• Archives of Craniofacial Surgery
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• 제18권1호
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• pp.37-43
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• 2017

Background: Skin cancer is the most common type of cancer. Of the 4 million skin lesions excised annually worldwide, approximately 2 million are considered cancerous. In this study, we aimed to describe a regional experience with skin cancers treated by a single senior surgeon and to provide a treatment algorithm. Methods: The medical records of 176 patients with head and neck non-melanocytic skin cancer (NMSC) who were treated by a single surgeon at our institution between January 2010 and May 2016 were retrospectively reviewed, and their data (age, sex, pathological type, tumor location/size, treatment modality) were analyzed. Patients with cutaneous squamous cell carcinoma (cSCC) who were classified as a high-risk group for nodal metastasis underwent sentinel node mapping according to the National Comprehensive Cancer Network guidelines. Results: Among the patients with NMSC who were treated during this period, basal cell carcinoma (BCC; n=102, 57.9%) was the most common pathological type, followed by cSCC (n=66, 37.5%). Most lesions were treated by complete excision, with tumor-free surgical margins determined via frozen section pathology. Thirty-one patients with high-metastasis-risk cSCC underwent sentinel node mapping, and 17 (54.8%) exhibited radiologically positive sentinel nodes. Although these nodes were pathologically negative for metastasis, 2 patients (6.5%) later developed lymph node metastases. Conclusion: In our experience, BCC treatment should comprise wide excision with tumor-free surgical margins and proper reconstruction. In contrast, patients with cSCC should undergo lymphoscintigraphy, as nodal metastases are a possibility. Proper diagnosis and treatment could reduce the undesirably high morbidity and mortality rates.

• Asian Pacific Journal of Cancer Prevention
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• 제15권5호
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• pp.2195-2199
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• 2014

Background: Despite being rare in incidence, malignant tumors of major salivary glands show diverse histological variation. There are limited data on major salivary gland tumor management and outcome from Pakistan. The objective of this study was to share our experience with management of malignant tumors of major salivary glands. Materials and Methods: Patients who received treatment at Shaukat Khanum Cancer Hospital and Research Center from July 2002 to June 2011 with an underlying diagnosis of a major salivary gland malignancy were included. Patient characteristics and treatment modalities were assessed. Local, regional and distant failures were determined. Disease free survival (DFS) and overall survival (OS) were calculated using Kaplan Meier curves and the Log rank test was used to determine statistical significance. Univariate and multivariate analyses were performed using Cox proportional hazard regression. Results: The parotid gland was the primary site of origin in 104 (80%) patients. Mucoepidermoid carcinoma (43%) and adenoid cystic carcinoma (24%) were the most common histological types. Surgery followed by adjuvant radiation remained the mainstay treatment modality with 81 (62%) patients. Nineteen (15%) patients were treated with surgery alone and 30 (23%) patients with locally advanced surgically inoperable tumors received radiation only. Forty one (32%) patients failed the treatment (local 12, regional 11, locoregional 5, distant 13). The expected 5 year DFS and OS were 65% and 74% respectively. On multivariate analysis, grade was the only independent predictor of DFS and nodal involvement was the only independent predictor of overall survival. Conclusions: Employing existing standards of treatment, comparable survival can be achieved in Pakistani population with major salivary gland malignancies as elsehwere in the world.

• Archives of Plastic Surgery
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• 제41권4호
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• pp.394-397
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• 2014

Background Proximal interphalangeal joint (PIPJ) dislocations represent a significant proportion of hand clinic visits and typically require frequent follow-ups for clinical assessment, orthotic adjustments, and physiotherapy. There are a large number of treatment options available for PIPJ dislocations, yet no prospective or controlled studies have been carried out, largely due to the diversity of the various types of injuries. Methods We retrospectively reviewed all the PIPJ dislocations in our institution over a five-year period and directly compared the different splinting techniques that we have used over this time frame. Results There were a total of 77 dislocations of the PIPJ (57 men and 20 women) that were included in our study. We found that our management has shifted gradually from complete immobilisation to controlled early mobilisation with figure-of-eight splints. Following treatment, the range of motion of the PIPJ in the figure-of-eight group was significantly greater than that in the other three methods (P<0.05) used. There were significantly fewer hospital visits in the figure-of-eight splint group than in the other treatment groups. Conclusions The treatment of PIPJ dislocations has undergone a significant evolution in our experience. Early controlled mobilisation has become increasingly important, and therefore, splints have had to be adapted to allow for this. The figure-of-eight splint has yielded excellent results in our experience. It should be considered for all PIPJ dislocations, but careful patient selection is required to achieve optimum results.

