• 제목/요약/키워드: Systemic approach

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Multiple brain abscesses treated by extraction of the maxillary molars with chronic apical lesion to remove the source of infection

  • Jung, Ki-Hyun;Ro, Seong-Su;Lee, Seong-Won;Jeon, Jae-Yoon;Park, Chang-Joo;Hwang, Kyung-Gyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제41권
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    • pp.25.1-25.5
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    • 2019
  • Background: Brain abscess is a life-threatening condition that occurs due to complications during a neurosurgical procedure, direct cranial trauma, or the presence of local or distal infection. Infection in the oral cavity can also be considered a source of brain abscess. Case presentation: A 45-year-old male patient was transported with brain abscess in the subcortical white matter. Navigation-guided abscess aspiration and drainage was performed in the right mid-frontal lobe, but the symptoms continued to worsen after the procedure. A panoramic radiograph showed alveolar bone resorption around the maxillary molars. The compromised maxillary molars were extracted under local anesthesia, and antibiotics were applied based on findings from bacterial culture. A brain MRI confirmed that the three brain abscesses in the frontal lobe were reduced in size, and the patient's symptoms began to improve after the extractions. Conclusion: This is a rare case report about multiple uncontrolled brain abscesses treated by removal of infection through the extraction of maxillary molars with odontogenic infection. Untreated odontogenic infection can also be considered a cause of brain abscess. Therefore, it is necessary to recognize the possibility that untreated odontogenic infection can lead to serious systemic inflammatory diseases such as brain abscess. Through a multidisciplinary approach to diagnosis and treatment, physicians should be encouraged to consider odontogenic infections as a potential cause of brain abscesses.

국내 노인간호연구 분석과 발전방향 (The Trend and Issues of the Gerontological Nursing Study in Korea)

  • 이영란;김신미;박혜옥;박효미;조계화;노유자
    • 대한간호학회지
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    • 제28권3호
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    • pp.676-694
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    • 1998
  • Issues related to the elderly have been recognized in Korea and nursing schalors have tried to study these issues. It is hard to say which the direction we, are going or have to go, since there has been little systemic effort to establish gerontological nursing field yet. Therefore, it is necessary to find out the trend and the guidelines of gerontolotical nursing studies for the future. Dissertation and published articles related to the elderly in the nursing field from 1991 to the Feburary of 1997 were are reviewed. Total 127 studies were analysed in terms of concept, design/methodology, and results, and the nature and issues of the gerontologic nursing studies in Korea were explored. The results are as follows : 1. There was no clear chronological definition of the elderly. 2. The most popular research design was an exploratory/descriptive study. 3. The major concepts studied were physical and mental health. 4. Among those studies using instruments which were developed and modified and/or translated by researchers, the reliability and validity were rarely reported. 5. Theory based studies were rare. We suggest the following issues for future studies : 1. The chronological and other criteria related to the defition of elderly is needed. 2. Physiopsychosocial characteristics of Korean elderly and their mangements in terms of intervention studies need to be conducted more systemically. 3. Social issues from the change of types and functions of family such as single elderly family need to be studied. 4. Participation in and collaborate with other disciplins are needed. 5. Development and test of instruments to measure phenomena or concepts is needed. 6. Macroscopic approach such as policy also needed. 7. Theory based studies are needed.

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총의치 난증례에 대한 접근법: 진단부터 최종의치까지 (Approach to complicated fully edentulous case: from the diagnosis to the definitive denture)

  • 오진아;이현민;백장현;노관태;권긍록;배아란
    • 대한치과보철학회지
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    • 제53권3호
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    • pp.250-255
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    • 2015
  • 심한 잔존치조제의 흡수와 의치지지조직의 손상을 동반한 총의치 난증례는 정확한 진단과 체계적인 치료계획 수립을 통해 보철물의 유지, 안정, 지지를 증진시켜야 한다. Provisional restoration은 총의치의 안정성을 다각도로 평가하고 환자와 치과의사의 피드백을 가능하게 하는 유용한 도구로서 사용될 수 있다. 본 증례에서는 진단용의치를 통해 인상면, 연마면, 교합면을 평가하여 의치의 안정성을 증대시키고 환자의 심미적 요구를 반영하여 최종의치로 이행하였으며 임상적으로 기능과 심미적인 측면에 있어서 만족할 만한 결과를 얻었기에 이를 보고하고자 한다.

