• Title/Summary/Keyword: Clinical implication

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Clinical Implication of Surgically treated Abdominoperineal Soild Tumor in the Newborn : A Single-Center Experience

  • Cho, Yong-Hoon;Kim, Soo-Hong;Kim, Hae-Young;Han, Young-Mi;Lee, Na-Rae;Bae, Mi-Hye;Park, Kyung-Hee;Byun, Shin-Yun
    • Neonatal Medicine
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    • v.25 no.1
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    • pp.23-28
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    • 2018
  • Purpose: Abdominoperineal solid tumors presenting in neonates often require surgical intervention during the neonatal period. Although we report our single-center experience, this study would be meaningful to understand the clinical implications of these neoplasms. Methods: We retrospectively reviewed and analyzed the clinical data and characteristics of 22 patients (${\leq}28$ days old) diagnosed with histopathologically confirmed abdominoperineal solid neoplasms (benign or malignant) after surgical resection. Results: The mean gestational age and postnatal age at the time of operation were $38.3{\pm}1.8weeks$ and $13.5{\pm}8.3days$, respectively. Most patients (18/22, 81.8%) were diagnosed during antenatal care visits; however, 4 (18.2%) were identified after birth. The mean tumor size was $6.4{\times}5.3cm$ (3.5-17.0 cm), and tumors occurred most frequently within the sacrococcygeal region (8/22, 36.4%). Histopathologically, 14 patients (63.6%) demonstrated benign tumors and 8 (36.4%) demonstrated malignant tumors. Germ cell tumors and hepatoblastomas were the most commonly observed tumors. Fortunately, all patients showed a localized pattern of tumor involvement without distant metastasis. No recurrence or mortality was observed during the follow-up period (mean $66.4{\pm}44.2months$). Conclusion: Abdominoperineal solid tumors occurring in neonates show variable clinical patterns during the antenatal and postnatal monitoring/screening periods. We conclude that aggressive and multidisciplinary approaches could achieve good clinical results in these patients.

Analysis of Differential Diagnosis System in Sasang Typology on the Basis of Greater-Lesser-Yin-Yang and Eight Principle Pattern Identification (태소음양(太少陰陽)과 팔강(八綱)의 분석에 근거한 사상인 변증분류체계 연구)

  • Kang, Chul-Min;Kang, Jung-Soo;Kim, Byoung-Soo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.22 no.5
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    • pp.1125-1131
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    • 2008
  • The purpose of this study is to evaluate the clinical implication of Eight Principle Pattern Identification, EPPI in Sasang Typology. Although EPPI is considered as the most basic differential diagnosis in Oriental Medical Science, it has not been used actively enough in clinical practice owing to the presumption that EPPI is not sufficient for the analysis of complex clinical symptoms. In Zhang Jiebin's Jingyuequanshu, he separates Yin-Yang with Six-identification in EPPI when explaining them. This implies that it is difficult to talk about each of EPPI in same perspective. Thus, for the active clinical usage of EPPI it is necessary to study in hierarchical perspective. Lee Je-ma's Sasang typology could be a good example that uses the hierarchical perspective of EPPI. In the book Dongeuisoosebowon Lee Je-ma talks about differentiating Yin with Yang by constitution, Exterior with Interior and Cold with Heat accordingly, to apply in prescriptions. After differentiation, Yin and Yang are placed in higher level from the rest of EPPI, thus Yin and Yang can influence the rest of EPPI. This study showed the importance of EPPI in understanding the differential diagnosis system of Sasang typology in clinical perspectives.

Clinical Implication and Proposed Mechanism of Direction Changing Vibration Induced Nystagmus in Unilateral Vestibular Hypofunction (일측 전정기능 저하 환자에서 방향전환 진동유발안진의 임상적 의의와 발생 기전 제안)

