• Title/Summary/Keyword: 임상 관찰

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Practice method and performance according to clinical practice contents of dental hygiene student (치위생과 학생의 임상실습내용에 따른 실습방법 및 수행 정도)

  • Shin, Myong-Suk;Kim, Chang-Hee;Ahn, Eun-Suk;Hwang, Ji-Min
    • The Journal of the Convergence on Culture Technology
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    • v.5 no.2
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    • pp.123-138
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    • 2019
  • The clinical institution of some dental hygiene students and the degree of practice and performance according to the practice contents are identified, so as to develop clinical practice guidelines and to improve the education of universities and practical institutions. From November 2016 to March 2017, the questionnaire was prepared by self-inclusion after explaining the purpose of research and how to prepare questionnaire to some dental hygiene students. This material has been analyzed using PASW Statistics 18.0. As for the clinical practice content items of basic care and infection control, the frequency of "execution" among practice methods was high, and the distribution rate was high in oral evil face radiation, preventive dentistry, prosthesis, periodontology, orthodontics, and oral internal medicine. The conservation department has conducted various practical methods such as "executing," "observing" and "preparing." Oral surgery showed similar distribution rates, such as "observation," "preparation," and "execution" in the "preparation and cooperation of the feet." In pediatric dentistry, "observation" was the most common practice, and among them, "observation," "preparation," and "execution" were performed in "preparation and cooperation for infantile development." In addition, students with more experience in clinical practice showed statistically significant differences in basic care, oral hygiene, preventative dentistry, conservation, dental dentistry, oral surgery, orthodontics, and oral internal medicine(p<0.05). Most clinical practice shows that it is more observable than performed.It is expected that the goal of clear clinical practice content should be set by grade or number of clinical practice experiences, as well as the practice method that can be performed by the trainees.

Clinical outcome in relation to stability of longitudinal meniscal tear associated with anterior cruciate ligament rupture (전방 십자인대 파열에 동반된 반월상 연골판 종파열의 파열부위 안정성에 따른 치료 결과)

  • Seo, Seung-Suk;Kim, Chang-Wan;Kim, Jin-Seok;Kim, Jeon-Gyo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.9 no.2
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    • pp.91-97
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    • 2010
  • Purpose: The purpose of this study was to evaluate the results of treatment for longitudinal meniscal tear in ACL rupture patients by clinical evaluation and $2^{nd}$ look arthroscopy. Materials and Methods: Among the patients who underwent surgery due to ACL rupture and longitudinal meniscal tear between 2002~2009, 32 patients were selected for the study. The patients were devided into three groups; group 1 had repair, group 2 had partial menisectomy due to impossible to repair, group 3 had conservative treatment due to stable meniscus. Comparative retrospective analysis was applied with KT 1000 arthrometer, Lysolm' score, Tegner activity score, IKDC subjective score, and $2^{nd}$ look arthroscopy. Results: Lysolm' score, Tegner activity score, IKDC subjective score showed no statistical difference in all three groups. KT-1000 side to side difference improved from 6.2, 6.15, 6.38 before surgery to 2.56, 2.49, 2.58 after surgery in group 1, 2, and 3, respectively. In group 1, second-look arthroscopy revealed complete healing in 12 patients, incomplete healing without any clinical symptoms in 2, and healing failure in 1. In group 2, second-look arthroscopy showed partial regeneration on margin of meniscectomy. In group 3, second-look arthroscopy revealed complete healing in 2 patients, while 4 showed incomplete healing so that have repaired. Conclusion: In the study, the outcome was better when the stable longitudinal meniscal tear on posterior horn with ACL rupture had active treatment.

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위평충제치료소아소화성궤양98례임상관찰여수방보고(胃平沖劑治療小兒消化性潰瘍98例臨床觀察與隨訪報告) -위평충제(胃平沖劑)로 소아 소화성궤양 환자 98예(例)에 대한 임상치료 및 추적관찰 결과에 대한 연구-

