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A LONG-TERM NEGLECTED BED PATIENT WITH CEREBRAL PALSY : A CASE REPORT (병상에서 장기간 방치 된 뇌성마비 환자 : 증례보고)

  • Kim, Do-young;Yang, Yeon-mi;Kim, Jae-gon;Lee, Dae-woo
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.13 no.1
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    • pp.33-36
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    • 2017
  • Cerebral palsy(CP) is a motor disorder of the central nervous system resulting from irreversible brain injury due to congenital or acquired causes. Health-related quality of their life is associated with severity of impairment and socioeconomic factors. These patients are particularly easy to be neglected because they lack capacity to care themselves unless they have the help of caregiver from high socioeconomic status. A 11-year-old girl with severe motor impairment came with the chief complaint of severe calculus deposition on whole dentition. She was taken with bed-ridden state with pediatrician not her parents. Since brain was damaged at the age of two, she has been left alone in the city care hospitals without parental care. Main caregiver is her father with not high educational level. Oral hygiene was not performed at all. Severe calculus deposition, gingival swelling, and gingival redness around the whole dentition were observed. During the 1st and 2nd visit, scaling and extraction was performed. CP patients with low socioeconomic status and severe motor impairment tend to be neglected from dental treatment. Dental care, along with medical care, is crucial to the quality of CP patients' lives. Therefore it is important that they visit for regular dental check ups and receive preventative care.

Long-term Management of a Gingival Fibromatosis Patient with the Primary Dentition (유치열기에서 나타난 치은섬유종증 환자의 장기간 관리)

  • Kang, Chungmin;Lee, Jaeho;Choi, Hyungjun;Song, Jeseon;Kim, Seongoh
    • Journal of the korean academy of Pediatric Dentistry
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    • v.41 no.4
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    • pp.328-334
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    • 2014
  • Gingival fibromatosis is a rare oral condition that is characterized by proliferative fibrous overgrowth of the attached gingiva, the marginal gingiva, and the interdental papilla, typically presenting in the growth period. A case of a 27-month-old girl with a generalized severe gingival overgrowth is described herein. The patient had no known systemic disease, but enlarged gingival tissue had gradually covered her teeth. The excess gingival tissue was removed by conventional gingivectomy, which involved extraction of the retentive primary teeth under general anesthesia when she was 5 years old. Post surgical follow-up at 18 months after the surgery demonstrated no recurrence. Resectional surgery of the enlarged gingival tissue is the treatment choice for gingival fibromatosis, although there is a high risk of recurrence. More frequent professional follow-ups and oral hygiene instruction might be required. A delay in the surgical treatment may have significant consequences for the patient, such as primary dentition retention and consequent delay in the eruption of the permanent teeth, difficulties in mastication and phonation, malpositioning of the teeth, and psychological problems. Early surgical treatment should be performed according to the severity of enlargement.

Maxillary Incisor Replacement with the Ectopically Erupting Canine : Case Reports (이소맹출하는 견치의 상악 전치로의 대체사용 : 증례보고)

  • Lim, Jieun;Choi, Sungchul;Park, Jaehong;Choi, Yeongchul;Kim, Kwangchul;Ann, Hyojung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.40 no.4
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    • pp.335-341
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    • 2013
  • Impacted maxillary canines are the most frequently impacted teeth after the third molars. The exact etiology of impacted maxillary canines is unknown, but several complications may result from impacted maxillary canines. An early detection of ectopically erupting teeth can lead to performing interceptive treatment such as early extraction of primary canine and provide the best long-term results. In the absence of prevention, clinicians should consider orthodontic treatment followed by surgical exposure of the canine to bring it into occlusion. However, in cases when the finding ectopically erupting teeth and severe root resorption of adjacent teeth are found late, malposed canine can replace the injured teeth. In these presented cases, early diagnosis and treatment of ectopic eruption and root resorption were not performed. The maxillary incisor replacement with ectopically erupting canine can be the alternative treatment of choice with successful results. The reconstructed canine is planned to be checked periodically for the condition of composite resin restoration. Orthodontic treatment and dental implant are planned. This report shows that when early diagnosis was not done, maxillary incisor replacement with ectopically erupting canine could prevent uncertain prognosis of the adjacent teeth with root resorption and provide esthetic satisfactory with time saved and cost reduced.

