Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.40
no.5
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pp.211-219
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2014
Objectives: The purpose of this research was to create a scoring system that provides comprehensive assessment of patients with oromaxillofacial cancer or odontogenic infection, and to statistically reevaluate the results in order to provide specific criteria for elective tracheostomy. Materials and Methods: All patients that had oral cancer surgery (group A) or odontogenic infection surgery (group B) during a period of 10 years (2003 to 2013) were subgrouped according to whether or not the patient received a tracheostomy. After a random sampling (group A: total of 56, group B: total of 60), evaulation procedures were observed based on the group classifications. For group A, four factors were evaluated: TNM stage, reconstruction methods, presence of pathologic findings on chest posterior-anterior (PA), and the number of systemic diseases. Scores were given to each item based on the scoring system suggested in this research and the scores were added together. Similarly, the sum score of group B was counted using 5 categories, including infection site, C-reactive protein level on first visit, age, presence of pathologic findings on chest PA, and number of systemic diseases. Results: The scoring system rendered from this research shows that there is a high correlation between the scores and TNM stage in oral cancer patients, or infection sites in odontogenic infection patients. However, no correlation between pathologic findings on chest PA could be found in either group. The results also indicated that for both groups, the hospital day increased with the tracheostomy score. The tracheostomy score cutoff value was 5 in oral cancer patients and 6 in odontogenic infection patients which was used for elective tracheostomy indication. Conclusion: The elective tracheostomy score system suggested by this research is a method that considers both the surgical and general conditions of the patient, and can be very useful for managing patients with severe oral disease.
The purpose of this study is to develop and evaluate the health promotion program to increase the functional status of the in-house stroke patients. The subjects for the experiment are 38 in-house stroke patients in a health center and welfare centers suffering from hemiplegia. The experimental group consists of 19 stroke patients and the control group consists of another 19 stroke patients. The program was applied to the experimental group for 8 weeks. The subjects were given health education at the first week. At the second and the fifth week they were given counselling on health by home visit. At the third, the fourth, the sixth and the seventh week they were interviewed by phone about health, and at the last week they shared their experiences through group meeting. The results of the study are as follows: 1. The degree of ADL in the experimental group increased significantly, compared with that of the control group. 2. In the experimental group the degree of Range of Motion in shoulder abduction, elbow flexion, hip flexion and ankle dorsiflexion increased significantly, compared with that of the control group. 3. In the experimental group the degree of muscle strength in elbow flexion, knee extension, and ankle dorsiflexion increased significantly, compared with that of the control group. 4. Systolic pressure, diastolic pressure in the experimental group decreased significantly, compared with that the control group. 5. HWR in the experimental group didn't decreased significantly, compared with that the control group. 6. The degree of depression in the experimental group decreased significantly, compared with that the control group. 7. The degree of social adaptation in the experimental group increased significantly, compared with that the control group. The results above show that the health promotion program for this study was effective in promoting the performance of lifestyle for health improvement of the in-house stroke patients. Therefore, it is considered that the program can be used as an efficient nursing intervention for the in-house stroke patients who need continuous health-improving behaviors.
Objectives : The aim of this study is to evaluate the effect of cervical Hyeopcheok(Jiaji) point for neck pain. Methods : The twenty-nine patients who feel neck pain, are chosen from chart review, received acupuncture treatment on cervical Hyeopcheok(Jiaji) point. The evaulation of progress was checked by NDI(neck disability index), and VAS(visual analog scale). Data were analyzed by Friedman two way analysis of variance and Wilcoxon matched pairs signed rank test. Results : NDI value(mean${\pm}$SD) was $17.76{\pm}8.26$(n=29) at the first visit, $13.41{\pm}8.04$(n=29) at 3days after treatment, $10.85{\pm}8.46$(n=26) at 5days, $11.00{\pm}7.80$(n=13) at 9days, $7.22{\pm}4.76$(n=9) at 15days, $3.86{\pm}4.06$(n=7) at 20days, and $3.33{\pm}3.78$(n=6) at 30days. VAS value(mean${\pm}$SD) was $4.07{\pm}1.33$(n=29) at the first visit, $12.97{\pm}1.05$(n=29) at 3days after treatment, $2.15{\pm}1.12$(n=26) at 5days, $2.15{\pm}0.99$(n=13) at 9days, $1.56{\pm}0.73$(n=9) at 15days, $1.29{\pm}0.49$(n=7) at 20days, and $0.83{\pm}0.41$(n=6) at 30days. The value of NDI and VAS gradually decreased. Repeated measurement results(the difference between the first visit and each measurement day) and the difference between before and after the interval(except between 5 and 9days, between 20 and 25days) were statistically significant. Conclusions : This result was shown that treatment of cervical Hyeopcheok(Jiaji) acupuncture point for neck pain can be effective. Further systematic research will be needed.