• Journal of Korean society of Dental Hygiene
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• 제15권6호
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• pp.1099-1105
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• 2015

Objectives: The purpose of this study was to investigate parents' recognition and attitudes toward national health insurance coverage of sealant by the dental hygienists. Methods: A self-reported questionnaire was filled out by 329 elementary school children parents in G metropolitan city and N city from July 11 to 27, 2015. The questionnaire consisted of general characteristics of the subjects, recognition and attitudes toward national health insurance coverage of sealant and sealant by the dental hygienist, and recognition toward national health insurance. The data were analyzed by a descriptive analyses, multiple regression and logistic regression analysis using SPSS 12.0 program. Results: Recognition of national health insurance coverage was 2.52 times higher in high school and 4.97 times higher in recognition toward purpose of sealant. Factor affecting recognition of national health insurance was subscription of private health insurance, recognition of sealant treatment by dental hygienist (DH) and recognition of national health insurance coverage of sealant. Attitude toward sealant treatment by DH was positive in experience of sealant, recognition of sealant treatment by DH and experience of sealant treatment by DH. Factor affecting satisfaction on the sealant by DH was recognition of sealant treatment by DH and recognition of purpose of sealant. Conclusions: To increase national health insurance coverage of sealant, it is necessary to expand positive public relations of sealant by the dental hygienist.

• Advances in pediatric surgery
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• 제14권2호
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• pp.134-143
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• 2008

Infantile hepatic hemangioendothelioma (IHHE) is the most common benign vascular hepatic tumor in children. We analyzed the 17-year experience of IHHE. The medical records of 16 patients (M:F=8:8) treated at the Department of Pediatric Surgery and the Department of Pediatrics Seoul National University Children's Hospital between January 1991 and January 2008 were reviewed retrospectively. Mean age at presentation was 87 days (1 day - 551 days). Seventy five percent of patients were diagnosed with imaging study and 25 % with biopsy. Major symptoms were hepatomegaly (N=5), palpable abdominal mass (N=4) and congestive heart failure (N=3). Six patients had no symptoms. Kasabach-Merritt syndrome was combined in one patient. Nine patients (56.3 %) underwent operation and 2 patients (12.5 %) underwent only medical treatment. Clinical observation was tried on 5 patients (31.3 %) without any treatment. Operation was performed on the patient with clinical symptoms or on patients where the differentiation between begin and malignant could not be determined. Patients who had clinical symptoms but tumor was unreresectabile were treated medically. Among the 5 patients who had been observed for their clinical course, 2 patients showed complete regression and the tumors of the remaining 3 patients were regressing. Clinical symptoms, the age at presentation, the size of tumor and ${\alpha}$-FP, all had no significant statistical relationship with the time required for complete tumor regression. There was no relationship between the size change of the tumor and the change of ${\alpha}$-FP level. Only the size of tumor was related with clinical symptoms. One patient died of post-operatvie bleeding. Treatment plan was determined by the extent of the tumor and the presence of clinical symptoms. Observation was enough for the patients without clinical symptoms and complete resection was curative for patients with clinical symptoms. Medical treatment is an alternative for the patient whose tumor is unresectable.

• Journal of Periodontal and Implant Science
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• 제38권1호
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• pp.23-30
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• 2008

Purpose: The purpose of this study was to investigate the incidence of curet fracture and its contributing factors. Material and Methods: Fifty-eight periodontal curets which were broken during periodontal treatment in Kangnung National University Dental Hospital for 1 year were used as study materials. The blade thickness of new curets and broken ones was measured using a digital micrometer. Types of treatment procedures, clinical experience of operators, point of breakage, and method of removal of broken fragments were recorded for each broken curet. Results: The incidence of curet fracture in root planing (16.4 curets per 1,000 procedures) was higher than those in flap surgery (7.5) or supragingival scaling (2.7). No curet was broken during supportive periodontal treatment. The incidence of fracture did not seem to be related with clinical experience of operators. The most frequent breakage point of the curets were upper 1/3 of blades. Fifty-six of 58 broken fragments were removed by non-surgical methods. Two broken tips which could not removed non-surgically were left in the pockets, and proved to be removed spontaneously 1 week later. Conclusion: Root planing showed higher incidence of curet fracture than any other type of periodontal treatment. Most of the fractured fragments were removed by non-surgical method. Further study is needed to develop methods of removal of the fragments which can not be removed non-surgically.

• Journal of Oral Medicine and Pain
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• 제47권1호
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• pp.38-51
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• 2022

Purpose: The purpose of this study was to analyze the extent of awareness and understanding of college students on temporomandibular disorder (TMD) and to search for avenues for raising public awareness and improving knowledge about TMD. Methods: One thousand and one hundred and twenty one college students in Gyeonggi-do completed a questionnaire related to awareness, experience and knowledge of TMD and collected data were analyzed by Pearson's chi-squared test. Results: Women were more significantly aware of the terms, 'TMD' (p<0.001) and 'jaw joint disease' (p<0.001) than men. Third graders were more significantly aware of the terms, 'TMD' (p<0.001) and 'jaw joint disease' (p<0.001) than any other graders. Third graders the most frequently chose to visit department of dentistry for the treatment of TMD among three graders (p<0.001). Women more frequently chose to visit department of dentistry for the treatment of TMD than men (p<0.001). Health field subjects were more significantly aware of the terms, 'TMD' (p<0.001) and 'jaw joint disease' (p<0.001) than non health field subjects. Having more frequently visited department of dentistry for the treatment of TMD than non health field subjects (p<0.001), health field subjects more frequently chose to visit department of dentistry for the treatment of TMD in the future (p<0.001). Conclusions: The level of awareness and knowledge of TMD was higher in women college students, health field subjects and third graders than men college students, non health field subjects and the rest of two graders, respectively. The higher the level of experience and education of the subject, the more aware the subject was of TMD. Therefore publicity activities and education through various routes are required to raise public awareness and knowledge of TMD. In addition, it is necessary to inform general public of the dentistry specialized for the accurate diagnosis and standardized treatment of TMD.

