• Journal of Chest Surgery
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• v.48 no.4
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• pp.289-293
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• 2015

A 38-year-old male was admitted with symptoms of upper respiratory infection. Despite medical treatment, his symptoms of dyspnea and anxiety became aggravated, and bilateral lung infiltration was noted on radiological imaging studies. His hypoxemia failed to improve even after the application of endotracheal intubation with mechanical ventilator care, and we therefore decided to initiate venovenous extracorporeal membrane oxygenation (VV ECMO) for additional pulmonary support. On his twentieth day of hospitalization, hypotension and desaturation (arterial saturated oxygen <85%) developed, and right ventricular failure was confirmed by two-dimensional echocardiography. Therefore, we changed from VV ECMO to venoarteriovenous (VAV) ECMO, and the patient ultimately recovered. In this case, right ventricular dysfunction and volume overloading were induced by long-term VV ECMO therapy, and we successfully treated these conditions by changing to VAV ECMO.

• Journal of Korean Neurosurgical Society
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• v.29 no.12
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• pp.1612-1619
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• 2000

Objective : To retrospectively analyse the surgical outcome and efficacy of the lumbar spinal surgery in sixty to older patients who failed to conservative treatments. Methods : Between July 1990 and November 1996, the authors retrospectively investigated the medical records of 46 patients who over 60 years of age at the time of surgery. The clinical severity was assessed with Prolo's grade(economic and functional). Questionnaire was sent to each patient regarding long-term effect, satisfaction, and side effects. Results : In 46 patients, 2 patients(1 case died of lung cancer, 1 case lost in follow-up) were lost. Among 44 patients (28 men, 16 women ; mean age 64 years), 22 patients underwent partial or total laminectomy, 17 spinal fusion with instruments, 2 chemonucleolysis, 2 adhesiolysis for failed back surgery syndrome, and 1 automated percutaneous lumbar discectomy. Although postoperative complications were observed in 5 patients, they were successfully managed. No deaths were documented in the perioperative periods. The average Prolo's economic and functional grade improved from 2.98 to 3.48 and 2.81 to 3.75, respectively. Conclusion : In overall, the favorable surgical outcome was obtained. This results indicated that with appropriate preoperative selections and indications, careful intraoperative monitoring, and attentive postoperative care, the surgical treatment of eldery patients for the lumbar spinal disorders, significant improvement with acceptable levels of morbidity and mortality can be achived.

• Journal of Korean Academy of Nursing
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• v.50 no.2
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• pp.298-312
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• 2020

Purpose: This study had two objectives: 1) to develop a scale for the process of exercise engagement (SPEE) for prediabetic individuals (PDIs); 2) to validate a structural model for the process of exercise engagement for PDIs. Methods: A cross-sectional survey with simple random sampling was conducted from September 2013 to December 2015 (in Taiwan). A total of 310 PDIs were enrolled for scale development and model validation via item analysis, factor analyses, and structural equation modeling. The Kuo model was used as the basis for developing the Chinese version of the SPEE for PDIs. Results: The SPEE contains five subscales with a total of twenty-one items that account for 54.9% to 65.9% of the total variance explained for assessing participants' process of engagement during exercise. For Kuo model validation, the model measures indicated goodness of fit between the Kuo model and sample data. Analysis further revealed a direct effect between the creating health blueprints (CHB) stage and the spontaneous regular exercise (SRE) stage (β=.60). Conclusion: The SPEE includes five subscales for assessing the psychological transition and behavioral expression at each stage of the process of exercise engagement for PDIs. The SPEE for people with prediabetes provides deeper insights into the factors of behavioral change stages that are required to initiate long-term health care outcomes and avoid developing diabetes. These insights are significant as they allow for patient-specific mapping and behavior modification to effect exercise.

