• Title/Summary/Keyword: health outcomes

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Effectiveness and Safety of Mechanical Thrombectomy with Stent Retrievers in Basilar Artery Occlusion : Comparison with Anterior Circulation Occlusions

  • Hu, Soo Young;Yi, Ho Jun;Lee, Dong Hoon;Hong, Jae Taek;Sung, Jae Hoon;Lee, Sang Won
    • Journal of Korean Neurosurgical Society
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    • v.60 no.6
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    • pp.635-643
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    • 2017
  • Objective : Acute basilar artery occlusion (BAO) is associated with severe neurological dysfunction and high mortality rates. The benefits of mechanical thrombectomy in BAO have not been explored in recent clinical trials. Therefore, we analyzed outcomes of stent retriever mechanical thrombectomy for BAO, and compared with anterior circulation occlusions (ACO). Methods : In total, 161 consecutive patients (24 BAO, 137 ACO) who underwent mechanical thrombectomy with the stent retriever between January 2013 and August 2016 enrolled in our study. All patients underwent clinical assessment with the National Institutes of Health Stroke Scale (NIHSS) and modified Rankin scale (mRS). Radiological results were used to evaluate thrombolysis in cerebral infarction (TICI) scores and successful recanalization was defined by TICI 2b or 3. Results : Mean NIHSS scores at 24 hours and 30 days were significantly higher in the BAO group than the ACO group (p=0.021, p=0.001). mRS at 90 days was significantly higher in the BAO group (4.2) compared with the ACO group (3.0) (p=0.003). The BAO group (2.0) performed fewer stent retriever passages than the ACO group (2.7) (p=0.049). There were no significant differences between the two groups in terms of complications, but the BAO patients experienced a higher mortality (16.6%) rate than ACO patients (5.8%) (p=0.001). In subgroup analysis of BAO, patients with short procedure times achieved successful recanalization (p=0.001) and successfully recanalized patients exhibited more favorable mRS at 90 days (p=0.027). Conclusion : In our study, mechanical thrombectomy of BAO patients showed worse clinical outcome and higher mortality rate than ACO patients. However, mechanical thrombectomy with a stent retriever in BAO is an effective treatment, because successfully recanalized patients showed good clinical outcome in BAO patients.

The phenomenological study of self-management intervention among breast cancer survivors: Non-pharmacological approaches (유방암 생존자들의 자가관리에 대한 현상학적 연구: 비약물적 접근방법을 중심으로)

  • Heo, Seok-Mo;Heo, Narae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.12
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    • pp.270-284
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    • 2016
  • The purpose of this study was to understand the essential structure and meaning of self-management intervention for breast cancer survivors by using non-pharmacological approaches. The study participants were 10 breast cancer survivors who were completing cancer treatment that involved surgery, chemotherapy, and radiation therapy. Data collected between August 2014 and February 2015 at E Hospital in S city were analyzed by using Colaizzi's phenomenological method. Outcomes were classified into seven essential themes: 1) application of comfort measures to alleviate ongoing symptoms, 2) movement to change physical conditions, 3) special herbal intake to prevent recurrence, 4) a specially designed diet plan for health self-management, 5) constant awareness of complementary and alternative medicine, 6) unmet needs treated by one's own doctor's prescription, and 7) future life toward a nature-friendly environment. The study results contribute to a deeper understanding of self-management interventions in the daily lives of Korean breast cancer survivors. In addition, results provide an essential resource, based on actual self-management styles, that will help survivors to obtain guidance and participate in appropriate programs.

Maxillary reconstruction using tunneling flap technique with 3D custom-made titanium mesh plate and particulate cancellous bone and marrow graft: a case report

  • Takano, Masayuki;Sugahara, Keisuke;Koyachi, Masahide;Odaka, Kento;Matsunaga, Satoru;Homma, Shinya;Abe, Shinichi;Katakura, Akira;Shibahara, Takahiko
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.43.1-43.5
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    • 2019
  • Background: Reconstructive surgery is often required for tumors of the oral and maxillofacial region, irrespective of whether they are benign or malignant, the area involved, and the tumor size. Recently, three-dimensional (3D) models are increasingly used in reconstructive surgery. However, these models have rarely been adapted for the fabrication of custom-made reconstruction materials. In this report, we present a case of maxillary reconstruction using a laboratory-engineered, custom-made mesh plate from a 3D model. Case presentation: The patient was a 56-year-old female, who had undergone maxillary resection in 2011 for intraoral squamous cell carcinoma that presented as a swelling of the anterior maxillary gingiva. Five years later, there was no recurrence of the malignant tumor and a maxillary reconstruction was planned. Computed tomography (CT) revealed a large bony defect in the dental-alveolar area of the anterior maxilla. Using the CT data, a 3D model of the maxilla was prepared, and the site of reconstruction determined. A custom-made mesh plate was fabricated using the 3D model (Okada Medical Supply, Tokyo, Japan). We performed the reconstruction using the custom-made titanium mesh plate and the particulate cancellous bone and marrow graft from her iliac bone. We employed the tunneling flap technique without alveolar crest incision, to prevent surgical wound dehiscence, mesh exposure, and alveolar bone loss. Ten months later, three dental implants were inserted in the graft. Before the final crown setting, we performed a gingivoplasty with palate mucosal graft. The patient has expressed total satisfaction with both the functional and esthetic outcomes of the procedure. Conclusion: We have successfully performed a maxillary and dental reconstruction using a custom-made, pre-bent titanium mesh plate.