동의보감(東醫寶鑑) 해독 처방에 대한 형상의학적 고찰 (HyungSang Medical Approach to Detoxification)

  • 김종원;전수형;정홍식;강경화;이인선;이상훈;김규곤;이용태
    • 동의생리병리학회지
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    • 제23권2호
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    • pp.278-287
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    • 2009
  • Ji-San, the founder of HyungSang medicine, emphasized food intake and detoxification by stating, "Korean medicine begins with detoxification." Toxin accumulates in one's body unless the internal and external conditions stay in their harmony. The accumulation of toxin is also caused by western medication or one-sided diet, and detoxification should be considered in those cases. HwangRyunHaeDok-Tang reduces fire and heat, and the lesion is likely to locate in the upper body. BangPoongTongSung-San can be used for systemic disease. IkWoon-San also reduces fire and heat but mainly focuses on promoting urination. InSamPaeDok-San has an effect of curing the external symptoms of SangHan(傷寒), in addition to detoxification. SeoGakJiHwang-Tang, SoDok-Eum, and SeoGakSoDok-Eum can resolve the heat-toxin when it is located on the surface. SibJeonDaeBo-Tang enhances the detoxifying function of human body. GhamDu-Tang and JaGeum-Jung have a general effect on detoxification.

Tumor Diameter for Prediction of Recurrence, Disease Free and Overall Survival in Endometrial Cancer Cases

  • Senol, Taylan;Polat, Mesut;Ozkaya, Enis;Karateke, Ates
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권17호
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    • pp.7463-7466
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    • 2015
  • Aims: To analyse the predictors of recurrence, disease free survival and overall survival in cases with endometrial cancer. Materials and Methods: A total of 152 women diagnosed with endometrial cancer were screened using a prospectively collected database including age, smoking history, menopausal status, body mass index, CA125, systemic disorders, tumor histology, tumor grade, lymphovascular space invasion, tumor diameter, cervical involvement, myometrial invasion, adnexal metastases, positive cytology, serosal involvement, other pelvic metastases, type of surgery, fertility sparing approach to assess their ability to predict recurrence, disease free survival and overall survival. Results: In ROC analyses tumor diameter was a significant predictor of recurrence (AUC:0.771, P<0.001). The optimal cut off value was 3.75 with 82% sensitivity and 63% specificity. In correlation analyses tumor grade (r=0.267, p=0.001), tumor diameter (r=0.297, p<0.001) and the serosal involvement (r=0.464, p<0.001) were found to significantly correlate with the recurrence. In Cox regression analyses when some different combinations of variables included in the model which are found to be significantly associated with the presence of recurrence, tumor diameter was found to be a significant confounder for disease free survival (OR=1.2(95 CI,1.016-1.394, P=0.031). On Cox regression for overall survival only serosal involvement was found to be a significant predictor (OR=20.8 (95 % CI 2.4-179.2, P=0.006). In univariate analysis of tumor diameter > 3.75 cm and the recurrence, there was 14 (21.9 %) cases with recurrence in group with high tumor diameter where as only 3 (3.4 %) cases group with smaller tumor size (Odds ratio:7.9 (95 %CI 2.2-28.9, p<0.001). Conclusions: Although most of the significantly correlated variables are part of the FIGO staging, tumor diameter was also found to be predictor for recurrence with higher values than generally accepted.

