• Journal of Korean Neurosurgical Society
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• 제66권2호
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• pp.199-204
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• 2023

It is critical to identify the ruptured cerebral arteriovenous malformations (AVMs) for secondary prevention. However, there are rare cases unidentified on the radiological evaluation. We report on a patient with the delayed appearance of radiologically occult AVM as a probable cause of the previous intracerebral hemorrhage (ICH). An 18-year-old male patient presented with a right temporal ICH. The preoperative radiological examination did not reveal any causative lesions. Because of the intraoperative findings suggesting an AVM, however, only hematoma was evacuated. Disappointedly, there were no abnormal findings on postoperative and follow-up radiographic examinations. Eleven years later, the patient presented with an epileptic seizure, and an AVM was identified in the right temporal lobe where ICH had occurred before. The patient underwent partial glue embolization followed by total surgical resection of the AVM and anterior temporal lobe. Based on the literature review published in the era of magnetic resonance imaging, common clinical presentation of radiologically occult AVMs included headache and seizure. Most of them were confirmed by pathologic examination after surgery. In cases of the ICH of unknown etiology in young patients, long-term follow-up should be considered.

• Restorative Dentistry and Endodontics
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• 제47권3호
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• pp.26.1-26.10
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• 2022

Wegener's granulomatosis (WG) is a condition with immune-mediated pathogenesis that can present oral manifestations. This report describes the case of a patient diagnosed with WG 14 years previously, who was affected by persistent pain of non-odontogenic origin after successful endodontic treatment. A 39-year-old woman with WG was diagnosed with pulp necrosis and apical periodontitis of teeth #31, #32, and #41, after evaluation through a clinical examination and cone-beam computed tomography (CBCT). At the first appointment, these teeth were subjected to conventional endodontic treatment. At 6- and 12-month follow-up visits, the patient complained of persistent pain associated with the endodontically treated teeth (mainly in tooth #31), despite complete remission of the periapical lesions shown by radiographic and CBCT exams proving the effectiveness of the endodontic treatments, thus indicating a probable diagnostic of persistent pain of non-odontogenic nature. After the surgical procedure was performed to curette the lesion and section 3 mm of the apical third of tooth #31, the histopathological analysis suggested that the painful condition was likely associated with the patient's systemic condition. Based on clinical, radiographic, and histopathological findings, this unusual case report suggests that WG may be related to non-odontogenic persistent pain after successful endodontic treatments.

• 한국간호교육학회지
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• 제29권4호
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• pp.427-439
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• 2023

Purpose: This study aimed to evaluate the effects of a nursing education program for hyperglycemia patient care using standardized patients. Methods: This study used a nonequivalent control group pre-test and post-test non-synchronized design. A total of 50 senior university nursing students who had completed an adult nursing course participated in this study (experimental group, n=24; control group, n=26). This nursing education program was developed according to the stages of analysis, design, development, implementation, and evaluation. The collected data were analyzed using χ² -test, Fisher's exact test, independent t-test, paired t-test, and repeated measure ANOVA. Results: Significant differences were shown between the experimental and control groups in clinical performance ability (F=277.41, p<.001), communication skills (F=47.18, p<.001), self-efficacy (F=3.81, p=.031), and learning satisfaction (t=2.25, p=.033). Problem-solving ability was not statistically significant between the groups. Conclusion: The nursing education program for hyperglycemia patient care using standardized patients was effective in improving nursing students' clinical performance ability, communication skills, and learning satisfaction. Therefore, it is proposed that the education program developed in this study be used as part of an education program to enhance nursing students' abilities in caring for hyperglycemia patients.

