• The Korean Journal of Pain
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• v.14 no.1
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• pp.51-55
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• 2001

Background: Oral mucositis is a common complication of anticancer chemotherapy. The sequelae of this consist of an increased risk of infection, moderate to severe pain, compromised oral function, and bleeding. This study was performed to evaluated the effects of the He-Ne laser and the Ga-Al-As laser on oral mucositis caused by anticancer chemotherapy in pediatric patients. Methods: There were 3 cases of osteosarcoma and 6 cases of leukemia. All patients received He-Ne laser (632.8 nm wavelength, power 60 mW) application on 400-600 Hz scanning for 5-20 minutes and Ga-Al-As laser (904 nm wavelength, power 40 mW) application by fiberoptic hand piece placed in immediate proximity to the tissue without direct contact with it for 30 seconds per point for 5 days per week. During the application patients wore wavelength-specific dark glasses and were instructed to keep their eyes closed. Results: The mean number of treatments with oral intake was $4.89{\pm}0.64$. The mean number of total treatments was $9.44{\pm}2.59$. There were no significant side effects during and after the laser treatments. Conclusions: He-Ne laser and Ga-Al-As (IR) laser treatment were well tolerated and reduced the severity and duration of chemotherapy-induced oral mucositis in pediatric oncologic patients.

• Journal of Korean Medicine for Obesity Research
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• v.7 no.1
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• pp.31-38
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• 2007

Objective : Women's obesity brings prblems not only appearance but also health which men do not have. This study was conducted to investigate the different factors of obesity between men and women. Materials and Methods : We searched papers usin key words (women, gender, and obesity) on pubmed and obesity journal. Result : Women's obesity leads to amenorrhea, abnormal uterine bleeding, infertility, poly cystic ovarian syndrome, abortion, and luteal phase inadequacy. Obesity induces metabolic syndrome, type-2 diabetes, cardiovascular problems, hypertension, cancer, and psychophysiologic diseases. The difference in body morphology and in particular fat distribution between the sexes leads to gender-specific differences in prevalence of chronic diseases, and unique problems for each sex including infertility, problems during pregnancy, polycystic ovarian syndrome, and endometrial carcinoma in women, and prostate and testicular cancer in men. The influence of gender on obesity is had by genetic view, hormones, pregnancy, delivery, and menopause. Conclusion : Obese women have higher risk factors than men by the influence of gender.

• Journal of Chest Surgery
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• v.22 no.2
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• pp.246-255
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• 1989

A total and consecutive 291 patients of isolated single mitral valve replacement using the Ionescu-Shiley bovine pericardial xenograft valve operated on between October 1978 and June 1983 were retrospectively studied for the durability of the substitute valves based on the structural degeneration of primary tissue failure which had been proved on their re-replacement surgery. The mean age at the initial surgery was 32.4*12.5 years, and the operative mortality rate was 5.2 %. The early survivors of 276 patients were followed up for a total 1148.3 patient-years[mean\ulcornerD, 4.16*2.57 years]at the follow-up end of June 1988. They experienced 4 major late complications: 1.045 % thromboembolism/patient-year [pt-yr]; 0.871 % bleeding/pt-yr; 0.610% endocarditis/pt-yr; and 3.309% overall valve failure/pt-yr or 1.655% primary tissue failure/pt-yr. The actuarial survival rates were 89.4*2.2% and 87.7*2.5% at 5 and 10 years after initial surgery respectively. The probabilities of freedom from thromboembolism were 95.1*1.6% and 93.2*2.0% at 5 and 10 years after surgery. Nineteen patients underwent re-replacement of the Ionescu-Shiley valve because of primary tissue failure, and there was no operative mortality. The incidence of primary tissue failure was highest for the patients less than 15 years of age occurring in 9 out of 27 patients [33.3 %] or 8.68 %/pt-yr, while it was 4.0 % or 0.96 %/pt-yr for the rest of patients older than this age. The probabilities of freedom from primary tissue failure were 96.7*1.4 % and 84.2*3.8% at 5 and 9 years after surgery. The freedom from tissue failure increased as the age limits of cumulative younger patients were increased while it decreased as the age limits of cumulative older patients were decreased. Although it is clear that the Ionescu-Shiley valve would degenerate prematurely in young patients, the definite age limit could not be identified when the risk of early failure was significantly high.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.27 no.4
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• pp.366-371
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• 2023