Purpose. The present study aimed to investigate the effective cleaning of healing abutment (HA) using Healing abutment case (HA case) by observing oral microorganisms with phase contrast microscope. Materials and methods. 32 patients with two or more implants placed in the same jaw, a total of 64 HAs (experimental group 32, control group 32) were selected and the control was cleaned with an alcohol swab. At the first and second visits, each group was observed before cleaning, and the experimental group was additionally observed after cleaning at the first visit. A 400× phase contrast microscope was used for the observation of oral microorganisms for its amounts. Results. There was no significant difference in the amount of oral microorganisms was found between the groups at the first visit, no significant difference according to gender, maxilla or mandible, and buccal or lingual surface. There was a statistically significant difference in the amount of oral microorganisms according to supra-gingival and sub-gingival (P<.05), There was also a significant difference in the comparison before and after cleaning in the experimental group (P<.05). There was a significant difference in the amount of oral microorganisms in each group at second visit (P<.05). Conclusion. Healing abutment cleaning using healing abutment case solution is more effective than simple cleaning with alcohol swab.
Journal of Physiology & Pathology in Korean Medicine
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v.26
no.2
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pp.206-211
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2012
Here we described 8 patients treated with acupuncture and moxiburstion due to chronic postoperative pain as a comlication of gastrointestinal surgery. The patients were suffering from pain that continued for more than 6 months after laparotomy for gastric cancer (n=1), rectal cancer (n=2), cholangiocarcinoma (n=2), hepatocellular carcinoma (n=2) and ischemic colitis (n=1), respectively. Mean time elased from surgery were 31.25(${\pm}21.72$)months, pain grade on first visit by VAS(visual analogue scale, 0~10mm) was 3.75(${\pm}0.97$)point, and acupuncture and moxiburstion were performed 12.63(${\pm}5.74$)times during 5.5(${\pm}2.4$)weeks, on average. At the end of treatment, pain was decreased 2.75(${\pm}0.97$)point compared to first visit. Based on the that results, it is reasonable to assume that acupuncture and moxiburstion can be effective to persistent post-surgical pain after laparotomic gastrointestinal surgery, at least to some laparotomized patients.
The aim of treatment of cleft lip and palate is to correct the cleft and associated problems surgically and thus hide the anomaly so that patients can lead normal lives. This correction involves surgically producing a face that does not attract attention, a vocal apparatus that permits intelligible speech, and a dentition that allows optimal function and esthetics. In neonatal periods, gross distortion of tissues surrounding the cleft requires considerable effort and time due to post operative functional defect and scarring and induces milk feeding problem, malocclusion of deciduous or permanent dentition, congenital missing teeth, skeletal dysplasia. The occurrence of a cleft deformity is a source of considerable shock to the parents of an afflicted baby, and the most appropriate approach is very important things. Thus we tried to analysis of dental arch, shape and size of deformity in cleft patients. The results were obtained as follows. 1. When the cast measurements of UCLP subjects at first visit it was found that the mean length was 9.29mm at the alveolar cleft width, also that was 11.7mm at the anterior width and 14mm at the posterior cleft width. 2. Comparison of UCLP group at first visit and just lip surgery, it was found that the older group showed a insignificant reduction in the width of the cleft in the alveolar, canine, and tuberosity regions. 3. The maxillary casts of the UCLP group at 6 months differ Significantly from those of the at 3 months in both length and width. but there was no statistical difference except anterior ridge length of nonclefted site. 4. Comparison at 6 months and 18 months, there was a greater change in length of the alveolar cleft width, intercanine width, and anterior cleft width. Maxillary arch became wider at both the canine region and intertuberosity region. also posterior anteroposterior length was increased but anterior AP length was decreased from 8.1mm to 7.7mm. There was meaningful increase at intertuberosity length; however, a significant reduction in width t-t'
This paper has surveyed above all what the patients call for physically, psychologically, and socially and researched how the ministers have acknowledge on cancers, their patients and hospice by means of enquete. To the difficulty the pastors should give their hands. This study researched what thoughts and behaviors the ministers actually had by the method of questionnaire. It was done from October 20, 1997 through December 10, 1997 on seven thousand of questionnaire paper of which 149 given back on the line of post or firsthandly were analyzed. The questioness consisted of 141 men(94.6%), 8 women(5.4) and 104 pastor on appentice(69.8%). There were 58 questionees(38.9%) who were hospitalized of their own diseases, and 121 questionees(81.3%) who had cancer patients hospitalized among their church people, relatives, or friends. Most of all the questionees(79.9%) had not any experience, such as they took some instruction about cancer patients. 72.5% of all the questionees had not ever served patients around them. The followings are the contents of the enquete: the questionees' view to chronic patients and death, where they put the priority in the case of that they look after patients who are under terrible pain ahead of death, what they think of such a situation as a patient has no technical possibility to be recuperated, why they think pastors do not like to visit chronics, which therapy they choose, whether they mainly control their pain or they do their best in order to heal their diseases, how much the questioned ministers know hospice, where and how they get the information on it, how much important role they play in the hospice team, whether the volunteers for hospice have not worked on account of pastors' misunderstanding to hospice service, whether the ministers want to take part in hospice service with their church people or not, and so forth. Suggestion: First, the education and P.R. about hospice are requested for the ministers. Second, the ministers must participate in hospice activities actively. Therefore the ministers and the churches must firsthandly take part in hospice activities beyond the education only and the raising of the recognition to them.
