• Title/Summary/Keyword: Treatment goal

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Prevention and treatment of microstomia

  • Sae Hwi Ki;Tae Jun Park
    • Archives of Craniofacial Surgery
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    • v.25 no.3
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    • pp.105-115
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    • 2024
  • The mouth, located in the lower third of the face, is a uniquely visible structure. It serves as a vital organ both aesthetically and functionally, playing a key role in speech, expression, and fundamental oral functions. Consequently, any alterations or defects in its shape, due to various causes, can lead to aesthetic and functional deficiencies. These issues may also result in challenges with social interactions and a decrease in confidence. In cases of microstomia, various surgical approaches are proposed based on the location, extent, shape, and cause of the defect, leading to numerous case reports. Plastic surgeons are proficient in oral reconstruction; however, cases of microstomia are relatively rare, which reduces their familiarity and interest in these cases. Additionally, preferences for oral size and shape vary according to factors such as geographical region and ethnicity, further complicating the functional definition of microstomia. Therefore, both subjective patient and physician judgments play crucial roles in the diagnosis and treatment of microstomia, as these may vary depending on individual and societal aspects. This review aims to classify the various causes and definitions of microstomia, as well as its non-surgical and surgical treatment options, with the goal of the treatment of this condition.

Endoscopic Suturing for the Prevention and Treatment of Complications Associated with Endoscopic Mucosal Resection of Large Duodenal Adenomas

  • Jaeil Chung;Kelly Wang;Alexander Podboy;Srinivas Gaddam;Simon K. Lo
    • Clinical Endoscopy
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    • v.55 no.1
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    • pp.95-100
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    • 2022
  • Background/Aims: Endoscopic mucosal resection (EMR) is the primary treatment for duodenal adenomas; however, it is associated with a high risk of perforation and bleeding, especially with larger lesions. The goal of this study was to demonstrate the feasibility and safety of endoscopic suturing (ES) for the closure of mucosal defects after duodenal EMR. Methods: Consecutive adult patients who underwent ES of large mucosal defects after EMR of large (>2 cm) duodenal adenomas were retrospectively enrolled. The OverStitch ES system was employed for closing mucosal defects after EMR. Clinical outcomes and complications, including delayed bleeding and perforation, were documented. Results: During the study period, ES of mucosal defects was performed in seven patients in eight sessions (six for prophylaxis and two for the treatment of perforation). All ES sessions were technically successful. No early or delayed post-EMR bleeding was recorded. In addition, no clinically obvious duodenal stricture or recurrence was encountered on endoscopic follow-up evaluation, and no patients required subsequent surgical intervention. Conclusions: ES for the prevention and treatment of duodenal perforation after EMR is technically feasible, safe, and effective. ES should be considered an option for preventing or treating perforations associated with EMR of large duodenal adenomas.

Incidence of Chronic Shunt-dependent Hydrocephalus after Surgical or Endovascular Treatment of Ruptured Intracranial Aneurysm (동맥류 결찰술 시행군과 GDC색전술 시행군에서 지주막하 출혈 후 만성 션트-의존성 수두증의 발생빈도)

  • Kwon, Young-Yi;Cho, Maeng Ki;Park, Bong-Jin;Sung, Jung-Nam;Kim, Young-Joon
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup1
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    • pp.68-72
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    • 2001
  • Objective : The goal of this study was to document the influence of the treatment modality(surgery versus endovascular treatment) on the development of chronic shunt-dependent hydrocephalus in a series of 296 patients treated after aneurysmal subarachnoid hemorrhage(SAH). Methods : The following parameters were retrospectively analyzed for association with chronic shunt-dependent hydrocephalus : 1) Age and Sex, 2) Hunt and Hess grade, 3) Fisher computed tomographic grade, 4) aneurysm location, and 5) treatment modality(surgery versus endovascular treatment). Results : Thirty-six of 251 patients(14.3%) who survived the SAH and its neurological and/or medical sequelae underwent definitive shunting for treatment of chronic hydrocephalus. The rate of shunt dependency was positively correlated with a higher age, a higher Hunt and Hess grade, a higher Fisher computed tomographic grade, and aneurysms arising at the anterior communicating artery(p<0.05). Conclusion : The results of the present study indicate that the treatment modality used does not affect the risk of the later development of chronic shunt-dependent hydrocephalus(surgery, 16.2% [25 of 154] ; endovascular treatment, 11.3% [11 of 97] ; p=0.45).

