• Title/Summary/Keyword: systemic approach

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Case Report : Treatment of Burning mouth Syndrome Using a Removable Anti-Nociceptive Appliance (가철성 유해자극차단장치를 이용한 구강작열감증후군의 치료 증례)

  • Roh, Byung-Yoon;Ahn, Jong-Mo;Yoon, Chang-Lyuk;Ryu, Ji-Won
    • Journal of Oral Medicine and Pain
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    • v.37 no.1
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    • pp.1-7
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    • 2012
  • Burning mouth syndrome(BMS) refers to a chronic orofacial pain disorder usually unaccompanied by mucosal lesions or other clinical signs. Tongue(anterior and lateral border) is found to be the most common site for the burning sensations in the oral cavity, and various oral sites may be affected including hard palate and lips. The etiology of this disorder remains poorly understood, but the various factors might be related with the pathogenesis of the BMS. These factors have been devided into local, systemic and psychological. Recently, there have been increasing reports that the pain of BMS may be neuropathic in origin. The complex and multifactorial etiology of BMS necessitates multidisciplinary approach for the management of these patients. Recently, several studies have reported that oral parafunctional habits could be related the pathogenesis of BMS, and tried to control the symptom of BMS with various methods. We reported the cases who had the symptom of burning mouth syndrome with removable anti-nociceptive appliance in the lower dentition.

Retrospective Analysis of Neoadjuvant Chemotherapy for Breast Cancer in Turkish Patients

  • Duman, Berna Bozkurt;Afsar, Cigdem Usul;Gunaldi, Meral;Sahin, Berksoy;Kara, I. Oguz;Erkisi, Melek;Ercolak, Vehbi
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.4119-4123
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    • 2012
  • Background: Neoadjuvant systemic chemotherapy is the accepted approach for women with locally advanced breast cancer. Anthracycline- and taxane-based regimens have been extensively studied in clinical trials and consequently are widely used. In this study aimed to research the complete response (pCR) rates in different regimens for neoadjuvant setting and determine associated clinical and biological factors. Methods: This study included 63 patients diagnosed with breast carcinoma among 95 patients that had been treated with neoadjuvant chemotherapy between 2007 and 2010. TNM staging system was used for staging. The histologic response to neoadjuvant chemotherapy was characterized as a pCR when there was no evidence of residual invasive tumor in the breast or axillary lymph nodes. Biologic subclassification using estrogen receptor (ER), progesterone receptor (PR), HER2 were performed. Luminal A was defined as ER+, PR+, HER2-; Luminal B tumor was defined as ER+, PR-, HER2-; ER+, PR-, HER2+; ER-, PR+, HER2-; ER+, PR+, HER2+; HER2 like tumor ER-, PR+, HER2+; and triple negative tumor ER, PR, HER2 negative. Results: Patients median age was 54.14 (min-max: 30-75). Thirty-two patients (50.8%) were premenapousal and 31 (49.2%) were postmenapousal. Staging was performed postoperatively based on the pathology report and appropriated imaging modalities The TNM (tumor, lymph node, metastasis) system was used for clinical and pathological staging. Fifty-seven (90.5%) were invasive ductal carcinomas, 6 (9.5%) were other subtypes. Thirty nine (61.9%) were grade II and 24 (38.1%) were grade III. Seven (11.1%) patients were stage II and 56 (88.9) patients were stage III. The patients were classified for ER, PR receptor and HER2 positivity. Seventeen patients had complete response to chemotherapy. Forty patients (63.5%) were treated with dose dense regimen (cyclophosphamide 600 mg/m2 and doxorubicine 60 mg/m every two weeks than paclitaxel 175 mg/m2 every two weeks with filgrastim support) 40 patients (48%) were treated anthracycline and taxane containing regimens. Thirteen patients (76%) from 17 patients with pCR were treated with the dose dense regimen but without statistical significance (p=0.06). pCR was higher in HER2(-), ER(-), grade III, premenopausal patients. Conclusion: pCR rate was higher in the group that treated with dose dense regimen, which should thus be the selected regimen in neoadjuvant setting. Some other factors can predict pCR in Turkish patients, like grade, menopausal status, triple negativity, percentage of ER positivity, and HER2 expression.