• Journal of Periodontal and Implant Science
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• v.37 no.2
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• pp.287-295
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• 2007

As a general treatment modality of subgingival tooth defect in aethetic area, implant or crown and bridge therapy after extraction of affected tooth can be used. But as more conservative treatment, crown lengthening can be considered and not to lose periodontal attachment and impair aethetic appearance, surgical extrusion can be considered as a treatment of choice. In this case report, 3 cases of surgical extrusion was represented and appropriate time for initiation of endodontic treatment according to the post-surgical tooth mobility was investigated. In 8 patient who has subgingival tooth defect in aethetic area, intracrevicular incision is performed and flap was reflected with care not to injure interproximal papillae. With forcep or periotome, tooth was luxated and sutured in properely extruded position according to biologic width with or without $180^{\circ}$ rotation. 8 cases show favorable short and long term results. In some cases, surgical extrusion with $180^{\circ}$ rotation can minimized extent of extrusion and semi-rigid fixation without apical bone graft seems to secure good prognosis. In 8 cases, endodontic treatment started about 3 weeks after surgery. This time corresponds with the moment when mobility of extruded tooth became 1 degree and this results concide with other previous reports. If it is done on adequate case selection and surgical technique, surgical extrusion seems to be a good treatment modalilty to replace the implant restoration in aethetic area.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.33 no.3
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• pp.99-114
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• 2020

Objectives : To investigate treatment approaches of psoriasis, and to provide universal and holistic standards to assist in optimizing patient care and future research. Methods : Review articles of psoriasis regarding pathophysiology, risk factor or treatment were searched from Pubmed (January 2016 to June 2020). Treatment approaches were investigated based on the searched articles. Additional data collecting was done for further discussion by searching Pubmed and Google scholar with keywords relevant to the approaches, and the relevant references of articles retrieved were manually inspected to be included. Results : Modalities to directly regulate the relevant helper T cell or inflammatory cytokines can constitute the treatment approaches of psoriasis. Modalities to treat gastrointestinal tract inflammation, to correct metabolic syndrome and to improve epidermal lipid abnormality via whole body lipid metabolism can also constitute the treatment approaches of psoriasis. Probable adverse effects of long term use of western medication should be addressed carefully, and alleviating the hazards of western medication can be a treatment approach of psoriasis. Conclusion : Treatment of psoriasis should take account of systemic aspects such as gastrointestinal tract and lipid metabolism. Treatment approaches of psoriasis established on the pathophysiological basis can serve as universal standards.

• Journal of Korean Medicine Rehabilitation
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• v.29 no.4
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• pp.89-100
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• 2019

Objectives We are going to analyze patient's medical and Korean medicine use trends after lumbar surgery, and examine the percentage of use of Korean medicine after surgery and its relevance to the medical care outcome after lumbar surgery. Methods Using 3% patients' sample data of the Health Insurance Review and Assessment Service, two groups were compared the treatment progress of the Korean Medicine treatment group and the untreated group after lumbar surgery by hierarchical logistic regression analysis. After hierarchical logistic regression analysis(including propensity scores), two groups were compared after lumbar surgery, the Korean Medicine treatment group within 50days and untreated group within 50days. Results Lumbar surgery was performed in 2750 patients in 2015. It was 3.72 that the risk(odds ratio) of finished treatment of patients treated without Korean Medicine, compared to patients with Korean Medicine. It was 0.12 that the risk of continuing treatment(odds ratio) of patients treated with Korean Medicine within 50 days, compared to patients treatment more than 50 days. Conclusions The ratio of Korean Medicine treatment after lumbar surgery was 14.8%. The group that did not have Korean Medicine showed a higher possibility of treatment termination than the group who did not. Among the groups treated with Korean Medicine, the early treatment group was more likely to end treatment than the late treatment group. Considering various situations in the medical environment, further studies such as prospective studies and long-term data analysis are considered to be necessary.

• Journal of the Korea Society of Computer and Information
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• v.19 no.11
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• pp.149-157
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• 2014

Diabetes is a chronic disease that requires continuous medical care and patient-self management education to prevent acute complications and reduce the risk of long-term complications. The worldwide prevalence and incidence of diabetes mellitus are reached epidemic proportions in most populations. Early detection of diabetes could help to prevent its onset by taking appropriate preventive measures and managing lifestyle. The major objective of this research is to develop an automated decision support system for detection of diabetes using mixture of experts model. The performance of the classification algorithms was compared on the Pima Indians diabetes dataset. The result of this study demonstrated that the mixture of expert model achieved diagnostic accuracies were higher than the other automated diagnostic systems.