  • Lee, Dong Han;Park, Moo Kyun;Lee, Jun Ho;Oh, Seung-Ha;Suh, Myung-Whan
    • Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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    • v.61 no.11
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    • pp.580-587
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    • 2018
  • Background and Objectives We evaluated the clinical characteristics and vestibular function of patients with direction changing vibration induced nystagmus (DC VIN) and unilateral vestibular hypofunction and suggest clinical implication and a proposed mechanism of DC VIN. Subjects and Method The records of 315 patients who underwent the VIN test were reviewed retrospectively. Among these, 18 patients (5.7%) showed DC VIN, and out of whom, 15 patients (4.8%) were diagnosed as unilateral vestibular hypofunction by caloric, rotation chair (RCT), and video head impulse test (vHIT). We analyzed the relationship between DC VIN and the dizziness characteristics, duration of disease, and the outcome of the vestibular function test. Results The mean age of 15 patients was $67.4{\pm}10.7years$ and the mean duration of dizziness was $13.6{\pm}29.7months$. The caloric test revealed 25% of the patients to have significant canal paresis [Caloric vestibular neuritis (VN)], while 75% showed normal caloric response. However, unilateral vestibular hypofunction was observed by abnormal results in RCT or vHIT (Non-caloric VN). Seven patients showed ipsilateral DC VIN (nystagmus to vibrated side) and eight patients contralateral DC VIN (nystagmus to opposite side of vibration). Patients with ipsilateral DC VIN were shown to have a significant longer duration of dizziness than those with contralateral DC VIN. Conclusion Although rare, DC VIN can also be found in patients with unilateral vestibular hypofunction. Patients with DC VIN had a mild vestibular asymmetry with Non-caloric VN or Caloric VN in the process of compensation. The mechanism of ipsilateral DC VIN seems to be due to the small amount of vestibular asymmetry, which is smaller than the interaural attenuation of vibration.

Full mouth rehabilitation on a bilateral condylar fractured patient using orthognathic surgery and dental implant

  • Park, Jee-Youn;Ahn, Kang-Min;Lee, Joo-Hee;Cha, Hyun-Suk
    • The Journal of Advanced Prosthodontics
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    • v.3 no.1
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    • pp.51-55
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    • 2011
  • BACKGROUND. Mandibular displacement is a common complication of condylar fracture. In the mandibular displacement due to condylar fracture, it is difficult to restore both esthetics and function without using orthognathic surgery. CASE DESCRIPTION. This clinical report described a full mouth rehabilitation in the patient with bilateral condylar fractures and displaced mandible using bilateral sagittal split ramus osteotomy (BSSRO) and simultaneous dental implant surgery. Mandibular position was determined by model surgery through the diagnostic wax up and restoration of fractured teeth. The precise amount of the mandibular shift can be obtained from the ideal intercuspation of remaining teeth. CLINICAL IMPLICATION. Mandibular displacement by both condylar fractures can be successfully treated by orthognathic surgery. Determination of occlusal plane and visualization from diagnostic wax up are mandatory for mandibular repositioning of model surgery. Stable occlusion and regular recall check up are needed for long-term outcome.

Impact of Clinical Nurses' Power and Empowerment on Job Satisfaction and Organizational Commitment (임상간호사의 파워와 임파워먼트가 직무만족 및 조직몰입에 미치는 영향)

  • Park, Hyeon-Hui;Park, Kyung-Sook;Yom, Young-Hee;Kim, Kyung-Hee
    • Journal of Korean Academy of Nursing
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    • v.36 no.2
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    • pp.244-254
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    • 2006
  • Purpose: This study was performed to analyze effects of the power and empowerment on job satisfaction and organizational commitment. This study was based on the Kanter's theory of organizational empowerment. Method: A predictive, non-experimental design was used to test the model in a sample of 688 nurses working in 7 university hospitals that have over 500 beds in Seoul, Kyunggi and Kangwon provinces. The data were collected from December, 2003 to January, 2004. It was analyzed with descriptive statistics and Pearson correlation of SPSS and with path analysis of LISREL. Result: The formal and informal power had direct effects on empowerment. Formal power also had direct effects on informal power. Empowerment had direct effects on job satisfaction and organizational commitment. Organizational commitment had direct effects on job satisfaction. There was positive effects in all of the variables. Conclusion: The positive changes show on personal behaviors and attitudes when the nurses who have formal and informal power are empowered. These findings would be important resource to nurse administrators for clinical implication.

Full mouth fixed implant rehabilitation in a patient with generalized aggressive periodontitis

  • Huh, Yoon-Hyuk;Shin, Hyung-Joo;Kim, Dae-Gon;Park, Chan-Jin;Cho, Lee-Ra
    • The Journal of Advanced Prosthodontics
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    • v.2 no.4
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    • pp.154-159
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    • 2010
  • BACKGROUND. Generalized aggressive periodontitis (GAP) is a destructive periodontal disease that can develop in young age. Only a few cases of full mouth rehabilitation, using dental implants, have been reported in a patient with aggressive periodontitis. CASE DESCRIPTION. This clinical report describes the treatment procedures and results of full mouth rehabilitation in a patient with aggressive periodontitis. After all teeth were extracted, 6 implants were placed in the maxilla and mandible, respectively. Fixed detachable implant prostheses were made. The patient was satisfied with the final results. She was followed for 10 months postloading. CLINICAL IMPLICATION. For a long-term success, continuous maintenance care is critical, as the contributing factors of the disease (such as immune factors or periodontal pathogens) may not be controlled adequately.

