• Title/Summary/Keyword: 평균 처치 효과

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Efficacy of Pigtail Catheter Drainage in Patients with Thoracic Empyema or Complicated Parapneumonic Effusion (농흉 및 합병된 부폐렴성 흉막 삼출 환자에서 Pigtail 도관 배액의 유용성)

  • Park, Jeong Woo;You, Seung Min;Seol, Won Jong;Paik, Eun Ki;Lee, Kyu Hoon;Seo, Joon Beom;Jeong, Seong Hwan;An, Chang Hyeok;Lim, Youg Hee;Park, Jeong Woong
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.2
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    • pp.219-229
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    • 2003
  • Background : The management of thoracic empyema and complicated parapneumonic effusion requires adequate antibiotics use and prompt drainage of infected pleural space. Tube thoracostomy for loculated empyema has low success rate and is also an invasive procedure with potential morbidity. Complications include hemothorax, perforation of intra-abdominal or intra-thoracic organs, diaphragmatic laceration, empyema, pulmonary edema, and Horner's syndrome. Given the potential morbidity of traditional chest tube insertion, use of the image-guided pigtail catheter drainage(PCD) of empyema has been employed. We retrospectively analyzed the medical records of patients with empyema or complicated parapneumonic effusion to determine the efficacy of percutaneous pigtail catheter drainage. Materials and Methods : 45 patients with complicated parapneumonic effusions or empyema were treated at Gil medical center from January 1998 to June, 1999. All were initially given PCD procedure and the following data were collected: clinical symptoms at the time of diagnosis, alcohol and smoking history, the characteristics of pleural effusion, radiologic findings (at the time of catheter insertion, removal and 1 month after catheter removal), the amount of effusion drained for initial 24 hours, the time from catheter insertion to removal and the use of surgical approach. Results : Male gender was more frequent (42 men vs. 3 women), the mean age of the study population was 52(range: 21~74) years. Empyema was found in 23 patients, complicated parapneumonic effusion in 22 patients. Four patients(three, parapneumonic effusion and one, with empyema) with PCD only treated, were cast off. Among the available patients, 36(80%) patients were treated with PCD only or PCD with urokinase. Among the 23 patients with empyema, surgical approach was required in five patients(27.1%, one required decortication, four open thoracostomy), one patient, treated with surgical procedure, died of sepsis. There was no significant difference of the duration of catheter insertion, the duration of hospital admission after catheter insertion and the mean amount of effusion drained for initial 24 hours between the patients with only PCD treated and the patients treated with PCD and urokinase. The duration of catheter insertion($9.4{\pm}5.25days$ vs. $19.2{\pm}9.42days$, p<0.05) and the duration of hospital admission after catheter insertion($15.9{\pm}10.45days$ vs. $38.6{\pm}11.46days$, p<0.01) of the patients with only PCD treated were more longer than those of the patients treated with surgical procedure after PCD. They were same between the patients treated with urokinase after PCD and the patients treated with surgical procedure after PCD($11.1{\pm}7.35days$ vs. $19.2{\pm}9.42days$, p<0.05, $17.5{\pm}9.17days$ vs. $38.6{\pm}11.46days$, p<0.01). In 16 patients(44.4%) with only PCD treated or PCD and urokinase treated, the amount of effusion at the time of catheter removal was decreased more than 75% and in 17 patients(47.2%) effusion decreased 50~75%. .In one patient effusion decreased 25~50%, in two patients effusion decreased less than 25%. One month after catheter removal, in 35 patients(97.2%, four patients were cast off), the amount of pleural effusion was successfully decreased more than 50%. There were no complications related to pigtail catheter insertion. Conclusion : In this study, PCD seemed to be an early efficacious procedure in treating the patients with complicated parapneumonic effusion or empyema without any serious procedure related complication.

