• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권2호
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• pp.102-108
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• 2015

In surgery for facial asymmetry, mandibles can be classified into two types, rotational and translational, according to the required mandibular movements for surgery. During surgery for rotational mandibular asymmetry, a bilateral sagittal split ramus osteotomy (BSSRO) may cause a large bone gap between the proximal and distal segments as well as condylar displacement, resulting in a relapse of the temporomandibular joint disorder, especially in severe cases. The intraoral vertical ramus osteotomy has an advantage, in this respect, because it causes less rotational displacement of the proximal segment on the deviated side and even displaced or rotated condylar segments may return to their original physiologic position. Unilateral intraoral vertical ramus osteotomy (UIVRO) on the short side combined with contralateral SSRO was devised as an alternative technique to resolve the spatial problems caused by conventional SSRO in cases of severe rotational asymmetry. A series of three cases were treated with the previously suggested protocol and the follow-up period was analyzed. In serial cases, UIVRO combined with contralateral SSRO may avoid mediolateral flaring of the bone segments and condylar dislocation, and result in improved condition of the temporomandibular joint. UIVRO combined with contralateral SSRO is expected to be a useful technique for the treatment of rotational mandibular asymmetry.

• 동서간호학연구지
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• 제15권2호
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• pp.157-167
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• 2009

Purpose: This study examines the patient problems and nursing interventions during telephone consultations by nurses in an ophthalmology nursing unit. Methods: The data were collected during telephone consultations. A total of 13 nurses consulted 170 patients between September 29 and November 30, 2008 at a tertiary teaching hospital. Problems were raised by the patients and nursing interventions were provided to the patients by the nurses. The SPSS program was used to analyze the data. Results: There were 228 telephone inquiries by 170 patients. The problems were categorized into four groups based on a literature review and validated by 14 nurses: physical symptoms, medications, administrative matters, and follow-up care. Interventions provided by the nurses were categorized into six groups: instructing patients; providing information; providing background knowledge; assuring the patients; referring to the patients to other ancillary departments; and delivering doctor's orders. Conclusions: Nurse interventions for a specific patient problem varied depending on the nurse providing the consultation. The participating nurses expressed the need for a common protocol for telephone consultations. Thus, it would be beneficial to develop a guideline for telephone consultations to minimize practice variations among nurses.

• Asian Pacific Journal of Cancer Prevention
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• 제14권2호
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• pp.769-773
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• 2013

Background: A literature review on 1,104,269 cancer patients concluded that the prevalence of multiple primary malignancies (MPM) is between 0.73% and 11.7%. MPMs seem to have higher incidence than that influenced by hazard only. The purpose of this study was to investigate clinically useful information for effective screening for synchronous and metachronous second primary cancers and to identify a potential surveillance protocol. Materials and Methods: Using statistical and epidemiological indicators we evaluated the patients with MPMs (double locations) admitted to Dr. Abdurrahman Yurtarslan Ankara Oncology Education and Research Hospital between 1981 and 2010. Results: Out of the 130 cases, 24 (18.4%) were synchronous while 106 cases (81.6%) were metachronous tumours. Mean interval time from first to second primary cancers was 4.65 years (0-27 years). The most frequent malignant associations were breast-breast, breast-endometrium and breast-ovary. Both primary and secondary tumors tended to be in an advanced stage explained by the low compliance of the patients to follow-up. Conclusions: The possibility that MPMs exist must always be considered during pretreatment evaluation. Screening procedures are especially useful for the early detection of associated tumors, whereas careful monitoring of patients treated for primary cancer and a good communication between patients and medical care teams should ensure early detection of secondary tumors, and subsequent appropriate management.

• International Journal of Computer Science & Network Security
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• 제22권1호
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• pp.269-275
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• 2022

Public healthcare has recently become an issue of great importance due to the exponential growth in the human population, the increase in medical expenses, and the COVID-19 pandemic. Speed is one of the crucial factors in saving life, particularly in case of heart attack. Therefore, a healthcare device is needed to continuously monitor and follow up heart health conditions remotely without the need for the patient to attend a medical center. Therefore, this paper proposes a portable electrocardiogram (ECG) monitoring system to improve healthcare for heart attack patients in both home and ambulance settings. The proposed system receives the ECG signals of the patient and sends the ECG values to a MySQL database on the IoT-cloud via Wi-Fi. The signals are displayed as an ECG data chart on a webpage that can be accessed by the patient's doctor based on the HTTP protocol that is employed in the IoT-cloud. The proposed system detects the ECG data of the patient to calculate the total number of heartbeats, number of normal heartbeats, and the number of abnormal heartbeats, which can help the doctor to evaluate the health status of the patient and decide on a suitable medical intervention. This system therefore has the potential to save time and life, but also cost. This paper highlights the five main advantages of the proposed ECG monitoring system and makes some recommendations to develop the system further.