Exposure Assessment of Hazardous gases in Confined Spaces (밀폐공간 종류별 유해가스 발생 농도 평가)

  • Park, Hyunhee;Yoo, Kye-mook;Ham, Seung-hon;Chung, Kwang-Jae;Shin, Min-a;Lee, Koo-yong;Jang, Kyung-jo;Yoon, Chung-sik
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.19 no.4
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    • pp.381-389
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    • 2009
  • Confined spaces are inherently dangerous workplace and many fatal and nonfatal accidents have been reported. Even though these accidents occur in various kinds of confined spaces, there has rarely been reported on the health hazard agent, i.e., the types of gases and their concentration ranges. Therefore in this study, we evaluated several toxic and asphyxiating gas concentrations in various confined spaces. We surveyed 57 manholes, 3 sewage treatment plants, 2 yellow radish manufacturing companies and 7 barges to measure the concentrations of oxygen($O_2$), hydrogen sulfide($H_2S$), carbon monoxide(CO), ammonia($NH_3$). Lower Explosion Limits(LEL) and Volatile Organic Compounds (VOCs). Those four types of confined spaces occupies 56% of accidents during last 9 years in Korea. In 57 manholes, the concentration varied according to the types of manholes; rainfall and sewage, and by location; residential and industrial areas. Sewage manhole in industrial area was evaluated as the most hazardous than other types of manhole like rainfall manholes, residential sewage manholes. The highest $H_2S$ concentration and the lowest $O_2$ concentration at sewage manhole in industrial area were 300 ppm, 8.7% respectively. In 3 sewage treatment plants, $H_2S$ and $NH_3$ concentrations were reached up to the 500 ppm and 200 ppm respectively. Two yellow radish manufacturing companies showed the concentrations of 316 ppm, 505.2 ppm, 90 ppm and 15.7% for $H_2S$, CO, VOCs and $O_2$, respectively. Seven barges showed 15.9%~20.9% oxygen concentration. Gas species and concentration ranges varied by the types and location of confined spaces; CO, $H_2S$, $O_2$ could be hazardous in manhole, especially manhole connected to sewage plants. CO, $H_2S$, LEL, $O_2$, $NH_3$ should be controlled in sludge silo and sluge pumping confined spaces in sewage treatment plant. The activity of lifting out radish from the storage tank was evaluated more hazardous rather than the other activities in yellow radish manufacturing industry. The employers must conduct the survey to identify all possible confined spaces in their local workplace prior to performing the tasks. At the national level to reduce the accidents in the confined spaces, we suggest that systemic approach and active education program including possible hazards, standard operation procedures, ventilation plan, and personal protective equipment in confined spaces should be implemented.

Development of Performance Management System for Contract Departments in the Korean Dual College Context (일학습병행제 대학연계형 계약학과의 성과관리체계 개발)

  • Im, Tami;Kang, Kiho
    • Journal of Practical Engineering Education
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    • v.12 no.1
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    • pp.145-162
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    • 2020
  • The dual system in Korea already plays an important role in quantitative terms in the Korean lifelong vocational competency development system. However, since most of the existing dual system performance management plans in Korea focus on qualification-linked dual system, research on the effective performance management of the four-year university-driven dual system is very insufficient. This paper presents multiple measures for developing a performance management system suitable for the university-driven dual system to achieve qualitative improvement of the contract departments of the dual colleges or universities. As an approach to the end, a performance evaluation system is established by developing the evaluation items and indicators for the dual colloeges' contract departments. Next, it analyzes the needs of various stakeholder groups such as field teachers of the involved companies, students in apprenticeship and OJT professors of KOREATECH through FGI's and polls to diagnose the current operational performance, especially the causes of high drpout rates of the contract departments. From these results, the paper presents firstly the development of measuring methods for the developed performance indicators of the evaluation system and then a systemic performance management system which is based on 'input-transformation-outcome-feedback' structure. In addition, some measures for improving the high dropout rate and performance are presented from the viewpoints of each stakeholder.

The Effect of Travel Motivation on Satisfaction for the Walking Tourist (도보여행객의 여행동기와 만족의 영향관계연구)