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Decision Making on the Non surgical, Surgical Treatment on Chronic Adult Periodontitis (만성 성인성 치주염 치료시 비외과적, 외과적 방법에 대한 의사결정)

  • Song, Si-Eun;Li, Seung-Won;Cho, Kyoo-Sung;Chai, Jung-Kiu;Kim, Chong-Kwan
    • Journal of Periodontal and Implant Science
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    • v.28 no.4
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    • pp.645-660
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    • 1998
  • The purpose of this study was to make and ascertain a decision making process on the base of patient-oriented utilitarianism in the treatment of patients of chronic adult periodontitis. Fifty subjects were chosen in Yonsei Dental hospital and the other fifty were chosen in Severance dental hospital according to the selection criteria. Fifty four patients agreed in this study. NS group(N=32) was treated with scaling and root planing without any surgical intervention, the other S group(N=22) done with flap operation. During the active treatment and healing time, all patients of both groups were educated about the importance of oral hygiene and controlled every visit to the hospital. When periodontal treatment needed according to the diagnostic results, some patients were subjected to professional tooth cleaning and scaling once every 3 months according to an individually designed oral hygienic protocol. Probing depth was recorded on baseline and 18 months after treatments. A questionnaire composed of 6 kinds(hygienic easiness, hypersensitivity, post treatment comfort, complication, functional comfort, compliance) of questions was delivered to each patient to obtain the subjective evaluation regarding the results of therapy. The decision tree for the treatment of adult periodontal disease was made on the result of 2 kinds of periodontal treatment and patient's ubjective evaluation. The optimal path was calculated by using the success rate of the results as the probability and utility according to relative value and the economic value in the insurance system. The success rate to achieve the diagnostic goal of periodontal treatment as the remaining pocket depth less than 3mm and without BOP was $0.83{\pm}0.12$ by non surgical treatment and $0.82{\pm}0.14$ by surgical treatment without any statistically significant difference. The moderate success rate of more than 4mm probing pocket depth were 0.17 together. The utilities of non-surgical treatment results were 100 for a result with less than 3mm probing pocket depth, 80 for the other results with more than 4mm probing pocket depth, 0 for the extraction. Those of surgical treatment results were the same except 75 for the results with more than 4mm. The pooling results of subjective evaluation by using a questionnaire were 60% for satisfaction level and 40% for no satisfaction level in the patient group receiving nonsurgical treatment and 33% and 67% in the other group receiving surgical treatment. The utilities for 4 satisfaction levels were 100, 75, 60, 50 on the base of that the patient would express the satisfaction level with normal distribution. The optimal path of periodontal treatment was rolled back by timing the utility on terminal node and the success rate, the distributed ratio of patient's satisfaction level. Both results of the calculation was non surgical treatment. Therefore, it can be said that non-surgical treatment may be the optimal path for this decision tree of treatment protocol if the goal of the periodontal treatment is to achieve the remaining probing pocket depth of less than 3mm for adult chronic periodontitis and if the utilitarian philosophy to maximise the expected utility for the patients is advocated.

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A Literature Study about Childhood Epilepsy - Focused on Chinese Medical Journals - (소아간질에 관한 문헌고찰 - 최근 중의학 저널을 중심으로 -)

  • Kang, Kyung Ha;Park, Eun Jung
    • The Journal of Pediatrics of Korean Medicine
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    • v.29 no.1
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    • pp.15-26
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    • 2015
  • Objectives The goal of this study is to investigate childhood epilepsy based on the recent literature of Eastern and Western medicine and look for better treatment. Methods This study reviewed definition, etiology and therapy method of childhood epilepsy based on 24 studies about the treatment of epilepsy in children Results and Conclusions Based on the comparison studies, not only herbal medication has shown better efficacy than anti-epileptics, but also as a monotherapy, or as combination therapies, herbal medications were superior in childhood epilepsy.

Benign convulsion with mild gastroenteritis

  • Kang, Ben;Kwon, Young Se
    • Clinical and Experimental Pediatrics
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    • v.57 no.7
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    • pp.304-309
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    • 2014
  • Benign convulsion with mild gastroenteritis (CwG) is a type of afebrile seizure that occurs in children. CwG is defined as a convulsion in a previously healthy child with no known central nervous system infection or encephalopathy, accompanying mild diarrhea without fever, electrolyte imbalance, or moderate to severe dehydration. Convulsions in CwG are characterized by multiple brief episodes of generalized or focal seizures. Although the etiology and pathophysiology have yet to be fully explained, many pathogenic mechanisms have been proposed including the possibility of direct invasion of the central nervous system by a gastrointestinal virus such as rotavirus or the possibility of indirect influence by the production and effects of certain mediators. The electroencephalogram findings are benign and long-term antiepileptic treatment is typically not required. Long-term prognosis has been favorable with normal psychomotor development. This review provides a general overview of CwG with the goal of allowing physicians practicing in the field of pediatrics to better recognize this unique entity and, ultimately, to minimize unnecessary evaluation and treatment.

