Background: We investigated the risk factors for the recurrence of anterior shoulder instability after arthroscopic surgery with suture anchors and the clinical outcomes after reoperation. Methods: A total of 281 patients (February 2001 to December 2012) were enrolled into our study, and postoperative subluxation and dislocation were considered as recurrence of the condition. We analyzed radiologic results and functional outcome including the American Shoulder and Elbow Surgeons Evaluation Form, the Korean Shoulder Society Score, and the Rowe scores. Results: Of the 281 patients, instability recurred in 51 patients (18.1%). Sixteen out of 51 patients (31.4%) received a reoperation. In terms of the functional outcome, we found that the intact group, comprising patients without recurrence, had a significantly better functional outcome than those in the recurrent group. The size of glenoid defect at the time of initial surgery significantly differed between intact and recurrent group (p<0.05). We found that the number of dislocations, the time from the initial presentation of symptoms to surgery, and the number of anchor points significantly differed between initial operation and revision group (p<0.05). The functional outcome after revision surgery was comparable to intact group after initial operation. Conclusions: Eighteen percent of recurrence occurred after arthroscopic instability surgery, and 5.6% received reoperation surgery. Risk factors for recurrence was the initial size of glenoid defect. In cases of revision surgery, good clinical outcomes could be achieved using additional suture anchor.
Aplastic anemia is a disease characterized by general lack of bone marrow activity; It may affect not only the red blood cells but also the white blood cells and platelets, resulting in pancytopenia. Spontaneous gingival hemorrhage is present in some cases and it is related to the blood platelet deficiency. This case report presents the periodontal treatment of a patient with aplastic anemia. A 43-year-old female was referred for continuous gingival bleeding after periodontal treatment. Periodontal findings revealed generalized gingival imflammation, oozing of blood from gingival crevice, and it was diagnosed as adult periodontitis. Root planing and extraction of the upper left third molar with poor prognosis were put into operation after elevation of the platelet count with platelet transfusion. The extraction socket was sutured with 3-0 silk. Bleeding continued even after digital compression at the upper right second premolar, second molar, and left canine areas, which presented severe inflammation. Although platelets were transfused repeatedly, platelet count did not stay elevated since survival rate of the transfused platelets were low due to alloimmunization. Thrombin gauze packing was not effective. Bleeding ceased 3 days after treatment with transfusion of donor platelets. 20 days after the treatment, the gingiva was generally healthy except upper right second premolar and lateral incisor areas. The result of periodontal treatment was good, but bleeding control after treatment was troublesome. In the periodontal treatment of patient with aplastic anemia, elevation of the platelet count with platelet transfusion seems to be the best method for hemorrhage control.
Kim, Sang-Chul;Kim, Ok-Su;Kim, Ok-Joon;Kim, Young-Joon;Chung, Hyun-Ju
Journal of Periodontal and Implant Science
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제40권4호
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pp.164-171
/
2010
Purpose: This study compared the total antioxidant status (TAS) and superoxide dismutase (SOD) activity in the saliva of periodontally compromised patients before and after scaling and root planing (SRP) to assess their diagnostic utility. Methods: Severe chronic periodontitis patient (test group) and subjects with no attachment loss, sites showing a 3 mm or more probing depth and a sulcus bleeding index < 10% (control group) were enrolled in this study. Saliva sampling and clinical examination were performed at one week, one month and 3 months after SRP. The TAS and SOD activity in each patient's saliva was measured for the comparative analysis between the groups. Results: In the test group, the TAS decreased directly after SRP. With time, it increased slightly and was relatively unchanged compared to the baseline. In the control group, the TAS also decreased immediately after SRP but increased gradually with time until 3 months. The SOD activity in the test and control subjects decreased immediately after SRP until 1 month. At 3 months, the SOD activity had increased. Both groups had a similar profile of SOD activity. However, the SOD activity of the control group was significantly higher than that of the test group at each point in time (P < 0.05). Conclusions: There was a significant difference in the total salivary antioxidant level between the periodontitis and healthy or gingivitis (control) group during the experiment period. The total antioxidant level in the saliva was higher in the patients with severe chronic periodontitis than the healthy or gingivitis control before SRP. The SOD activity of the periodontitis patients was lower than the control at each time point. These findings conclusively reveal the possible use of saliva as a diagnostic tool for periodontal health.