  • Son, Ha-Na;Yhang, Wii-Joo
    • Asia-Pacific Journal of Business
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    • v.6 no.2
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    • pp.81-95
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    • 2015
  • This study is an investigative study into the effects that the 'travel motivations' of participants on walking tourism has on their 'degree of satisfaction' by identifying tourist motivations for selecting walking tour among many types of tourism and their effects on hikers' degree of satisfaction. This study was conducted with hikers affiliated with 'walking on beautiful roads '-one of Busan's preliminary social enterprises- with a total of 176 copies used for a final effective sample. Data collected was analyzed using SPSS WIN 18.0 to conduct a frequency analysis of the sample. Along with exploratory factor analysis, Cronbach's ${\alpha}$ coefficient was used as an estimate of the validity and reliability of each factor. Multiple regression analysis was done for an analysis of travel motivations and their effects on satisfaction. The scale rates items in the questionnaire in the following categories: 'Motivations' for walking tours consist of 5 factors- vacation, soul-searching, social get-togethers, nature tour, community experience-with a total of 20 items. 'The degree of satisfaction' is made up of a factor with a total of 4 items. The results of the study are as follows: with respect to the hypothesis that motivations for walking tour would have a positive effect on the degree of satisfaction, test results show that 'motivations' have significant partial effects on the 'degree of satisfaction'. Motivations affect the degree of satisfaction in the order of nature tour and soul-searching except for experience and social get-togethers- an indication that participants on walking tours tend to travel for the attractiveness of nature, wanting time for reflection and meditation. As the first investigative study into participants in walking tours products offered by travel agencies, the study has the following implications for marketers: First, travel agencies selling walking tour products and government institutions concerned about the development of hiking trails need to discuss ways to make the most of natural resources as they are- rather than using development-oriented approaches. The study has its own limitation: it is that with the lack of domestic and international studies on walking tours, the study has not gained access to precedent studies on the subject so it has not established a systemic approach to the emerging type of tourism. Hopefully, this study will make a small contribution to its development.

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Clinical Application of Radial Head Prosthesis (요골두 치환술의 임상적 적용)

  • Moon, Jun-Gyu
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.140-145
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    • 2011
  • Purpose: Installing a radial head prosthesis has developed into a reliable procedure to replace the native radial head for treating unreconstructible radial head fracture when this is associated with an unstable elbow or forearm. A variety of implants have been developed and these are now commercially available. This article reviews the literature related to the indications, the available implants and the surgical techniques of radial head replacement arthroplasty. Materials and Methods: The main indication for a metallic radial head prosthesis is a comminuted fracture that is not amenable to reconstruction, and particularly if it is associated with complex elbow injuries. Excision of the radial head should be avoided in the presence of combined injured ligaments or interosseous membrane injury. Three different implants are available in Korea, including the bipolar, press fit monopolar and loose fit monopolar radial head prostheses. A primary technical goal of radial head arthroplasty is the insertion of an implant that closely replicates the native radial head. The major pitfall when using a metallic radial head prosthesis is the insertion of a longer implant, which results in overstuffing of the radiocapitellar joint. Results and Conclusion: Satisfactory clinical results can be anticipated when a radial head prosthesis is used for the correct indications and when a systemic approach is undertaken to ensure proper sizing. For the future studies, we need data regarding the long term outcomes and comparison of the various types of prostheses.

Surgical Experience of the Remnant Thoracoabdominal Aortic Replacement after Aortic Surgery (대동맥수술 후 잔존 흉복부대동맥치환술에 대한 임상 경험)

  • Cho, Kwang-Jo;Woo, Jong-Su;Choi, Pil-Jo;Bang, Jung-Hee
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.49-54
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    • 2008
  • Background: Aortic diseases tend to involve the entire aorta. Hence, there is the constant possibility of the need for a secondary operation at the remnant aorta. This study analyzed our cases of secondary aortic surgery in order to determine its characteristics and problems. Material and Method: Between April 2003 and June 2007, 12 patients (6 male and 6 female) underwent thoracoabdominal aortic replacement as a secondary aortic operation. Their clinical courses were analyzed. Four of the patients underwent lower thoracobadominal aortic replacement under the normothermic femorofemoral bypass, and the others underwent an entire thoracobdominal aortic replacement under deep hypothermic circulatory arrest. Result: There was no death or paraplegia. As local complications, there were 3 cases of wound infection and 2 cases of an immediate reoperation caused by bleeding and one case of delayed wound. revision for a contaminated perigraft hematoma. As a systemic complication, there was one case of renal insufficiency, which required hemodialysis and one case of respiratory insufficiency that needed prolonged ventilator care. The mean admission period was $30{\pm}21$ days. All the patients were followed up for $626{\pm}542$ days without reoperation or other problems. Conclusion: Using properly selected patients and a careful approach, thoracoabdominal aortic replacement can be performed safely as a secondary aortic surgery.

