• 대한치과교정학회지
• /
• 제49권4호
• /
• pp.222-234
• /
• 2019

Objective: To investigate the three-dimensional lip vermilion changes after extraction and non-extraction orthodontic treatment in female adult patients and explore the correlation between lip vermilion changes and incisor changes. Methods: Forty-seven young female adult patients were enrolled in this study (skeletal Class III patients were excluded), including 34 lip-protruding patients treated by extraction of four first premolars (18 patients requiring mini-implants for maximum anchorage control and 16 patients without mini-implants) and 13 patients requiring non-extraction treatment. Nine angles, seven distances, and the surface area of the lip vermilion were measured by using pre- and post-treatment three-dimensional facial scans. Linear and angular measurements of incisors were performed on lateral cephalograms. Results: There were no significant changes in the vermilion measurements in the non-extraction group. The vermilion angle, vermilion height, central bow angle, height/width ratio, and vermilion surface area decreased significantly after the orthodontic treatment in the extraction groups, but the upper/lower vermilion proportion remained unchanged. Significant correlations were found between the changes in incisor position and those in vermilion angles, vermilion height, and surface area. Conclusions: Extraction of the four first premolars probably produced an aesthetic improvement in lip vermilion morphology. However, the upper/lower vermilion proportion remained unchanged. The variations in the vermilion were closely related to incisor changes, especially the upper incisor inclination changes.

• 대한치과교정학회지
• /
• 제52권3호
• /
• pp.210-219
• /
• 2022

Objective: The purpose of this study was to examine the effectiveness and mechanism of clear aligner therapy for the correction of anterior open bite in adult nonextraction cases. Methods: Sixty-nine adult patients with anterior open bite were enrolled and classified into Angle's Class I, II, and III groups. Fifty patients presented with skeletal open bite (mandibular plane angle [MPA] ≥ 38°), whereas 19 presented with dental open bite. Fifteen cephalometric landmarks were identified before (T1) and after (T2) treatment. The magnitudes of planned and actual movements of the incisors and molars were calculated. Results: Positive overbite was achieved in 94% patients, with a mean final overbite of 1.1 ± 0.8 mm. The mean change in overbite was 3.3 ± 1.4 mm. With clear aligners alone, 0.36 ± 0.58 mm of maxillary molar intrusion was achieved. Compared with the Class I group, the Class II group showed greater maxillary molar intrusion and MPA reduction. The Class III group showed greater mandibular incisor extrusion with no significant vertical skeletal changes. Conclusions: Clear aligners can be effective in controlling the vertical dimension and correcting mild to moderate anterior open bite in adult nonextraction cases. The treatment mechanism for Class III patients significantly differed from that for Class I and Class II patients. Maxillary incisor extrusion in patients with dental open bite and MPA reduction with mandibular incisor extrusion in patients with skeletal open bite are the most significant contributing factors for open bite closure.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제25권5호
• /
• pp.406-412
• /
• 2022

Purpose: The role of endoscopic retrograde cholangiopancreatography (ERCP) in the management of hepatobiliary and pancreatic diseases in the pediatric population was not well defined until recently. Our aim was to determine the feasibility, outcomes, and safety of ERCP in a local pediatric population, particularly using standard adult endoscopes and accessories. Methods: This retrospective study was conducted at the National Hospital of Sri Lanka. Pediatric patients (aged <16 years) who underwent ERCP from January 2015 to December 2020 were included in the study. Data, including patient demographics, indications for the procedure, technical details, and associated complications, were collected from the internal database and patient records maintained at the hospital. Results: The study included 62 patients who underwent a total of 98 ERCP procedures. All the procedures were performed by adult gastroenterologists using standard adult endoscopes and accessories. The mean age was 11.01±3.47 years. Pancreatic diseases were the major indications for most of the procedures (n=81, 82.7%), with chronic pancreatitis being the most common. Seventeen procedures (17.3%) were carried out for biliary diseases. Overall cannulation and technical success rates were 87.8% and 85.7%, respectively. Stent placement was the most common therapeutic intervention (n=66; 67.4%). Post-ERCP pancreatitis was the most common complication, occurring in eight patients (8.2%). Conclusion: ERCP can be successfully and safely performed in pediatric populations using standard adult endoscopes and accessories with complications similar to those of adults. Adult ERCP services can be offered to most pediatric patients without additional costs of pediatric endoscopes and accessories.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• 제34권4호
• /
• pp.275-282
• /
• 2023