Background Some patients who need surgery refuse a blood transfusion because of their religious beliefs or concerns about blood-borne infections. In recent years, bloodless surgery has been performed successfully in many procedures, and is therefore of increasing interest in orthognathic surgery. Methods Ten Jehovah's Witnesses who visited our bloodless surgery center for orthognathic surgery participated in this study. To maintain hemoglobin (Hb) levels above 10 g/dL before surgery, recombinant erythropoietin (rEPO) was subcutaneously administered and iron supplements were intravenously administered. During surgery, acute normovolemic hemodilution (ANH) and induced hypotensive anesthesia were used. To elevate the Hb levels to >10 g/dL after surgery, a similar method to the preoperative approach was used. Results The 10 patients comprised three men and seven women. Their average Hb level at the first visit was 11.1 g/dL. With treatment according to our protocol, the average preoperative Hb level rose to 12.01 g/dL, and the average Hb level on postoperative day 1 was 10.01 g/dL. No patients needed a blood transfusion, and all patients were discharged without any complications. Conclusions This study presents a way to manage patients who refuse blood transfusions while undergoing orthognathic surgery. rEPO and iron supplementation were used to maintain Hb levels above 10 g/dL. During surgery, blood loss was minimized by a meticulous procedure and induced hypotensive anesthesia, and intravascular volume was maintained by ANH. Our practical approach to orthognathic surgery for Jehovah's Witnesses can be applied to the management of all patients who refuse blood transfusions.
The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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v.31
no.1
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pp.71-80
/
2018
Objectives : The purpose of this study is to evaluate the clinical aspects of patients with Soyangin vitiligo. Methods : This clinical investigation was made with 148 Soyangin Vitiligo patients who visited Haneulmaeum Oriental Medicine Clinic (Incheon) from July 1st 2007 to June 30th 2017. Results & Conclusions : 1. There were 73 males(49.3%) and 75 females(50.7%). 2. The Mean age at the first visit was 36.1 years(male: 36.4, female: 35.8). 3. The Mean age of onset was 27.9 years(male: 28.6, female: 27.4). 4. The mean duration of the disease was 8.0 years(male: 7.8, female: 8.3). 5. Of the 148 patients, 41(27.7%) had the symmetric lesions and 107(72.3%) had the asymmetric vitiligo lesions. Of the patients with asymmetric vitiligo lesions, 46(31.1%) had the localized lesions and 26(17.6%) had the segmental lesions and 35(24.3%) had the multiple lesions. 6. The most common site of initial involvement of the vitiligo was the face (39.2%). 7. The most common site of the vitiligo lesions was the face(49.3%). 8. Familial history was obtained in 12 patients(8.1%). 9. There was no known precipitating factor in most cases(89.4%). 10. Thyroid disease was the most common associated disease. 11. The progression of vitiligo was present in 92 patients(62.2%).
The purpose of this study was to investigate the effect of the characteristics of patients who underwent spinal nerve block on the fear of injection and the risk of radiation. Subjects were 137 patients (67 males, 70 females) who visited the Department of Anesthesiology and Pain Medicine in Cheongju. The method was conducted as a research study using a total of 28 questionnaires consisting of patient characteristics, experience characteristics of nerve block surgery, nerve block fear scale, and radiation risk perception scale. The reliability of the questionnaire response was secured with a Cronbach's alpha coefficient of 0.6 or higher. For statistical analysis, correlation was tested by descriptive statistics, frequency analysis, independent sample T-test, and Pearson and Spearman correlation coefficients by measurement scale and factor. As a result, the fear scale of nerve block was significantly higher in women than in men (p<0.05). The fear scale of nerve block injection was significantly higher in the first-visit patients than in the second-visited patients (p<0.05). However, there was no significant difference among all variables in radiation risk perception. In conclusion, patients undergoing spinal nerve block were more aware of the fear of injection than the risk of radiation exposure during the procedure.
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