This study was designed to investigate the effects of a smoking cessation school program on attitudes towards smoking cessation, the subjective norm, perceived behavioral controls, the intent to cease smoking and smoking behavior. Also included was the goals of the program itself. Study subjects were 80 adolescent smokers who at least attended the smoking cessation school program without absence. had smoked one cigarette at the time of the first study before the program and attended the first. second. and third studies (The study was conducted from September 26. to December 21. 1999. a period of 59 days). Data collection was performed using the TPB questionnaire which was developed by Jee Yon-Ock(1994). The survey included questions covering the intended areas of study mentioned above. The first data was collected during the first day of the five day program. The second survey was conducted immediately after the last day of the program and the last survey was four weeks later. Data was analyzed with a SAS/PC program including N. %. a paired t-test. The results were as follows; 1. After the program. the scores representing attitude towards smoking cessation (before program: 14.5. after program: 16.8) and perceived behavioral control (before program: 1.2. after program: 2.1) rose significantly, but the scores for attitudes towards the subjective norm and the intent to cease smoking were not notably different. 2. After the program. the frequency of daily smoking fell significantly (before program: 5.7 cigarettes. after program: 3.2 cigarettes). In conclusion, the five day smoking cessation school program increased attitude. perceived behavioral control and decreased smoking behavior but did not influence subjective norm, smoking cessation intention. Thus, further study is required to better evaluate the effects of the program and to improve any shortcomings.
Background Liposuction has become one of the most frequently performed procedures in the field of aesthetic surgery. Fat embolism syndrome after liposuction can easily be overlooked or underestimated; however, occasionally, fulminating fat embolism syndrome can develop and lead to a critical situation within 2-3 days after lipoplasty. Changes over time in the amount of circulating fat particles and the histology of major organs have not yet been studied. Methods This study was conducted using 18 male Sprague-Dawley rats aged 12 weeks and weighing 500-628 g (average, 562 g). Fifteen rats were used as the experimental group and 3 as the control group. Under general anesthesia, tumescent-technique liposuction was performed at the lateral flank areas and abdomen for 1 hour. Blood, lung, and brain tissue specimens were obtained at 1 hour, 1 day, and 2 days after the liposuction procedure. Results The average number of fat particles in the blood samples was 25,960/dL at 1 hour, 111,100/dL at 24 hours, and 21,780/dL at 48 hours. The differences between study groups were statistically significant. Both intravascular and extravascular fat particles with inflammation were seen in all 15 rats, as were inflammatory cell infiltration, hemorrhage, and consolidation with shrinkage of the lung alveoli. Conclusions These results imply that there is a strong possibility of fat embolism syndrome after liposuction in real clinical practice, and the first 24-48 hours after the operation were found to be the most important period for preventing pulmonary embolism and progression to fulminating fat embolism syndrome.
Jun Ho Choi;Sang Seong Oh;Jae Ha Hwang;Kwang Seog Kim;Sam Yong Lee
대한두개안면성형외과학회지
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제24권1호
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pp.37-40
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2023
Penetrating wounds to the face are cosmetically devastating and can be life-threatening. If the foreign body causing the penetrating wound is a piece of wood, small remnants might be left behind after the initial treatment. A 33-year-old male patient presented to the emergency center after a piece of lumber pierced his face as a passenger in a traffic accident. The patient's vital signs were stable, and emergency surgery was performed to remove the foreign body and repair the soft tissue. No noteworthy complications were seen after open reduction and internal fixation of the facial bone fractures. Seven months after the accident, the patient underwent scar revision along with full-thickness skin grafting for post-traumatic scars. After the surgery, pus-like discharge which was not previously present was observed, and the graft did not take well. A residual foreign body, which was the cause of graft failure, was found on computed tomography and the remaining foreign body was removed through revision surgery. The patient is receiving outpatient follow-up without any complications 6 months after surgery. This case demonstrates the importance of performing a careful evaluation to avoid missing a residual foreign body, especially if it is of wooden nature.
