• Title/Summary/Keyword: treatment failure

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A CLINICAL STUDY ON THE CARE OF ODONTOGENIC INFECTIONS IN THE PATIENTS WITH MAJOR BLEEDING DISORDERS (주요 출혈성 질환자에서 치성감염 관리에 관한 임상적 연구)

  • Kim, Jong-Bae;Chung, Won-Gyun;Noh, Hie-Jin;Jang, Sun-Ok;Yoo, Jae-Ha;Han, Sang-Kwon;Chung, Jae-Hyung;Kim, Byung-Wook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.29 no.5
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    • pp.330-337
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    • 2003
  • This is a retrospective study on the care of odontogenic infections in admission patients with major bleeding disorders. The study was based on a series of 514 patients treated at Dong San Medical Center, Wonju Christian Hospital and Il San Health Insurance Hospital, from Jan. 1, 2000, to Dec. 31, 2002. The obtained results were as follows : 1. The cardiovascular disease was the most frequent cause of the systemic diseases with major bleeding disorders, and liver disease, cerebrovascular disease and renal failure were next in order of frequency. But, there was the most frequent dental consultation in the liver disease, owing to the many odontogenic infectious diseases. 2. Male prediction (66.3%) was almost existed in the odontogenic infectious patients with major bleeding disorders. But, there was slight female prediction (53.4%) in the cardiovascular disease. 3. The most common age group of the odontogenic infectious patients with major bleeding disorders was the fifty decade(27.2%), followed by the forty, sixty & thirty decade in order. 4. In the contents of chief complaints on the odontogenic infectious patients with major bleeding disorder, peak incidence was occurred as toothache (42.2%), followed by intraoral bleeding, ulcer pain, dental extraction in order. 5. In the diagnosis group of odontogenic infectious diseases, periodontitis, pulpitis and periapical abscess were more common. 6. In the treatment group of odontogenic infectious diseases, the most frequent incidence(44.2%) was showed in primary endodontic drainage(pulp extirpation, occlusal reduction & canal opening drainage) and followed by the incision & drainage, the medications & oral hygiene instruction, scaling, indirect pulp capping in order.

High Prevalence of Helicobacter pylori Resistance to Clarithromycin: a Hospital-Based Cross-Sectional Study in Nakhon Ratchasima Province, Northeast of Thailand

  • Tongtawee, Taweesak;Dechsukhum, Chavaboon;Matrakool, Likit;Panpimanmas, Sukij;Loyd, Ryan A;Kaewpitoon, Soraya J;Kaewpitoon, Natthawut
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8281-8285
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    • 2016
  • Background: Helicobacter pylori is a cause of chronic gastritis, peptic ulcer disease, and gastric malignancy, infection being a serious health problem in Thailand. Recently, clarithromycin resistant H. pylori strains represent the main cause of treatment failure. Therefore this study aimed to determine the prevalence and pattern of H. pylori resistance to clarithromycin in Suranaree University of Technology Hospital, Suranree University of Technology, Nakhon Ratchasima, Northeastern Thailand, Nakhon Ratchasima province, northeast of Thailand. Materials and Methods: This hospital-based cross-sectional study was carried out between June 2014 and February 2015 with 300 infected patients interviewed and from whom gastric mucosa specimens were collected and proven positive by histology. The gastric mucosa specimens were tested for H. pylori and clarithromycin resistance by 23S ribosomal RNA point mutations analysis using real-time polymerase chain reactions. Correlation of eradication rates with patterns of mutation were analyzed by chi-square test. Results: Of 300 infected patients, the majority were aged between 47-61 years (31.6%), female (52.3%), with monthly income between 10,000-15,000 Baht (57%), and had a history of alcohol drinking (59.3%). Patient symptoms were abdominal pain (48.6%), followed by iron deficiency anemia (35.3%). Papaya salad consumption (40.3%) was a possible risk factor for H. pylori infection. The prevalence of H. pylori strains resistant to clarithromycin was 76.2%. Among clarithromycin-resistant strains tested, all were due to the A2144G point mutation in the 23S rRNA gene. Among mutations group, wild type genotype, mutant strain mixed wild type and mutant genotype were 23.8%, 35.7% and 40.5% respectively. With the clarithromycin-based triple therapy regimen, the efficacy decreased by 70% for H. pylori eradication (P<0.01). Conclusions: Recent results indicate a high rate of H. pylori resistance to clarithromycin. Mixed of wild type and mutant genotype is the most common mutant genotype in Nakhon Ratchasima province, therefore the use of clarithromycin-based triple therapy an not advisable as an empiric first-line regimen for H. pylori eradication in northeast region of Thailand.

