• Title/Summary/Keyword: 기피 환자

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Treatment of Pectus Carinatum with a Compressive Brace (압박 교정기를 이용한 새가슴의 치료)

  • Son, Jin-Sung;Jeon, Cheol-Woo;Lee, Seong-Jin;Lee, Chol-Sae;Lee, Kihl-Rho;Lee, Seock-Yeol
    • Journal of Chest Surgery
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    • v.40 no.5 s.274
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    • pp.369-375
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    • 2007
  • Background: Patients suffering with pectus carinatum complain of cosmetic problems when they stand and this in spite of wearing cloths. The standard surgical treatment of pectus carinatum is resection of the deformed cartilages, but the wide operative scar, post-operative pain and complications related with such an operation can occur. Therefore, we have peformed compressive brace therapy as a non-operative treatment for pectus carinatum and we observed the effects and the efficiency of this treatment. Material and Method: From January, 2001 to December, 2006, 109 patients wore the compressive brace for all day. The degree of satisfaction was evaluated after $6\sim9$ months of wearing the compressive brace. The degree of satisfaction was evaluated by a score of from $1\sim4$. A score of 1 was assigned when the status was worse, 2 when it was the same, 3 when there was partial improvement and 4 when remarkable improvement was observed. The degree of satisfaction was assessed subjectively by the parent if the patient was a child younger than middle school age, and the patients older than middle school age assessed the score themselves. Result: The mean score of the overall degree of satisfaction was $3.93{\pm}0.33$. Recurrence of pectus carinatum after removal of compressive brace occurred in 6 patients (5.5%) of the total 109 patients. But 4 patients of the total 6 recurred patients stopped wearing of compressive brace against our advice. The 6 recurred patients were re-corrected by re-wearing the compressive brace within 3 months after they originally removed the compressive brace. The complications were discomfort with initially wearing the compressive brace, which occurred in all patients, skin rash due to the compressive brace for 76 patients (69.7%) and skin discolorization with excessive compression for f6 patients (5.5%). The skin rash and discolorization returned to normal within a few months after removal of the compressive brace. Conclusion: This study demonstrated that non-surgical treatment with using the compressive brace for patients with pectus carinatum was effective, and especially for children and teenagers. Non-surgical treatment with using a compressive brace would be helpful for the patients suffering with pectus carinatum and who dislike surgical operations because of their fear about general anesthesia and operation-related complications. Yet long-term follow up is necessary to accurately evaluate the effectiveness of this compressive brace and the recurrences after removal of the compressive brace.

A Study on Treatment under General Anesthesia in Pediatric Dentistry at Seoul National University Dental Hospital (서울대학교치과병원 소아치과에서 시행된 전신마취 하 치료에 대한 연구)

  • Han, Jeong-Hwa;Song, Ji-Soo;Shin, Teo Jeon;Hyun, Hong-Keun;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.45 no.2
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    • pp.170-178
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    • 2018
  • Behavior management of the child constitutes an important part of pediatric dentistry. The majority of children can be treated with adequate behavior management. However, some children who have extensive dental problems or mental, physical disabilities cannot cooperate. So, the need for general anesthesia as a special method of behavior management has increased recently. This study analyzes the records of patients who received dental treatment under general anesthesia. The 1378 cases of 1322 patients under 18 years of age, who received dental treatment under general anesthesia in department of pediatric dentistry at the Seoul National University dental hospital, from October, 2011 to December, 2015 were included. In this study, male (60.9%) was more than female (39.1%). The mean age of patients was 5.9 years and age from 5 to 9 years was the most frequent (56.0%). The primary dental treatment which patients received was dental caries treatment (51.1%), followed by surgical treatment (42.2%). The dental treatment under general anesthesia has many advantages including of performing a lot of treatments at once, producing good quality of treatment, and reducing the number of visits. General anesthesia may be a useful method of behavior management.

Measurement Accuracy of Blood Glucose Test on the Forearm (전완 부위 혈당검사의 정확도 분석)

  • Park, Kyung-Soon;Song, Yeon-Yi;Park, Mi-Sook;Kim, Kyoung-Oak;Choi, Seong-Su;Kim, Kyung-Ah;Ryu, Jae-Duck;Cha, Eun-Jong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.10 no.9
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    • pp.2451-2459
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    • 2009
  • The present study aimed to evaluate the accuracy of the blood glucose test with almost painless vacuum assisted auto-lancing technique. The blood glucose concentration measurements in the capillary blood sampled from the alternative (forearm) site were compared with the standard venous or finger sampling techniques. Capillary blood was sampled from both the left index finger and the forearm, followed by the venous blood sampling in 531 patients who visited the C University Hospital. Blood sugar test was performed for each blood samples for comparative analysis. Mean blood glucose concentration measured on the forearm was closer to the venous glucose level than that of the finger, but the difference was approximately 10 mg/dL small enough to ignore from the clinical point of view. The correlation coefficients of the measured blood glucose levels between finger and vein and between forearm and vein were 0.94 and 0.92, respectively (p<0.001). The blood glucose measurement on the forearm also well correlated with the finger, showing a correlation coefficient of 0.94, and both data were very much close to each other. Therefore, the blood sugar test on the alternative capillary blood sampling site such as forearm was accurate enough for clinical practice. The vacuum assisted auto-lancing technique on the alternative site would be of particular interest for the disease management of the chronic diabetes, since it induces almost no pain when sampling blood from the capillaries.

