• Title/Summary/Keyword: treatment approach

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Delayed Reduction of Facial Bone Fractures (정복 시기가 지난 안면골 골절의 수술적 교정)

  • Lee, Kyu-Seop;Park, Jae Beom;Song, Seung Han;Oh, Sang Ha;Kang, Nak Heon
    • Archives of Craniofacial Surgery
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    • v.14 no.2
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    • pp.119-123
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    • 2013
  • Except for special situations, it is generally agreed that best results in the treatment of facial fractures is expected if reduction is done within the first 2 or 3 weeks after injury. We reduced facial bone fractures at 4 to 7 weeks after trauma. A 44-year-old female patient underwent open reduction for her right zygomaticomaxillary complex fracture at 7 weeks after injury. A 59-year-old female patient underwent surgery for the right mandible body and left parasymphysis fractures at 4 weeks after injury. Using traditional approaches, granulation tissue and callus were removed from the fracture sites, and malunited fracture lines were separated by a small osteotome. We reduced the displaced fractured zygoma and mandible to their normal anatomical positions and fixed them using titanium plates. No complications such as asymmetry, malunion, malocclusion, or trismus were seen. Unfavorable asymmetric facial contours were corrected, and we obtained good occlusion with favorable bony alignment. The functional and aesthetic outcomes were satisfactory. Through removal the callus and limited osteotomy, a successful approach to the previously fractured line was possible, and an exact correction with symmetry was obtained. This method can be a good option for obtaining good mobility and clinical results in treating delayed facial bone fractures.

The Effects of Integrated Environmental Experience Program on Environmental Attitude of Elementary Schoolers (통합 환경체험 프로그램이 초등학생의 환경태도에 미치는 영향)

  • Kim, Chan-Ki;Choi, Sung-Bong
    • Journal of Environmental Science International
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    • v.19 no.12
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    • pp.1409-1419
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    • 2010
  • Recently, Korea's interest in environment protection is increasingly growing, and Korea realizes the seriousness of environmental pollution and national movement to minimize the effect is arising. As part of the movement, the need of environmental education in elementary schools is on the rise. This study aims to develop integrated environmental experience programs allowing students to have experience activities in forests, rivers, and seas that they can approach easily around them and to have environmental education through various plays. In addition, the study purposes to compare general educational education programs in actual education in terms of the effect of the program on students' environment attitudes. This study was conducted to 50 fourth graders in two classes of S elementary school in Busan, and the 25-student comparative group had the normal educational education program that is mostly being performed in actual education while the 25-student treatment group had the survey on environmental attitude after a class using an integrated environmental experience program. The survey content is about environmental attitudes, and it consists of six subjects such as general environment, environmental pollution, energy, water resources, recycling, and animal protection and has 7 or 8 items by each subject which is divided into eight sub-items including sensibility, belief, values, spontaneity, criticism, patience, attention and interest. The findings are as follows. First, the integrated environmental experience program has a more positive effect on environmental attitudes than the general educational program. In particular, it is really effective about the topic of animal protection among students' environmental attitudes. Second, the integrated environmental experience program has a more positive effect on values and interests than the general environmental education program.

Recognizing the Two Faces of Gambling: The Lived Experiences of Korean Women Gamblers

  • Kim, Sungjae;Kim, Wooksoo;Dickerson, Suzanne S.
    • Journal of Korean Academy of Nursing
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    • v.46 no.5
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    • pp.753-765
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    • 2016
  • Purpose: The aim of this study was to explore the lived experiences of women problem gamblers, focusing on the meaning of gambling to them, how and why these women continue to gamble or stop gambling, and their needs and concerns. In order to effectively help women problem gamblers, practical in-depth knowledge is necessary to develop intervention programs for prevention, treatment, and recovery among women problem gamblers. Methods: The hermeneutic phenomenology approach was used to guide in-depth interviews and team interpretation of data. Sixteen women gamblers who chose to live in the casino area were recruited through snowball sampling with help from a counseling center. Participants were individually interviewed from February to April 2013 and asked to tell their stories of gambling. Transcribed interviews provided data for interpretive analysis. Results: In the study analysis one constitutive pattern was identified: moving beyond addiction by recognizing the two faces of gambling in their life. Four related themes emerged in the analysis-gambling as alluring; gambling as 'ugly'; living in contradictions; and moving beyond. Conclusion: Loneliness and isolation play a critical role in gambling experiences of women gamblers in Korea. In other words, they are motivated to gamble in order to escape from loneliness, to stop gambling for fear of being lonely as they get older, and to stay in the casnio area so as not to be alone. The need for acceptance is one fo the important factors that should be considered in developing intervention program for women.