Bending Impact Properties Evaluation of Sn-xAg-Cu Lead Free Solder Composition and aging treatment (시효처리한 Sn-xAg-Cu계 무연솔더 조성에 따른 굽힘충격 특성평가)

  • Jang, Im-Nam;Park, Jai-Hyun;Ahn, Yong-Sik
    • Journal of the Microelectronics and Packaging Society
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    • v.18 no.2
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    • pp.49-55
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    • 2011
  • The failure of electronic instruments is mostly caused by heat and shock. This shock causes the crack initiation at the solder joint interface of PCB component which is closely related with the formation of intermetallic compound(IMC). The Ag content in Pb-free Sn-xAg-0.5Cu solder alloy used in this study was 1.0, 1.2 and 3.0 wt.%, respectively. After soldering with PCB component, isothermal aging was performed to 1000 hrs. The growth of IMC layer was observed during isothermal aging. The drop impact property of solder joint was evaluated by impact bending test method. The solder joint made with the solder containing lower Ag content showed better impact bending property compared with that with higher Ag content. On the contrary to this result, the solder joint made with solder containing higher Ag content showed better impact bending property after aging. It should be caused by the formation of fine $Ag_3Sn$, which relieved the impact. It showed consequently the different effect of fine $Ag_3Sn$ and coarse $Cu_6Sn_5$ particles formed in the IMC layer on the impact bending property.

Postoperative irradiation after implant placement: A pilot study for prosthetic reconstruction

  • Doh, Re-Mee;Kim, Sungtae;Keum, Ki Chang;Kim, Jun Won;Shim, June-Sung;Jung, Han-Sung;Park, Kyeong-Mee;Chung, Moon-Kyu
    • The Journal of Advanced Prosthodontics
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    • v.8 no.5
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    • pp.363-371
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    • 2016
  • PURPOSE. On maxillofacial tumor patients, oral implant placement prior to postoperative radiotherapy can shorten the period of prosthetic reconstruction. There is still lack of research on effects of post-implant radiotherapy such as healing process or loading time, which is important for prosthodontic treatment planning. Therefore, this study evaluated the effects of post-implant local irradiation on the osseointegration of implants during different healing stages. MATERIALS AND METHODS. Custom-made implants were placed bilaterally on maxillary posterior edentulous area 4 weeks after extraction of the maxillary first molars in Forty-eight Sprague-Dawley rats. Experimental group (exp.) received radiation after implant surgery and the other group (control) didn't. Each group was divided into three sub-groups according to the healing time (2, 4, and 8 week) from implant placement. The exp. group 1, 2 received 15-Gy radiation 1 day after implant placement (immediate irradiation). The exp. group 3 received 15-Gy radiation 4 weeks after implant placement (delayed irradiation). RESULTS. The bone mineral density (BMD) was significantly lower in the immediate irradiation groups. BMD was similar in the delayed irradiation group and the control group. The irradiated groups exhibited a lower bone-to-implant contact ratio, although the difference was not statistically significant. The irradiated groups also exhibited a significantly lower bone volume and higher empty lacuna count than the control groups. No implant failure due to local irradiation was found in this study. CONCLUSION. Within the limits of this study, the timing of local irradiation critically influences the bone healing mechanism, which is related to loading time of prostheses.

Acute Respiratory Distress Syndrome after Topotecan Therapy in a Patient with Small Cell Lung Cancer (소세포폐암 환자에서 토포테칸 투약 후 발생한 급성호흡곤란증후군)

  • Tae, Jung Hyun;Lee, Jin Hwa;Kim, Yoon Kyung;Sim, Yun Su;Lee, Kyung Jong;Noh, Young Wook;Park, Jae Jung;Ryu, Yon Ju;Chun, Eun Mi;Chang, Jung Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.2
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    • pp.142-146
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    • 2008
  • Small cell lung cancer is characterized by an aggressive clinical course and a high tendency for early dissemination in spite of a good chemotherapy response. Topotecan is a topoisomerase I inhibitor, and it is used as second-line treatment for small cell lung cancer. The reported dose-limiting adverse reactions to topotecan are mainly hematologic. Yet pulmonary toxicity associated with topotecan is known to be rare. We report here on a case that showed the development of acute respiratory distress syndrome during the 3rd cycle of topotecan chemotherapy in a patient with small cell lung cancer. He developed dyspnea and respiratory failure, and the chest CT scan revealed diffuse ground-glass opacity that was probably due to chemotherapy-related pulmonary toxicity. He finally died of acute respiratory distress syndrome.