Bloodless Cardiac Surgery in a Neonate Weighing 2.8 kg (2.8 kg 신생아에서 시행한 무혈 개심술)

  • Choi, Jin-Ho;Kim, Woong-Han;Nam, Jin-Hae;Lee, Young-Ok;Min, Byoung-Ju;Lim, Hong-Gook
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.721-724
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    • 2010
  • Despite increased interest in bloodless cardiac surgery, its use has been mostly confined to adult patients. Especially, bloodless pediatric cardiovascular surgery using cardiopulmonary bypass has been avoided mainly due to hemodilution. Authors recently experienced a case of bloodless cardiac surgery in a 2.8 kg-weighing neonate whose parents were Jehovah's Witness.

Case report: Treatment of Facial Nerve Palsy Following Bilateral Sagittal Split Ramus Osteotomy (증례보고 : 양측 하악지 시상골 절단술 후 발생한 안면신경 마비)

  • Ryu, Ji-Won
    • Journal of Oral Medicine and Pain
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    • v.38 no.3
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    • pp.255-260
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    • 2013
  • Bilateral sagittal split ramus osteotomy(BSSRO) of the mandible is an essential and commonly used procedure to correct dentofacial deformities and malocclusion. The possible complications associated with BSSRO include inferior alveolar nerve injury, bleeding, temporomandibular disorder, unfavorable fractures, and clinical relapse. The incidence of facial nerve palsy after orthognathic surgery recently reported is 0.1%. The probable etiologies have included facial nerve compression, complete or incomplete nerve transection, nerve traction, and nerve ischemia from anesthetic injection. Postoperative facial palsy is one of the most serious complications because it reduces the quality of life and significantly reduces social interaction. The case of a 24-year-old patient who underwent bilateral sagittal split ramus osteotomy is described. The medical records and postoperative photographs were reviewed in detail to collect information on the clinical course, treatment, and outcomes.

A Study on the Distribution of Heavy Metal Elements in Arc Welding Fume (아크용접 Fume의 중금속 분포에 관한 연구)

