• Title/Summary/Keyword: Types of surgery

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Comparing Quality of Life following Liver Transplantation for Cadaveric versus Living Donor Liver Transplant Recipients: A Single-Center Study (사체간이식 환자와 생체간이식 환자들의 삶의 질 비교 연구)

  • Kim, Gum Hi;Yoon, Seok-Jun;Ahn, Hyeong-Sik;Lee, Jun-Young;Park, Hyeung-Keun;Suh, Kyung-Suk
    • Quality Improvement in Health Care
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    • v.11 no.1
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    • pp.32-45
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    • 2004
  • Objective : The aim of this study were to measure quality of life(QOL) in liver transplant recipients, to compare QOL between living donor liver transplant recipients and cadaveric liver transplant recipients and to investigate whether SF-36 may be used as a disease-specific instrument in liver transplant recipients. Methods : We conducted a single-center cross-sectional study of 133 LT recipients ages 13 to 65 years, all of whom had had Liver Transplantation(LT) at least 1 months previously. QOL was assessed using a self-completion questionnaire consisting of the Bang Whal Ran(1991) instruments and the 36-Item Short-Form Health Survey(SF-36) health status profile measure. We investigated whether the SF-36 instrument may be used as a disease-specific instrument in LT recipients. Individual scale scores range from 0 to 100, with higher score reflecting better health. Data on demographics, clinical status at pre transplantation 1 day, post transplantation clinical status, and graft function were collected to identify predictors of post transplantation QOL. Results : Standard measures for test-retest reliability, internal consistency, and discriminant and concurrent validity were examined. The reliability of the SF-36, as measured by test-retest correlation(Pearson coefficients: 0.729, p=0.002) and by internal consistency(Cronbach's alpha: 0.9431) exceeded conventional acceptability criteria. The correlation between domain scores of SF-36 and the Bang Whal Ran(l991) was clear and logical in that the clinical characteristics of SF-36 strongly correlated with the clinical component summary score of the Bang Whal Ran(l991)(r = 0.8155, P<.01). SF-36 scale scores were compared between Cadaveric Liver Transplant recipients and Living Donor Liver Transplant recipients. Donor types of post LT did not influence HRQOL(p>0.05). 87% of the liver transplant recipients were satisfied to get LT. Satisfaction of post LT showed significantly greater HRQOL(p<0.001). Conclusion : SF-36 is found reliable and valid. This study indicates thet Donor Type did not influence HRQOL after LT. The information gained from this study will help us to better define expectations and the clinical course after liver transplantation to patients and their families.

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Study of the Amount and Share of Drug Cost in the Total Medical Fee under Medical Insurance Scheme (의료보험(醫療保險) 의약품(醫藥品)의 요양취급기관(療養取扱機關) 종별(種別), 약효군별(藥效群別), 상병별(傷病別) 사용(使用)에 관(關)한 조사연구(調査硏究))

  • Lee, Chu-Won;Hahn, Oh-Surk
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.2 s.26
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    • pp.223-235
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    • 1989
  • To grasp the idea about how drugs are used under Medical Insurance Scheme, the amount and share of drug cost in the total medical fee have been reviewed and analyzed for different types of patients (in-patient out-patient), medical institutions and frequently seen diseases and following findings were revealed. In 1986, drug cost took 32.78% of total medical fee for in-patients and 32.98% for out-patients averaged over 30% share as a whole. When drug cost per case in 1980 be indexed to 100, it has shown steady growth to become 200 for in-patients and about 150 for out-patients in 1986. The contribution of drug cost to the total medical fee is, regardless of patient type-in-patients and out-patients, the highest in University hospitals and followed by General hospitals, Hospitals and Clinics in decending order That for the most frequent 10 diseases came out the highest,79 a with the essential benign hypertension of out-patients in the General hospitals, 61% for the gastric ulcer of out-patients in Hospitals and 33% for the female genital diseases of out-patients in Clinics. The drug cost of oral formula was contributed the most, 7.93% by cardiovascular agents followed by hepatic detoxicants(5.47%) and out-patients(4.93%), and that of injectable formula was contributed the most by antibiotics(24.17%), followed by protein amino-acid preparations(6.19%). The order of drug usage by specialty for the in-patients was the highest with internal medicine followed by general surgery and E.N.T, and that for the out-parients was in the order of Internal medicine, neuropsychology and Ob/Gy. This study revealed that the drug dependency was characteristically different to specialty. In view of the fact that drug cost on average exceeds over 30% of total medical fee, proper drug administration appears to be vitally important for the stabilization of the financial standing of the Medical Insurance Scheme. As a consequence, drug usage guidelines including antibiotics usage shall be established first of all and the voluntary participation for the regulation of drug usage and propagation of the guidelines to medical institutions are strongly coerced.