• Journal of Oral Medicine and Pain
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• v.46 no.2
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• pp.41-48
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• 2021

Purpose: To evaluate compliance by analyzing and comparing treatment duration, degree of improvement after treatment and treatment response of oral lichen planus (OLP) patients according to characteristics of them and the severity of the lesion. Methods: According to treatment process, 132 subjects with OLP who first visited the Department of Oral Medicine at the Pusan National University Dental Hospital from January 2017 to December 2020were classified into three groups: Treatment completed (CT) group, Under treatment (UT) group, and Dropped out during follow-up (DT) group. The reticulation/keratosis, erythema, and ulceration (REU) scoring system was used to assess the severity of OLP. The degree of improvement after treatment was evaluated in CT group. Results: There were 53 (40.15%) CT, 27 (20.45%) UT and 52 (39.39%) DT. In CT group, according to initial REU score there was a statistical difference in the degree of improvement, but not in the length of time to complete treatment. There was no statistical difference between the days it took for patients to feel symptom relief, and the days of entire treatment among three groups. However, there was a positive correlation between the REU score of gingiva and duration of treatment in DT group. In the CT and DT groups, there was a correlation between the length of time taken to relieve symptoms and the duration of treatment. Conclusions: The severity of the gingival lesion and the initial response to treatment have a large effect on the entire treatment period and prognosis, so it should be considered when explaining the disease prognosis and treatment period to patients, and the clinician needs to focus on initial symptom relief.

• Journal of Korea Entertainment Industry Association
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• v.14 no.3
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• pp.443-454
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• 2020

This study aims to develop one-stop support service for the ALS. To achieve the purpose, the cases of Korea and Japan were researched. The data used in the multiple-case study mainly referred to diaries, blogs, social networking sites, Youtube, and interviews of the disabled with ALS disease in Korea and Japan, and analyzed support services of both countries. The result of the study showed that, in the onset stage of ALS disease, a fellow counselor should be assigned by family member or person who experienced the disease from KALSA or other organizations to which a patient belongs. Also, it need a counseling by fellow counselor in the stage of softening disability. And after the gastrointestinal procedure, the number of home visits by visiting nurses should increase, and other services by OT and PT are required. In the stage of wearing a respirator, it needs to train and dispatch volunteers for ALS exclusive activities. And it is necessary to set up a family rest area or a respite service for the mentally and physically exhausted primary caregiver by long-term care. Most of all, these services should be one-stop support with linking step by step, not fragmentary support.

• Restorative Dentistry and Endodontics
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• v.46 no.4
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• pp.51.1-51.13
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• 2021

Objectives: This study aimed to evaluate the effect of improper positioning single-peak and multi-peak lights on color change, microhardness of bottom and top, and surface topography of bulk fill and incremental composites after artificial aging for 1 year. Materials and Methods: Bulk fill and incremental composites were cured using multi-peak and single-peak light-emitting diode (LED) following 4 clinical conditions: (1) optimal condition (no angulation or tip displacement), (2) tip-displacement (2 mm), (3) slight tip angulation (α = 20°) and (4) moderate tip angulation (α = 35°). After 1-year of water aging, the specimens were analyzed for color changes (ΔE), Vickers hardness, surface topography (Ra, Rt, and Rv), and scanning electron microscopy. Results: For samples cured by single-peak LED, the improper positioning significantly increases the color change compared to the optimal position regardless of the type of composite (p < 0.001). For multi-peak LED, the type of resin composite and the curing condition displayed a significant effect on ΔE (p < 0.001). For both LEDs, the Vickers hardness and bottom/top ratio of Vickers hardness were affected by the type of composite and the curing condition (p < 0.01). Conclusions: The bulk fill composite presented greater resistance to wear, higher color stability, and better microhardness than the incremental composite when subjected to improper curing. The multi-peak LED improves curing under improper conditions compared to single-peak LED. Prevention of errors when curing composites requires the attention of all personnel involved in the patient's care once the clinical relevance of the appropriate polymerization reflects on reliable long-term outcomes.