A STUDY ON THE CHANGE OF SALIVARY FLUORIDE CONCENTRATION WITH TIME AFTER VARIOUS TOPICAL FLUORIDE TREATMENTS (각종 불소처치 이후 시간변화에 따른 타액내 불소농도 변화에 관한 연구)

  • Park, Soo-Jin;Kim, Hyung-Doo;Kim, Chong-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.26 no.2
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    • pp.262-274
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    • 1999
  • Several alternatives for increasing the fluoride concentration in the mouth, such as water fluoridation, ingestion of fluoride supplements, fluoride paste, fluoride mouthrinse, application of fluoride gel are available. There is an impressive body of evidence that the topically deliverd fluorides are clinically effective in inhibiting the progression of dental caries. Recent studies on the cariostatic action of fluoride have indicated the importance of fluoride in the fluid environment of the teeth. The fluoride levels in unstimulated whole saliva can be considered indicative of F in the aqueous phase available for interaction with the tooth surface at a given time. The retention of F in the mouth after topical fluoride treatment is considered to be an important factor in the clinical efficacy of F. The aim of this study was to determine the elevation and clearance of fluoride in whole saliv after the following topical flouride treatments using HMDS-diffusion technique and fluoride ion electrode. The obtained results were as follow: 1. Average salivary fluoride concentration in the unstimulated whole saliva was $0.0152ppm{\pm}0.0091ppm$. Unstimulated salivary flow rate was between 0.34-0.36ml/min and there was no statistically significant difference among the groups(p>0.05). 2. Except for the immediate time after treatment, fluoride levels followed as APF gel>neutral gel>F-rinse>F-paste. There was no statistical difference between the salivary F concentration of F-paste group and that of control group after 2 hours. In case of F-rinse group, after 3 hours the concentration had dropped to baseline value. But there was statistically significant difference among the F concentraion of F gel groups and that of control group(p<0.05). 3. The mean $AUC_{0-120min}$ values were followed as neutral gel>APF gel>F-rinse>F-paste, and the values of the two former groups were significantly higher than those of the two latter groups(p<0.05).

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A Study on the Characteristic of Treatment and Dental Caries Occurrence after the Insurance Benefit about the Pit and Fissure Sealing (치면열구전색술에 대한 보험급여 이후 진료특성 및 치아우식 발생에 관한 연구)

  • Sung, Soon-Im;Lee, Chong Hyung;Park, Arma;Kim, Kwang-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.8
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    • pp.654-661
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    • 2016
  • This study was conducted to investigate treatment tendency and dental caries occurrence after receiving insurance coverage for pit and fissure sealing. Data were obtained from statements for insurance payments received by the Daejeon branch health insurance review and assessment service from December 2009 until December 31 2014. As to the Pit and Fissure Sealing current state by year, there was most a lot of the number of examinee and the treatment number of teeth in 2010. The per capita average treatment number of teeth was highest (3.39) in 2013. As to the result that it analyze the first molar Pit and Fissure Sealing in 2010 according to the general feature, man was high than the woman, it showed up by age in the age of 7 most highly, and the summer was the highest among by season. The upper jaw left first molar was the most common location, although the upper jaw on the right side first molar, lower jaw right side first molar, and lower jaw left first molar were also affected. In 2010, the procedure was conducted more in the upper jaw right side first molar and enforces the recharge since 2011 to 2014, men were treated more than women, the recharge which is the most abundant in the age of 7 was performed by age, and the procedure was performed more during summer than in other seasons. It is forecasted that at August, 2015 most high demand shows according to the result that it predicts the tooth treatment number until December 2015 based upon the treatment number of teeth from December 2009 until November 2014 and be reduced in comparison with the year 2014. Thus, tooth brushing alone is not sufficient to prevent dental caries. Indeed, conducting pit and fissure sealing in infants and toddlers, as well as elementary middle and high school oral health centers is expected to be effective at preventing dental caries.

