The purpose of this study was to find out the long-term effects of the self-help program through the follow-up with peer group meetings of arthritis patients. In order to fulfil the purposes, the follow-up program with peer group meetings was developed by researchers with consisting of monthly health contract, group discussion, group counseling, recreation, and exercise. This program was carried out 2-3 hours once in a month for 5 months (1999-2000) and evaluated in a nonequivalent control group pretest-posttest quasi-experimental design. The subjects were 34 patients of experimental group and 24 of control group. The measurement tools of this study are pain rating scale(Lee & Song), KHAQ(Bae), rating scale of fatigue, and goniometer. The results of this study revealed no significant differences on number of pain site, fatigue, physical functioning, flexibility of the shoulder joints, and level of the extension of the knee joints between experimental group and control group. Whileas pain reaction of the control group was significantly high. However, the peers expressed very much their satisfaction and appreciations with the follow-up program with Peer group meetings. Actually, they wanted to have this peer group meeting continuously. This results suggested that the follow-up program with peer group meeting could be recommended as good nursing intervention to help the arthritis patients after having the Self Help Program in the community setting.
Background Facial laceration is the most common injury encountered in the emergency room in the plastic surgery field, and optimal treatment is important. However, few authors have investigated this injury in all age groups or performed follow-up visit after repair. In the present study, the medical records of patients with lacerations in the facial area and underwent primary repair in an emergency room over a 2-year period were reviewed and analyzed. Methods Medical records of 3,234 patients with lacerations in facial area and underwent primary repair in an emergency room between March 2011 and February 2013 were reviewed and identified. Results All the 3,234 patients were evaluated, whose ratio of men to women was 2.65 to 1. The forehead was the most common region affected and a slip down was the most common mechanism of injury. In terms of monthly distribution, May had the highest percentage. 1,566 patients received follow-up managements, and 58 patients experienced complications. The average days of follow-up were 9.8. Conclusions Proportion of male adolescents was significantly higher than in the other groups. Facial lacerations exhibit a 'T-shaped' facial distribution centered about the forehead. Careful management is necessary if a laceration involves or is located in the oral cavity. We were unable to long term follow-up most patients. Thus, it is necessary to encourage patients and give them proper education for follow-up in enough period.
Bae, Yo Han;Jang, Woo Sung;Kim, Jin Young;Kim, Yun Seok
Journal of Chest Surgery
/
v.54
no.1
/
pp.45-52
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2021
Background: Atrial septal defect (ASD) is the most common congenital heart disease. However, the details of cardiac chamber remodeling after surgery are not well known, although this is an important issue that should be analyzed to understand long-term outcomes. Methods: Between November 2017 and January 2019, cardiac magnetic resonance imaging was performed preoperatively, at a 1-month postoperative follow-up, and at a 1-year postoperative follow-up. Cardiac chamber volume, valve regurgitation volume, and ejection fraction were measured as functions of time. Results: Thirteen patients (10 men and 3 women) were included. The median age at surgery was 51.4 years. The preoperative median ratio of flow in the pulmonary and systemic circulation was 2.3. The preoperative mean right ventricular (RV) end-diastolic volume index (EDVi) and RV end-systolic volume index (ESVi) had significantly decreased at the 1-month postoperative follow-up (p<0.001, p=0.001, respectively). The decrease in the RVEDVi (p=0.085) and RVESVi (p=0.023) continued until the postoperative 1-year follow-up, although the rate of decrease was slower. Tricuspid valve regurgitation had also decreased at the 1-month postoperative follow-up (p=0.022), and continued to decrease at a reduced rate (p=0.129). Although the RVEDVi and RVESVi improved after ASD closure, the RV volume parameters were still larger than the left ventricular (LV) volume parameters at the 1-year follow-up (RVEDVi vs. LVEDVi: p=0.016; RVESVi vs. LVESVi: p=0.001). Conclusion: Cardiac remodeling after ASD closure is common and mainly occurs in the early postoperative period. However, complete normalization does not occur.