Objectives: This study aimed to identify the psychiatric comorbidity status of adult patients diagnosed with attention-deficit hyperactivity disorder (ADHD) and determine the impact of comorbidities on neuropsychological outcomes in ADHD. Methods: The study participants were 124 adult patients with ADHD. Clinical psychiatric assessments were performed by two board-certified psychiatrists in accordance with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. All participants were assessed using the Mini-International Neuropsychiatric Interview Plus version 5.0.0 to evaluate comorbidities. After screening, neuropsychological outcomes were assessed using the Comprehensive Attention Test (CAT) and the Korean version of the Wechsler Adult Intelligence Scale, Fourth Edition (K-WAIS-IV). Results: Mood disorders (38.7%) were the most common comorbidity of ADHD, followed by anxiety (18.5%) and substance use disorders (13.7%). The ADHD with comorbidities group showed worse results on the Perceptual Organization Index and Working Memory Index sections of the K-WAIS than the ADHD-alone group (p=0.015 and p=0.024, respectively). In addition, the presence of comorbidities was associated with worse performance on simple visual commission errors in the CAT tests (p=0.024). Conclusion: These findings suggest that psychiatric comorbidities are associated with poor neuropsychological outcomes in adult patients with ADHD, highlighting the need to identify comorbidities in these patients.

• 지역사회간호학회지
• /
• 제31권3호
• /
• pp.279-289
• /
• 2020

Purpose: This study is to identify how the meaning in life, depression, and social support influences the suicidal ideation of old adult hemodialysis patients. Methods: A cross-sectional design was used. A descriptive correlative study was conducted through an organized and structured self-administrated questionnaire survey for 120 sampled old adult renal dialysis patients. The collected data were analyzed by t-tests, ANOVA, Pearson's correlation coefficient, and multiple linear regression analysis using the Stata 13.0 program. Results: The suicidal ideation of participants was positively correlated with the meaning in life, and social support, and the depression was negatively correlated with the suicidal ideation. Significant factors influencing the suicidal ideation included the meaning in life, depression, social support, age, caregiver, monthly income, and smoking. These factors explained 68% of the variance. Conclusion: The depression of old adult hemodialysis patients was a major risk factor that increased suicidal ideation, and the meaning in life and social support was a protective factor that reduced the suicidal ideation. These results suggest that health professionals should provide old adult hemodialysis patients with proper management of suicidal ideation, and depression as well as its meaning in life, and social support.

• 성인간호학회지
• /
• 제18권1호
• /
• pp.3-9
• /
• 2006

Purpose: The purpose of this study was to assess the difference between prevalence and risk factors of the metabolic syndrome(MS) by gender in type2 diabetic patients. Method: 108 participants(males 69, females 39) were recruited from the endocrinology outpatient department of a tertiary care hospital in an urban city. MS was defined by a third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults(Adult Treatment Panel III)(ATP III), and abdominal obesity was determined by Asia-Pacific criteria in waist circumference. Results: The prevalence of MS by definition of NCEP-ATP III and the Asia-Pacific criteria in waist circumference was 39.3% in males and 66.7% in females type2 diabetic patients. The abdominal obesity prevalence was seen in 44.9% of males and in 79.5% of females patients. The prevalence of low HDL-cholesterolemia in serum was 26.2% in male, 52.8% in female type2 diabetic patients. Conclusion: These results show that nurses should focus on female diabetic patients for preventing MS.

• Journal of Chest Surgery
• /
• 제22권1호
• /
• pp.95-105
• /
• 1989

The records of 248 patients over 16 years of age who had undergone a surgical correction of a congenital cardiovascular malformation during the period of 10 years from August, 1978 to July, 1988 were reviewed. During this period, the incidence of congenital cardiovascular malformation in adult was 18.2% of 1376 total heart disease operated on and 25.5% of 986 congenital heart defects. Among them, there were 200 patients in acyanotic group and 48 patients in cyanotic group. Male versus female ratio was 1:1.28. The oldest patient was 59 years old female who had atrial septal defect. The mean age was 24.4 years old. The distribution of the lesions showed a large preponderance of atrial septal defects [37.19o] followed in frequency by ventricular septal defects [918.1%], patent ductus arteriosus [17.3%], tetralogy of Fallot [16.1%], and a variety of other complex malformations[3.2%]. In the pediatric age group, relative frequency was different from that of this adult group, showing ventricular septal defects, tetralogy of Fallot, patent ductus arteriosus and atrial septal defects in order of incidence. The hospital mortality and late mortality were 6.0% and 1.7% respectively. The causes of hospital death were low cardiac output in 10 patients, arrhythmia in 2, air embolism in 1, sepsis in 1 and respiratory failure in l. Clinical improvement upto NYHA functional class I or II postoperatively has been achieved and sustained in all patients following repair except the patients of late death and receiving reoperation. This result confirms that congenital heart defects in the adults can be corrected with a good outcome and an aggressive operative approach seems justified.

