Purpose: The aim of this study was to report seven cases of metallic radial head prosthesis and present the limit of use in Korea. Materials and Methods: Metallic radial head arthroplasty was performed on 7 patients between April 2006 and December 2006, who had complex elbow injury including comminuted radial head fracture. Indication, operative findings and outcome were assessed. Availability and payment of implant were investigated. Results: All of the patients had more than one associated injury including coronoid fracture, olecranoan fracture, and ligament ruptures. According to Mason classification, there were three type III and four type IV fractures. All radial head fractures were too comminuted to reconstruct. There were two excellent results, four good, and one poor, as graded by Mayo score. There were no patient with instability and implant related complications. Insufficient supply of implant did not enable to do scheduled surgery in 2 cases. Current medical insurance did not cover charge for radial prosthesis, five patients could not help paying for that by themselves. Conclusion: Metallic radial head implants are useful when the radial head cannot be repaired reliably. Preoperative preparing and coverage by medical insurance based on appropriate indication are helpful for decision for a treatment option.
Finger injuries are becoming more common with the increasing use of mechanical industrial and household appliances. Among the hand injuries, amputation is the serious disaster to the patient. Recently, application of microsurgical technique to the reattachment of ampuatated digits has been common clinical procedures. We performed microsurgical replantation to the 75 patients with 102 digits from march in 1986 to february in 1988. The following results were obtained. 1. The most common age distribution was third decade and male to female ratio was about 5:1. 2. The ratio of right to left hand was about 1:1 but the dominant to non-dominant hand was about 2:1. 3. The index finger was most commonly injured and the next was middle finger. 4. The most common type of the injuries was the crushing injury and the most common vector was a kind of pressor. 5. The anesthesia was performed in equal ratio between the general and regional anesthesia. 6. The survival rate of microreplantation to the injuries of the zone II was 77.8% and zone III was 80%. 7. The functional result after replantation at zone II was better than zone III. 8. Microreplantation was performed in any case of the type of the injury, the severity of crushing and the ischemic time, and the patients requirement was an important factor.
Park, Kyung Eui;Kim, Sung Ah;Kang, Moon Joo;Kim, Hee Sun;Cho, Sung Im;Yoo, Kyoung Won;Kim, So Yeon;Lee, Hye Jun;Oh, Sun Kyung;Seong, Moon-Woo;Ku, Seung-Yup;Jun, Jong Kwan;Park, Sung Sup;Choi, Young Min;Moon, Shin Yong
Clinical and Experimental Reproductive Medicine
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v.40
no.1
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pp.42-46
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2013
Hypochondroplasia (HCH) is an autosomal dominant inherited skeletal dysplasia, usually caused by a heterozygous mutation in the fibroblast growth factor receptor 3 gene (FGFR3). A 27-year-old HCH woman with a history of two consecutive abortions of HCH-affected fetuses visited our clinic for preimplantation genetic diagnosis (PGD). We confirmed the mutation in the proband (FGFR3:c.1620C>A, p.N540K), and established a nested allele-specific PCR and sequence analysis for PGD using single lymphocyte cells. We performed this molecular genetic analysis to detect the presence of mutation among 20 blastomeres from 18 different embryos, and selected 9 embryos with the wild-type sequence (FGFR3:c.1620C). A successful pregnancy was achieved through a frozen-thawed cycle and resulted in the full-term birth of a normal neonate. To the best of our knowledge, this is the first report of a successful pregnancy and birth using single-cell allele-specific PCR and sequencing for PGD in an HCH patient.