Backgrounds/Aims: Biliary surgery in patients with extrahepatic portal vein obstruction with portal cavernoma (PC) is technically challenging, and associated with the risk of bleeding. Therefore, prior portal vein decompression is usually recommended before definitive biliary surgery. Only a few studies have so far reported the safety of isolated laparoscopic cholecystectomy. We aimed to evaluate our experience of laparoscopic cholecystectomy in patients with PC without prior portal decompression. Methods: Prospectively maintained data for patients with PC who underwent laparoscopic cholecystectomy for symptomatic gallstone disease without portal decompression were analyzed. Clinical features, imaging, intraoperative factors, conversion rate, complications of surgery, and long-term outcomes were assessed. Results: Sixteen patients underwent cholecystectomy without portal decompression from 2012 to 2021, of which interventions 14 were laparoscopic cholecystectomies. One patient required conversion (7.1%) to open surgery. Jaundice was present in 5 patients (35.7%), and underwent endoscopic stone clearance before surgery. Median intraoperative blood loss, operative time, and hospital stay were 100 mL (20-400 mL), 105 min (60-220 min), and 2 days (1-7 days), respectively. Blood transfusion was required in two patients (14.2%). Prior endoscopic or percutaneous intervention was associated with significant blood loss and prolonged intraoperative time. Conclusions: In centers with experience, prior portal decompression can be avoided in patients with PC requiring isolated cholecystectomy to treat gallstones or their complications. Laparoscopic surgery is safe and feasible for these patients, and gives excellent outcomes in the selected group.

• Journal of Periodontal and Implant Science
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• v.46 no.6
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• pp.396-404
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• 2016

Purpose: The aim of this retrospective study was to determine the association between dental implants in the posterior region and traumatic occlusion in the adjacent premolars, using data collected during from 2002 to 2015. Methods: Traumatic occlusion in the adjacent premolars was assessed by examining clinical parameters (bleeding on probing, probing pocket depth, fremitus, and tooth mobility) and radiographic parameters (loss of supporting bone and widening of the periodontal ligament space) over a mean follow-up of 5 years. Clinical factors (gender, age, implant type, maxillary or mandibular position, opposing teeth, and duration of functional loading) were evaluated statistically in order to characterize the relationship between implants in the posterior region and traumatic occlusion in the adjacent premolars. Results: The study inclusion criteria were met by 283 patients, who had received 347 implants in the posterior region. The incidence of traumatic occlusion in the adjacent premolars was significantly higher for splinted implants (P=0.004), implants in the maxillary region (P<0.001), and when implants were present in the opposing teeth (P<0.001). The other clinical factors of gender, age, and duration of functional loading were not significantly associated with traumatic occlusion. Conclusions: This study found that the risk of traumatic occlusion in the adjacent premolars increased when splinted implants were placed in the maxillary molar region and when the teeth opposing an implant also contained implants.

• Journal of Periodontal and Implant Science
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• v.43 no.2
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• pp.96-100
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• 2013