• Clinical and Experimental Pediatrics
• /
• 제52권5호
• /
• pp.529-537
• /
• 2009

Drug-resistant tuberculosis in children has important implications for both the patients and tuberculosis control programs. In Korea, among all new patients, the isoniazid resistance rate was 9.9% and multidrug-resistant tuberculosis rate was 2.7% in 2004 (in patients aged 10-19 yr, the multidrug-resistant tuberculosis rate reached 2.1%). Tuberculosis in pediatric patients is difficult to diagnose because many children have nonspecific clinical signs and the detection rates of acid-fast bacilli smears and cultures are low. Therefore, every effort should be made to identify adult sources and obtain information on drug susceptibility because symptomatic adult patients have a higher chance of culture positivity and drug-susceptibility patterns are the same in most adult-child pair patients. Korean children are at significant risk of drug-resistant tuberculosis. As the isoniazid resistance rate is greater than 4% among the new cases in Korea, a four-drug regimen should be considered for initial treatment of children with active tuberculosis, unless drug-susceptibility test results are available. Treatment of drug-resistant tuberculosis in children is challenging and there are only few available data. Tuberculosis control programs should be continuous with specific focus on pediatric populations because they can serve as reservoirs for future active cases. Further studies are needed regarding treatment of drug-resistant tuberculosis in children.

• Journal of Korean Neurosurgical Society
• /
• 제47권3호
• /
• pp.191-198
• /
• 2010

Objective : This study is planned to determine the neurocognitive difficulties of hydrocephalic adults. Methods : The research group contained healthy adults (control group, n : 15), and hydrocephalic adults (n : 15). Hydrocephalic group consisted of patients with idiopathic aquaduct stenosis and post-meningitis hydrocephalus. All patients were followed with shunted hydrocephalus and not gone to shunt revision during last two years. They were chosen from either asymptomatic or had only minor symptoms without motor and sensorineural deficit. A neuropsychological test battery (Raven Standart Progressive Matrices, Bender-Gestalt Test, Cancellation Test, Clock Drawing Test, Facial Recognition Test, Line Orientation Test, Serial Digit Learning Test, Stroop Color Word Interference Test-TBAG Form, Verbal Fluency Test, Verbal Fluency Test, Visual-Aural Digit Span Test-B) was applied to all groups. Results : Neuropsychological assessment of hydrocephalic patients demonstrated that they had poor performance on visual, semantic and working memory, visuoconstructive and frontal functions, reading, attention, motor coordination and executive function of parietal lobe which related with complex and perseverative behaviour. Eventually, these patients had significant impairment on the neurocognitive functions of their frontal, parietal and temporal lobes. On the other hand, the statistical analyses performed on demographic data showed that the aetiology of the hydrocephalus, age, sex and localization of the shunt (frontal or posterior parietal) did not affect the test results. Conclusion : This prospective study showed that adult patients with hydrocephalus have serious neuropsychological problems which might be directly caused by the hydrocephalus; and these problems may cause serious adaptive difficulties in their social, cultural, behavioral and academic life.

• 한국안광학회지
• /
• 제21권3호
• /
• pp.275-280
• /
• 2016

목적: 본 연구는 성인 한국인에게 많이 발생하는 성인병인 녹내장, 고혈압, 당뇨가 백내장에 어느 정도 영향을 미치는 위험 요인을 분석하여 수술 효과에 따른 차이를 밝히는데 목적을 갖는다. 방법: 분석방법은 전남 지역 소재 병원에서 백내장 수술을 받은 환자를 대상으로 수술 전 후 진료 결과에 영향을 미칠 수 있는 변수로 진료의 투입적 변수인 환자 특성과 의료 특성을 진료의 과정적 변수로 기능적 상태, 일반적 상태, 임상적 결과를 분석방법에 반영하였다. 결과: 성인병 중 녹내장, 고혈압, 당뇨가 있는 환자들은 기본적으로 백내장 수술 전부터 성인병이 없는 환자보다 시력이 약 10%정도 낮은 것으로 나타났으며 수술효과 또한 상대적으로 수술 후 시력과 굴절력에서 약 16%정도의 차이가 나는 것으로 나타났다. 결론: 이상의 연구 결과를 통해 성인병 환자의 녹내장, 당뇨, 고혈압이 백내장과 밀접한 상관성을 가짐을 확인하였으며 이들 성인병의 유병 정도에 따라 백내장 또한 수술 전 후 시력 및 안구 굴절력이 기존 일반 성인 대조군과 비교할 때 낮고 큰 차이를 나타내는 것을 확인할 수 있었다.