• 대한방사선기술학회지:방사선기술과학
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• 제46권6호
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• pp.501-508
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• 2023

This study used a adult absorption dose phantom (CIRS model 701-G, USA) made of human equivalent material and the vascular imaging equipment Allura Xper FD 20 (Philips, Netherlands). Optically stimulated luminescent dosimeters (OSLD) were inserted into the anatomical positions corresponding to each organ, and the exposure dose was measured. Dose area product (DAP) and air kerma (AK) measured by the dose meter in the equipment were compared. Continuous imaging was performed at two angles for a total of 20 minutes, with a frame per seconds of 3.75 and 7.5 fps and an FOV of 42 cm, 37 cm, and 31 cm, respectively, under the conditions of fluoflavor I, II, and III, each selected for 5 repetitions. This study was found that selecting a lower fps was the most effective way to reduce patient exposure dose, and adjusting the fluoflavor was a good alternative method for reducing patient exposure dose at high fps. Therefore the method of condition change with the greatest dose reduction effect is to set the minimum FPS and can reduce patient exposure dose according to geometric conditions and fluoflavor characteristics.

• 동의신경정신과학회지
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• 제34권4호
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• pp.453-461
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• 2023

Objectives: Major depressive disorder is a severe disease that is associated with suicidal ideation and behavior. In this case, Korean medicine psychotherapy and Korean medicine treatment were used to treat an adolescent patient with major depressive disorder. Methods: The Beck Depression Inventory, Reynolds Suicidal Ideation Questionnaire, and Crisis Triage Rating Scale were used as psychological evaluation scales. Korean medicine psychotherapy focuses on Giungoroen-therapy and IiGyeungByunQi-therapy and Korean medicine treatment combined with acupuncture, moxa, and herbal medicine. Results: Comparison before and after treatment showed improvement in clinical symptoms, Beck Depression Inventory, Reynolds Suicidal Ideation Questionnaire, and Crisis Triage Rating Scale. Conclusions: As a result of applying Korean medicine, psychotherapy and Korean medicine treatment reduces to an adolescent patient with major depressive disorder, depression, suicidal thoughts, and suicidal behavior.

• 동의신경정신과학회지
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• 제34권4호
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• pp.473-485
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• 2023

Objectives: The purpose of this study was to report the effectiveness of the combination of Korean medicine therapy on elderly patients with delirium due to overdose of sedative-hypnotics. Methods: The patient was diagnosed with delirium, which occurred after an overdose of sedative-hypnotics. The patient received Korean Medicine treatment, including herbal medicine, acupuncture, moxibustion and psychotherapy, and other treatments. The evaluation variables to check the effectiveness of the interventions were the Korean Version of the Delirium Rating Scale-Revised-98 (K-DRS-R-98) Mini-Mental State Examination-Korean (MMSE-K) Clinical Dementia Rating (CDR) and Manual Muscle Test (MMT). Results: During the hospitalization period, the K-DRS-R-98 score decreased from 31 to 4, MMSE-K score increased from 18 to 26. CDR score decreased from 2 to 0. MMT in the Right lower extremity was improved. Normal daily activities were possible. Conclusions: Combining Korean Medicine treatments, including herbal medicine, acupuncture, moxibustion, psychotherapy, and other treatments, may help alleviate delirium.

• Archives of Plastic Surgery
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• 제37권2호
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• pp.195-198
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• 2010

Purpose: The zygoma is a key element which composes the facial contour. Zygomatic fracture induces facial asymmetry. We use radiologic evaluation or inspections mainly for identification of symmetry after reduction depressed zygomatic fracture. But the disadvantages of such methods are time-consuming and complicated process. So we tried to develop a new testing method with a ruler and a level. Methods: In unilateral depressed zygomatic fracture patient, parallel to the patient's head to make sure lay horizontaly. Put the leg of a ruler on the malar eminence so that it is at the same distance from the facial midline. Then take the level of malar eminence as put the level above the ruler. This process was performed before and after the reduction. Results: We were able to fix with plate and screw after checking the results of reduction fast and easily. Good results were obtained at post-operative radiologic evaluation. Conclusion: We can easily get the ruler and level around life. This method is not only simple but also shorttime process compared with other method-radiologic evaluation or inspection. And the operator can explain the results to the patients easily and objectively. Authors obtained the good results with this new method, and would introduce it for another method of identifying the result of reduction in depressed zygomatic fractures.