• Journal of Society of Preventive Korean Medicine
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• 제27권3호
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• pp.47-67
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• 2023

Objectives : The objective of this study is to examine the findings of a survey assessing the treatment and management status of individuals with diabetes and pre-diabetes, along with their inclination to participate in the Korean Medicine Chronic Disease Management Program. Methods : The survey focused on individuals with diabetes and pre-diabetes, gathering information on respondents' demographic details, diabetes diagnosis, duration of diabetes, attitudes and experiences regarding Korean medicine diabetes treatment, and their willingness to participate in the 'Korean Medicine Chronic Disease Management Program'. Results : 33.1% of participants reported prior experience with Korean medicine treatment for diabetes. The intention to actively utilize Korean medicine treatment was positively observed, with a response rate of 61.1% expressing a favorable inclination and 8.9% indicating a negative stance. Furthermore, 75.3% of patients expressed their intention to participate in the 'Korean Medicine Chronic Disease Management Program' in the future. Among those expressing this intention, 81.4% stated a preference for the 'Korean-Western medicine combined management' in the chronic disease management Program. Conclusions : Patients' willingness to participate in 'Korean Medicine Diabetes Management Program' is high, but lack of information about Korean medicine is a factor that deprives people of the opportunity to experience Korean medicine treatment, and non-medical factors such as difficulty in visiting and administrative complexity are factors that impede participation in the 'Korean Medicine Chronic Disease Management Program'. It should be considered for improvement when formulating policies.

• Journal of dental hygiene science
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• 제9권2호
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• pp.231-239
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• 2009

The study distributed the total 210 questionnaires to women of childbearing age in Seoul, Gyeonggi and North Chungcheng from March 26, 2008 to April 16, 2008 and made them draw up them directly. The study applied 208 copies excepting two copies not suitable to data process to data analysis. The purpose of the study was to investigate/analyze awareness of dental treatment, oral health conditions and oral health management during the period of pregnancy and to serve the analyzed data as basic data of oral health education program development to improve expectant mothers' behaviors of oral health management: 1. According to the survey by age with regard to a question 'Should expectant mothers take dental treatment during the period of pregnancy?', women of 18~29 years old (41.9%) and more than 50 years old (52.0%) answered 'They should not take dental treatment'. Women of 30~39 years old (53.6%) and 40~49 years old (54.7%) answered 'They should take dental treatment'. According to pregnant experience, expectant mothers (63.9%) and women with their parity (46.3%) answered 'They should take dental treatment'. 34.8% women without their parity answered 'They should take dental treatment' and 34.8% women with Out their parity answered 'They should not take dental treatment'(p < 0.05). 2. According to the survey by age with regard to a question 'Do you brush your teeth lifter having morning sickness during the period of pregnancy?', women of 18~29 years old (67.3%), 30~39 years old (47.3%) answered 'Brush my teeth' and women of 40~49 years old (51.0%) and more than 50 years old (52.0%) answered 'Don't brush my teeth'(p < 0.001). According to pregnant experience, expectant mothers (72.2%) and women with their parity (43.0%) answered 'Brush my teeth'(p < 0.05). 3. With regard to a question 'Are oral aid hygiene supplies required?', women of 18~29 years old (47.3%) and 30~39 years old (46.4%) answered 'Required' and women of 40~49 years old (41.5%) and more than 50 years old (48.0%) answered 'do not know'(p < 0.05). 4. According to the survey by age with regard to a question 'What are you anxious about during the period of dental treatment?', women of more than 50 years old (56.0%) answered 'Expenses' and women of 18~29 years old (39.2%), 30~39 years old (44.6%) and 40~49 years old (41.5%) answered 'Pain'(p < 0.05). According to pregnant experience, expectant mothers answered 'Pain (38.9%), abort ion (27.8%) and expenses (22.2%)' and women with their parity, answered 'Pain (45.0%), expenses (22.8%) and abortion (14.8%). Women without their parity answered 'Expenses (52.2%) and pain (13.0%)'(p < 0.05).

• Anxiety and mood
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• 제2권1호
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• pp.9-16
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• 2006

As an aging population is increasing, more elderly people are exposed to traumatic stress. Although this issue has received more attention in some literature, it is clear that numerous questions exist in aftermath of trauma exposure in elderly people. In case of Korean elderly suffers, traumatic experience includes the Korean war, military dictatorship and violent demonstration. Studies regarding elderly PTSD is not active and a lot of patients are not still engaged in treatment. We suggest that concerns that are unique to this population are necessary.