Ranjini Srinivasan;Jennifer A. Faerber;Grace DeCost;Xuemei Zhang;Michael DiLorenzo;Elizabeth Goldmuntz;Mark Fogel;Laura Mercer-Rosa
Journal of Cardiovascular Imaging
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제30권1호
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pp.50-58
/
2022
BACKGROUND: Little is known regarding right ventricular (RV) remodeling immediately after Tetralogy of Fallot (TOF) repair. We sought to describe myocardial deformation by cardiac magnetic resonance imaging (CMR) after TOF repair and investigate associations between these parameters and early post-operative outcomes. METHODS: Fifteen infants underwent CMR without sedation as part of a prospective pilot study after undergoing complete TOF repair, prior to hospital discharge. RV deformation (strain) was measured using tissue tracking, in addition to RV ejection fraction (EF), volumes, and pulmonary regurgitant fraction. Pearson correlation coefficients were used to determine associations between both strain and CMR measures/clinical outcomes. RESULTS: Most patients were male (11/15, 73%), with median age at TOF repair 53 days (interquartile range, 13,131). Most patients had pulmonary stenosis (vs. atresia) (11/15, 73%) and 7 (47%) received a transannular patch as part of their repair. RV function was overall preserved with mean RV EF of 62% (standard deviation [SD], 9.8). Peak radial and longitudinal strain were overall diminished (mean ± SD, 33.80 ± 18.30% and -15.50 ± 6.40%, respectively). Longer hospital length of stay after TOF repair was associated with worse RV peak radial ventricular strain (correlation coefficient (r), -0.54; p = 0.04). Greater pulmonary regurgitant fraction was associated with shorter time to peak radial RV strain (r = -0.55, p = 0.03). CONCLUSIONS: In this small study, our findings suggest presence of early decrease in RV strain after TOF repair and its association with hospital stay when changes in EF and RV size are not yet apparent.
Komakech, Alfred;Im, Ji-Hye;Gwak, Ho-Shin;Lee, Kyue-Yim;Kim, Jong Heon;Yoo, Byong Chul;Cheong, Heesun;Park, Jong Bae;Kwon, Ji Woong;Shin, Sang Hoon;Yoo, Heon
Journal of Korean Neurosurgical Society
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제63권5호
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pp.566-578
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2020
Objective : Radiation is known to induce autophagy in malignant glioma cells whether it is cytocidal or cytoprotective. Dexamethasone is frequently used to reduce tumor-associated brain edema, especially during radiation therapy. The purpose of the study was to determine whether and how dexamethasone affects autophagy in irradiated malignant glioma cells and to identify possible intervening molecular pathways. Methods : We prepared p53 mutant U373 and LN229 glioma cell lines, which varied by phosphatase and tensin homolog (PTEN) mutational status and were used to make U373 stable transfected cells expressing GFP-LC3 protein. After performing cell survival assay after irradiation, the IC50 radiation dose was determined. Dexamethasone dose (10 μM) was determined from the literature and added to the glioma cells 24 hours before the irradiation. The effect of adding dexamethasone was evaluated by cell survival assay or clonogenic assay and cell cycle analysis. Measurement of autophagy was visualized by western blot of LC3-I/LC3-II and quantified by the GFP-LC3 punctuated pattern under fluorescence microscopy and acridine orange staining for acidic vesicle organelles by flow cytometry. Results : Dexamethasone increased cell survival in both U373 and LN229 cells after irradiation. It interfered with autophagy after irradiation differently depending on the PTEN mutational status : the autophagy decreased in U373 (PTEN-mutated) cells but increased in LN229 (PTEN wild-type) cells. Inhibition of protein kinase B (AKT) phosphorylation after irradiation by LY294002 reversed the dexamethasone-induced decrease of autophagy and cell death in U373 cells but provoked no effect on both autophagy and cell survival in LN229 cells. After ATG5 knockdown, radiation-induced autophagy decreased and the effect of dexamethasone also diminished in both cell lines. The diminished autophagy resulted in a partial reversal of dexamethasone protection from cell death after irradiation in U373 cells; however, no significant change was observed in surviving fraction LN229 cells. Conclusion : Dexamethasone increased cell survival in p53 mutated malignant glioma cells and increased autophagy in PTEN-mutant malignant glioma cell but not in PTEN-wildtype cell. The difference of autophagy response could be mediated though the phosphatidylinositol 3-kinase/AKT/mammalian target of rapamycin signaling pathway.