Purpose: Chronic periodontitis (CP) seems to be associated with stress and depression, but little information on this possible association is available in the literature. Thus, the objective of this study was to evaluate the association among stress, the salivary cortisol level (SCL), and CP. Methods: Seventy systemically healthy subjects were included in the study from January to September 2011. Full medical and dental histories were obtained, and the following measurements were recorded: 1) probing depth; 2) clinical attachment level; 3) bleeding on probing; and 4) tooth mobility. Saliva samples were collected for the evaluation of SCL (via a highly sensitive electrochemiluminescence immunoassay), and all subjects also answered a questionnaire (i.e., the Zung Self-rating Depression Scale). The odds ratio (OR) with a 95% confidence interval (CI) was calculated, and one way analysis of variance and the Tukey-Kramer method were performed. Results: A total of 36 subjects with CP (51.4%) and 34 without CP were evaluated. Of them, all of the subjects with CP and one periodontally healthy subject were diagnosed with depression. Subjects with moderate CP had statistically significantly higher levels of SCL than subjects with a diagnosis of slight CP (P=0.006). Also, subjects with severe CP showed the same outcome when compared to those with slight CP (P=0.012). In addition, 46 subjects presented high SCL whereas 24 had a normal level. CP was found to be correlated with the SCL, with an OR of 4.14 (95% CI, 1.43 to 12.01). Conclusions: Subjects with a high SCL and depression may show an increased risk for CP.

• Journal of The Korean Society of Integrative Medicine
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• v.12 no.3
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• pp.237-247
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• 2024

Purpose : This study aimed to systematically review the effectiveness of nursing interventions for patients receiving extracorporeal membrane oxygenation (ECMO). As the use of ECMO increases in critical care settings, it is important to understand how nursing interventions affect patient outcomes, survival, and complication rates. Methods : This systematic review followed the preferred reporting items for systematic reviews and meta-analysis guidelines. A literature search was performed using terms related to ECMO and nursing interventions in several international electronic databases including CINAHL, Embase, MEDLINE, and Web of Science. Studies were screened and selected according to predefined eligibility criteria, focusing on those that evaluated the impact of nursing interventions on adult. Data extraction and risk-of-bias assessment were independently performed by two researchers. Results : A total of 647 studies were identified, and seven met the inclusion criteria for qualitative analysis. The included studies demonstrated that high-quality nursing care significantly improves clinical outcomes and reduces complications in patients receiving ECMO. Effective nursing interventions included prone positioning combined with ECMO for patients with acute respiratory distress syndrome, meticulous infection control, comprehensive and continuous nursing protocols, skilled nursing, and multidisciplinary management. These interventions have been shown to improve oxygenation, reduce complications, such as bleeding, manage blood pressure, and enhance overall clinical outcomes. Conclusion : High-quality nursing interventions are critical to improve survival and reduce complications in patients receiving ECMO. Implementing a multidisciplinary approach and comprehensive nursing protocols, including infection control and psychological support, is essential for the effective management of these patients. The findings of this study provide a foundation for the development of practical guidelines and educational programs to improve the quality of care for patients undergoing ECMO, ultimately enhancing the effectiveness of ECMO treatment and patient outcomes.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.5
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• pp.1747-1749
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• 2015

Background: Esophageal cancer is one of the major health concerns in Southeast Asian countries, including Thailand. However, only a limited number of studies have been reported from this region. This study was designed to evaluate the prevalence, clinical characteristics and survival rate of esophageal cancer in Thailand. Materials and Methods: Clinical information, histological features and endoscopic findings were collected from a tertiary care center in central region of Thailand between September 2011- November 2014 and reviewed. Results: A total of 64 esophageal cancer patients including 58 men and 6 women with mean age of 62.6 years were enrolled. Common presenting symptoms were dysphagia (74%), dyspepsia (10%) and hematemesis (8%). Mean duration of symptoms prior to diagnosis was 72 days. Esophageal stenosis with contact bleeding was the most common endoscopic finding (55.6%). The location of cancer was found in proximal (16%), middle (50%) and distal (34%) esophagus. Squamous cell carcinoma was far more common histology than adenocarcinoma (84.2% vs 10.5%). However, esophageal adenocarcinoma was significantly more common than squamous cell carcinoma in distal area of esophagus (100% vs 22.9%; p=0.0001, OR=1.6, 95%CI=1.1-2.2). Esophageal cancer stages 3 and 4 accounted for 35.2% and 59.3% respectively. Overall 2-year survival rate was 20% and only 16% in metastatic patients. Conclusions: Most esophageal cancer patients in Thailand have squamous cell carcinoma and nearly all present at advanced stage with a grave prognosis. Screening of high risk individuals and early detection might be important keys to improve the survival rate and treatment outcome in Thailand.