Backgrounds/Aims: Double duct sign (DDS) (dilated common bile and pancreatic duct) is synonymous with pancreatic head/peri-ampullary tumor (PHPAT). There is limited evidence on whether incidental DDS (I-DDS) is associated with an increased risk of malignancy. This study aimed to evaluate 5-year outcomes of I-DDS. Methods: Patients were categorized according to their risk of malignancy. 'Low-risk' patients, including those with I-DDS between 2010 and 2015, were analyzed in this study. The primary outcome was incidence of PHPAT within five years of identification of DDS. Histology results from endoscopic ultrasound-guided biopsy were considered diagnostic. Secondary outcomes were incidence of benign causes, extent of follow-up investigations, and clinical indicators of malignancy in patients with DDS. Results: Among 103 patients with DDS, 20 had I-DDS. Subsequent follow-up of these 20 patients found no patient with PHPAT, two (10%) patients with chronic pancreatitis, and 18 (90%) patients with no cause found. The median follow-up duration for 'low-risk' patients was 7.3 years (range, 6-11 years). The mean number of follow-up investigations per patient was two (range, 0-9). Investigations included computed tomography (n = 27), magnetic resonance cholangiopancreatography (n = 23), endoscopy (n = 16), and ultrasound (n = 14). Patients with jaundice were more likely to have malignancy (p < 0.01). Those with abdominal pain were more likely to have a benign cause (p < 0.01). Hyperbilirubinemia and/or deranged liver enzymes and raised CA19-9 were more likely to be associated with PHPAT (p < 0.01). Conclusions: Patients with I-DDS have a low risk of developing PHPAT within five years.
Byung Soo Im;Dong Il Gwon;Hee Ho Chu;Jin Hyoung Kim;Gi-Young Ko;Hyun-Ki Yoon
Korean Journal of Radiology
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v.23
no.9
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pp.889-900
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2022
Objective: To investigate the long-term outcomes of percutaneous treatment of benign biliary strictures using temporary placement of a retrievable expanded polytetrafluoroethylene (PTFE) covered stent. Materials and Methods: We retrospectively analyzed the outcomes of 148 patients (84 male and 64 female; age range, 11-92 years) who underwent percutaneous transhepatic placement and removal of a retrievable PTFE-covered stent for the treatment of benign biliary strictures between March 2007 and August 2019 through long-term follow-up. Ninety-two patients had treatment-naïve strictures and 56 had recurrent/refractory strictures. Results: Stent placement was technically successful in all 148 patients. The mean indwelling period of the stent was 2.4 months (median period, 2.3 months; range, 0.2-7.7 months). Stent migration, either early or late, occurred in 28 (18.9%) patients. Clinical success, defined as resolution of stricture after completing stent placement and removal, was achieved in 94.2% (131 of 139 patients). The overall complication rate was 15.5% (23 of 148 patients). During the mean follow-up of 60.2 months (median period, 52.7 months; range, 1.6-146.1 months), 37 patients had a recurrence of clinically significant strictures at 0.5-124.5 months after removal of biliary stent and catheter (median, 16.1 months). The primary patency rates at 1, 3, 5, 7, and 10 years after removal of biliary stent and catheter were 88.2%, 70.0%, 66.2%, 60.5%, and 54.5%, respectively. In the multivariable Cox proportional hazard regression analysis, sex, age, underlying disease, relation to surgery, stricture type, biliary stones, history of previous treatment, and stricture site were not significantly associated with the primary patency. Conclusion: Long-term outcomes suggest that percutaneous treatment of benign biliary strictures using temporary placement of retrievable PTFE-covered stents may be a clinically effective method.
Objectives: The authors intended to evaluate long-term outcome of group cognitive behavioral therapy(GCBT) for panic disorder and examined the variables to predict high end-state functioning in 12 months follow-up. Methods: 236 patients meeting DSM-IV criteria for panic disorder were assessed by STAI, ASI, BDI, BSQ, PBQ, ACQ at pre & post treatment, and were asked about the frequency of panic attacks during recent one month. We executed stepwise discriminant analysis on the clinical variables at pre treatment assessment to find the variables for discriminating between high end-state function(HES) and low end-state function(LES). Results: After GCBT, 82.6% of panic patients maintained high end-state functioning at 12 months follow-up. The results of discriminant analysis showed that BDI and BSQ at pre treatment assessment were significant variables to predict end-state functioning at 12 months follow-up. The hit ratio of discriminant analysis was 69.2%. Conclusion: These results suggest that the therapeutic effect of GCBT can be maintained through 12 months. Especially, it is likely that patients who were less depressed and who had less experienced the fear of physical symptoms at pre-treatment can maintain HES.
