• Tuberculosis and Respiratory Diseases
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• v.48 no.3
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• pp.357-364
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• 2000

Background : Complicated exudative pleural fluid collections have traditionally been treated by either closed tube thoracostomy drainage or by open surgical drainage. Complete drainage is important in order to control pleural sepsis, restore pulmonary function, and entrapment. Recently intracavitary fibrinolytic therapy has been advocated as a method to facillitate drainage of complicated exudative pleural effusion and to allow enzymatic debridemant of the restrictive fibrinous sheets covering the pleural surface. The purpose of this study is to prospectively evaluate the effects of image-guided catheter drainage with high dose urokinase(UK) instillation in the treatment of complicated pleural effusions. Patients : Twenty complicated pleural effusion patients that poorly respond to image-guided drainage were allocated to receive UK. There were 8 pneumonia and 12 tuberculosis. Methods : Drugs were diluted in 250 mL normal saline and were infused intrapleurally through the chest tube or pig-tail catheter in a daily dose of 250,000 IU of UK. Response was assessed by clinical outcome, fluid drainage, chest radiography, pleural ultrasound and/or computed tomography. Results : The mean UK instillation time was $1.63{\pm}0.10$. The mean volume drained UK instillation was $381.3{\pm}314.4\;mL$, and post-UK was $321.6{\pm}489.5\;mL$. The follow up duration after UK therapy was mean $212.9{\pm}194.5$ days. We had successful results in 19 cases (95.0%). There were 12 pleural thickenings (60.0%), 2 markedly decreased effusions (10.0%) and 5 cases of no thickening or effusion. There was recurrence after treatment in only one patient(5%) with complicated pleural effusiondue to tuberculosis. Conclusions : Image-guided drainage with high dose UK instillation (250,000 U/day) in complicated pleural effusion is a safe and more effective method than closed thoracostomy drainage. And this management, in turn, can obviate surgery in most cases.

• Journal of dental hygiene science
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• v.13 no.4
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• pp.501-509
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• 2013

The purpose of the study is to confirm the effect of the oral health management program in exemplary kindergartens for prevent the dental caries. The study performs the survey on the parents about the changes in the oral health behaviors after the oral health education in April 2012 and measures the patient hygiene performance (PHP) index before the education, after the education and 3 weeks after the education to assess the removal capability to plaque on the teeth surface for the children. The analysis is performed on 130 people who join the program and respond the survey. There is no change in the behavior related to the tooth brushing of children after the oral health education. No change is found from the interest in the oral health education (p>0.05) but the recognition in the importance of the tooth positively change, as well as recognition of the tooth brushing method and the reaction to recommending to tooth brushing. The PHP index of children is significantly improved from 3.87 before the education through 2.71 after the education and 3.27 3 weeks after the education (p<0.001). The observation from the patents shows that their children have interest in preventing the cavities including 33.1% after having xylitol and 60.7% after the oral health education. In conclusion, the study confirms the effect of the oral health management program in exemplary kindergartens to prevent the cavities, meaning that it is required to activate the programs and keep implementing the programs including providing xylitol and education for teachers, parents and children to habituate the oral health behavior of the children and completely learn toothbrushing method under continuous management and reeducation.