Survival of isolated human preantral follicles after vitrification: Analyses of morphology and Fas ligand and caspase-3 mRNA expression

  • Wiweko, Budi;Soebijanto, Soegiharto;Boediono, Arief;Mansyur, Muchtaruddin;Siregar, Nuryati C;Suryandari, Dwi Anita;Aulia, Ahmad;Djuwantono, Tono;Affandi, Biran
    • Clinical and Experimental Reproductive Medicine
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    • v.46 no.4
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    • pp.152-165
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    • 2019
  • Objective: This study aimed to examine the effect of vitrification on apoptosis and survival in human preantral follicles after thawing. Methods: This experimental study was conducted at an acute tertiary care hospital from March 2012 to April 2013. Ovaries were sliced into 5 × 5 × 1-mm pieces and divided into the following three groups: preantral follicle isolation, ovarian tissue vitrification-warming followed by follicle isolation, and immunohistochemistry of fresh ovarian tissue. For statistical analyses, the Student t-test, chi-square test, Kruskal-Wallis test, and Kaplan-Meier survival analysis were used. Results: A total of 161 preantral follicles (70% secondary) were collected from ovarian cortex tissue of six women between 30 and 37 years of age who underwent oophorectomy due to cervical cancer or breast cancer. There were no significant differences in the follicular morphology of fresh preantral follicles and vitrified follicles after thawing. The mean Fas ligand (FasL) mRNA expression level was 0.43 ± 0.20 (relative to β-actin) in fresh preantral follicles versus 0.51 ± 0.20 in vitrified follicles (p= 0.22). The mean caspase-3 mRNA expression level in fresh preantral follicles was 0.56 ± 0.49 vs. 0.27 ± 0.21 in vitrified follicles (p= 0.233). One vitrified-thawed secondary follicle grew and developed to an antral follicle within 6 days of culture. Conclusion: Vitrification did not affect preantral follicle morphology or mRNA expression of the apoptosis markers FasL and caspase-3. Further studies are required to establish whether vitrification affects the outcomes of in vitro culture and the maturation of preantral follicles.

Relationship Between Orthodontic Root Resorption and Asthma, Allergy, and Psychological Stress (교정치료와 관련된 치근흡수와 천식, 앨러지 및 심리적 스트레스와의 상관성에 관한 연구)

  • Shim, Youn-Soo;Davidovitch, Ze'ev
    • Journal of dental hygiene science
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    • v.3 no.1
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    • pp.33-38
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    • 2003
  • One aspect of undesirable outcomes in orthodontic treatment includes excessive resorption of dental roots with mechanotherapy. The aim of this study is to demonstrate whether diseases affecting the immune system adversely are prevalent in orthodontic patients who manifest excessive resorption of dental roots with orthodontic tooth movement. The records of 51 orthodontic patients (25 males and 26 females, $16.1{\pm}3.3$ yr old) and 51 pair-matched controls ($1.5.4{\pm}4.1$ yr old) were analyzed retrospectively. The pretreatment questionnaires and the treatment records disclosed that the incidence of asthma, allergy, and signs indicative of psychological stress, was significantly higher in the root resorption cohort. The immune system is either altered or adversely affected in all these conditions. Since the progenitors of osteoclasts and odontoclasts are derived from mononucleated cells of monocyte and macrophage lineage, which are prominent cellular members of the immune system, the study leaded to the conclusion that excessive root resorption may occur in orthodontic patients who are psychologically stressed, or who have asthma and allergy, or any other conditions that may adversely affect and modify the immune system, and a careful examination and interpretation of a patient's medical history may be beneficial to both patient and practioner.