Journal of the korean academy of Pediatric Dentistry
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v.45
no.3
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pp.378-385
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2018
Mandibular fractures occur with high incidence among various fractures in maxillofacial region in children. Jaw fractures in children should be approached differently than in adults because bone growth continues throughout childhood. As far as displacement of the fragment is not severe, or if it is condyle that is fractured, closed reduction and additional intermaxillary fixation can be considered. Functional exercise is also required to prevent ankylosis of temporomandibular joint. Several complications, particularly malocclusion and facial asymmetry due to growth disturbances, can occur after condylar fractures. If growth disturbances take place after mandibular fractures, catch-up growth may occur in some patients, thus, periodic observation is necessary. In case of persistent growth disturbances, functional devices may be used to prevent severe facial asymmetry. This case report describes the long-term follow-up of two patients with facial asymmetry after mandibular fracture.
Improved clinical performance was expected from the introduction of the low-profile model of the Ionescu-Shiley pericardial valve. The long-term clinical results were assessed on the consecutive 47 patients who underwent MVR + AVR with this valve between 1984 and 1988. Three patients died within 30 days of surgery[operative mortality, 6.4%], and 44 early survivors were followed up for a total of 203.8 patient-years [Mean + SD, 4.63 + 1.47 years]. One died during the follow-up with a linearized late mortality of 0.491%/patient~year[pt-yr]. None experienced thromboembolism. Bleeding and endocardiris were seen in each single patient with the incidences of complication of 0.491%/pt-yr respectively. The linearized rate of primary tissue failure [PTF] was 0.491%/pt-yr. The actuarial survival and rate of freedom from PTF were 97.6 _+ 2.4% and 92.6 +7.1% at 7 years of follow-up.These results are favorably comparable with the ones seen in the patients of MVR + AVR with the standard profile lonescu-Shiley valve in all respects except the higher mean age of the low-profile group. Although the clinical performance was compatible with other major reports, the durability of the valve remains to be proved with the prolonged follow-up.
PURPOSE. The purpose of this study was to analyze the current literatures and to assess outcomes of implant treatment in patients with generalized aggressive periodontitis. MATERIALS AND METHODS. Studies considered for inclusion were searched in Pub-Med. The literature search for studies published in English between 2000 and 2012 was performed. Our findings included literature assessing implant treatment in patients with a history of generalized aggressive periodontitis (GAP). All studies were screened according to inclusion criteria. The outcome measures were survival rate of superstructures, marginal bone loss around implant and survival rate of implants. All studies were divided into two follow-up period: short term study (< 5 years) and long term study (${\geq}5$ years). RESULTS. Seven prospective studies were selected, including four short-term and three long-term studies. The survival rates of the superstructures were generally high in patients with GAP, i.e. 95.9-100%. Marginal bone loss around implant in patients with GAP as compared with implants in patients with chronic periodontitis or periodontally healthy patients was not significantly greater in short term studies but was significantly greater in long term studies. In short term studies, the survival rates of implants were between 97.4% and 100% in patients with GAP-associated tooth loss, except one study. The survival rates of implants were between 83.3% and 96% in patients with GAP in long term studies. CONCLUSION. Implant treatment in patients with GAP is not contraindicated provided that adequate infection control and an individualized maintenance program are assured.
The first Mitral Commissurotomy was performed for tight mitral stenosis on March 1957. The patient was at that time 22-year-old male, student. The longest follow 9p for 22 years and 8 months has been obtained. During the follow up period, late deterioration due to restenosis developed 4 years after initial good result and reoperation was succeeded by transventricular Mitral Valvotomy with Tubb`s ilator on April 1964. The possible cause of restenosis was attributed to recurrent rheumatic activity. After more than 13 years long-good life following 2nd operation, Endocarditis such as episode of high fever & chill intermittently followed by mild fever and night sweat, I t. tibial artery embolization and rupture of aortic cusp. At present, patient complained of no subjective symptom, enjoying ordinary life {NYHA II]. Blood pressure has been 110/50-60 mmHg, trivial diastolic murmur at apex and moderate degree of mechanical murmur on diastole at Erb`s rea. Neither signs of RVH for mitral stenosis nor sign of LVH. ST-T change for aortic regurgitation appeared yet during last 2 yrs. The patient`s are for prevention of Rheumatic activity and development of endocarditis is important for obtaining the better long-term result.
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