Complex oncologic resection and reconstruction of the scalp: Predictors of morbidity and mortality

  • Tecce, Michael G.;Othman, Sammy;Mauch, Jaclyn T.;Nathan, Shelby;Tilahun, Estifanos;Broach, Robyn B.;Azoury, Said C.;Kovach, Stephen J.
    • Archives of Craniofacial Surgery
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    • v.21 no.4
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    • pp.229-236
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    • 2020
  • Background: Oncologic resection of the scalp confers several obstacles to the reconstructive surgeon dependent upon patient-specific and wound-specific factors. We aim to describe our experiences with various reconstructive methods, and delineate risk factors for coverage failure and complications in the setting of scalp reconstruction. Methods: A retrospective chart review was conducted, examining patients who underwent resection of fungating scalp tumors with subsequent soft-tissue reconstruction from 2003 to 2019. Patient demographics, wound and oncologic characteristics, treatment modalities, and outcomes were recorded and analyzed. Results: A total of 189 patients were appropriate for inclusion, undergoing a range of reconstructive methods from skin grafting to free flaps. Thirty-three patients (17.5%) underwent preoperative radiation. In all, 48 patients (25.4%) suffered wound site complications, 25 (13.2%) underwent reoperation, and 47 (24.9%) suffered from mortality. Preoperative radiation therapy was an independent risk factor for wound complications (odds ratio [OR], 2.85; 95% confidence interval [CI], 1.1-7.3; p=0.028) and reoperations (OR, 4.45; 95% CI, 1.5-13.2; p=0.007). Similarly, the presence of an underlying titanium mesh was an independent predictor of wound complications (OR, 2.49; 95% CI, 1.1-5.6; p=0.029) and reoperations (OR, 3.40; 95% CI, 1.2-9.7; p=0.020). Both immunosuppressed status (OR, 2.88; 95% CI, 1.2-7.1; p=0.021) and preoperative radiation therapy (OR, 3.34; 95% CI, 1.2-9.7; p=0.022) were risk factors for mortality. Conclusion: Both preoperative radiation and the presence of underlying titanium mesh are independent risk factors for wound site complications and increased reoperation rates following oncologic resection and reconstruction of the scalp. Additionally, preoperative radiation, along with an immunosuppressed state, may predict patient mortality following scalp resection and reconstruction.

THE LONG-TERM CONSERVATIVE DRAINAGE CARE OF EXTENSIVE OSTEOMYELITIS ASSOCIATED WITH MANDIBULAR COMPOUND FRACTURE : REPORT OF A CASE (장기간의 보존적 배농술로 치료된 하악 복합골절 관련 광범위 골수염 치험 : 증례보고)

  • Kim, Ha-Rang;Yoo, Jae-Ha;Choi, Byung-Ho;Sul, Sung-Han;Mo, Dong-Yub;Lee, Chun-Ui
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.6
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    • pp.544-549
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    • 2009
  • Failure to use effective methods of reduction, fixation and immobilization may lead to osteomyelitis with the exposed necrotic bone, as the overzealous use of transosseous wires & plates that devascularizes bone segments in the compound comminuted fractures of mandible. Once osteomyelitis secondary to fractures has become established, intermaxillary fixation should be instituted as early as possible. Fixation enhances patient comfort and hinders ingress of microorganisms and debris by movement of bone fragments. Teeth and foreign materials that are in the line of fracture should be removed and initial debridement performed at the earliest possible time. Grossly necrotic bone should be excised as early as possible ; no attempt should be made to create soft tissue flaps to achieve closure over exposed bone. The key to treatment of chronic osteomyelitis of the mandible is adequate and prolonged soft tissue drainage. If good soft tissue drainage is provided over a long period, sequestration of infected bone followed by regeneration or fibrous tissue replacement will occur so that appearance and function are not seriously altered. Localization and sequestration of infected mandible are far better performed by natural mechanism of homeostasis than by cutting across involved bone with a cosmetic or functional defect. As natural host defenses and conservative therapy begin to be effective, the process may become chronic, inflammation regresses, granulation tissue is formed, and new blood vessels cause lysis of bone, thus separating fragments of necrotic bone(sequestra) from viable bone. The sequestra may be isolated by a bed of granulation tissue, encased in a sheath of new bone(involucrum), and removed easily with pincettes. This is a case report of the long-term conservative drainage care in osteomyelitis associated with mandibular fractures.