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A Clinical Usefulness of Office Hysteroscopy (Office Hysteroscopy의 임상적 유용성)

  • Koh, Min-Whan;Lee, Tae-Hyung;Kim, Jeong-Suk;Choi, Yoon-Young;Jeong, Sang-Hoon
    • Journal of Yeungnam Medical Science
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    • v.22 no.1
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    • pp.81-89
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    • 2005
  • Background: Hysteroscopy is considered to be the gold standard not only for visualizing the cervical canal and the uterine cavity, but also for treating many different types of benign pathologies localized to those regions. The advent and evolution of endoscopic imaging and surgery during the last two decades has added new dimensions to the armamentarium of a gynecologist to combat intrauterine lesions. Office hysteroscopy is increasingly being used as a first line investigation for abnormal uterine bleeding and other diseases involving the uterine cavity. The aim of our study is to assess the diagnostic and operative efficacy of office hysteroscopy. Materials and Methods: In our department, 140 patients underwent a hysteroscopy examination and 18 of these underwent an office based hysteroscopy examination from September 1995 to March 2005. The cases who underwent an office based hysteroscopy examination were reviewed in order to assess the clinical usefulness and significance in the management of intrauterine lesions. Results: Major indication was abnormal uterine bleeding(12 cases, 66.7%). The others were a missed IUD and infertility. The hysteroscopic findings were a normal uterine cavity(6 cases, 33.3%), IUD in situ, polyp, submucosal myoma, endometrial hyperplasia and a placenta remnant. Conclusion: Office hysteroscopy is a safe, quick and effective method for making an intrauterine evaluation. In addition, it provides immediate results, offers the capacity of direct targeted biopsies of suspicious focal lesions, and offers the direct treatment of some intrauterine conditions.

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PERIPHERAL ODONTOMA IN A CHILD: CASE REPORT (소아에서 발생한 변연성 치아종의 증례보고)

  • Lee, Young-Ho;Park, Ho-Won;Lee, Ju-Hyun;Seo, Hyun-Woo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.39 no.3
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    • pp.301-305
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    • 2012
  • The odontoma is a hamartoma of odontogenic origin and consists of enamel, dentin, cementum and pulp tissue. Two types of odonotma are histologically recognized: complex and compound. Odontoma may be the cause of noneruptoin or impaction of teeth, formation of cyst and resorption of adjacent bone. The recommended treatment for an odontoma is conservative surgical excision. No propensity for recurrence has been noted. Peripheral odontoma is relatively rare lesion and shows the histological characteristics of an intraosseous odontoma. This report described a 3-year-old Korean girl with a firm gingival mass in the posterior mandibular area, which had been gradually enlarging over 18months. Radiographic examination showed a radiopaque mass but no evidence of underlying intraosseous lesion. Excisional biopsy was performed for the mass removal and histopathological examination. The result of histopathological study was identified as hamartous supernumerary tooth germ. Based on the clinical presentation, radiographic and histopathologic findings, we concluded that the final diagnosis was peripheral odontoma. For three years after surgery, there is no clinical sign of recurrence.

Prognostic Factors and Treatment Outcomes in 93 Patients with Uterine Sarcoma from 4 Centers in Turkey

  • Durnali, Ayse;Tokluoglu, Saadet;Ozdemir, Nuriye;Inanc, Mevlude;Alkis, Necati;Zengin, Nurullah;Sonmez, Ozlem Uysal;Kucukoner, Mehmet;Anatolian Society of Medical Oncology (ASMO), Anatolian Society of Medical Oncology (ASMO)
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.1935-1941
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    • 2012
  • Introduction: Uterine sarcomas are a group of heterogenous and rare malignancies of the female genital tract and there is a lack of consensus on prognostic factors and optimal treatment. Objective and Methodology: To perform a retrospective evaluation of clinicopathological characteristics, prognostic factors and treatment outcomes of 93 patients with uterine sarcomas who were diagnosed and treated at 4 different centers from November 2000 to October 2010. Results: Of the 93 patients, 58.0% had leiomyosarcomas, 26.9% malignant mixed Mullerian tumors, 9.7% endometrial stromal sarcomas, and 5.4% other histological types. According to the last International Federation of Gynecology and Obstetrics (FIGO) staging, 43.0% were stage I, 20.4% were stage II, 22.6% were stage III and 14.0 % were stage IV. Median relapse free survival (RFS) was 20 months (95% confidence interval (CI), 12.4-27.6 months), RFS after 1, 2, 5 years were 66.6%, 44.1%, 16.5% respectively. Median overall survival (OS) was 56 months (95% CI, 22.5-89.5 months), and OS after 1, 2, 5 years was 84.7%, 78%, 49.4% respectively. Multivariate analysis showed that age ${\geq}60$ years and high grade tumor were significantly associated with poor OS and RFS; patients administered adjuvant treatment with sequential chemotherapy and radiotherapy had longer RFS time. Among patients with leiomyosarcoma, in addition to age and grade, adjuvant treatment with sequential chemotherapy and radiotherapy after surgery had significant effects on OS. Conclusion: Uterine sarcomas have poor progrosis even at early stages. Prognostic factors affecting OS were found to be age and grade.