Trends of Arsenic Maximum Levels on Agricultural Commodities and Processed Agricultural Products (농산물 및 농산가공품 중 비소 허용기준에 관한 국내외 동향)

  • Paik, Min-Kyoung;Kim, Won-Il;Yoo, Ji-Hyock;Kim, Jin-Kyoung;Kim, Mi-Jin;Im, Geon-Jae;Hong, Moo-Ki;Om, Ae-Son
    • Journal of Food Hygiene and Safety
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    • v.25 no.1
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    • pp.16-23
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    • 2010
  • Although concerns about Arsenic (As) contamination in agricultural foods have currently increased, there in on adequate international risk management standards for As particularly on agricultural commodities and processed agricultural products. This scenario holds true also in Korea. Australia, and New Zealand has determined the As maximum level (ML) but only on cereals grains which is based on total As contents. ln addition, Japan has regulated the ML based on trivalent As contents in agricultural commodities, which do not have legal restrictions. On the other hand, China has developed a systemic risk management to restrict the As contamination above MLs in agricultural commodities and processed agricultural products based on inorganic and total As contents. The establishment of an adequate analytical method for As specification in agricultural foods is essential to determine the acceptable level of As in agricultural food. Probabilistic approach may remove some uncertainties in calculating human risk assessment from As. It should be reviewed in terms of maximum levels to set the best scenario based on a realiability and availability to achieve effective As management on agricultural foods in Korea.

A Case of Pulmonary Sequestration Treated with Arterial Embolization (동맥색전술로 시술한 폐격리증 1예)

  • Lee, Gun-Wha;Kim, Dong-Kyun;Na, Hyun-Sik;Bae, Jun-Yong;Choi, Jun-Ho;Kim, Yang-ki;Kim, Ki-up;Uh, Soo-taek;Kim, Dong-hoon;Hwang, Jung Hwa;Goo, Dong-Erk
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.1
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    • pp.68-73
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    • 2005
  • Pulmonary sequestration is a very rare congenital malformation in which a mass of pulmonary tissue is detached from the normal lung and receives its blood supply from a systemic artery. It may be clinically asymptomatic or it has a wide spectrum of various clinical manifestations. The clinical therapeutic approach is to resect the sequestered lobe to prevent frequent complication such as infection. The arterial embolization of feeding artery is a new technique and a less invasive treatment than conventional surgical removal. We have experienced a 17-year-old male with pulmonary sequestration whose complaints were pain in left lower chest. He was diagnosed by computed tomography and aortography and successfully treated with embolization of feeding artery. We report a case of pulmonary sequestration treated with arterial embolization instead of surgery.

Treatment of Pulmonary Sequestration with Thoracoscopic Approach (폐분리증의 치료와 흉강경적 절제술의 경험)

  • Cho, Min-Jeng;Kim, Tae-Hoon;Kim, Dae-Yeon;Kim, Seong-Chul;Kim, In-Koo
    • Advances in pediatric surgery
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    • v.16 no.2
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    • pp.154-161
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    • 2010
  • Pulmonary sequestration (PS) is a rare congenital malformation of the lower respiratory tract. The anomaly is characterized by absence of communication with the tracheobronchial tree and isolated blood supply from an anomalous systemic vessels. With the utilization of antenatal ultrasound, the diagnosis of asymptomatic neonatal PS has increased. Treatment options include observation, arterial embolization and surgical resection. The aim of the present study is to review the clinical course of PS and to share our experience with thoracoscopic resection. A total of 96 patients with PS were treated at Asan Children's Hospital between 1999 and 2010. The diagnosis of PS was established by CT in the cases managed by observation or embolization, and by tissue pathology in the surgical cases. Medical records and radiographic images were retrospectively reviewed. Thirty-nine patients were managed by embolization and 30 patients by surgery. The remaining 27 patients have been under observation without any procedures. Among 27 observation patients, 1 patient regressed completely and 10 patients were lost to follow up. Of the 39 embolizations patients, 2 had their lesion regress and sepsis was suspected after embolization. In 1 patient, the microcoil migrated to the iliac artery during the embolization procedure, and another patient developed renal abscess caused by renal artery embolization. Among 30 surgical cases, resection by thoracotomy was performed in 27 at the Department of Thoracic Surgery, and thoracoscopic resection in 3 at the Division of Pediatric Sugery. Only one wound complication ocurred. We conclud that surgical excision should be recommended for pulmonary sequestration, whether the sequestration is symptomatic or not because of the risk of infection, the low rate of natural regress, poor compliance, severe complications after embolization, and to exclude other pathology. In summary, thoracoscopic resection of the pulmonary sequestration is feasible, efficacious, safe and cosmetically superior even in neonatal period.

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