A Reliability Study of the Scale for Contraversive Pushing in Stroke Patients (뇌졸중 환자의 Scale for Contraversive Pushing의 신뢰도 연구)

  • Kim, Chung-Sun;Chang, Jong-Sung
    • The Journal of Korean Physical Therapy
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    • v.21 no.4
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    • pp.31-36
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    • 2009
  • Purpose: Pusher syndrome in stroke patients is the tendency to push strongly toward the paretic side with the non-affected limbs. The purpose of this study was to estimated inter-rater and intra-rater reliability of the Scale for Contraversive Pushing (SCP). Methods: Fourteen patients in the acute phase after stroke onset were diagnosed with pusher syndrome. Two physical therapists randomly assessed the same patients on different occasions on the same day. Almost all patients were assessed on more than one day. The inter-rater and intra-rater reliability of the SCP was estimated by calculation of the intraclass correlation coefficient (ICC). Results: The intra-rater reliability of the SCP ranged from 0.87 to 0.97; the inter-rater reliability of the SCP ranged from 0.71 to 0.99 in sitting and standing positions. These results show good reliability for the calculated variables. Conclusion: The results provide support for the use of the SCP in assessing pusher syndrome based on its reliability in stroke patients. It may use the standardized clinical assessments in clinical implication.

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Immune Evasion Mechanism as a Guide for Immunotherapy in Head and Neck Cancer (두경부암에서 면역회피 기전과 면역항암제 치료)

  • Chang, Hyun
    • Korean Journal of Head & Neck Oncology
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    • v.33 no.1
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    • pp.1-5
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    • 2017
  • Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer globally with high morbidity and mortality. Immune surveillance is well recognized as an important mechanism to prevent development or progression of HNSCC. HNSCC can escape the immune system through multiple mechanisms including development of tolerance in T cells and inhibition of T-cell-related pathways, generally referred to as checkpoint inhibitors. Recent clinical trials have demonstrated a clear advantage in advanced HNSCC patients treated with immune checkpoint blockade. Right at the front of the new era of immunotherapy, we will review current knowledge of immune escape mechanisms and clinical implication for HNSCC.

The Development and Validation of the Parenting Style Inventory(PSI) (부모역할행동검사의 개발 및 타당화 연구)

  • Kim, Eun-Jeong;Kim, Young-Ah;Kim, Yu-Jin;Moon, Soo-Jong
    • Korean Journal of Child Studies
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    • v.27 no.4
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    • pp.219-232
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    • 2006
  • The purpose of this research is to develop and validate an instrument that can be used to measure critical aspects of a parent's attitude and behavior that influence child development and adaptation. This instrument is named Parenting Style Inventory and self-reporting assessment of parent for preschoolers. We reported findings from 578 preschooler's care-givers. Five factors were extracted from 55 items developed for preschooler version and finally 29 items were selected. Subscales were empathy, respect, parental authority, coerciveness, perfectionism. Internal consistency of these subscales were .77, .86, .70, .74, .68 relatively. Empathy, respect and authoritative scales were regarded as the basic dimensions of parent's behavior. For clinical validation, we divided the preschooler care-giver sample into 8 groups according to scores of the basic dimensions and compared the 8 groups with parenting stress and parenting self-efficacy scores. The results indicated that three basic factors would have different effects on parental experiences and satisfaction. We suggested the clinical implication and limitation of this instrument.

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Recovery Phase Spontaneous Nystagmus, Its Existence and Clinical Implication

  • Lee, Min Young;Son, Hye Ran;Rah, Yoon Chan;Jung, Jae Yun;Suh, Myung-Whan
    • Journal of Audiology & Otology
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    • v.23 no.1
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    • pp.33-38
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    • 2019
  • Background and Objectives: Determination of the lesion side based on the direction of the nystagmus could result in confusions to the clinicians due to mismatch between the vestibular function tests and also between vestibular and audiologic features. To minimize these mistakes, we elucidated the clinical manifestation and vestibular function test results in cases with recovery spontaneous nystagmus (rSN). Subjects and Methods: Patients who visited ENT clinic of tertiary referral hospital for acute onset continuous vertigo from January 2008 to December 2011 were enrolled. In these patients, we assessed onset time of vertigo, time point of paralytic spontaneous nystagmus (SN) and time point of rSN. At each time point of SN, vestibular function tests and hearing function tests were performed. Results: We confirmed the rSN among patients with unilateral vestibulopathy and demonstrated that high gain of the rotatory chair test (slow harmonic acceleration) and/or mismatch of the SN direction and contralateral caloric weakness could indicate the recovery state of patients and nystagmus observed in this stage is recovery phase nystagmus. Conclusions: In acute vestibulopathy patients, recovery phase nystagmus was observed and on this stage of disease vestibular function tests shows several features that could predict recovery state.