Comparison of Tiletamine/Zolanzepam, Xylazine - Tiletamine/Zolazepam and Medetomidine-Tiletamine/Zolazepam Anesthesia in Dogs (개에서 Tiletamine/Zolazepam, Xylazine-Tiletamine/Zolazepam과 Medetomidine-Tiletamine/Zolazepam의 마취효과)

  • Kwon, Young-Sam;Jeong, Jae-Hoon;Jang, Kwang-Ho
    • Journal of Veterinary Clinics
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    • v.20 no.1
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    • pp.33-41
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    • 2003
  • The cardiopulmonary and anesthetic effects of tiletamine/zolazepam(TZ, 10 mg/kg IV), xylazine-tiletamine /zolazepam(XTZ, X: 1.1 mg/kg IM, TZ: 10 mg/kg IV) and medetomid-ine-tiletamine/zolazepam(MTZ, M: 30$\mu\textrm{g}$/kg IM, TZ: 10 mg/kg IV) were evaluated to 15 healthy mongrel dogs (4.16$\pm$0.65 kg). These dogs were randomly assigned to the three treatment groups(Control, XTZ, MTZ) with 5 dogs in each group. All experimental animals were premedicated with atropine(0.03 mg/kg, IM). Xylazine or medetomidine were administered to dogs in XTZ group and MTZ group 10 minutes after atropine injection. TZ was administered 20 minutes after atropine injection in all groups. The loss of pain response at pedal reflex and ear pinching tests in XTZ and MTZ groups were much longer compared with those of Control group(P < 0.01). All dogs in this study showed head rocking and hypersalivation during recovery time. Body temperature decreased progressively during experimental period in all groups, but it was not significant. After TZ injection, heart beat rate significantly increased 10 and 20 minutes in Control group, and 20 and 40 minutes in XTZ group(P < 0.05). Respiratory rate significantly decreased 0,10,20 and 40 minutes after 72 injection in XTZ and MTZ groups. In Control group, systolic arterial pressure (SAP) 20 minutes. diastolic arterial pressure(DAP) 10 minutes and mean arterial pressures (MAP) 10 and 20 minutes after 72 injection significantly decreased(P < 0.05). In XTZ group, SAP, DAP and MAP significantly decreased 20 and 40 minutes after 72 injection(P < 0.05). Thus, it was considered that XTZ and MTZ were useful in a canine surgical treatment that requires long anesthetic duration and deep analgesia.

Migrant Multi-Cultural Family Women's Life Quality Related to Oral Health: Survey in Dae-Gu (다문화가족 이주여성의 구강건강관련 삶의 질: 대구지역 조사)

  • Jeon, Eun-Suk;An, Seo-Young;Choi, Yeon-Hee
    • Journal of dental hygiene science
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    • v.11 no.3
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    • pp.181-187
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    • 2011
  • This study conducted oral examinations and individual interviews on migrant multi-cultural family women in Daegu and measured their socio-demographic characters, oral health conditions and OHIP-14 in an aim to investigate the relevance between the oral health of migrant multi-cultural family women living in some big cities and their quality of life. Based on data finally collected from 189 women, the t-test, ANOVA and binary logistic regression analysis were conducted and the conclusions are as follows: The average number of decayed teeth was 2.23, loss teeth was 1.48, and treated teeth was 5.58. Women from the Philippines had more number of loss teeth than those from other countries, and women from China relatively had a small number of filled permanent teeth. The quality of life related to oral health was found to be poor in proportion to the number of loss teeth. A comparison of life quality related to oral health depending on loss teeth showed that life quality related to oral health was lowest in the areas of mental discomfort, physical ability decrease, mental ability decrease, social ability decrease and social disadvantage. Life quality related to oral health was found to be low in proportion to the number of permanent teeth with decay experience and poor monthly household income, which shows that the number of permanent teeth with decay experience and monthly income are mostly related to life quality related to oral health. As migrant multi-cultural family women's life quality related to oral health is low in proportion to the number of loss teeth and decayed teeth, it needs to develop a program to improve their oral healthrelated life quality and conduct follow-up research to verify its effect.