Approaches for Developing National STI Strategies

  • Meissner, Dirk
    • STI Policy Review
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    • 제5권1호
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    • pp.34-56
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    • 2014
  • This paper reviews the most central analytical and methodological issues that arise in developing national STI strategies. First, an outline of the relationship between national innovation systems and the strategic dimension is presented. The paper shows that science, technology and innovation strategy are often used in different forms and that there is no common understanding yet of the actual meaning and coverage of these strategies. The paper develops the terminology from a discussion of different approaches towards company innovation processes analyzing their evolution in different socioeconomic environments and the role and impact of science, technology and innovation policy on company innovation processes. Based on this conceptual understanding the paper defines national science, technology, innovation, and STI strategy and explains the basic terminology. From these definitions, the strategic dimension including the impact on the stakeholders is discussed. It is shown that a major success factor for STI strategy development is the involvement of stakeholders to vary and extend their use of their portfolio of instruments. Moreover it becomes evident that stakeholders follow their own interests which aren't necessarily in the interest of the national STI strategies. The analysis shows advantages and disadvantages as well as potentials and limitations of different approaches to develop STI strategies in their ability to describe the reality of innovation processes and to allow conclusions about the relationship between innovation policy and the innovation processes implemented by companies. It is shown that knowledge of these limitations is an important factor to consider in designing consistent and coherent national STI policy which aims at supporting innovation eventually. Finally the paper concludes that the STI policy mix concept needs a more systemic development approach which is integrated in the national STI strategy development and implementation.

비강 및 부비동에 발생한 반전성 유두종 1례 (A Case of the Inverted Papilloma of the Nose and Paranasal Sinuses)

  • 권혁진;박호선;윤병용
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 1982년도 제16차 학술대회연제순서 및 초록
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    • pp.15.2-15
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    • 1982
  • 비강 및 부비동의 점막에서 발생하는 양성상피종양인 반전성 유두종은 비교적 드물며 1854년 Ward에 의해 처음으로 기술된 이래 여러 학자들에 의해 본증이 논의되어 왔으나 한국에서는 그 보고례가 매우 드물었다. 병리조직학적으로 양성인 이 종양은 비강이나 골 및 주위조직의 파괴성 병변이 빈번하고 수술 후 재발이 잘되고 드물게 악성으로 변하는 성질을 나타내므로 임상적으로 악성으로 알려져 왔다. 일단 반전성 유두종으로 확진되게 되면 가능한 한 광범위한 절제가 필요하며 술 후에도 계속적이 추적조사가 필요하다고 하겠다. 최근 저자들은 비폐색, 종류감을 주소로하여 내원한 48세된 남자환자에서 우측비강, 상악동에서 발생하여 국소적으로 악성화 변화를 일으킨 반전성 유두종 1례를 비내 및 Caldwell_LUC식 방법으로 절제후 Bleomycin 정맥주사, 5_FU 국소분무요법 및 방사선요법($Co^{60}$)을 병용하여 좋은 결과를 얻었기에 이를 문헌적 고찰과 함께 보고하는 바이다.

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진행성 치주염에서의 치은열구액내 교원질분해효소 활성 (Collagenolytic Activity Of Gingival Crevicular Fluid In Progressive Periodontitis)