Histological Evaluation of Bioresorbable Threads in Rats (랫드에서의 생분해성 매선요법에 대한 조직학적 분석)

  • Lee, Chang Gun;Jung, Jaeyun;Hwang, Samnoh;Park, Chan Oh;Hwang, Soonjae;Jo, Minjeong;Sin, Min Hi;Kim, Hyun Ho;Rhee, Ki-Jong
    • Korean Journal of Clinical Laboratory Science
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    • v.50 no.3
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    • pp.217-224
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    • 2018
  • Thread lifting has become popular as a minimally invasive technique for facial rejuvenation. Commercially available threads are composed of poly-L-lactic acid (PLLA), polycaprolactone (PCL), or polydioxanone (PDO). However, the histological changes that occur in response to implanted threads are unclear. The aim of this study was to evaluate histological changes that occur in response to implantation with three types of bioresorbable threads (PLLA, PCL, PDO) in rat skin. PLLA, PCL and PDO threads were implanted in the dorsal skin of Sprague Dawley rats and tissue samples were harvested 2, 4, 8 and 12 weeks post-implantation. To evaluate histologic changes induced by bioresorbable face-lifting threads, tissue samples were stained with hematoxylin & eosin, Masson's trichrome stain and Herovici's collagen stain. All three threads induced neocollagenesis of type 3 collagen in the rat skin. The amount of collagen induced by the threads was dependent on the thread surface area. The PDO cavern-type thread was most effective in inducing neocollagenesis due to its extensive surface area. Our results suggest that type 3 collagen induced by bioresorbable threads depends on the thread surface area to uphold the dermis and contributes to facial rejuvenation.

Medical-and-Psychosocial Factors Influencing on the Quality of Life in Patients with Cervix Cancer (자궁경부암환자의 삶의 질에 영향을 미치는 치료관련 및 심리사회적 요인)

  • Chun, Mi-Son;Lee, Eun-Hyun;Moon, Seong-Mi;Kang, Seung-Hee;Ryu, Hee-Sug
    • Radiation Oncology Journal
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    • v.23 no.4
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    • pp.201-210
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    • 2005
  • Purpose: Quality of life in patients with cancer may be influenced by various kinds of variables, such as personal, environmental, and medical factors. The purpose of this study was to identity the influencing factors on the quality of life in patients with cancer. Materials and Methods: One hundred and forty seven patients, who were taking medical therapy or following up after surgery for cervix cancer, participated in the present study. Quality of life, medical variables (cancer stage, types of treatment, follow-up status, and symptom distress), and psychosocial variables (mood disturbance, orientation to life, and social support) were measured. The obtained data were computed using multiple regression analyses. Results: The medical-and-psychosocial variables explained 63.3% of the total variance in the quality of life ($R^2=0.633$ F:16.959, p=.000). Cancer stage, symptom distress, mood disturbance, social support(family), and optimistic orientation to life were significant factors influencing on the quality of life in patients with cervix cancer. Conclusion: An integrative care program which includes medical - and - psychosocial characteristics of patients is essential to improve quality of life in patients with cervix cancer.

The History of CO2 Laser Acupuncture and Moxibustion (CO2 레이저 침구 치료의 역사)

  • Jang, Insoo;Yang, Changsop;Sun, Seungho;Jeong, Minjeong;Han, Changho;Hwang, Eui-Hyoung;Seo, Hyungsik
    • Korean Journal of Acupuncture
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    • v.36 no.1
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    • pp.36-43
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    • 2019
  • Objectives : Carbon dioxide ($CO_2$) laser, a high power laser has been used for pain management, dermatology, and surgery and laser acupuncture and moxibustion as well, since it had been oscillated in 1964 at Bell Telephone Laboratories in the US. The purpose of this study is to investigate the history of $CO_2$ laser acupuncture through reviewing studies published in early stage of laser medicine. Methods : To investigate the early history of $CO_2$ laser acupuncture, studies were searched in the electronic databases, including PubMed, ScienceDirect, CNKI, Wanfang, J-STAGE, CiNii, KTNP, and OASIS, since 1964. Articles in English, Chinese, Japanese and Korean were included, and there were no limitations in literature types such as reviews, essays, clinical trials, animal experiments and veterinary research. Results : We found that the first $CO_2$ laser application to acupoints was done by a research team in Shanghai in 1976. They used $CO_2$ laser for acupuncture treatment and it was also the first laser acupuncture treatment in China. Since the first case report of $CO_2$ laser for leukopenia, it has been applied to various diseases in China, Korea, Japan and other western countries. It has been widely applied in the fields of dentistry and veterinary medicine, as well as clinical applications. Conclusions : Not only $CO_2$ laser can be used as laser acupuncture by stimulating the acupoints and meridians, but also can produce moxibustion effect by using heat stimulus. Therefore, it is expected that it will be used in various clinical fields in the future.