• Archives of Plastic Surgery
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• 제49권3호
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• pp.397-404
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• 2022

Background Excessive use of corticosteroids therapy along with gross immunocompromised conditions in the novel coronavirus disease 2019 (COVID-19) pandemic has raised the risks of contracting opportunistic fungal infections. Here, we describe our experience with the implementation of a surgical protocol to treat and reconstruct rhino-orbital-cerebral mucormycosis. Methods A retrospective review of our prospectively maintained database was conducted on consecutive patients diagnosed with mucormycosis undergoing immediate reconstruction utilizing our "Mucormycosis Management Protocol." All patients included in this study underwent reconstruction after recovering from COVID-19. Wide local excision was performed in all cases removing all suspected and edematous tissue. Reconstruction was done primarily after clear margins were achieved on clinical assessment under a cover of injectable liposomal amphotericin B. Results Fourteen patients were included. The average age was 43.6 years and follow-up was 24.3 days. Thirteen patients had been admitted for inpatient care of COVID-19. Steroid therapy was implemented for 2 weeks in 11 patients and for 3 weeks in 3 patients. Eight patients (57.1%) had a maxillectomy and mucosal lining resection with/without skin excision, and six patients (42.8%) underwent maxillectomy and wide tissue excision (maxillectomy and partial zygomatic resection, orbital exenteration, orbital floor resection, nose debridement, or skull base debridement). Anterolateral thigh (ALT) flaps were used to cover defects in all patients. All flaps survived. No major or minor complications occurred. No recurrence of mucormycosis was noted. Conclusion The approach presented in this study indicates that immediate reconstruction is safe and reliable in cases when appropriate tissue resection is accomplished. Further studies are required to verify the external validity of these findings.

• 융합보안논문지
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• 제15권5호
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• pp.47-52
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• 2015

본 연구에서는 학생건강체력평가제(PAPS)기반 데이터를 활용하여 비만아동을 관리하기 위한 효과적인 프로토콜을 제시하였다. 매년 시행되는 PAPS는 비만평가를 포함하고 있는데, 학교에서는 PAPS에서 얻은 데이터를 통해 급증하고 있는 비만아동의 관리를 위한 노력을 하고 있다. 그러나 현실적으로 학교 교사들의 업무 부담과 제공인력 부족으로 인해 비만아동들의 사후관리에는 효율적이지 못했다. 보다 체계적이고 적극적인 관리를 위해서는 web-PAPS 접속을 통해 학생이나 학부모가 건강종합평가나 비만의 유무를 확인하고 신체활동 처방을 확인할 수 있었던 기존의 방식에 스마트 디바이스 전송방식을 결합하여 정보에의 접근을 용이하게 하는 것이 효율적이다. web-PAPS에서 비만아동의 부모에게 자녀의 체력 및 건강, 비만에 관련한 정보를 자동으로 전송하여, 개인의 상태에 적절하게 처방된 운동과 영양에 대한 처방내용 및 교육내용을 부모와 공유하게 될 때 비만관리에 더욱 효과적일 것이다.

• Archives of Plastic Surgery
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• 제32권4호
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• pp.441-446
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• 2005

Sole reconstruction should consider both functional and aesthetic aspects; durable weight bearing surface, adequate contour for normal footwear, protective sensation and solid anchoring to deep tissue to resist shearing. The anterolateral thigh perforator free flap has such favorable characteristics as long pedicle, reliable perforators and minimal donor site morbidity. This flap can be safely thinned to 3-4 mm. It can also be elevated with sufficient bulk with muscles like vastus lateralis for complex defect. Between June 2002 and December 2004, 48 cases of sole reconstruction were performed with anterolateral thigh perforator free flaps. Follow up period ranged from 4 to 34 months with a mean of 14.7 months and with exception of one case, all flaps survived. One case of total flap loss was noted due to infection in a patient who was administered lifetime immunosuppressant. Partial necroses developed in three cases but were treated conservatively. Satisfactory aesthetic and functional results were achieved and acceptable gait recovery was noted. Seventy-eight percent of the patients regained protective sensation by 6 months and earlier sensory recovery was noted in sensate flap group. The authors also present a standardized protocol for preoperative patient evaluation and postoperative management and rehabilitation.