  • 채현병;김정한
    • Proceedings of the Safety Management and Science Conference
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    • 1999.11a
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    • pp.343-343
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    • 1999
  • 아크용접은 산업전반에 걸쳐 그 생산기반에 없어서는 안될 필수기술로써 자동차 및 조선, 항공우주산업에 이르기까지 경제기반에 미치는 파급효과가 매우 크다. 그러나 이 아크용접을 하게 되면 각종 가스와 미세입자로 이루어진 흄이 발생하게 되는데 이들은 작업자들의 건강에 많은 영향을 미치는 것으로 보고되어 있다. 용접흄에는 용접재료 및 용접공정에 따라 다양한 유해원소가 포함되어 있고 그 종류에 따라 인체에 미치는 잠재적 독성효과도 매우 광범위하다. 최근 국내에서는 용접사들 중에 용접흄에 포함된 중금속 중 Mn중독에 의한 파킨스씨병 환자들과 Cr중독에 의하여 콧속 연골에 구멍이 뚫리는 비중격천공(鼻中隔穿孔) 환자들이 직업병으로 판정 받아 산재요양이 승인된 사례가 있다. 이러한 계기로 인하여 용접사들의 용접기피 현상이 심화되고 작업환경에 대한 법적규제는 선진 외국뿐만 아니라 국내에서도 한층 엄격하게 강화되고 있는 실정이다. 따라서 이제는 작업자와 사용자 모두 용접흄에 대한 인식의 전환이 요구되는 때이며 여러 분야에서 이러한 용접흄에 대한 연구가 활발히 진행되어야 한다. 해외에서는 이미 용접흄에 대한 연구가 활발히 진행되어 왔으나 국내의 경우는 매우 미비한 상태이며 용접산업의 미래 영향력이나 필요성을 고려할 때 국내에서도 적극적인 관심을 가져야 할 부분으로 판단된다. 본 연구에서는 아크용접공정에서 발생하는 흄의 특정 중금속 성분이 인체에 치명적인 악영향을 미치는 것에 착안하여 여러 종류의 용접재료에서 발생되는 용접흄의 중금속 분포를 조사하여 비교하였다. 이것은 향후 용접재료별 및 용접공정별 발생되는 흄의 유해원소를 저감시킬 수 있고 또한 각종 유해원소의 노출기준 및 평가기준을 마련할 수 있는 기초data로써 도움이 되리라 사료된다.동, 공정중재고가 줄어드는 결과를 보였고, 가동률 수준이 높을수록 ORR 방법간의 차이가 크게 나타났다. 그리고 부하평준화 기능은 Order Release 정책의 유효성에 별 영향을 주지 않는 것으로 나타났다. 결론적으로, Order Release 방법은 우선순위규칙간의 성능차이를 줄이거나, 대체할 수 통제 기법이라기보다는 우선순위규칙을 보완하여 공정중재고와 작업현장에서의 리드타임, 리드타임의 편차를 줄여주는 역할을 한다고 볼 수 있다. 그리고, 계획시스템이 존재하여 계획오더가 일정기간간격으로 이송되는 환경에서 특히 유용하다는 결론을 얻었다. 알 수 있었다. 것인데, 제조업에서의 심각한 고비용, 저효율 문제 를 해결하기 위해 필수적으로 도입해야만 하는 실정이다. 또한 소비자의 다양한 요구로 인 하여 제품의 종류와 사양면에서 심한 변동을 보이는 시장 수요에, 신속한 정보처리로 대응 하는데도 크게 기여하고 있다. 이에 본 연구에서는, 자동차 Job Shop의 동기화 생산방식을 지원하는 동기화 생산시스템의 구축 모델을 제시하고자 한다.과로 여겨지며, 또한 혈청중의 ALT, ALP 및 LDH활성을 유의성있게 감소시키므로서 감잎 phenolic compounds가 에탄올에 의한 간세포 손상에 대한 해독 및 보호작용이 있는 것으로 사료된다.반적으로 홍삼 제조시 내공의 발생은 제조공정에서 나타나는 경우가 많으며, 내백의 경우는 홍삼으로 가공되면서 발생하는 경우가 있고, 인삼이 성장될 때 부분적인 영양상태의 불충분이나 기후 등에 따른 영향을 받을 수 있기 때문에 앞으로 이에 대한 많은 연구가 이루어져야할 것으로 판단된다.태에도 불구하고 [-wh]의미의 겹의문사는 병렬적 관계의 합성어가 아니라 내부구조를 지니지 않은 단순한 단어(min

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Vacuum Assisted Auto-Lancing Technique for Capillary Blood Sampling on the Forearm with Minimized Pain (전완부위 최소통증 채혈을 위한 진공 자동 채혈기법)

  • Park Mi Sook;Park Kyung Soon;Kim Kyung Ah;Jun Myung Hee;Kim Tae Im;Lee Tae Soo;Cha Eun Jong
    • Journal of Biomedical Engineering Research
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    • v.25 no.6
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    • pp.557-563
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    • 2004
  • A new vacuum assisted auto-lancing technique is proposed to minimize pain. Specially designed lancing device was introduced, which applied -100mmHg right after skin puncture on the forearm. Sampled blood volumes were measured in 58 normal females. Mean volume of 464 samples was approximately 2.6$\muL$ and the frequency of more than 0.5$\muL$ was 86%. Thus the success rate of blood sugar test should also be the same when using modern glucose meters capable of testing with only 0.3~0.5$\muL$ of capillary blood. When pain scores were quantitatively evaluated by the visual pain measure, only 23% pain of the traditional finger sampling was experienced, demonstrating that capillary blood sampling was performed on the forearm with almost no pain. The present technique reduced pain to a great degree, though resampling might be unavoidable due to 14% of test failure rate estimated for modern glucose meters. However, minimized pain makes the present technique of great convenience for diabetic patients who need blood sampling a few times a day.

A CASE OF TREATMENT-RESISTANT CHILDHOOD-ONSET SCHIZOPHRENIA WITH LONG-TERM TRIAL OF CLOZAPINE (치료저항성 소아기 발병 정신분열증의 Clozapine 장기치험 1례)

  • Jang, Soon-Ah;Kim, Kyung-Hee;Lee, Hong-Shick;Song, Dong-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.9 no.1
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    • pp.98-104
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    • 1998
  • A 12-year-old girl with a 6 year history of childhood-onset schizophrenia required 2 hospitalizations and long-term clozapine trial due to inadequate responses to combinations of typical neuroleptics and traditional treatments of schizophrenic disorder. On admission, she had continuous auditory and visual hallucinations, persecutory delusion, emotional instability, regression of behaviors including temper tantrums as well as specific developmental delays in learning, language, and motor coordination. The clozapine trial significantly reduced most of the positive symptoms, and facilitated in successful discharge from the hospital. During the 4 year clozapine treatment, no significant adverse reactions were noted, and she returned to a structured school setting with minimal degrees of schizophrenic symptoms. From this clinical experience, we suggest that clozapine might be safe and effective in treating treatment-refractory schizophrenic children.