Results of Microvascular Decompression in Hemifacial Spasm (편측안면경련에서 미세혈관감압술의 성적)

  • Kwak, Hyoung Jun;Kim, Jae Hyoo;Lee, Jung Kil;Kim, Tae Sun;Jung, Shin;Kim, Soo Han;Kang, Sam Suk;Lee, Je Hyuk
    • Journal of Korean Neurosurgical Society
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    • v.30 no.4
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    • pp.501-508
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    • 2001
  • Objectives : Hemifacial spasm is painless uncommon disorder characterized by involuntary paroxysmal movement on one side of face. It is known that hemifacial spasm is mainly due to pulsatile compression by vessels at the root exit zone(REZ) of the facial nerve. Microvascular decompression at REZ of the facial nerve has become the standard treatment modality for hemifacial spasm. The authors have analized patients with hemifacial spasm treated with microvascular decompression to evaluate operation result and clinical course after operation. Patients and Methods : From 1992 to 1999, 41 patients with hemifacial spasm underwent this operation. Retrospective analysis of operation results and clinical recovery patterns was done. The length of observation had been more than 6 months in all cases. Results : The ratio of male to female was 1:1.4, and age at operation ranged from 24 to 66 years. Their mean age was 47.6 years and the mean preoperative duration of symptoms was 7.2 years. Most common offending vessels were AICA in 18 cases(48%) and second most common were PICA in 13 cases(31.7%). The rest of them were 3 case in vertebral artery, and 7 cases(13%) in multiple offending vessels. Patterns of improvement after surgery could be divided into 4 clinical types. There was complete recovery in 3 days after operation in 24 cases(58.6%, Immediate complete recovery). There was complete recovery in 3 days after operation, and symptom was recurred partially, which was gradually subsided in 2 weeks after operation in 4 cases(9.8%, Delayed complete recovery type I). There was partial recovery after operation and symptom was compretely disappeared gradually in 6 months after operation in 7 cases(17.1%, Delayed complete recovery type II). Finally, there was partial recovery after operation, and symptom was somewhat remained after 6 months later(14.5%, Delayed partial recovery). Conclusion : In conclusion, microvascular decompression for hemifacial spasm is a safe and reliable treatment modality with good results of improvement and there are 4 recovery patterns in clinical course after operation in our series. Therefore, follow-up observation after microvascular decompression is necessary to evaluate the operative results and complication, especially in the delayed resolved cases.

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Periodontal wound healing following reciprocal autologous root transplantation in class III furcation defects

  • Takeuchi, Naoshi;Shirakata, Yoshinori;Shinohara, Yukiya;Sena, Kotaro;Noguchi, Kazuyuki
    • Journal of Periodontal and Implant Science
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    • v.47 no.6
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    • pp.352-362
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    • 2017
  • Purpose: Furcation involvement in the molars is difficult to treat, and has been recognized as a risk factor for tooth loss. Although periodontal regenerative therapies, including guided tissue regeneration and various types of bone grafts, have been applied to furcation defects, the effects of these treatments are limited, especially in large class III furcation defects. The purpose of this pilot study was to investigate the effect of reciprocal autologous root transplantation on periodontal wound healing and regeneration in class III furcation defects in dogs. Methods: Furcation defects (7 mm wide and 6 mm high) were surgically created after root separation of the unilateral third and fourth premolars in 4 dogs. Eight furcation defects were randomized to receive either reciprocal autologous root transplantation (test) or no further treatment (control). In the test group, the mesial and distal roots were transplanted into the distal and mesial extraction sockets, respectively. The animals were sacrificed 10 weeks after surgery for histologic evaluation. Results: The healing pattern in the control group was characterized by extensive collapse of the flap and limited periodontal regeneration. New bone formation in the test group ($3.56{\pm}0.57mm$) was significantly greater than in the control group ($0.62{\pm}0.21mm$). Dense collagen fibers inserting into the residual cementum on the transplanted root surfaces were observed in the test group. Slight ankylosis was observed in 2 of the 4 specimens in the test group on the mesiodistal sides where the root-planed surfaces faced the existing bone. Root resorption (RR) was detected in both the control and test groups. Conclusions: Within the limits of this study, it can be concluded that reciprocal autologous root transplantation was effective for bone regeneration in class III furcation defects in dogs. However, further studies are required to standardize the approach in order to prevent unwanted RR prior to clinical application.