• Journal of Chest Surgery
• /
• v.32 no.1
• /
• pp.32-37
• /
• 1999

Background: Early detection and surgical resection offer the most advantage out of all cures for lung cancer. Elderly patients may fail to benefit maximally from these interventions because of their general condition and residual lung function. To study the impact of age on stages, histology, symptoms, and treatments of the patients with non-small cell lung cancer, we undertook a retrospective review. Material and Method : Two hundred eleven patients with non-small cell lung cancer were operated on at Samsung Seoul hospital between October 1994 and June 1997. Patients were arbitrarily arbitrarily by age less than 70 years(176 patients) and 70 years or more(35 patients), and their medical records were reviewed. Result: There were no differences in pathologic staging and diagnosis. But there were differences in surgical methods, complications, and mortality rates between the two groups. There were much more complications in the 70 years or more group(p=0.02). We chose less invasive surgical methods in the 70 years or more group. Conclusion: More complications were experienced in the 70 years or more group. Although thoracic operation imparts the greatest survival advantage, this benefit is diminished in elderly patients because of their high complications and mortality rate. We recommend serious consideration of surgical indications and operative methods.

• The korean journal of orthodontics
• /
• v.30 no.3 s.80
• /
• pp.367-375
• /
• 2000

If a mandibular prognathic patient has an extremely unnatural anteroposterior and vertical maxilla or keen esthetical perception for facial profile, orthognathic surgery must be performed along with orthodontic treatment, which alone cannot provide satisfactory results in this case. Esthetical improvement becomes an important factor in the satisfaction level of the patient's treatment result, but an attempt to objectively measure beauty holds many problems. Therefore, in the end, the patient submits the final esthetical evaluation based on his/her subjective viewpoint. Because Korean people have a tendency to prefer the facial appeareance of westerners, they favor an oval shaped face over the traditional round face. This research was conducted in response to the complaints raised by patients who claim that their face had become more round from widening of facial width after the orthognathic surgery for manidibular prognathism than before the surgery. The following results were obtained on the changes in facial appearance and patient satisfaction level by analyzing the skull P-A analysis of total of 14 patients (8 male and 6 female) who underwent orthognathic surgery primarily chief complaint for manidibular prognathism and from their responses on questionnaires. These results are to be used in the research on the pre- and post- operative changes in facial height and width from orthognatic surgery. 1. Three ($21.4\%$) of 14 patients said that their face had widened. 2. The A group showed no change in mandibular width but B group showed a 0.7mm reduction. The facial width increased by 0.45mm and 0.66mm in groups A and B, respectively, after the orthognathic surgery 3. After the surgery the facial length changed by an 0.52mm increase in upper facial height , 1.19mm reduction in lower facial height, and 0.7mm reduction in mandibular height in group A. In group B group, there was a 0.67mm reduction in upper facial height, 3.66mm reduction in lower facial height, and 5mm reduction in mandibular height. 4. In reference to facial width, the facial height showed $1.5\%$ reduction in group A and $3.6\%$ reduction in group B after the surgery. 5. In reference mandibular height-to-facial width ratio, there was a $1.3\%$ reduction in group A, and $4.4\%$ reduction in group B after the surgery. 6. In reference to the mandibular height-to-width ratio, there was a $1.3\%$ reduction in group A and $4.3\%$ reduction in group B after the surgery. 7. Although the change in the facial width due to surgery can be ignored, sufficient explanation should be Provided to the patient before surgery on the fact that the face can appear to be relatively wide because of the reduced facial length as result of the surgery.

• The Korean Society of Law and Medicine
• /
• v.15 no.1
• /
• pp.335-373
• /
• 2014

