead to an increase of obesity in patients with IBD at the time of diagnosis. Methods: Retrospective review of all patients with IBD seen at Children's Hospital and Medical Center from January 1st 2010 to December 31st 2014. From the initial visit and endoscopy, we obtained: age; sex; BMI; disease phenotype; disease severity. Results: We had a total of 95 patients, 35 patients were excluded due to incomplete data or referral being made after diagnosis was made. 28 were males and 32 were females, Age range was 2-17 years. A 37 had Crohn's disease, 19 ulcerative colitis, and 4 indeterminate colitis. Disease severity in 19 cases was mild, 29 moderate and 12 severe. BMI distribution was as follows-obese (5.0%), overweight (6.7%), normal weight (65.0%), mild malnutrition (8.3%), moderate malnutrition (15.0%), severe malnutrition (1.7%). Conclusion: Our data is consistent with other series. Showing most children had a normal BMI, regardless of disease severity or phenotypes. One confounding factor is the possibility of delay in referral to GI. This could mean some obese children may fall in the normal BMI range at the time of diagnosis due to ongoing weight loss. Future studies should include prospective cohort studies, comparing incidence of IBD in obese and non-obese patients, severity at presentation, duration of symptoms, and clinical outcomes.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제46권3호
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• pp.174-182
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• 2020

Objectives: Joint injuries frequently lead to progressive joint degeneration that causes articular disc derangement, joint inflammation, and osteoarthritis. Such arthropathies that arise after trauma are defined as post-traumatic arthritis (PTA). Although PTA is well recognized in knee and elbow joints, PTA in the temporomandibular joint (TMJ) has not been clearly defined. Interestingly, patients experiencing head and neck trauma without direct jaw fracture have displayed TMJ disease symptoms; however, definitive diagnosis and treatment options are not available. This study will analyze clinical aspects of PTA in TMJ and their treatment outcomes after joint arthrocentesis and lavage. Materials and Methods: Twenty patients with history of trauma to the head and neck especially without jaw fracture were retrospectively studied. Those patients developed TMJ disease symptoms and were diagnosed by computed tomography or magnetic resonance imaging. To decrease TMJ discomfort, arthrocentesis and lavage with or without conservative therapy were applied, and efficacy was evaluated by amount of mouth opening and pain scale. Statistical differences between pre- and post-treatment values were evaluated by Wilcoxon signed-rank test. Results: Patient age varied widely between 20 and 80 years, and causes of trauma were diverse. Duration of disease onset was measured as 508 post-trauma days, and 85% of the patients sought clinic visit within 2 years after trauma. In addition, 85% of the patients showed TMJ disc derangement without reduction, and osteoarthritis was accompanied at the traumatized side or at both sides in 40% of the patients. After arthrocentesis or lavage, maximal mouth opening was significantly increased (28-44 mm on average, P<0.001) and pain scale was dramatically decreased (7.8-3.5 of 10, P<0.001); however, concomitant conservative therapy showed no difference in treatment outcome. Conclusion: The results of this study clarify the disease identity of PTA in TMJ and suggest early diagnosis and treatment options to manage PTA in TMJ.

• 농촌계획
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• 제13권2호
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• pp.133-142
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• 2007

Tourism and recreation spots in Korea have been developed metropolitan cities-oriented that facility construction has too much importance in local tourist site development more than satisfaction and experience. Tourism hardly seems to play its role as a motive power even in locals where tourism occupies much in their economic development. Therefore, the ministry of culture & tourism has introduced a plan to discover cultural and tourism resources as a development alternative which handles theme-ability and specialization. However, most projects of local tourism resources developed since 1999 have resulted similar features comparing to previous and existing tourist spots. And the main objectives of this paper have not been realized very well. This research hence forth suggests a program-based model development in tourism resources, with a case study of Gokun-gugok, one of the historical and cultural sites and is located in Hwachon-gun, Gangwon Province. Main points include: Since the Gokun-gugok landscape has been undermined and been loosed the traditional cultural value due to the road development, this study intends to plan to make the adventure of tourism destination including restoring the site as a cultural place. The Gokun-gugok site needs to develop combining various types of tours and adventures with instructive and educational programs to meet the visitors' needs. This research also intends to precede a development plan based on harmonizing natural, historical and cultural assets of the Gokun-gugok with facility maintains and tourism development. Meanwhile, the study stresses on realizing development of tourism resources categorizing programs by seasonality, visitor's economic class, and visit duration. Asa consequence, the research presents a "Culture & Tourism Academy" which deals with these types of adventure programs and informative educations. To assess feasibility of the development plan in terms of economy, environment and policy, the research conducted the site inspection and examined the site's surroundings, land properties and inundation. 145,000 square meters have been extracted as a feasible development area out of total 392,500 square meters. Finally, the study segmentizes target markets basedon the result of the survey on visitors and local residents. The more segmentized markets employ facilities according to their traditional characters.