A clinical study on the effect of attachable periodontal wound dressing on postoperative pain and healing (부착형 치주 창상 피복재가 치주수술 후 동통 및 치유에 미치는 효과에 관한 임상 연구)

  • Min, Han-Seul;Kang, Dae-Young;Lee, Sung-Jo;Yun, Sei-Young;Park, Jung-Chul;Cho, In-Woo
    • Journal of Dental Rehabilitation and Applied Science
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    • v.36 no.1
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    • pp.21-28
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    • 2020
  • Purpose: After periodontal surgery, studies have found that the use of periodontal wound dressing reduces the risk of wound infection and increases healing. The purpose of this study is to evaluate the effect of attachable periodontal wound dressing on the healing and patient satisfaction after periodontal flap surgery. Materials and Methods: Twenty-eight patients requiring periodontal surgery underwent periodontal flap surgery on both quadrants of maxilla or mandible. Postoperative pain, bleeding, dietary discomfort and hypersensitivity in relation to attachable periodontal wound dressing was assessed using Visual Analogue Scale (VAS). Additional survey on frequency of burning sensation and overall satisfaction rates were assessed. Results: VAS mean values for pain, bleeding, and dietary discomfort depending on the presence and absence of attachable wound dressing were; pain: 2.82, 3.96 (P = 0.002), bleeding: 1.61, 2.54 (P = 0.008), dietary discomfort: 2.82, 4.18 (P < 0.001), respectively. Test groups with attachable wound dressing reported significantly lower rates of discomfort. No significant difference was observed in burning sensation and hypersensitivity related with wound dressing. Satisfaction was higher in 75% of patients who received wound dressing. Conclusion: According to the results of this study, patients who received attachable periodontal wound dressing reported less postoperative pain, bleeding, and dietary discomfort. There was no statistical significance related to the use of wound dressing with burning sensation and hypersensitivity.

The Effects of Semi-Fowler's position on Post-Operative Recovery and Pain for Patients with Laparoscopic Abdominal Surgery (복강경 수술 후 반좌위가 수술회복성과 통증에 미치는 영향)

  • Choi, Un Jong;Ha, Tae Uk;Kang, Ji Sook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.5
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    • pp.412-419
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    • 2017
  • Purpose:This study was conducted to identify the effects of theSemi-Fowler's position on post-operative recovery and pain for patients with laparoscopic abdominal surgery Methods: This study utilized a non-equivalent control group non-synchronized design to validate the effects of theSemi-Fowler's position. After IRB approval, 56 patients took part in this study, 29 in the experimental group and 27 in the control group. Consent was obtained from the participants. The Semi-Folwer's position was applied to experimental group and the supine position was applied to the control group for 24 hours after surgery. All data were reviewed retrospectively from April to June 2016. Collected data, frequency, percentage, average, standard deviation, chi-squared test, independent t-test and repeated measures ANOVA were conducted using SPSS 20.0. Results: There was no significant difference between the experimental and control group with regard to recovery outcomes; however, there was a significance differencebetween groups and among check times with regard to post operational pain. Conclusion:The results of this study provide information that will be usefulto the development of strategies for improving recovery outcomes and pain for laparoscopic operation patients.

Clinical Use of Thromboelastography as Monitor of Coagulopathy at the Pre and Post-Cardiopulmonary Bypass (개심술 환자의 체외순환 전후 혈전 탄성 묘사도의 임상적 이용)

  • 강경훈;김경훈
    • Journal of Chest Surgery
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    • v.30 no.11
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    • pp.1092-1096
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    • 1997
  • Thromboelastography(TEG) enables a global assessment of hemostatic function to be made from a single blood sample, documenting the interaction of platelets with protein coagulation cascade from the time of the initial platelet-fibrin interaction, through platelet aggregation, clot strengthening and fibrin cross linking to eventual clot Iysis. Thirty-five patients(mean age 34$\pm$ 12) undergoing open heart surgery from April 1st, 1996 to August 31th, 1996 were investigated at preoperatively and immediate, one hour, and 24 hours after cessation of cardiopulmonary bypass using TEG. Comparisons were made between classic hematological indices and TEG data. There were statistically significant correlation between maximal amplitude(MA) and platelet count before CPB, activating clotting time(ACT) and TEG date(R time, K time and a angle) at 24-hour after CPB. The data on the predictive accuracy for postoperative bleeding at 24-hour after CPB, the TEG was significantly better than ACT(57%) or the coagulation profiles(43%) as a predictor of postoperative bleeding, with an accuracy rate of 100% (P=0.0043). In conclusion, TEG seems to be easy to use, clinically accurate, cost effective and provides data which can effectively manage a patient's hemostasis.