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RELATIONSHIP BETWEEN QUALITY OF LIFE AND BODY MASS INDEX IN MIDDLE SCHOOL STUDENTS (중학생들에서의 체 질량 지수와 삶의 질의 관계)

  • Jang Won-Seok;Yang Jae-Won;Joung Yoo-Sook;Hong Sung-Do
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.17 no.1
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    • pp.3-9
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    • 2006
  • Objectives: Obesity is one of risk factors for psychological and social adjustment problems (depression, low self esteem, low school function etc). Quality of life(QOL) is comprehensive and multidimensional construct including physical, emotional, social and school functioning. Some authors reported that child and adolescent obesity is associated with impaired QOL. This study was to examine the association between QOL and body mass index (BMI) in middle school students. Methods : Cross sectional analysis of 471 adolescents between the ages of 13 and 14 years ($mean{\pm}SD,\;13.4{\pm}0.6$), who attended one of middle schools in Seoul, Korea. Participants' QOL were scored by using Korean version of pediatric QOL inventory generic score scale ($PedsQL^{TM}$ 4.0). Participants had a $mean{\pm}SD\;BMI\;of\;21.3{\pm}4.0$. Self reports and parent proxy reports using $PedsQL^{TM}$ 4.0 were administered to measure participant's QOL. Participants were divided into four groups by BMI (Male: obesity group >26.5, at risk group 23.2-26.5, normal weight group 15.8-23.1, underweight group <15.8, Female : obesity group >25.2, at risk group 22.9-25.2, normal weight group 16.0-22.8, underweight group <16.0). Results : Compared with other groups, obese adolescents reported significantly(p<0.01) love. QOL in all domains. Obese adolescents were more likely to have impaired QOL than normal weight adolescents (Odds Ratio, 8.3, 95% confidence interval, 4.0-16.7). Conclusion : Obese adolescents have lower QOL than normal weight adolescents. Psychiatrist, parents, and teachers need to be informed of the risk fur impaired QOL in obese adolescents to target interventions that could enhance health outcomes.

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Comparison of Treatment Outcome Assessment for Class I Malocclusion Patients: Peer Assessment Rating versus American Board of Orthodontics-Objective Grading System

  • Hong, Mihee;Kook, Yoon-Ah;Baek, Seung-Hak;Kim, Myeng-Ki
    • Journal of Korean Dental Science
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    • v.7 no.1
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    • pp.6-15
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    • 2014
  • Purpose: The purpose of this retrospective study is to investigate the degree of coincidence between the peer assessment rating (PAR) index and American Board of Orthodontics objective grading system (ABO-OGS) in the assessment of orthodontic treatment outcomes of Class I malocclusion cases. Materials and Methods: The sample consisted of 26 Class I patients. The PAR index was used for evaluation of pre-(T0) and posttreatment (T1) casts, and the ABO-OGS for assessment of T1 casts. If there was a reduction in PAR scores from T0 to T1 of more than 30%, the label 'PAR+' was given to the case, and if not, it was labeled 'PAR-'. If the ABO-OGS was less than 27, the label 'OGS+' was given to the case and if not, it was labeled 'OGS-'. 'A PAR-only qualified group' (PAR+), 'ABO-OGS-only qualified group' (OGS+), 'both indices qualified group' (PAR+/OGS+), and 'both indices disqualified group' (PAR-/OGS-) were compared with a Wilcoxon rank-sum test, sensitivity/specifi city test and Spearman's correlation test. Result: PAR scores for T0, T1, and percentage reduction were 21.1, 6.4, and 65.9%, respectively, and 35.4 for ABOOGS. The distribution of the 'PAR+/OGS+', 'PAR+', and 'PAR-/OGS-' group was 19.3%, 76.9%, and 3.8%, respectively. The T0-PAR, T1-PAR and PAR point reductions for the 'PAR+' group were significantly higher than those of 'PAR+/OGS+' groups (23.1 vs. 15.6; 6.7 vs. 4.6; and 16.5 vs. 11.0; all P<0.05). However, the PAR-percentage reduction and treatment duration between the two groups were not statistically different (70.0% vs. 67.0%, P=0.4325; 24.1 months vs. 25.0 months, P=0.4057). The T1-ABO-OGS score for 'PAR+' group was significantly higher than that of the 'PAR+/OGS+' groups (38.2 vs. 24.0, P<0.001). Conclusion: Since the fraction of the 'PAR+/OGS+' group was less than 20% and there was no significant correlation between PAR-percentage reduction and T1-ABO-OGS, development of a new index system for the accurate evaluation of treatment outcome is needed.

The Phenomenoloical Study on the Stress of Family Caregivers with Demented Elderly (치매노인 부양가족의 스트레스에 관한 현상학적 연구)

  • Lee, Young-man;Shin, Dong-yeol
    • Industry Promotion Research
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    • v.5 no.2
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    • pp.41-50
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    • 2020
  • WIn Korea, the rapid rise of elderly population and dementia prevalence resulting from the unprecedently rapid aging in the world is being emerged as a serious social issue. Caring the elderly with dementia is a different way from a general life and is a world which new cultural existential relationships are interlaced from the relationship viewpoint. From this aspect, the psychological matter of family caring a demented elderly needs to be studied for existential understanding in depth and fundamentally. This study focused on in-depth understanding and description of the stress phenomena experienced by family caregivers with a demented elderly based on Giorgi's method among phenomenological research methods and using existential group counseling techniques. Total 8 sessions of existential group counseling were conducted. This study drew out the outcomes(emotional stress, psychosocial stress, time-dependent stress) of participants' self-awareness experiences by applying 4 steps of Giorgi's phenomenological research methodology based on the Existential Philosophy to participant's intensive statements about stress of family caring a demented elderly drawn out of the existential group counselling sessions. It is hoped that understanding the pain of the supporters who cannot express their own pains through the research results and their self-help group counseling activities will become active, contributing to the health of our society which is about to enter post-aged society.