• Korean Journal of Clinical Pharmacy
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• v.26 no.3
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• pp.207-212
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• 2016

Objective: Prescription rate of dabigatran and rivaroxaban, which are the direct oral anticoagulants (DOAC), has increased. We have analyzed the prescription trend and medication use of dabigatran and rivaroxaban in patients with non-valvular atrial fibrillation (NVAF). Methods: It was retrospectively studied from September 2012 to April 2014 using the electronic medical records and the progress notes. Patients with NVAF (n=424) were evaluated on the medication use, prescribing preferences, adverse drug reactions (ADRs) and the availability of prescription reimbursement of dabigatran (n=210) and rivaroxaban (n=214). Results: Dabigatran was prescribed higher than rivaroxaban (23.3% versus 7.5%, p<0.001) in the neurology department, but rivaroxaban was prescribed higher compared to dabigatran in the cardiology department (87.4% versus 74.3%, p<0.001). Dabigatran was prescribed more than rivaroxaban in high risk patients with CHADS2 score ${\geq}3$ (44.3% versus 31.3%, p=0.006). Dabigatran patients seemed to have more ADRs than patients with rivaroxaban (25.2% versus 11.2%, p<0.001), but no serious thrombotic events and bleeding were found. Only 35.6% (n=151) were eligible for prescription reimbursement by the National Health Insurance (NHI). Bridging therapy (86, 31.5%) and direct-current cardioversion (57, 20.2%) were main reasons of ineligibility for reimbursement. Conclusion: Prescription preferences were present in choosing either dabigatran or rivaroxaban for patients with NVAF. Inpatient protocols and procedures considering patient-factors in NVAF need to be developed.

• Journal of Chest Surgery
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• v.33 no.8
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• pp.630-637
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• 2000

Backgroud: There are well-known problems in the management of low weight neonates or infants with congenital heart defects. In the past, because of a perceived high risk of operations using cardiopulmonary bypass(CPB) in these patients, there was a tendency for staged palliation without the use of CPB. However, the recent trend has been toward early reparative surgery using CPB, with acceptable mortality and good long-term survival. Therefore we reviewed our results of the operations in infants weighing less than 3kg and considered the technical aspect of conducting the CPB including myocardial protection. Material and Method: Between Jan. 1995 and Jul. 1998, 28 infants weighing less than 3kg underwent open heart surgery for many cardiac anomalies with a mean body weight of 2.7kg(range; 1.9-3.0kg) and a mean age of 41days(range; 4-110days). Preoperative management in the intensive care unit was needed in 20 infants and preoperative ventilator support therapy in 11. Total correction was performed in 23 infants and the palliative procedure in 5. Total circulatory arrest was needed in 11 infants(39%). Result: There were seven hospital deaths(25%) caused by myocardial failure(n=3), surgical failure(n=2), multiorgan failure(n=1), and sudden death(n=1). The median duration of hospital stay and intensive care unit stay were 13days(range; 6-93days) and 6days(range; 2-77days) respectively. The follow-up was achieved in 21 patients and showed three cases of late mortality(15%) and a one-year survival rate of 62%. No neurologic complications such as clinical seizure and intracranial bleeding were noticed immediately after surgery and during follow-up. Conclusion: The early and late mortality rate of open heart surgery in our infants weighing less than 3 kg stood relatively high, but the improved outcomes are expected by means of the delicate conduct of cardiopulmonary bypass including myocardial protection as well as the adequate perioperative management. Also, the longer follow-up for the neurologic development and complications are needed in infants undergoing circulatory arrest and continuous low flow CPB.