Quantitative and Qualitative Gradient of Pain Experience, Sleep Quality and Psychological Distress in Patients with Different Phenotypes of Temporomandibular Disorders

  • Choi, Hee Hun;Kim, Hye-Kyoung;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.45 no.3
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    • pp.56-64
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    • 2020
  • Purpose: Temporomandibular disorders (TMD) is a mosaic of clinical signs and symptoms that can be regarded as a set of phenotypes that are affected by various factors including pain sensitivity, pain disability, sleep and psychological functioning. The aims of this study were to evaluate association of pain experience, sleep quality and psychological distress with different phenotypes of TMD patients. Methods: This retrospective study included a cohort (n=1,858; 63.8% for female, mean age=34.9±15.9 years) of patients with TMD. A set of self-administered questionnaires concerning pain interference (Brief Pain Inventory), pain disability (Graded Chronic Pain Scale), sleep quality (Pittsburg Sleep Questionnaire Index), psychological distress (Symptom Checklist-90 revised), and pain catastrophizing (Pain Catastrophizing Scale) were administered to all participants at the first consultation. All TMD patients were classified into four groups including TMD with internal derangement without pain (TMD_ID, n=370), TMD with joint pain (TMD_J, n=571), TMD with muscle pain (TMD_M, n=541) and TMD with muscle-joint combined pain (TMD_MJ, n=376). Results: The female ratio was particularly high in the group with TMD_MJ (p=0.001). The patients with muscle pain and both muscle and joint pain had longer symptom duration (p=0.004) and presented significantly higher scores in pain experience (p<0.001), subjective sleep quality (p<0.001), pain catastrophizing (p<0.001) and psychological distress (p<0.05) except for paranoid-ideation than the groups with only joint problems. Conclusions: The results of this study highlight the importance of multi-dimensional approach that consider pain disability, sleep quality, and psychological functioning in the management of TMD with muscle component. This study would contribute to a better understanding of interaction between heterogeneous TMD and multiple risk factors in order to build tailored treatment based on different phenotypes.

Conservative approach for anterior crown-root fractured teeth: forced eruption (상악 전치부 치관-치근 파절 증례에서의 보존적 접근법: 교정적 정출술)

  • Kim, Ji-Eun;Choi, Sung-Hyeon;Chang, Hoon-Sang;Hwang, Yun-Chan;Hwang, In-Nam;Oh, Won-Mann
    • Journal of Dental Rehabilitation and Applied Science
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    • v.36 no.1
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    • pp.48-54
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    • 2020
  • In the case of crown-root fracture due to traumatic injury in anterior tooth and the fracture margin is located subgingivally, forced eruption has been proposed for the reconstruction of deficient bone and soft tissue. Forced eruption is one of the easiest orthodontic approaches that can have an acceptable outcome and prognosis, and has a low incidence of relapse. However, using heavy forces or very fast movements can also cause tissue damage or ankylosis. The following case reports present forced eruption as treatment option of crown fracture in maxillary anterior teeth.