THE PATIENTS' SATISFACTION FOLLOWING IMPLANT TREATMENT

  • Heo, Yoon-Young;Heo, Seong-Joo;Chang, Myung-Woo;Park, Ji-Man
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.6
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    • pp.569-576
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    • 2008
  • STATEMENT OF PROBLEM: While patient-centered outcomes are usually not reported, these may represent major aspects of the implant success for the patient. Use of a well-designed patient survey form can be an invaluable asset to the implant practitioners. PURPOSE: The objective of this study was to investigate patient satisfaction after implant therapy by means of a questionnaire. MATERIAL AND METHODS: South Korean patients (n = 100), who visited the dental examination center of Soon Chun Hyang university hospital, were asked to fill out the satisfaction questionnaire regarding aspects of cost, comfort, esthetics, chewing, gingival health, food impaction, phonetic aspect, screw loosening, and general satisfaction. Responses to statements were given on the Likert response scale. Four experimental groups of patients were distinguished with various location ($A_1,\;A_2,\;A_3$), year ($B_1,\;B_2,\;B_3$), number of implant replacements ($C_1,\;C_2,\;C_3$), and treatment cost ($D_1,\;D_2,\;D_3$). The reliability of the response scales was measured by calculation of its internal consistency, expressed as Cronbach's ${\alpha}$. The scales were distinguished by means of factor analysis method. Possible differences in scale scores among the groups were assessed by One-way ANOVA (${\alpha}$= 0.05). RESULTS: Patients responded to most of the statements with high satisfaction. But the mean scale score of statement about cost was low. After the verification of internal consistency and factor analysis, five components, e.g. general satisfaction, comfort, chewing efficiency, esthetics, and phonetic aspect were grouped together. These components could be explained with common meaning and the first factor was named as 'general satisfaction'. Differences in patient satisfaction on the scale with esthetics were present between patients who have been wearing the implant prosthesis less than three years and those more than seven years ($B_1<B_3$). CONCLUSION: The patients were generally satisfied with the outcome of implant treatment. But the patients' major complaint was high cost and while the statistically significant difference was not shown, the satisfaction scale about food impaction and esthetics was low. So the continuing efforts to make improvements about these problems are needed for the implant practitioners.

Korean Asthma Guideline 2014: Summary of Major Updates to the Korean Asthma Guideline 2014

  • Kim, Deog Kyeom;Park, Yong Bum;Oh, Yeon-Mok;Jung, Ki-Suck;Yoo, Ji Hong;Yoo, Kwang-Ha;Kim, Kwan Hyung
    • Tuberculosis and Respiratory Diseases
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    • v.79 no.3
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    • pp.111-120
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    • 2016
  • Asthma is a prevalent and serious health problem in Korea. Recently, the Korean Asthma Guideline has been updated by The Korean Academy of Tuberculosis and Respiratory Diseases (KATRD) in an effort to improve the clinical management of asthma. This guideline focuses on adult patients with asthma and aims to deliver up to date scientific evidence and recommendations to general physicians for the management of asthma. For this purpose, this guideline was updated following systematic review and meta-analysis of recent studies and adapting some points of international guidelines (Global Initiative for Asthma [GINA] report 2014, National Asthma Education and Prevention Program [NAEPP] 2007, British Thoracic Society [BTS/SIGN] asthma guideline 2012, and Canadian asthma guideline 2012). Updated issues include recommendations derived using the population, intervention, comparison, and outcomes (PICO) model, which produced 20 clinical questions on the management of asthma. It also covers a new definition of asthma, the importance of confirming various airflow limitations with spirometry, the epidemiology and the diagnostic flow of asthma in Korea, the importance and evidence for inhaled corticosteroids (ICS) and ICS/formoterol as a single maintenance and acute therapy in the stepwise management of asthma, assessment of severity of asthma and management of exacerbation, and an action plan to cope with exacerbation. This guideline includes clinical assessments, and treatment of asthma-chronic obstructive pulmonary disease overlap syndrome, management of asthma in specific conditions including severe asthma, elderly asthma, cough variant asthma, exercise-induced bronchial contraction, etc. The revised Korean Asthma Guideline is expected to be a useful resource in the management of asthma.