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Is It Appropriate to Insert Pedicle Screws at an Infected Vertebral Body in the Treatment of Lumbar Pyogenic Spondylodiscitis? (요추부 화농성 척추염의 수술적 치료: 이환된 추체에 척추경 나사 고정이 타당한가?)

  • Na, Hwa-Yeop;Jung, Yu-Hun;Lee, Joo-Young;Kim, Hyung-Do
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.5
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    • pp.419-426
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    • 2021
  • Purpose: In the surgical treatment of pyogenic lumbar spondylodiscitis, screw insertion at the affected vertebra has been avoided because of biofilm formation, and the risk of infection recurrence. The authors analyzed the success rate of infection treatment while minimizing the number of instrumented segments by inserting pedicle screws into the affected vertebrae. Therefore, this study examined the usefulness of this technique. Materials and Methods: From January 2000 to June 2018, among patients with pyogenic lumbar spondylodiscitis treated surgically, group A consisted of patients with pedicle screws inserted directly at the affected vertebrae (28 cases), and group B underwent fusion by inserting screws at the adjacent normal vertebrae due to bone destruction of the affected vertebral pedicle (20 cases). The classified clinical results were analyzed retrospectively. All patients were treated via the posterior-only approach, so the affected disc and sequestrum were removed. Posterior interbody fusion was performed with an autogenous strut bone graft, and the segments were then stabilized with pedicle screw systems. The hospitalization period, operation time, amount of blood loss, EQ-5D index, duration of intravenous antibiotics, and the clinical and radiological results were analyzed. Results: In group A, the number of instrumented segments, operation time, blood loss, and EQ-5D index at one month postoperatively showed significant improvement compared to group B. There were no significant differences in the duration of antibiotic use, hospitalization, radiological bone union time, sagittal angle correction rate, and recurrence rate. Conclusion: Minimal segmental fixation, in which pedicle screws were inserted directly into the affected vertebrae through the posterior approach, reduced the surgery time and blood loss, preserved the lumbar motion by minimizing fixed segments and showed rapid recovery without spreading or recurrence of infection. Therefore, this procedure recommended for the surgical treatment of lumbar pyogenic spondyodiscitis.

Long-term Results of Thoracoscopic T2 Sympathicotomy for Craniofacial Hyperhidrosis in Woman (여성의 안면 다한증에 대한 제2흉부 교감신경 차단술 후 장기결과)

  • 조덕곤;조민섭;박찬범;왕영필;이선희;조규도
    • Journal of Chest Surgery
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    • v.37 no.7
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    • pp.591-596
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    • 2004
  • Recently, thoracic sympathicotomy for craniofacial hyperhidrosis (FH) is increasingly avoided contrast to palmar hyperhidrosis. We recently demonstrated that selective T2 sympathicotomy for FH in woman might be recommended because of differences of the postoperative satisfaction between man and woman. Therefore, this study was designed to analyze the postoperative long term results, evaluate the effectiveness of T2 sympathicotomy and establish the new strategy in treatment of FH in woman. Material and Method: From May 1998 to July 2001, 27 cases of FH in woman that were performed T2 sympathicotomy and minimum 2 years have passed since then at the follow up period. Among them, 20 cases were evaluated by telephone review and medical record. Bilateral sympathetic trunks were severed on the 2nd rib with 2mm thoracoscopic instruments. 7 patients combined with gustatory sweating (GS). Ages ranged from 25 to 62 (mean age, 46.4 years). Result: All patients were relieved of symptom immediately after operation. At postoperative 1 week, all patients were satisfied: 15 patients, “very satisfaction” and 5 patients, “relatively satisfaction”. However, during long term follow up period (from 25 to 63 months postoperatively), 9 patients (45%) were relatively satisfied, 8 patients (40%) complained that there was no difference of postoperative satisfaction and 3 patients (15%) complained of non satisfactory results (regret for surgery). 16 patients (80%) had complaint of uncomfortable feeling because of postoperative GS. Some degree of compensatory sweating (CS) had occurred in all patients: severe 10 patients (50%), severe but acceptable 6 patients (30%), and just conventional 4 patients (20%). The sites of CS were trunk, back, axilla and extremities. Conclusion: Thoracoscopic T2 sympathicotomy is relatively considerable method for FH in woman and the postoperative satisfaction depends on GS and the degree of individual adaptation for CS. Therefore, it is required that the prediction of preoperative risk factors for GS and CS and then careful selection of patients to increase the postoperative satisfaction, and the development of acceptable new treatment modalities.