• Advances in pediatric surgery
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• 제9권1호
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• pp.12-18
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• 2003

The purpose of this study is to evaluate children who underwent hepatic resection for primary malignant hepatic tumor in the period from January 1994 to December 2001. A total of 8 patients, seven with hepatoblastoma (HB) and one with hepatocellular carcinoma (HCC), were studied. One HCC was resectable at the initial diagnosis, but five cases of unresectable HB received two cycles of transarterial chemoembolization (TACE) before operation. One patient with an unresectable HB with bone marrow metastasis was operated after one cycle of TACE and one cycle of systemic chemotherapy based on CCG-823F protocol. Another unresectable HB patient received systemic chemotherapy instead of TACE before operation. Postoperative chemotherapy was administered to all of the patients after complete surgical resection on CCG-823F protocol. All 6 patients who underwent TACE and neoadjuvant chemotherapy showed marked reduction in tumor volume and a clear outline of the lesion. Major complication was not noticed. Mean alpha-fetoprotein (${\alpha}$-FP) level at diagnosis, after neoadjuvant chemotherapy and after postoperative chemotherapy was 9,818 (42-35,350), 664, and 10.1 ng/mL, respectively. Half life of the ${\alpha}$-FP after complete resection was 5.1 days (3.0-8.7 days). Median follow up period was 57.1 months (10-97 months) and all the patients are alive with NED. In conclusion, preoperative chemotherapy, especially TACE, is effective, safe, and useful to treat initially unresectable hepatoblastoma, and serial level of the serum ${\alpha}$-FP is a useful tumor marker for diagnosis and monitoring therapeutic responses.

• Journal of Chest Surgery
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• 제57권1호
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• pp.25-35
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• 2024

Background: Prothrombin complex concentrate (PCC) and fresh frozen plasma (FFP) are commonly used to manage bleeding in patients during cardiac surgery. However, the relative efficacy and safety of these 2 strategies remain uncertain. Methods: MEDLINE, Embase, and Cochrane were searched for studies comparing PCC and FFP in patients who underwent cardiac surgery complicated by bleeding. Review Manager (RevMan) ver. 5.4 (Nordic Cochrane Centre, The Cochrane Collaboration) was used for statistical analysis. Binary and continuous outcomes were compared using pooled risk ratios and mean differences, respectively. The meta-analysis protocol was registered in the International Prospective Register of Systematic Reviews under protocol number CRD42022379144. Results: We included 8 studies with 1,500 patients, of whom 613 (40.9%) received PCC. The mean follow-up period ranged from 28 to 90 days. The PCC group had significantly lower chest tube drainage at 24 hours (mean difference [MD], -148.50 mL; 95% CI, -253.02 to -43.99 mL; p=0.005; I² =42%). Fewer units of red blood cells (RBCs) were transfused within the first 24 hours (MD, -1.02 units; 95% CI, -1.81 to -0.24 units; p=0.01; I² =56%), and fewer patients required RBC transfusion within the first 24 hours (risk ratio, 0.85; 95% CI, 0.78-0.93; p<0.007; I² =45%) in the PCC group. There were no statistically significant differences in secondary outcomes. Nonetheless, a subgroup analysis of randomized controlled trials failed to corroborate the results obtained from the main analysis. Conclusion: Our findings suggest that PCC can be effective, without increased adverse events, when compared with FFP in patients undergoing cardiac surgery complicated by bleeding.

• Asian Pacific Journal of Cancer Prevention
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• 제13권8호
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• pp.4133-4136
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• 2012

Aim: To report the results of radiotherapy with or without chemotherapy in the patients with oral cancer. Methods: Over the 2003-2009 periods, a total number of 69 patients with squamous cell carcinoma of the oral cavity that refused surgery or had unresectable tumor were enrolled in this study. A total dose of 60 to 70 Gy (2 Gy per day) was given to the primary tumor and clinically positive nodes. In the patients with locoregionally advanced disease (57 patients with $T_3$, $T_4$ lesions and/ or $N^+$) induction chemotherapy following by concomitant chemoradiation was used. Induction chemotherapy consisted of 3 cycles of Cisplatin and 5-Flourouracil with or without Docetaxel. Weekly cisplatin was used in concomitant protocol. Kaplan-Meier method was used to calculate overall survival. Log-rank test and Cox regression model were used for comparison purposes. Results: Median follow-up was 32 months. The mean age of the patients was 59.2 years. The overall response rate after induction chemotherapy was 68.4%. Actuarial overall survival rates after 2 and 3 years were 38% and 26%, respectively. Clinical stage emerged as the only independent predictor of survival. Conclusion: Outcome of the patients with oral cancer is poor. Presenting with an advanced stage lesion contributed to this result. The role of chemotherapy in advanced cases remains to be defined.