  • Jin So-Jeong;Yun Hye-Min;Lee So-Jeong;Yeon Yun-Guk
    • The Journal of Pediatrics of Korean Medicine
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    • v.15 no.1
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    • pp.261-265
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    • 2001
  • 소아의 소화성궤양은 소아 소화계질환 중에서 발병율이 점차 늘어나고 있는 추세에 있다. 최근 소아과에서 내시경의 활용이 활발해지면서 장기적으로 반복하여 위완통(胃脘痛), 변혈 (便血)및 구혈(嘔血)이 나타나는 경우 궤양성질환의 가능성이 높은 것으로 밝혀지고 있다. 본원에서는 유명한 중의사 왕붕비(王鵬飛) 교수의 비완통(脾脘痛) 치험방을 토대로 많은 임상을 거쳐 위평충제(胃平沖劑)를 개발하여 1992년6월부터 1997년12월까지 위내시경 검사를 통하여 위궤양으로 진단된 98명의 소아환자에게 투여하여 관찰한 바 만족스러운 효과가 나타나 이를 보고한다. 위평충제(胃平衝劑)의 처방구성은 자초(紫草), 청대(靑黛), 곽향(藿香), 유향(乳香), 회향(茴香), 정향(丁香), 황련(黃連), 적석지(赤石脂), 황정(黃精) 등이다. 한의학적 이론에 따르면 불규칙하고 자극성이 강한 음식섭취 습관은 비위(脾胃)를 손상시켜 중주(中州)를 옹체(壅滯)시키므로 기(氣)의 원활한 소통이 이루어지지 않으면 부통즉통(不通卽痛)의 기전으로 발전한다. 또한 근래 소아들이 각종 정신적인 압박으로 스트레스가 쌓이면서 간기울결(肝氣鬱結)을 초래하여 울화(鬱火)로 인하여 혈락(血絡)이 손상되면서 출혈증상이 나타난다. 왕교수의 견해에 따르면 체내에 어혈이 제거되지 않으면 기혈(氣血)의 순환이 더욱 악화되어 어적(瘀積)이나 궤양 또는 경새(梗塞) 등을 일으키게 된다고 하였다. 따라서 위평충제(胃平沖劑)는 활혈화어(活血化瘀), 청열해독(淸熱解毒)과 더불어 익기양위(益氣養胃), 거어지통(祛瘀止痛)의 효능이 있는 약물들로 구성되었다. 동물실험에서 위평충제(胃平衝劑)는 궤양표면을 보호하고 치유하며 재발을 방지하는 효과가 있는 것으로 확인되었고, 위액의 분비, 위단백질효소의 활성에 대한 억제 및 진통효과도 있는 것으로 입증되었다.행하여 사용하는 것이 바람직하며, 단순한 중약 투여는 일부 양약에 의한 소아성장에 미치는 영향을 피할 수 있어 더 많은 임상연구가 이어져야 한다.(當歸) 목단피(牧丹皮) 울김(鬱金) 정력자(?歷子) 세신(細辛) 오미자(五味子) 구기자(枸杞子) 산수황육(山茱黃肉) 황기(黃?) 감초(甘草) 등을 기본적으로 사용한다. 비신양허형(脾腎陽虛型)은 온보비신(溫補脾腎) 화어척담(化瘀滌痰)을 원칙으로 하며, 처방에는 구마황( 灸麻黃) 세신(細辛) 오미자(五味子) 당귀(當歸) 단삼(丹蔘) 울김(鬱金) 정력자(?歷子) 반하(半夏) 보골지(補骨脂) 선령비(仙靈脾) 태자삼(太子蔘) 황기(黃?) 감초(甘草) 등을 기본적으로 사용한다. 치험(治驗): (1) 천식의 실증(實證)은 치료를 한 뒤 완화단계에 접어들면서 허증(虛證)으로 전화되는데, 허천(虛喘)도 역시 천식이니 만큼 단순히 보법(補法)만 사용하여서는 안된다. 시종일관 천식치료에는 척담화어(滌痰化瘀)의 원칙을 지켜야 한다. 폐내(肺內)의 담어(痰瘀)가 철저하게 제거되어야 폐(肺)의 순환기능을 개선시켜 기도(氣道)의 염증을 신속히 흡수하고 치유할 수 있다. 이와 같은 치료과정은 약 3-6개월이 필요하다. 완화단계의 기간이 길어질수록 완치될 확률도 높아진다. (2) 급성기 천식은 폐(肺)를 다스려야 한다. 폐(肺)를 다스리는 방법에는 선폐(宣肺), 청폐(淸肺), 온폐(溫肺), 윤폐(潤肺) 및 척담거어(滌痰祛瘀) 등이 있다. (3) 증상이 완화되면 신(腎)을 다스린다. 천식은 신허(腎虛)가 근본적인 원인이므로 완화단계에서 심지어 발작기에도 보신제(補腎劑)를 추가하여 사용하면 배의 효과를 얻을 수 있다. (4) 비(脾)의 기능을 강화하여 근본을 채우는 부비배본(扶脾培本)도 중요하다. 후천의 수곡정미(水穀精微)로 선천을 충족시키고 자양하는 것은 질병에 대한 저항력을