According to one Medicare report, in the US, total federal spending on health care expends almost 18 percent of the nation's GDP, about double what most industrialized nations spend on health care. And in 2011, Medicare spending reached close to $554 billion, which amounted to 21 percent of the total spent on U.S. health care in that year. Of that $554 billion, Medicare spent 28 percent, or about $170 billion, on patients' last six months of life. So what are the reasons of this high cost in EOL care and its possible solutions? Much spendings of Medicare on End-of-Life care for the terminally ill/chronically ill in the US has led health economics experts to assess the characteristics of the care. Decades of study shows that EOL care is usually supply-sensitive and poor in cost-effectiveness. The volume of care is sensitively depending on the supply of resources, rather than the severity of illness or preferences of patients. This means at the End-of-Life care, the medical resources are being overused. On the other hand, opposed to the common assumption, "The more care the better utility", the study shows that the outcome is very poor. Actually the patient preference and concerns are quite the opposite from what intense EOL care would bring about. This study analyzes the reasons for the supply-sensitiveness of EOL care. It can be resulted from the common misconception about the intense care and the outcome, physicians' mission for patients, lack of End-of-Life Care Decision which helps the patients choose their own preferred treatment intensity. It also could be resulted from physicians' fear of legal liabilities, and the management strategy since the hospitals are also seeking for financial benefits. This study suggests the possible solutions for over-treatment at the End-of-Life resulting from supply-sensitiveness. Solutions can be sought in two aspects, legal implementation and management strategy. In order to implement advance directive properly, active ethics education for physicians to change their attitude toward EOL care and more conversations about end-of-life care between physicians and patients is crucial, and incentive system for the physicians who actively have the conversations with patients will also help. Also, the general education towards the public is also important in the long run, and easy and official advance directive registry system-such as online registry-has to be built and utilized more widely. Alternative strategies in management are also needed. For example, the new strategic cost management and management education, such as cutting unnecessary costs and resetting values as medical providers have to be considered. In order to effectively resolve the problem in EOL care for the terminally ill/chronically ill and provide better experience to the patients, first of all, the misconception and the wrong conventional wisdom among doctors, patients, and the government have to be overcome. And then there should be improvements in systems and cultures of the EOL care.

• The Journal of the Korea Contents Association
• /
• v.20 no.9
• /
• pp.520-530
• /
• 2020

The purpose of this study was to investigate the effects of occupation-based bilateral upper extremity training and transcranial direct current stimulation on upper limb function in stroke patients. The study group was divided into 13 experimental groups with occupation-based bilateral upper extremity training and transcranial direct current stimulation, and 13 controls with only occupation-based bilateral upper extremity training. A total of 4 weeks, 50 minutes, 5 times a week conducted, the patients were tested with Canadian Occupational Performance Measure(COPM), Accelerometer, Fugle-Meyer Assessment(FMA), and Motor Activity Log(MAL). As a result of the study, the experimental group and the control group showed significant improvement in both occupation satisfaction and performance, usage of the affected side and the tendon side, recovery of upper limb function, and quality of movement, In particular, the experimental group showed a significant difference in the amount of the affected side than the control group. Therefore, it was found that the combination of occupation-based bilateral upper extremity training and transcranial direct current stimulation had a positive effect on the recovery of upper limb function in stroke patients.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.26 no.1
• /
• pp.33-38
• /
• 2010

Maxillectomy is a treatment option for maxillary cancer, which leaves the patient with a palatal defect. It may cause problems with facial deformation, swallowing, mastication, and speech. These functional problems and changes in appearance may result in psychological problems. To control these deficits after maxillectomy, surgical reconstruction or prosthodontic treatment can be chosen as a treatment option. Obturator prosthesis has been used as a preferred method of rehabilitation for most maxillectomy patients. This case is a patient who was classified Aramany classification II hemi-maxillectomy patient with residual teeth from #11-25, whose teeth had substantial labioversion and clinically lengthened from alveolar bone involution, thus making it hard to select proper framework design and resist to the rotational dislodging force of the obturator. Therefore we selected swing-lock attachment design to remain pre-existing crown and bridges and obtain retention and stability of obturator. The swing-lock RPD is economical than the conventional RPD because we can remain pre-existing crown and bridges. And residual teeth which have mobility and poor prognosis can be successfully retained through properly designed swing-lock RPD as it is functioning as a removable splint on the teeth.

• Therapeutic Science for Rehabilitation
• /
• v.5 no.2
• /
• pp.11-22
• /
• 2016

Objective: This study is executed systematic review targeted at international journals intended to investigate on effect of peripheral sensory nerve stimulation on upper extremity function for stroke patients. Method: After literature search, researchers selected for 10 studies registered up to October 2015 based on PubMed database, using the following search terms: peripheral nerve stimulation, electrical stimulation, sensory stimulation, somatosensory stimulation, stroke, hemiplegia, hemiparesis and hand, arm, upper limb. Result: There were significant improves of upper extremity function and positive effect on the cortical activation in the use of peripheral sensory nerve stimulation. Conclusion: domestic studies in future requires a study of the method for measuring more accurately the effect of peripheral sensory nerve stimulation in RCT studies applying various intervention.