  • 정현주
    • Journal of Periodontal and Implant Science
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    • 제26권1호
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    • pp.161-175
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    • 1996
  • There were many reports that elevations in the levels of active and latent collagenase in gingival crevicular fluid(GCF) have been correlated positively with periodontal disease activity. To provide a simple diagnostic approach for testing GCF collagenolytic activity, the detection limit of enzyme activity was compared using radiofibril assay(Sodek et.al.1981) and spectrophotometric collagenolytic assay(Nethery et al. 1986). The detection limits of both assay for standard bacterial enzyme were similar and the radiofibril assay showed a little (1/2) lower detection limit for tad pole collagenase. To evaluate the relationship between periodontal tissue destruction and the collagenolytic activity, GCF was collected, and latent and active enzyme activities were measured by a spectrophotometric collagenolytic assay. Twelve subjects showing progressive lesions were selected according to the presence of immediate tissue destruction, frequent abscess formation, and increasing need for tooth extraction, and the absence of underlying systemic disease and previous antibiotic medication history within 6 months. Comparisons were made between sites with either: 1) inflammation with a previous history of progressive loss of periodontal tissue and bone support(2l progressive sites): 2) previous history of bone loss and periodontal destruction but now clinically stable(12 comparably stable sites); or 3) no loss of periodontal tissue and bone support(11 control sites including 5 gingivitis sites and 6 healthy sites). Active collagenase activity was the highest in the progressive sites and decreased in the order of the gingivitis sites, the stable sites, and the healthy sites. The total enzyme activity was $2{\sim}3$ fold higher in the progressive sites and the gingivitis sites, compared to the stable and the healthy sites. The ratio of active to total collagenolytic activity was twice in the progressive sites. Analysis of active collagenase level(5mU) and the ratio of active to total collagenolytic activity(0.8) as a diagnositic test indicates that these measurements have the sensitivity of 0.81 and 0.86, the specificity of 0.70 and 0.65, and the overall agreement of 0.75 and 0.73, respectively. Thus, this method has significant merits as a diagnostic tool to determine wherher the site is in a state of remission or progression.

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청년의 세대관계 유형화: 세대 간 결속의 하위차원을 중심으로 (Typology of Young Korean Adults' Relationships with their Parents from an Intergenerational Solidarity Lens)

  • 이재림;박제인;김혜지;오상민;권소영
    • Human Ecology Research
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    • 제58권1호
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    • pp.43-60
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    • 2020
  • The literature on parent-child relationships in young adulthood lacks a systemic approach that considers the multifaceted nature of intergenerational relationships. In this paper, we identify the latent profiles of young Korean adults' relationships with their parents based on the six dimensions of intergenerational solidarity (structural, associational, affectual, consensual, functional, and normative solidarity) as indicators. We considered solidarity for the mother and the father separately for structural, associational, affectual, and consensual dimensions. In terms of functional and normative solidarity, we measured both upstream and downstream intergenerational support. The sample included 1,015 young adults who were 19-34 years old, never married, not in secondary school, and had both parents living. The latent profile analysis revealed four profiles: (a) independent but intimate (22.7%), (b) coresident, outwardly intimate (32.4%), (c) detached from father (6.7%), and (d) coresident, intimate (38.2%). The factors that predicted each profile included the young adults' education, income, subjective socioeconomic status, and experiencing the features of emerging adulthood along with the parents' marital status, father's employment, and overparenting. The "coresident, intimate" group reported significantly higher levels of life satisfaction and fewer depressive symptoms compared to the other three groups. The lowest levels of psychological adjustment were found in the "coresident, outwardly intimate" group and "detached from father" group.

Aortic valve replacement surgery for a case of infantile Takayasu arteritis

  • Kwon, Hye-Won;Suh, Yoon-Jung;Bang, Ji-Seok;Kwon, Bo-Sang;Kim, Gi-Beom;Bae, Eun-Jung;Kim, Woong-Han;Noh, Chung-Il
    • Clinical and Experimental Pediatrics
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    • 제55권7호
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    • pp.254-258
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    • 2012
  • Takayasu arteritis is a chronic inflammatory disease of unknown etiology primarily affecting the aorta and its major branches and usually occurring in the second or third decade of life. Here, we report a case of Takayasu arteritis in a 10-month-old patient. The infant presented with signs of congestive heart failure and severe aortic regurgitation. Echocardiography and computed tomography angiography showed an abnormally dilated thoracic and abdominal aorta. The infant was initially treated with prednisolone, followed by commissuroplasty of the aortic valve but neither approach ameliorated the heart failure. The patient was eventually treated with a mechanical aortic valve replacement surgery at the age of 12 months, and her condition stabilized. Although unusual, this case indicates that the diagnosis of Takayasu arteritis should be considered in children with unexplained systemic symptoms, aortic valve regurgitation, and heart failure. Because severe aortic regurgitation may be a fatal complication of Takayasu arteritis, early aortic valve replacement surgery should be considered, even in very young children.