This study aims to examine the effects of art therapy on challenging behavior of schoolchildren. For this purpose, I selected one class of 4th year student of S primary school, located at Jeongeup city, Jeonlabukdo, and selected 4 study subjects through examination of K-CBCL children. juvenile behavior evaluation scale, characters, school life and K - HTP test. With regard to procedure of this study, I carried out art therapy program at the art class for 60 minutes one time a week for 4 months, a total of 17 sessions from Apr. 3, 2007 to July 24, 2007. I made this program with some modification in reference to Arts Therapy Technique (Counpia Remote Training Center, 2005), Group Art Therapy (Choi Seon Nam. Kim Gap Sook. Jeon Jong Kuk, 2007) and the Effects of Peer Group Art Activity on Sociality Skill of Offensive Children (Park Ju Yeon. Lee Byeon In, 2005). For each child, I compared and analyzed the changes in score of K-CBCL children. juvenile behavior evaluation scale, behavior by K-HTP (dynamic house-wood-human figure test) analysis and by school life(KSD) image analysis before and after treatment. I also carried out qualitative analysis on behavioral feature of each child for each session. This study obtained the following conclusions. First, child A showed positive change in comparison before and after art treatment program of score K-CBCL children. juvenile behavior evaluation, K-HTP image test and school life. Since he was so active and wanted to obtain good evaluation from anyone that he frequently had quarrel with friends, spoke against others well and beaten others much but was changed and did not speak against others or beat. Second, child B showed clear difference in comparison before and after art treatment program of score K-CBCL children. juvenile behavior evaluation, but no significant difference in K-HTP image test and school life. However, I observed substantial changes. While he could not speak frankly to others, felt empty in mind and was offensive in personal relations, he was changed, did not have quarrel with others or speak against others that much and improved his relationship with friends or teachers. Third, child C showed positive change in score of K-CBCL children juvenile behavior evaluation after art therapy program. In comparison of K-HTP image test and school life treatment before and after treatment, he still longed for mothers in mind but found rather stable after treatment. Fourth, child D showed positive chance in score of K-CBCL children. juvenile behavior evaluation scale after art therapy program, but almost no changes in K-HTP image test. But he depicted good relationship and socializing with other friends in school life. While he could not carry his point due to social immaturity and felt depressed, he got more confident. This result of study showed that art therapy had positive effects on correction of schoolchildren.
The purpose of this study was to collect basic data for the development of oral health education program of parents and to encourage their actual interest and participation in school oral health program. The authors surveyed parents' awareness and behaviors about the oral health of their children. The subjects in this study were 193 parents of elementary school children in Seoul. The collected data were analyzed, the obtained results were as follows: 1. Thirty-five percent of the parents investigated paid a regular visit to a dental clinic. The most common tooth brushing time among them was after dinner, the second was after breakfast, and this was followed by before bedtime and before breakfast 2. Ninety-four percent of the parents responded that prevention is necessary, 92.2% had a plan to visit a dental clinic to prevent dental caries, and 60.1% experienced receiving pit and fissure sealants. Ninety-seven percent responded that they did check their children's dental caries. 54.9% checked their children's oral status after tooth brushing. The parents who visit a dental clinic on a regular basis were more likely to check their children's teeth after tooth brushing than those who don't(P<0.05). 3. Eighty eight percent of respondents wanted to keep the fluoride mouth rinse program. 4. It is recommended that an oral health education program be developed for parents to visit dental clinics on a regular basis, to educate as to the right tooth brushing time, and to check out their children's oral status after tooth brushing.
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