Effectiveness of Cognitive Behavioral Therapy Techniques for Control of Pain in Lung Cancer Patients: An Integrated Review

  • Phianmongkhol, Yupin;Thongubon, Kannika;Woottiluk, Pakapan
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.6033-6038
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    • 2015
  • Background: Experience of lung cancer includes negative impacts on both physical and psychological health. Pain is one of the negative experiences of lung cancer. Cognitive behavioral therapy techniques are often recommended as treatments for lung cancer pain. The objective of this review was to synthesize the evidence on the effectiveness of cognitive behavioral therapy techniques in treating lung cancer pain. This review considered studies that included lung cancer patients who were required to 1) be at least 18 years old; 2) speak and read English or Thai; 3) have a life expectancy of at least two months; 4) experience daily cancer pain requiring an opioid medication; 5) have a positive response to opioid medication; 6) have "average or usual" pain between 4 and 7 on a scale of 0-10 for the day before the clinic visit or for a typical day; and 7) able to participate in a pain evaluation and treatment program. This review considered studies to examine interventions for use in treatment of pain in lung cancer patients, including: biofeedback, cognitive/attentional distraction, imagery, hypnosis, and meditation. Any randomized controlled trials (RCTs) that examined cognitive behavioral therapy techniques for pain specifically in lung cancer patients were included. In the absence of RCTs, quasi-experimental designs were reviewed for possible conclusion in a narrative summary. Outcome measures were pain intensity before and after cognitive behavioural therapy techniques. The search strategy aimed to find both published and unpublished literature. A three-step search was utilised by using identified keywords and text term. An initial limited search of MEDLINE and CINAHL was undertaken followed by analysis of the text words contained in the title and abstract, and of the index terms used to describe the article. A second search using all the identified keywords and index terms was then undertaken across all included databases. Thirdly, the reference list of all identified reports and articles were searched for additional studies. Searches were conducted during January 1991- March 2014 limited to English and Thai languages with no date restriction. Materials and Methods: All studies that met the inclusion criteria were assessed for methodological quality by three reviewers using a standardized critical appraisal tool from the Joanna Briggs Institute (JBI). Three reviewers extracted data independently, using a standardized data extraction tool from the Joanna Briggs Institute (JBI). Ideally for quantitative data meta-analysis was to be conducted where all results were subject to double data entry. Odds ratios (for categorical data) and weighted mean differences (for continuous data) and their 95% confidence intervals were to be calculated for analysis and heterogeneity was to be assessed using the standard Chi-square. Where statistical pooling was not possible the finding were be presented in narrative form. Results: There were no studies located that met the inclusion requirements of this review. There were also no text and opinion pieces that were specific to cognitive behavioral therapy techniques pain and lung cancer patients.Conclusions: There is currently no evidence available to determine the effectiveness of cognitive behavioural therapy techniques for pain in lung cancer patients.

The Expression of Genes Related to Egg Production in the Liver of Taiwan Country Chickens

  • Ding, S.T.;Ko, Y.H.;Ou, B.R.;Wang, P.H.;Chen, C.L.;Huang, M.C.;Lee, Y.P.;Lin, E.C.;Chen, C.F.;Lin, H.W.;Cheng, Winston Teng Kuei
    • Asian-Australasian Journal of Animal Sciences
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    • v.21 no.1
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    • pp.19-24
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    • 2008
  • The purpose of this study was to detect expression of genes related to egg production in Taiwan Country chickens by suppression subtractive hybridization. Liver samples of mRNA extraction from two Taiwan Country chicken strains (L2 and B), originated from the same population but with very distinct egg production rates after long-term selection for egg and meat production respectively. Two-way subtraction was performed. The hepatic cDNA from the low egg production chickens (B) was subtracted from the hepatic cDNA from the high egg production strain (L2). The reversed subtraction (L2 from B) was also performed. The resulting differentially expressed gene fragments were cloned and sequenced. We sequenced 288 clones from the forward subtraction and 96 clones from the reverse subtraction. These genes were subjected to further screening to confirm the differential expression between the two genetic breeds of chickens. The apolipoprotein B (apoB) was expressed to a greater extent in the liver of the L2 than in the B line chickens. The 5-aminoimidazole- 4-carboxamide ribonucleotide formyltransferase/IMP cyclohydrolase (PURH) was expressed to a greater extent in the liver of the B than in the L2 strain chickens. We demonstrated that both apoB and PURH were more highly expressed in the liver than that in other tissues (muscle, ovary, and oviduct) in laying Taiwan Country chickens. Taken together, these data suggest that after the selection for egg production, expression of apoB and PURH genes were also changed. Whether the changed expression of these genes is directly related to egg production is not known, but these two genes may be useful markers for egg laying performance in Taiwan Country chickens.