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Comparison of Dysphagia Rehabilitation Therapy with Natural Recovery on Swallowing Ability among Acute Stroke Patients (연하재활치료의 효과와 자연회복과의 비교연구 - 급성기 뇌졸중 환자를 중심으로 -)

  • Heo, S.Y.;Kim, K.K.
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.8 no.2
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    • pp.109-118
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    • 2014
  • The purpose of this study was to compare the effectiveness of rehabilitation therapy with natural recovery in patients who had dysphagia due to stroke. Swallowing functions were examined on a total of 98 patients with stroke-caused dysphagia based on a videofluoroscopic swallowing study (VFSS) for 8 weeks. The each group was evaluated with DOSS, DSS and FOSS to assess swallowing ability in the first week and re-evaluated in the $8^{th}$ week during the session for investigating the recovery status. The author compared the above initial data and follow-up data using a Mann-Whitney U test, Kruskal-Wallis test and Wilcoxon's Signed Rank test, ANCOVA to confirm statistically controlling for the effects of other continuous variables, performed by IBM SPSS Statistics 20.0 for windows. There was statistically significant recovery in the experimental group except measure of DOSS (p>0.05). In the control group, it showed improvement in all the scales(p<0.05). After terminating each session, the comparison of the two group of patients showed statistical significant differences in DSS and FOSS(p<0.05). These results suggest that possibility of natural neurologic recovery has positive effects on early stage of dysphagia caused by stroke.

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The Effect of Doxapram on Cardiopulmonary Function in Dogs under Total Intravenous Anesthesia with Remifentanil and Propofol (개에서 Remifentanil과 Propofol에 의한 완전 정맥 내 마취 시 Doxapram 투여가 심폐기능에 미치는 효과)

  • Yun, Sungho;Kwon, Youngsam
    • Journal of Veterinary Clinics
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    • v.32 no.6
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    • pp.491-498
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    • 2015
  • We investigated the effect of constant rate infusion (CRI) with doxapram on cardiopulmonary function during total intravenous anesthesia (TIVA) with remifentanil and propofol CRI in dogs. Fifteen male Beagle dogs were randomly divided into 3 groups. All groups were premedicated with medetomidine ($20{\mu}g/kg$, IV) and anesthetized by remifentanil/propofol CRI for one and half hour. At the initiating of the anesthesia, different doses of doxapram for each group were administrated as the followings; D1 group - doxapram 0.25 mg/kg bolus followed by doxapram $8.33{\mu}g/kg/min$, D2 group - doxapram 2 mg/kg bolus followed by doxapram $66.66{\mu}g/kg/min$, control group - normal saline. The anesthetic depth for surgery was well maintained in all groups throughout the anesthetic periods. The respiratory rate was significantly higher in D2 group than that of control group (p < 0.05). The values of $PaO_2$ and $SaO_2$ were significantly increased in both D1 and D2 groups compared with control group (p < 0.05). High dose of doxapram (D2 group) significantly decreased the level of $PaCO_2$ compared with control group (p < 0.05). The values of systolic, mean and diastolic arterial pressure were significantly increased in doxapram 2 group (p < 0.05). There were no significant differences in the values of heart rate and pH of arterial blood. Therefore, doxapram CRI may be useful to alleviate the suppression of cardiopulmonary function including hypoxia and hypotension during TIVA with remifentanil and propofol in dogs.