Background: The purpose of this study was to evaluate the potential association of five (p.P47S, p.R72P, PIN3 Ins16bp, p.R213R and r.13494g>a) polymorphisms of TP53 with the risk of developing breast cancer in North Indian Punjabi population. Methods: We screened DNA samples of 200 sporadic breast cancer patients (197 females and 3 males) and 200 unrelated healthy, gender and age matched individuals for the polymorphisms. Results: For the p.P47S polymorphism, we observed the PP genotype in 99.5% of the patients and PS genotype in only 1 patient. All the controls had the wild type PP genotype. The frequency of RR, RP and PP genotype of p.R72P was 23.5% vs 33.5%, 51.5% vs 45.5% and 25% vs 21% in patients and controls respectively. Heterozygous (RP) genotype was increased in breast cancer patients as compared to controls (51.5 vs 45.5%) and showed 1.61 fold significantly increased risk for breast cancer (OR=1.61, 95% CI, 1.01-2.58, p=0.04). In breast cancer patients the frequencies of A1A1, A1A2 and A2A2 genotypes of PIN3 Ins16bp polymorphism were 67%, 26% and 7% respectively whereas in controls the genotype frequencies were 68.5%, 27.5% and 4% respectively, with no significant difference. For p.R213R (c.639A>G), all individuals had homozygous wild type genotype. The frequencies of GG, GA and AA genotypes of TP53 r.13494g>a polymorphism were 62 vs 67.5%, 33 vs 28% and 5 vs 4.5% in patients and controls respectively, again without significant difference. We observed that RP-A1A1 genotype combination of p.R72P and PIN3 Ins16bp and RP-GG combination of p.R72P and r.13494g>a polymorphism showed significant risk of breast cancer (OR=1.65, 95%CI: 0.98-2.78, p=0.05; OR=1.72, 95%CI: 1.01-2.92, p=0.04). Conclusion: The results of present study indicated that among the five TP53 polymorphisms investigated, the p.R72P polymorphism, and the RP-A1A1 and RP-GG genotype combination contribute to breast cancer susceptibility in North Indians.
This descriptive study was done to identify the relationship between coping style and trait anxiety in patients undergoing cardiac catheterization. The subjects selected were 69 patients who were scheduled for cardiac catheterization in S hospital from , November 1st, 1994 to May 30th, 1995. Data collection was done using Spielberger's Trait Anxiety Scale, Bendig's Short Form of the Manifest Anxiety Scale, Crowne & Morlowe's Social Desirability Scale, Millers Behavioral Style Scale, Information Subscale of Krantz Health Opinion Survey and Visual Analog Scale about informaton seeking behavior. The summary of the findings is as follows : 1. No significant relationship was found between the general characteristics of age, sex, marital status, level of education and occupation, and the variables coping style and trait anxiety. 2. The mean of trait anxiety scores for the Spielberger Scale was 46.68. It is slightly above average. The subjects were classified as to personality type: truely low anxious 25 (36.2%), highly anxious 25 (36.2%), and repressing 16 (23.2%), using a combination of scores from the Bendig Short Form Anxiety Scale and the Crowne Marlowe Social Desirability Scales. 3. No significant relationship was found between Spielberger s trait anxiety and Bendig's personality type. 4. Each subject's preference for either monitor or blunter coping strategy was assessed via the Miller Behavioral Style Scale. The proportion of Monitors (47.8%) and Blunters (52.2%) among the subjects were similar. The means of preference for information measured on the Krantz's subscale and Visual Analog Scale were 4.18, 80.79 respectively. Because these scores appeared above average, subjects tended to be higher seeker an information rather than avoiding it. 5. There was no significant relationship between Miller's Behavioral Style and Spielberger's trait anxiety. 6. There was no significant relationships between Bendig's personality types. and the preference on information of Krantz's and Visual Analog Scale. and Miller's Behavioral Styles. But 56.0% of the subjects who were highly anxious used Monitor strategy for coping. Findings from the current study do not permit any relationship inferences between coping style and trait anxiety. Patients undergoing cardiac catheterization must receive interventions on stress reduction because the cardiac 'catheterization creats a situation of psychological stress. Therefore, the nursing intervention of providing information about cardiac catheterization have to be given based on each patient's coping style and on their trait anxiety.