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Oral Amelanotic Malignant Melanoma in a Dog: Melan A Immunohistochemical Findings (개에서 발생한 구강 멜라닌결핍 악성흑색종 예 : Melan A 면역화학조직 염색 고찰)

  • Kang, Min-Hee;Park, Chul;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.26 no.6
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    • pp.612-615
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    • 2009
  • A 10-year-old intact male mixed breed dog was presented with a three-month history of massive oral mass. Physical examination revealed extending mass from the right upper gingiva. No metastasis was found at the time of presentation. Histopathologic examination of biopsied tissue from the oral mass was consistent with a neuroendocrine tumor with generalized epithelioid cells and few spindle cells. There were highly mitoses and no visible melanin granules with H&E staining. Immunohistochemical staining for Melan A was performed on section of tumor and was strongly positive. Diagnosis was made as amelanotic malignant melanoma based on histopathology with Melan A immunohistochemistry. This case study indicates that the Melan A immunohistochemical staining may be valuable to diagnose amelanotic malignant melanoma in dogs.

Preliminary Results of Fractionated Stereotactic Radiotherapy for Benign Brain Tumors (양성 뇌종양에 대한 분할 정위 방사선치료의 예비 결과)

  • Choi, Byung-Ock;Kang, Ki-Mun
    • Radiation Oncology Journal
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    • v.21 no.1
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    • pp.10-18
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    • 2003
  • Purpose : To evaluate the role of fractlonated sterotactic radiotherapy (FSRT) in the management of benign brain tumors, we reviewed the clinical, and radiographic responses of patients treated. Methods and Materials : Between March 1995 and March 2002, 36 patients with benign brain tumors were treated by FSRT. The pathological diagnoses consisted of pituitary adenomas (12 patients), cranio-pharyngiomas (5 patients), meningiomas (10 patients), and acoustic neurinomas (9 patients). Radiotherapy doses of 25 to 35 Gy (3~6 Gy/fraction, 5~10 fractions) were prescribed to the 85~90% isodose line, depending upon the location, size and volume of the tumors. The median clinical and radiographical follow up periods were 31 (range, 2~74) and 21 (range, 4~56) months, respectively. Results : In the 35 patients that could be evaluated for their clinical response, 13 (37.1%) were considered improved, 16 (45.7%) stable and 6 (17.2%) worse. Of the 33 patients who had radiographic studies, tumor shrinkage was noted in 17 (51.5%), tumor stabilization in 13 (39.4%), and tumor progression in 3 (9.1%). Of the 17 tumor shrinkage patients, 7 (21.2%) showed a complete response. Acute radiation-induced complications occurred iin 11 (30.6%) patients. Conclusions : FSRT is considered a safe and effective treatment method for begin brain tumors, but large numbers of patients, with relatively long follow-up periods are needed to assess the exact role or effect of FSRT.

Retrospective Study of Patent Ductus Arteriosus in 37 Dogs: Clinical Presentations and Interventional Therapy (37마리 개의 동맥관 개존증의 임상소견과 비외과적 치료의 회고연구)

  • Park, Jong-In;Choi, Ran;Lee, Seung-Gon;Hyun, Changbaig
    • Journal of Veterinary Clinics
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    • v.30 no.2
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    • pp.87-94
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    • 2013
  • This retrospective study reviewed the clinical and diagnostic features, therapeutic outcome and compilations of interventional ductal occlusion in 37 dogs with patent ductus arteriosus (PDA). Malteses and female dogs were over-presented. Bounding pulse and left basal continuous murmur were most common findings in physical examination, while the differential cyanosis was rarely observed. Left ventricular (LV) enlargement patterns and sinus tachycardia were common in the ECG. Typical radiographic findings included LV elongation and triple bumps indicating left atrial (LA), aortic and pulmonary dilation. Echocardiographic features were typical shunt flow at the ductus arteriosus and marked LV dilation with mild to moderate mitral regurgitation (MR). The 32 of 37 dogs were interventionally treated with either thromboemolic coils (TCE) or Amplatz canine ductal occluder (ACDO). Transient hemoglobinuria caused by incomplete closure was occurred in 2 dogs treated with TCE, although the hemoglobinuria was disappeared within a week of intervention. The dislodgement of occlusion device was occurred in 2 dogs with TCE and 1 dog with ACDO. However there were no significant complications associated with this dislodgement, since those were dislodged at the lower pulmonary vasculature. We also found that no serious complications and no further medical intervention in 29 dogs having long-term follow-ups.