Development of a Genetic Algorithm for the optimization in River Water Quality Management System (하천 수질관리 시스템에서 최적화를 위한 유전알고리즘의 개발)

  • 성기석;조재현
    • Proceedings of the Korean Operations and Management Science Society Conference
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    • 2001.10a
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    • pp.203-206
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    • 2001
  • Finding the optimal solution in the river water quality management system is very hard with the non-linearity of the water quality model. Many suggested methods for that using the linear programming, non-linear programming and dynamic programming, are failed to give an optimal solution of sufficient accuracy and satisfaction. We studied a method to find a solution optimizing the river water quality management in the aspect of the efficiency and the cost of the waste water treatment facilities satisfying the water Quality goals. In the suggested method, we use the QUAL2E water quality model and the genetic algorithm. A brief result of the project to optimize the water quality management in the Youngsan river is presented.

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The Cytokine-mediated Link Between Depression and Cachexia in Cancer Patients (암환자의 우울증과 카켁시아 간 시토카인 매개 연결)

  • Lim, Woo Taek
    • Journal of Korean Physical Therapy Science
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    • v.26 no.3
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    • pp.44-56
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    • 2019
  • Despite the advances in medical technology, there are limited therapeutic interventions for cancer. Currently, the main goal of treatment is to remove a tumor completely. However, recent studies have shown that mortality is highly influenced by symptoms such as depression and cachexia, not solely by cancer itself. Depression is caused by psychological stress, and cachexia involves extreme weight loss with skeletal muscle atrophy, which are widely observed in patients with cancer. Although those two appear completely different from each other, they have a common etiology: cytokines. The production of cytokines can lead to depression and cachexia, and it contributes greatly to the increase in mortality rate. A better understanding of depression and cachexia in patients with cancer will help establish efficient treatment strategies.

Physical therapy and Occupational therapy on the hand infections (수부 감염에 대한 물리치료와 작업치료)

  • Jung, Seok;Kim, Jeong-Ja
    • Journal of Korean Physical Therapy Science
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    • v.6 no.1
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    • pp.861-877
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    • 1999
  • The hand is a very specialized organ that functions to obtain information and to execute motor acts essential to human interaction with the environment. Loss of hand function through infections affects the mechanical tasks that the hand performs and psychological adjustments to their disability. Infection is a disastrous complication of hand injuries and adequacy of circulation is of greatest importance to prevention of infection. Careful debridement, incision, and adequate drainage and antibacterial treatment are of great importance. Optimal care of the infected hand demands that carefully surgical care, early postoperative exercises and other therapy. Hand rehabilitation has grown as a specialty area of both physical and occupational therapy. It is essential that the surgeon and therapist work together, and communicate freely-all of which generally require daily contact. Treating the psychological loss suffered by the patient with a hand infections is an integral part of the rehabilitation therapy as well. Treatment techniques, Whether thermal modalities or specifically designed exercises, are used as a bridge to reach a further goal of returning to functional performance.

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A Case Report of Progressive Hemifacial Atrophy (진행성 반안면위축환자의 치험례)

  • Choi, Moon-Gi
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.4
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    • pp.344-350
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    • 2010
  • A progressive hemifacial atrophy is characterized by progressive atrophy of subcutaneous fat and rarely muscle and bone. Its contour follows the underlying muscle. Unilateral involvement is common. The treatment goal has been focused on the augmentation of the soft tissue. Many materials such as implants, collagen, fat graft, fat injection, dermal fat graft, filler and vascualized autogenous graft have been used. Although these materials have been used, the best treatment hasn't been achived. In severe cases underlying soft tissue, muscle and bone may be atrophied and massive soft tissue graft, implant and orthognathic surgery must be used. The author used the dermal-fat tissue for the pupose of soft tissue augmentation. We can get the massive soft tissue by the dermolipectomy procedure through the mini-abdominoplsty. The facial augmentation was done by augmentation of the dermal-fat tissue. The progressive hemifacial atrophy is hard to treat by only one procedure and many modalites must be considered.