• Journal of Korea Entertainment Industry Association
• /
• v.15 no.1
• /
• pp.229-236
• /
• 2021

The purpose of this study is to investigate how the combined intervention of occupation-based intervention and computerized cognitive rehabilitation treatment affects the psychosocial function, cognitive function, and depression of stroke patients. 23 stroke patients were divided into experimental group(n=11) and a control group(n=12), and the experimental group and the control group received CoTras for 4 weeks and 30 minutes each, and additionally the experimental group received task-based intervention for 30 minutes before the start of CoTras. It was conducted 20 times for a total of 4 weeks. Self-efficacy scale, stress scale, depression scale, neurobehavioral cognitive status examination were used. As a result of the study, the experimental group showed significant improvement in improvement of self-efficacy, stress, and depression than the control group, and the experimental group showed a small effect difference in magnitude of effect from the control group in cognitive function. Based on this study, it is possible to utilize the simultaneous task-based intervention with CoTras to improve psychosocial function, depression and cognitive function in stroke patients.

• The Journal of the Korea Contents Association
• /
• v.16 no.6
• /
• pp.627-635
• /
• 2016

The purpose of this study was to investigate the communication skill of a dental hygienist for the elderly. The self-administered questionnaire selected by convenience sampling method from January 2 to February 14, 2015, Seoul, Kyungki, Incheon regions final analysis section 233 to target dental hygienist working under a dentist institutions. This study analyzed collected data by t-test, ANOVA, pearson correlation coefficient, and multiple regression. According to multiple regression analysis results can be number of worker, the main task, living experience feelings adjusted variable, as a result work in the dental hospital(B=.292 SE=.074), more like the elderly preference(B=.282, SE=.141), the behavior of the elderly(B=-.223, SE=.043) found that the more positive the impact. Therefore, the more exposure for your understanding and the elderly relationships for the the elderly appeared to affect the communication skill necessary to develop training programs that can improve the communication skill of a dental hygienist and apply to be prepared for the coming aging society.

• The Journal of Korean Academy of Prosthodontics
• /
• v.47 no.3
• /
• pp.295-300
• /
• 2009

Statement of problem: As the number of elders is growing with the advancement of medicine, partially or fully edentulous patients have increased. Medically compromised conditions are common in the older population so that it should be taken into account in prosthetic treatment planning as well as their economic conditions. In the older patients, removable prosthesis has been preferred to implant prosthesis. However, cast metal based removable partial dentures also has several limitations. Purpose: In this report, we present several cases of Valplast$^{(R)}$ flexible denture which were fabricated in patients who had medically compromised conditions or whose remaining teeth showed a relatively poor prognosis. Results & Conclusion: This article describes an alternative treatment for a partially edentulous patient with mouth opening limitation, after cancer surgery, compromised general condition and questionable remaining teeth. In these patients, Valplast$^{(R)}$ flexible denture was used because of its unique characteristics and the results were all satisfactory. Patients had 1-2 check-up and there were no postoperative pain or fracture of denture up to now.

• Journal of the Korea Society of Computer and Information
• /
• v.25 no.6
• /
• pp.155-164
• /
• 2020

In this paper, we proposed the dimensional system and pattern of middle-aged women's rashguard swimwear for breast cancer patients. First, a survey of 37 breast cancer patients was conducted to determine the preferred swimsuit design for breast cancer patients. According to a survey of breast cancer patients, a rashguard swimwear with a low-exposure chest was designed. It has a pocket shape in which the cap is easy to insert and the cap is fixed. Second, we developed a dimensional system for swimsuits for breast cancer patients. Using direct measurement data from Size Korea for 1,625 women aged 30 to 69, 17-sizes for breast cancer patient's swimsuits were set through cross-analysis of major dimensions, with a coverage rate of 74.3%. It also extracted a standard size of bust circ. 90cm, hip circ. 95cm, and trunk circ. 150cm. Third, we developed a pattern for the central size of the swimsuit for breast cancer patients. For this purpose, we first produced the first central size pattern, and then completed the pattern after modifying it through the second and third wearing experiments. Experimental suits were produced at each pattern-making stage to evaluate wearing fit and motion suitability. Finally, the reduction rate of each dimension item for optimal pattern production was obtained, and the lashguard swimwear pattern for breast cancer patients was developed.