BACKGROUND/OBJECTIVES: Type 2 Diabetes mellitus (T2DM) is a hereditary disease that is also strongly dependent on environmental factors, lifestyles, and dietary habits. This study explored the relationship between lifestyle habits and glycosylated hemoglobin management in T2DM patients to provide empirical outcomes to improve T2DM management and patient health literacy. SUBJECTS/METHODS: This study enrolled 349 diabetic patients with more than 5 care visits to a Diabetes Mellitus care network under the Health Management Plan led by Taiwan Department of Health (DOH). Based on relevant literature, an Outpatient Record Form of Diabetes Mellitus Care was designed and lipid profile tests were conducted for data collection and analysis. RESULTS: When modeling the data, the results showed that the odds for HbA1c > 7.5% in T2DM patients duration over 10 years was 3.785 (P = 0.002) times that in patients with disease duration of fewer than 3 years. The odds of HbA1c > 7.5% in illiterate patients was 3.128 (P = 0.039) times that in patients with senior high school education or above. The odds of HbA1c > 7.5% in patients with other chronic illness was 2.207 (P = 0.019) times that in participants without chronic illness. Among 5 beneficial lifestyle habits, the odds of HbA1c > 7.5% in patients with 2 or 3 good habits were 3.243 (P = 0.003) and 3.424 (P = 0.001) times that in patients with more than 3 good habits, respectively. CONCLUSION: This empirical outcome shows that maintaining a good lifestyle improves T2DM management and patients' knowledge, motivation, and ability to use health information. Patients with longer disease duration, education, or good lifestyle habits had optimal HbA1c management than those in patients who did not. Thus, effective selfmanagement and precaution in daily life and improved health literacy of diabetic patients are necessary to increase the quality of T2DM care.
Journal of rehabilitation welfare engineering & assistive technology
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v.5
no.1
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pp.1-10
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2011
Our study is to verify validation of exercise effect that developing exercise and rehabilitation instrument using pneumatic actuators available rehabilitation and healthcare, while at the same time safer and more convenient for the user to select the desired exercise. Shares subject to the usual exercise is conducted in less than a week in the knee extension and flexion at the undergraduate level there is no more than 10 of the 20 patients were female. Subject performed knee exercise 3 set a day with 12times a set using fluid type exercise instrument and pneumatic exercise instrument that build in this study. Experiment has progressed in 4-weeks with 3-days a week. Our exercise load consist of two type. One is active exercise load with developed instrument in our study and the other one is passive exercise load with fluid instrument. Exercise program based on real-time muscle activation patterns and muscle activity before and after exercise by comparing the effects of exercise for rehabilitation has been verified. The results showed that muscular activity is higher in active exercise load than passive load, and improvement of muscle strength more increased too. Equipment more user-centered exercise more effectively exercise may enhance muscle strength was found. This study can adapt rehabilitation program and exercise for patient and weaker. Also our system can provide easily and convenient prescription of rehabilitation for expert related rehabilitation.
Background: Implants are becoming the first choice of rehabilitation for tooth loss. Even though they have a high success rate, failures still occur for many reasons. The objective of this study is to analyze the reasons for recurring failure at the same site and the results of re-implantation. Methods: Thirteen patients (11 males and 2 females, mean age 60 ± 9.9 years) who experienced implant surgery failure at the same site (same tooth extraction area) two or more times in the Department of Oral and Maxillofacial Surgery, Seoul National University Bundang Hospital, between 2004 and 2017 were selected. The medical records on a type, sites, diameter, and length of implants; time and estimated cause of failure; and radiographs were reviewed. Data were collected and analyzed retrospectively, and the current statuses were evaluated. Results: A total of 14 implants experienced failure in the same site more than two times. Twelve implants were placed in the maxilla, while 2 implants were placed in the mandible. The maxillary molar area was the most common site of failure (57.1%), followed by the mandibular molar, anterior maxilla, and premolar areas (14.3% each). The first failure occurred most commonly after prosthetic treatment (35.7%) with an average period of failure of 3.8 months after loading. Ten cases were treated as immediate re-implantation, while the other 4 were delayed reimplantation after an average of 3.9 months. The second failure occurred most commonly after prosthetic treatment (42.9%), with an average of 31 months after loading; during the healing period (42.9%); and during the ongoing prosthetic period (14.3%). In 3 cases (21.4%), the treatment plan was altered to an implant bridge, while the other 11 cases underwent another implant placement procedure (78.6%). Finally, a total of 9 implants (64.3%) survived, with an average functioning period of 60 months. Conclusions: Implants can fail repeatedly at the same site due to overloading, infection, and other unspecified reasons. The age and sex of the patient and the location of implant placement seem to be associated with recurring failure. Type of implant, bone augmentation, and bone materials used are less relevant.