Interventions for anesthetic success in symptomatic irreversible pulpitis: A network meta-analysis of randomized controlled trials

  • Sivaramakrishnan, Gowri;Alsobaiei, Muneera;Sridharan, Kannan
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.19 no.6
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    • pp.323-341
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    • 2019
  • Background: Local anesthetics alone or in combination with adjuncts, such as oral medications, have routinely been used for pain control during endodontic treatment. The best clinical choice amongst the vast numbers of agents and techniques available for pain control for irreversible pulpitis is unclear. This network meta-analysis combined the available evidence on agents and techniques for pulpal anesthesia in the maxilla and mandible, in order to identify the best amongst these approaches statistically, as a basis for future clinical trials. Methods: Randomized trials in MEDLINE, DARE, and COCHRANE databases were screened based on inclusion criteria and data were extracted. Heterogeneity was assessed and odds ratios were used to estimate effects. Inconsistencies between direct and indirect pooled estimates were evaluated by H-statistics. The Grading of Recommendation, Assessment, Development, and Evaluation working group approach was used to assess evidence quality. Results: Sixty-two studies (nine studies in the maxilla and 53 studies in the mandible) were included in the meta-analysis. Increased mandibular pulpal anesthesia success was observed on premedication with aceclofenac + paracetamol or supplemental 4% articaine buccal infiltration or ibuprofen+paracetamol premedication, all the above mentioned with 2% lignocaine inferior alveolar nerve block (IANB). No significant difference was noted for any of the agents investigated in terms of the success rate of maxillary pulpal anesthesia. Conclusion: Direct and indirect comparisons indicated that some combinations of IANB with premedication and/or supplemental infiltration had a greater chance of producing successful mandibular pulpal anesthesia. No ideal technique for maxillary anesthesia emerged. Randomized clinical trials with increased sample size may be needed to provide more conclusive data. Our findings suggest that further high-quality studies are required in order to provide definitive direction to clinicians regarding the best agents and techniques to use for mandibular and maxillary anesthesia for irreversible pulpitis.

Inferior Capsular Shift Procedure for Multidirectional Instability of the Shoulder in Contact Athletes (접촉성 운동선수의 다방성 불안정 견관절의 하관절낭 이동술)

  • Kim Young Kyu;Baek Seung Jeong
    • Clinics in Shoulder and Elbow
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    • v.2 no.1
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    • pp.53-59
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    • 1999
  • Initial treatment of multidirectional instability of the shoulder would be a thorough rehabilitation program. If rehabilitation fails to resolve a patient's symptoms, the most commonly performed surgical procedure remains the inferior capsular shift. Eleven patients who had disabling multidirectional instability of the shoulder were managed with the inferior capsular shift. All of the procedure were performed by means of an anterior approach and a laterally based capsular shift. All of the patients were the contact athletes. The purpose of our study was to evaluate the efficacy of the inferior capsular shift procedure in the contact athletic patients, to review the loss of external rotation postoperatively and to discuss their return to sports. Mean follow up duration was 14.5 months(range, 12 to 24). Pain was relieved postoperatively in all cases and most patients could get stability except one case of recurrent subluxation. The average loss of external rotation and forward flexion after the operation were Y and 30 at last follow up. By the rating scale from American Shoulder and Elbow Society, overall scores improved from 49 points to 85 points. The results were excellent or good in 9 patients(82%) out of 11 patients. In reference to return to sports, 10 patients(91 %) of 11 patients returned to their sports with 7 patients (64%) returning at the same levels of competitiveness. The inferior capsular shift procedure was considered to be a recommendable method for the management of the multidirectional instability of the shoulder.

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Glomus Tumors of the Fingers -A Report of 66 Cases - (수지의 사구체 종양 - 66예 증례 분석 -)

  • Chon, Han-Kyong;Roh, Hyong-Rae;Lee, Han-Dong;Lee, Yu-Sang
    • Archives of Reconstructive Microsurgery
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    • v.21 no.1
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    • pp.50-55
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    • 2012
  • Purpose: We reviewed 66 cases of the glomus tumors in the hands. The purpose of this study was to review the characteristic signs and symptoms of glomus tumors and the surgical outcomes. We made hypothesis that (1) our guideline for surgical excision are reliable and (2) our surgical technique is efficient and less harmful to the nail root. Materials and Methods: The clinical diagnosis was made with occasional radiological studies and surgical excision was performed according to our indications. Patients with electrical shock-like pain by touching (the essential symptom) and at least 2 of 4 clinical signs and symptoms (cold hypersensitivity, paroxysmal pain that radiated proximally, blue discoloration, nail deformity for dorsal tumor or a palpable nodule for pulp tumor) underwent surgical excision. Results: The duration of symptoms of the patients was about 5.3 years. No difference of prevalence was found in both hands, but the thumb and the middle finger were more affected than the other fingers. The mean follow up period was 2.4 years and none of the patients complained the same characteristic pain at the last visit. Conclusion: To the best of our knowledge, this report is the largest case series about glomus tumors in the finger tip. The clinical signs and symptoms are important to make a diagnosis of glomus tumors, and surgical excision is the treatment of choice.