• The Korean Journal of Pain
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• 제22권3호
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• pp.229-233
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• 2009

Background: Sacroiliac (SI) joint pain is a challenging condition that causes lower back or buttock pain; however, there is no universally accepted long-term treatment. There have been several reports of ligament prolotherapy for SI joint pain, but these have had inconsistent results, probably due to the lack of a specific diagnosis for patient selection and variability in the volume, number and sites of injection. Therefore, this study was conducted to assess the efficacy of intraarticular prolotherapy for relieving SI joint pain diagnosed by local anesthetic intraarticular injection. Methods: Twenty-two patients with SI joint pain confirmed by 50% or more improvement in response to local anesthetic block underwent intraarticular prolotherapy with 25% dextrose water every other week three times. The numeric rating scale (NRS) for pain and Oswestry disability index (ODI) were assessed at the initial visit and after completion of a series of prolotherapy and the NRS was checked during monthly follow-up sessions to evaluate the long-term effectiveness of this technique. Results: Twenty patients completed prolotherapy and followed up as scheduled. The NRS and ODI were significantly improved from 6 (4-8) and $34.1{\pm}15.5$ to 1 (0-3) and $12.6{\pm}9.8$ (P < 0.01), respectively, at 1 month after prolotherapy. The mean duration of pain relief of 50% or more was 12.2 months (95% CI, 10.0-14.3) as determined by Kaplan-Meier survival analysis. Conclusions: Intraarticular prolotherapy provided long-term relief of sacroiliac joint pain and may have more benefits than ligament prolotherapy or neurolysis.

• 한국보건간호학회지
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• 제9권2호
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• pp.52-68
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• 1995

This is the quasi experimental study to evaluate the effect of individual health education for hypertensive patients at home on knowledge of hypertesnion, attitude about chronic disease, self-care management. The individual health education program was performed at each patient's home every one month through, 1 years. The first data collection was carried out in May 1991. and the last was done in July 1992 through questionaires. The study results were as follows; 1) The subjects were 22 hypertensive patients who agreed the participation of study among registered patients at a public health center in Incheon. They were consisted of thirteen males and nine females. And their duration of illness were average 5 years, their mean age were 65 years. The over all living conditions were poor and the average monthly income was 50 thousdand won. 2) The effect of individual health education through home visit was statistically significant. The Knowledge of hypertension (t= -4.40, p<.001), attitude about chronic disease (t=­2.65, p<.05), self-care management of the subjects were significantly improved. (t=-3.76, p<.001), and their blood pressure were decreased. 3) Between the knowledge of hypertesnion and the attitude about chronic disease showed significant positive relationship. But the self-care management had not relationship with these two factors. unexpectedly. 4) The knowledge of hypertension, attitude about chronic disease, and self-care management had not evenly influenced the control of hypertension. These results suggested that the effort needed to find out the other factors influencing self-care management and develop the self-care management measuring tool. And the health education programs for chronic patients were developed, systematically. And the standardized health education model was developed for home health care nursing intervention in community based.

• 한방재활의학과학회지
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• 제26권2호
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• pp.133-144
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• 2016

Objectives This study was designed to find out influential factors associated with Hospitalization of the patients from traffic accident by Groups. Methods Based on the medical charts, we analyzed statistical study of 486 patients putting them into two groups to identify the factors associated with the duration of hospitalization involving age, sex, elapse day (Interval between time of injury and visit to hospital), and the types of accident. Patients in group A were diagnosed with a mere 'sprain', and patients in Group B had other symptoms accompanied by 'sprain'. Results 1. In group A, cervical sprain was the most and male patients with the symptom outnumbered female patients. In group B, headache was most where female patients had the symptom 1.7 times more than male patients. 2. Female patients in group B were found to stay for a longer period of time in the hospital than the male counterparts (p<0.05). 3. Both group A and B have positive correlation between length of hospital stay and age though group B exhibited stronger correlation. 4. Patients who had accident while riding bus in group A and those who were pedestrians in group B were found to stay in the hospital for a significantly longer period of time than those who had any other types of accident (p<0.05). Conclusions We noticed that hospital stay lengthened when the patients were older and when they had accidents while riding bus in Group A whereas in Group B, patients stayed longer when they were females and older as well as when they were pedestrians in accidents.

• 가정간호학회지
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• 제24권2호
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• pp.210-220
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• 2017

Purpose: The study aimed to describe the utilization of home healthcare in patients using home mechanical ventilator(HMV) Method: A descriptive cross-sectional design was used in this study. A Questionnaires were sent to nation wide home healthcare agencies to assess their utilization status of home healthcare. A convenience sample of 158 patients data was reviewed. Result: A total of 88(55.7%) men with the mean age of 51.94(${\pm}19.52$) years were included in the study. Approximately 55.1% of patients at the outpatient department were referred to the home healthcare services after discharge. The underlying diseases were as follows : 129 amyotrophic lateral sclerosis and 27 muscular dystrophies. A total of 155 patients have invasive HMV. Efficient home healthcare nursing activities provided by a highly skilled home healthcare advanced practice nurses(HHCAPN) were tracheotomy and gastrostomy tube management and urinary catheterization. The average frequency of home visit for one patient was 2.52times per month. The duration of home healthcare utilization with >1 year was 82.9%. HHCAPNs have limited knowledge and skill for HMV. Conclusion: The government support is required to provide sufficient home healthcare services to the patients discharged with HMV. HHCAPNs should be properly educated on the effective HMV care.