This study was performed to invetigate the relationship between clinical manifestations related to temporomandibular joint sounds and temporomandibular joint vibrations that occurred synchronously with sounds. There have been reported in many articles that joint sounds indicate internal joint pathology. Therefore, it is necessary to evaluate type and patterns of joint sounds, and radiographic changes of temporomandibular joint(TMJ) in order to diagnose and deal with the Temporomandibular Disorders(TMD). For this study 142 patients with TMDs were collected and they were examined by routine diagnostic procedure for TMDs. The author classified TMJ sounds clinically into 3 types : click, popping, and crepitus. Transcranial and panoramic radiographs were taken for observein bony changes of TMJ, and for observing vibrations of TMJ Sonopak of Biopak system was used. The obtained results were as follows : 1. Female subjects with crepitus were older than those with click or popping and their mean ages were about 45 years old. But in male subjects, there was no age difference. 2. For all subjects, mean value of maximal mouth opening were above 40mm, which are lower limit of normal vertical opening. But in subjects with L-type opening deviation, mouth opening capacity were about 36mm of range. 3. Symptom duration stated when patient presented first were slightly longer in subjects with crepitus but there were no statistical differences. And there were also no radiographic differences among 3 types of joint sounds in regard to symptom duration. 4. In subjects wih click, it might have been interpreted that 12% had closed lock, 12% had degenerative joint disease, and about 17% of he subjects had normal joints by Sonopak. 5. There were no significant relationships between subjective loudness of joint sounds and magnitude of joint vibrations. 6. The highest value of Integral and peak amplitude were observed in popping sounds and though it was not significant, value of peak frequency was highest in crepitus. 7. Amount of mandibular positional change were differed between click and crepitus on frontal plane, between click, crepitus and popping on horizontal plane in rotational movement, respectively. However, there no difference among them in translational movements.
A dental treatment room is always exposed to diverse kinds of pathogenic bacteria, and may be a mediating place of cross-infection given being contaminated the interior of a room through several routes in the form of patient's secretion and aerosol. The main agent of preventing cross-infection is a dental hygienist in the dental treatment and the dental treatment room where are scattered about a risk of cross-infection. A dental hygienist needs to have right recognition on infection control before being active as a clinical expert. This infection-control recognition level is influenced from the clinical practice. Accordingly, to survey recognition of infection control, a self-administered questionnaire research was conducted targeting 314 students who are fixed the clinical practice as regular subject in the junior course out of curriculum for the Department of Dental Hygiene at some of 4-year universities. Data collection was performed from December 9, 2011 to February 22, 2012. Except 11 copies of questionnaire with insincere response among the collected materials, 303 copies were finally analyzed by using SPSS WIN 20.0. The following conclusions were obtained. In the infection disease section, both on and off campus showed 4.89 points from 'the importance of recognizing the infections prevention', 4.65 points from 'recognizing the compulsory preventative injection for hepatitis type B', 4.77 points from 'recognizing the necessity of the preventative injection for hepatitis type B', 4.71 points from 'whether practice the prevention in reality or not', and 4.76 points from 'the educational helps to the prevention'. In other words, the section recorded the highest and meaningful points. It is considered to be needed the development in systematic and diverse infection-control educational programs and the differentiated education depending on school year for dental hygiene students.
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