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Type analysis of Pharmacopuncture papers published in the Journal of Korean Institute of Pharmacopuncture (대한약침학회지에 개재된 약침관련논문의 유형 분석)

  • Lee, Jong-Young;Han, Young-Joo;Kim, Jin-Ho;Kim, Young-Jin;Kwon, Ki-Rok
    • Journal of Pharmacopuncture
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    • v.9 no.3 s.21
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    • pp.147-154
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    • 2006
  • Objectives : The focus of the analysis was laid on changes in research pertaining to pharmacopuncture in regards to time progression. Methods : Type analysis was done on pharmacopuncture related papers published in the Journal of Korean Institute of Pharmacopuncture from the inaugural issue to June 2006 issue. 196 papers are analyzed to the sort of type. Results : For type analysis of the type of studies, experiment papers outnumbered other types with 94 cases, followed by 67 for clinical trials, and 35 for literary studies. Type analysis on the type of illnesses listed in the Methods section, 31 papers concentrated on arthritis or HIVD of spine, 6 for Pharmacopuncture response in human, 5 for anti-cancer and immune disorders, etc. Conclusion : Since its inaugural issue in 1997 to August 2006 issue ranging 10 years, type analysis revealed that the number of journals pertaining to pharmacopuncture has risen steadily over the years and nearly half of papers published recently are dealing with pharmacopuncture. Pharmacopuncture is a treatment method based on the unique theory of Korean traditional medicine. Its superior efficacy is proven through numerous research works, and effort and academical approach on pharmacopuncture are expected to receive positive evaluation.

Identification of Differentially Expressed Genes in Human Small Cell Lung Carcinoma Using Subtractive Hybridization

  • Ahn Seung-Ju;Choi Jae-Kyoung;Joo Young Mi;Lee Min-A;Choi Pyung-Rak;Lee Yeong-Mi;Kim Myong-Shin;Kim So-Young;Jeon Eun-Hee;Min Byung-In;Kim Chong-Rak
    • Biomedical Science Letters
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    • v.10 no.3
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    • pp.195-202
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    • 2004
  • Lung cancer is a leading cause of cancer death worldwide; however, despite major advances in cancer treatment during the past two decades, the prognostic outcome of lung cancer patients has improved only minimally. This is largely due to the inadequacy of the traditional screening approach of diagnosis in lung cancer, which detects only well­established overt cancers and fails to identify precursor lesions in premalignant conditions of the bronchial tree. In recent years this situation has fundamentally changed with the identification of molecular abnormalities characteristic of premalignant changes; these concern tumour suppressor genes, loss of heterozygosity at crucial sites and activation of oncogenes. Basic knowledge at the molecular level has extremely important clinical implications with regard to early diagnosis, risk assessment and prevention, and therapeutic targets. In this study we used a 'cap-finder' subtractive hybridization method, 'long distance' polymerase chain reaction (PCR), streptavidin magnetic beads mediated subtraction, and spin column chromatography to detect differential expression genes of human small cell lung carcinoma. We have now isolated ninety two genes that expressed differentially in the human small cell lung carcinoma cells and analyzed of 12 clones with sequencing, nine cDNAs include tapasin (NGS-17) mRNA, BC200 alpha scRNA, chromosome 12q24 PAC RPCI3-462E2, protein phosphatase 1 (PPPICA), translocation protein 1 (TLOC1), ribosomal protein S24 (RPS24) mRNA, protein phosphatase (PPEF2), cathepsin Z, MDM2 gene and three novel genes. They may be oncogenesis­related proteins.

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