Development and Validation of HPLC Method for Pharmacokinetic Study of Promethazine in Human (염산프로메타진 체내동태 연구를 위한 혈청 중 프로메타진의 HPLC 정량법 개발 및 검증)

  • Cho, Hae-Young;Kang, Hyun-Ah;Lee, Hwa-Jeong;Choi, Hoo-Kyun;Lee, Yong-Bok
    • Journal of Pharmaceutical Investigation
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    • v.36 no.1
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    • pp.23-29
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    • 2006
  • A rapid, selective and sensitive reversed-phase HPLC method for the determination of promethazine in human serum was developed, validated, and applied to the pharmacokinetic study of promethazine. Promethazine and internal standard, chlorpromazine, were extracted from human serum by liquid-liquid extraction with n-hexane containing 0.8% isopropanol and analyzed on a Capcell Pak CN column with the mobile phase of acetonitrile-0.2 M potassium dihydrogen phosphate (42:58, v/v, adjusted to pH 6.0 with 1 M NaOH). Detection wavelength of 251 nm and flow rate of 0.9 mL/min were fixed for the study. The assay robustness for the changes of mobile phase pH, organic solvent content, and flow rate was confirmed by $3^{3}$ factorial design using a fixed promethazine concentration (10 ng/mL) with respect to its peak area and retention time. In addition, the ruggedness of this method was investigated at three different laboratories using same quality control (QC) samples. This method showed linear response over the concentration range of 1-40 ng/mL with correlation coefficients greater than 0.999. The lower limit of quantification using 1 mL of serum was 1 ng/mL, which was sensitive enough for pharmacokinetic studies. The overall accuracy of the quality control samples ranged from 96.15 to 105.40% for promethazine with overall precision (% C.V.) being 6.70-11.22%. The relative mean recovery of promethazine for human serum was 63.54%. Stability (freeze-thaw and short-term) studies showed that promethazine was stable during storage, or during the assay procedure in human serum. However, the storage at $-80^{\circ}C$ for 4 weeks showed that promethazine was not stable. Extracted serum sample and stock solution were not allowed to stand at ambient temperature for 12 hr prior to injection. The peak area and retention time of promethazine were not significantly affected by the changes of mobile phase pH, organic solvent content, and flow rate under the conditions studied. This method showed good ruggedness (within 15% C.V.) and was successfully used for the analysis of promethazine in human serum samples for the pharmacokinetic studies of orally administered Himazin tablet (25 mg as promethazine hydrochloride) at three different laboratories, demonstrating the suitability of the method.

Stability Analysis of Multiple Thermal Energy Storage Caverns Using a Coupled Thermal-Mechanical Model (열-역학적 연계해석 모델을 이용한 다중 열저장공동 안정성 분석)

  • Kim, Hyunwoo;Park, Dohyun;Park, Eui-Seob;Sunwoo, Choon
    • Tunnel and Underground Space
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    • v.24 no.4
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    • pp.297-307
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    • 2014
  • Cavern Thermal Energy Storage system stores thermal energy in caverns to recover industrial waste heat or avoid the sporadic characteristics of renewable-energy resources, and its advantages include high injection-and-extraction powers and the flexibility in selecting a storage medium. In the present study, the structural stability of rock mass pillar between these silo-type storage caverns was assessed using a coupled thermal-mechanical model in $FLAC^{3D}$. The results of numerical simulations showed that thermal stresses due to long-term storage depended on pillar width and had significant effect on the pillar stability. A sensitivity analysis of main factors indicated that the influence on the pillar stability increased in the order cavern depth < pillar width < in situ condition. It was suggested that two identical caverns should be separated by at least one diameter of the cavern and small-diameter shaft neighboring the cavern should be separated by more than half of the cavern diameter. Meanwhile, when the line of centers of two caverns was parallel to the direction of maximum horizontal principal stress, the shielding effect of the caverns could minimize an adverse effect caused by a large horizontal stress.