Effectiveness of Public Credit Guarantee System and Its Coexistence with Market-based Finance Schemes (공적보증의 효과성과 시장기반 금융제도와의 공존)

  • Noh, Yong-Hwan;Hong, Jaekeun
    • The Journal of Small Business Innovation
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    • v.19 no.3
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    • pp.1-16
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    • 2016
  • Korean government had used public 'credit guarantee schemes' (CGS) as a counter-cyclical measure. However, it is still controversial about the effectiveness of policy financing on the SMEs. Criticism on policy financing involves the argument that supporting enterprises hampers competition and innovation of SMEs by increasing their dependence on the government and delays the exit of marginal firms. In this paper, we investigate how to effectively build up the rationale of running public CGSs. At the same time, we propose the ways to coexist of public credit guarantee and market-based private finance system for SMEs. First, CGS, as a counter-cyclical function, must coexist with the private financial system by compensating the market failure caused by pro-cyclical behavior of the private financial market. Second, CGS has the comparative advantages, compared to both the interest rate policy of the central bank and fiscal policy of the government. The credit guarantee is the symptomatic treatment that could revitalize the economy shortly by providing liquidity. Also, knowing that CGS is provided based on the leverage ratio defined by outstanding guarantee divided by capital fund, public 'credit guarantee' (CG) has an advantage that is free from the risk of government deficit. Third, the reason for existence of the CGS should be founded in supporting services for SMEs, available only in a public sector that is difficult to expect from private banks. In this regard, it is desirable to strengthen the publicness of credit guarantee over the support for start-ups, growing companies, the improvement of productivity, increase of exports, a long-term investment in facilities, the employment-creating businesses, and innovative enterprises.

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Re-establishment of occlusal plane in a patient with a failed implant prosthesis (실패한 임플란트 보철수복물을 가진 환자의 교합평면 재설정)

  • Kang, Hyeon-Goo;Ko, Kyung-Ho;Huh, Yoon-Hyuk;Cho, Lee-Ra;Park, Chan-Jin
    • The Journal of Korean Academy of Prosthodontics
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    • v.56 no.2
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    • pp.141-153
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    • 2018
  • A non-physiological occlusal plane caused by continuous tooth loss, occlusal wear, and failure of a prosthesis may result in an unattractive appearance and functional problems, such as reduced masticatory efficiency and occlusal interference. Therefore, when undertaking prosthetic treatment for edentulous patients or patients with a collapsed occlusal plane, it is important to establish an occlusal plane that is compatible with masticatory function. The patient in this case report had undergone restoration of a completely edentulous maxilla using an implant-supported fixed prosthesis. On follow-up examination in the following 6 years, mechanical complications were observed in the existing implant prosthesis, including porcelain chipping, occlusal wear, and screw loosening. Moreover, due to occlusal wear and supraeruption of the opposing anterior teeth, as well as loss of some posterior teeth, the occlusal plane had collapsed. Following diagnosis, the patient underwent full mouth rehabilitation, involving additional implant installation in edentulous sites, recreation of the existing prosthesis, and prosthetic restoration of all remaining teeth.

A Case of Broncho-esophageal Fistula Associated with Bronchiectasis (기관지확장증과 동반된 식도기관지루 1례)

  • Chung, Hyuck-Joon;Ku, Sung-Hyun;Lee, Sun-Min;Park, Kwang-Joo;Hwang, Sung-Chul;Lee, Yi-Hyeong;Han, Myung-Ho;Kim, Yung-Jin;Lee, Chul-Ju;Lee, Ki-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.5
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    • pp.729-734
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    • 1999
  • Broncho-esophageal fistula(BEF) is an uncommon clinical entity which can cause severe suppurative lung disease. Acquired fistulas between the esophagus and tracheobronchial tree are relatively uncommon. They are caused by many diseases including malignancy and chronic inflammation such as tuberculosis and have favorable outcome with proper treatment To our knowledge, there has been no description of patients with BEF due to the bronchiectasis. We report a case of broncho-esophageal fistula in association with bronchiectasis in a 35-year-old male patient with hemoptysis. Bronchoscopy revealed mild bleeding from the superior segment of the right lower lobe without specific endobronchial lesion. Barium esophagogram could not confirm the fistula. The diagnosis of a broncho-esophageal fistula was established by an esophagogastroscopy using fistulogram and subsequent bronchoscopy, in which the communication between the bronchial tree and the esophagus was demonstrated by instilling dye selectively through the fistulous opening using esophagogastroscopy and visualizing the fistula and the bronchial tree. The patient was treated with resection of the right lower lobe, extirpation of the diverticulum and surgical closure of the bronchial defect and fistula, but he suffered from pneumonia thereafter and eventually expired due to sepsis and multiple organ failure.

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