• Archives of Plastic Surgery
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• 제33권2호
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• pp.233-236
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• 2006

Merkel cell carcinoma is rare skin malignancy originated from epidermal mechanoreceptor of neural origin. The tumor usually affects older individuals at sun exposed area such as head, neck and extremity. Subclinical involvement of regional lymph node is reported frequently at the time of initial treatment. Thus even asymptomatic patients who present with clinically localized tumor should undergo evaluation with computed tomography and lymphangiography. Positron emission tomography(PET) scans can imaging the metabolic difference of malignant tumors. Increased glucose uptake of malignant tumor cells are detected by PET scanner. PET scans can provide qualitative and quantitative informations about systemic metastasis of tumors. Although there are no data that define the efficacy of PET scans in the initial diagnostic evaluation of head and neck cancer, they could be considered. Current standards of treatment of Merkel cell carcinoma is wide surgical excision and regional lymphadenectomy if there are suspicious lymph nodes. The author reported a patient with Merkel cell carcinoma of cheek. Wide surgical excision and postoperative PET/CT was done for evaluation of regional lymph node and distant metastasis. There were two hot-uptakes in patient's neck, so they were considered as metastatic node, but finally they were proved to be tuberculosis lymphadenitis after excision.

• Journal of Korean Dental Science
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• 제13권2호
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• pp.43-51
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• 2020

Purpose: The practical examination portion of the National Dental Licensing Examination (NDLE) is slated to be administered in the latter half of 2021 in the form of a clinical performance examination that comprehensively evaluates the patient-dentist interaction using standardized patients (SPs). The SPs should be equipped with the basic qualities and capacity as evaluators for a fair and reliable administration of the test. Materials and Methods: In this study, we analyzed the existing training materials for SPs who participated in domestic and overseas practical tests for the development of training materials for SPs through seminars and surveys of 11 dentistry schools and colleges. Result: First, SPs should be selected according to the basic quality criteria and capacity, which they must possess, and the preliminary basic training about the details which they must have knowledge of and be provided through videorecorded cases before the implementation of the preliminary field training. Second, the roles of SPs and the calibration process of the evaluation result forms are needed when conducting the preliminary field training for SPs. After watching video-recorded scenario cases, the SPs participate in discussions about the watched videos before proceeding to calibration practices of evaluation result forms. Third, because the Type A questionnaire of the practical examination of the NDLE is dependent on the SPs' capacity and training, the fairness of the practical test is largely dependent on the SPs. Therefore, practicing the roles as evaluators and evaluation training should be provided using practical test items that can improve the reliability of the test and show a high level of reproducibility about the same case. Conclusion: The findings of this study will be utilized for the development of training materials for SPs, so they can participate in the administration of a fair and reliable practical examination of the NDLE.

• 대한물리의학회지
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• 제19권1호
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• pp.95-105
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• 2024

PURPOSE: This study aimed to utilize the International Classification of Functioning, Disability, and Health (ICF) tool to identify a problem list and explore intervention effects using proprioceptive neuromuscular facilitation (PNF) for improving the crosswalk performance of patients who have undergone a bilateral hip arthroplasty. METHODS: The subject of this study was a 43-year-old male who had undergone a bilateral hip arthroplasty. To address the subject's functional status, a clinical decision-making process was carried out in the order of examination, evaluation, diagnosis, prognosis, intervention, and outcome. Patient information during the examination was collected using the ICF core set. The evaluation involved listing the items of each problem using the ICF assessment sheet and identifying the interaction between activity limitations and the impairment level. The diagnosis explicitly described the causal relationships derived from the evaluation using ICF terminology. The prognosis presented activity goals, body function, and structured goals in terms of the activity and participation levels that needed to be achieved for an individual's functional status. The intervention approached problems through the four components of the PNF philosophy, namely basic principles and procedures, techniques, and patterns, in an indirect-direct-task sequence. Results were compared before and after the intervention using the ICF evaluation display. RESULTS: The results of the study showed that the primary activity limitation, which was the walking time across the crosswalk, showed improvement, and the trunk's counter rotation and the weight-bearing capacity of both the lower limbs, which were impairment level indicators, were enhanced. CONCLUSION: This study suggests that PNF intervention strategies will serve as a positive approach for improving crosswalk walking in patients with bilateral hip arthroplasty.