Moving Object Contour Detection Using Spatio-Temporal Edge with a Fixed Camera (고정 카메라에서의 시공간적 경계 정보를 이용한 이동 객체 윤곽선 검출 방법)

  • Kwak, Jae-Ho;Kim, Whoi-Yul
    • Journal of Broadcast Engineering
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    • v.15 no.4
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    • pp.474-486
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    • 2010
  • In this paper, we propose a new method for detection moving object contour using spatial and temporal edge. In general, contour pixels of the moving object are likely present around pixels with high gradient value along the time axis and the spatial axis. Therefore, we can detect the contour of the moving objects by finding pixels which have high gradient value in the time axis and spatial axis. In this paper, we introduce a new computation method, termed as temporal edge, to compute an gradient value along the time axis for any pixel on an image. The temporal edge can be computed using two input gray images at time t and t-2 using the Sobel operator. Temporal edge is utilized to detect a candidate region of the moving object contour and then the detected candidate region is used to extract spatial edge information. The final contour of the moving object is detected using the combination of these two edge information, which are temporal edge and spatial edge, and then the post processing such as a morphological operation and a background edge removing procedure are applied to remove noise regions. The complexity of the proposed method is very low because it dose not use any background scene and high complex operation, therefore it can be applied to real-time applications. Experimental results show that the proposed method outperforms the conventional contour extraction methods in term of processing effort and a ghost effect which is occurred in the case of entropy method.

Effect of the Sulfur Removal in Manufacturing Pt/C Electrocatalysts on the Performance of Phosphoric Acid Fuel Cell (인산형 연료전지용 백금촉매제조에서 황의 제거에 따른 전극 성능)

  • Shim, Jae-Cheol;Lee, Kyung-Jik;Lee, Ju-Seong
    • Applied Chemistry for Engineering
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    • v.9 no.4
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    • pp.486-490
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    • 1998
  • Pt/C powder which was used as electrocatalyst in a Phosphoric Acid Fuel Cell(PAFC) was fabricated by colloid method. It was reported that the sulfur from reductant, $Na_2S_2O_4$, worked as a poison against catalyst during long term operation. To remove these sulfurs, we try to treat Pt/C powder by three different methods. First, we tried to remove the sulfur according to temperature and time in $H_2$ atmosphere. As the heat treatment temperature is raised up, the effect of the removal is increased but the electrode performance is decreased because of the growth of Pt particle size. The optimal heat treatment temperature is $400^{\circ}C$, the size of Pt particle is approximately $35{\sim}40{\AA}$ and the electrode performance is $360mA/cm^2$ at 0.7 V. At $400^{\circ}C$, even though the time of heat treatment is extended, size of Pt, amounts of remaining sulfur and electrode performance is almost constant. Secondly, when we removed in a crucible at $900^{\circ}C$ the removal of the sulfur was not better, but the size of Pt particle, approximately $80{\AA}$, was smaller than that of heat treatment in $H_2$ atmosphere at $900^{\circ}C$. Lastly we treated with solvents such as acetone, benzene, and carbon disulfide. It was observed that sulfur components were removed partly by extraction with solvents, the electrode performances were similar each other.

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UNERUPTED PRIMARY MOLARS (미맹출 유구치의 치험례)

  • Kang, Sun-Hee;Yang, Young-Sook;Lee, Kwang-Hee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.2
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    • pp.217-223
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    • 2005
  • The term 'impaction teeth' is used to designate a tooth which remains unerupted in jaw beyond the time at which it should normally be erupted. Most cases of impacted teeth reported in the literature are permanent teeth. The impaction of primary teeth occur rarely whereas impaction of second primary molars is more numerous than all other impactions. Failure of eruption of primary teeth may cause a number of complications, such as interference with development and eruption of successive permanent teeth, malocclusion, cystic change of tooth follicle. The clinican should consider the various treatment option available (a) No treatment and observation, (b) surgical extraction (c) space regainer. Proper treatment plan should be established after thought consideration of impacted tooth and it's relation with successive permanent tooth.

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