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3개월간 한방치료를 받은 난치성 자궁경부 이형증 환자 1례 (A Case of Intractable Cervical Dysplasia Patient Treated with Korean Medicine for Three Months)

  • 한재현;김성수;성신;방선휘
    • 대한한방부인과학회지
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    • 제25권4호
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    • pp.154-160
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    • 2012
  • Objectives: This report is aimed to investigate the efficacy of Korean medicine including intravenous Cultivated Wild Ginseng(Panax ginseng C.A. Meyer) Pharmacopuncture(CWGP) with intractable cervical dysplasia patient. Methods: A 49-year-old woman who was diagnosed as cervical dysplasia on Feb 2012 was treated with Korean medicine for 3 months. Korean medicine includes intravenous CWGP, acupuncture, moxibustion and herbal medicine. The effect of therapies was evaluated with human papillomavirus deoxyribonucleic acid(HPV DNA) testing. And lower limb cold sense and genital pruritus were recorded with Visual Analogue Scale(VAS). Results: Lower limb cold sense and genital pruritus were decreased from VAS 8-9(2012.04.11.) to VAS 1-2(2012.07.10.). HPV DNA test result was changed from positive to negative. From these results, this report suggests that the Korean medicine, especially CWGP may be a useful method to treat intractable cervical dysplasia. Conclusions: This report shows that Korean medical treatments are effective on intractable cervical dysplasia.

Implementation of contextualized, emergency management cognitive aids in a periodontics clinic

  • Siemens, Mikaela J.;Rice, Andi N.;Jensen, Trenton F.;Simmons (Muckler), Virginia C.
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제21권3호
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    • pp.227-236
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    • 2021
  • Background: Emergencies in outpatient clinics are rare. However, potentially catastrophic events can be challenging to manage due to a variety of factors, including limited equipment and staff. The purpose of this quality improvement project was to improve the staff knowledge and familiarity with critical performance elements for emergencies encountered in the setting of a periodontics clinic. Methods: Emergency cognitive aids tailored to the clinic's resources were created for anaphylaxis, airway obstruction, and sublingual hemorrhage. The project pre-post-test repeated measures design evaluated the effectiveness of cognitive aids using a combination of hands-on simulation, written knowledge assessments, and self-efficacy surveys. Training sessions and simulations were provided to the clinic's existing care teams made up of a periodontist and two dental assistants with an anesthetist who was present for simulations involving sedation. Due to the small sample size (N = 14) and non-normal distribution, all metrics were evaluated using non-parametric statistics. Results: Significant improvements were found in knowledge assessment (-2.310, P = 0.021) and self-efficacy (-2.486, P = 0.013) scores when retention after a training session before and after the introduction of cognitive aid was compared. The mean simulation scores and times improved steadily or reached maximum scores during the project progression. Conclusion: Training sessions before and after cognitive aid introduction were effective in improving knowledge, self-efficacy, and simulation performance. Future projects should focus on validating the process for creating contextualized cognitive aids and evaluating the effectiveness of these cognitive aids in larger samples.

삼차 신경절 액조내 글리세롤 주입에 의한 삼차신경통 치험(12예 보고) (Retrogasserian glycerol Injection as a Treatment of Tic Doulouruex -Report of twelve cases-)

  • 박욱;황경화;김용익;김일호;송후빈;김성열
    • The Korean Journal of Pain
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    • 제1권2호
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    • pp.154-163
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    • 1988
  • In 1983, Sten H$\ddot{a}$kanson first reported the clinical safety and efficacy of retrogasserian glycerol injection as a treatment of typical trigeminal neuralgia in 96 of 100 patients during a follow-up period of 1~6 years. Since September 1987, we have injected sterile pure glycerol into the trigeminal cistern using an anterior percutaneous approach via the foramen ovale (H$\ddot{a}$rtel route) for treatment of tic douloureux in 12 patients who were suffering from attacks pain of following discontinuation of carbamazepine. The results were as follows; 1) Eight patients were completely free from pain attacks with a single dose of glycerol (0.4 ml). The remaining four patients needed a second dose (0.4 ml) several days later following the single dose. The degree of patient's subjective satisfaction by those injections was very good in 11 and fair in one. 2) During the follow-up period (1~13 months), persistent sensory deficit as determined by the pin prick test, appeared to be mild in 10 and moderate in one patient. There was no sensory deficit in one patient. further attacks of pain from those injections were still noted. 3) As a transient complication, there was headache in all patient, facial hematoma in 4, nausea and vomiting in two each, and vertigo and herpes simplex in one each. In conclusion, we confirmed that the above glycerol injections into the trigeminal cistern were clinically very effective as a treatment of tic douloureux even though the follow-up period was short.

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Evaluation of Non-Watertight Dural Reconstruction with Collagen Matrix Onlay Graft in Posterior Fossa Surgery

  • Kshettry, Varun R.;Lobo, Bjorn;Lim, Joshua;Sade, Burak;Oya, Soichi;Lee, Joung H.
    • Journal of Korean Neurosurgical Society
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    • 제59권1호
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    • pp.52-57
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    • 2016
  • Objective : Many surgeons advocate for watertight dural reconstruction after posterior fossa surgery given the significant risk of cerebrospinal fluid (CSF) leak. Little evidence exists for posterior fossa dural reconstruction utilizing monolayer collagen matrix onlay graft in a non-watertight fashion. Our objective was to report the results of using collagen matrix in a non-watertight fashion for posterior fossa dural reconstruction. Methods : We conducted a retrospective review of operations performed by the senior author from 2004-2011 identified collagen matrix (DuraGen) use in 84 posterior fossa operations. Wound complications such as CSF leak, infection, pseudomeningocele, and aseptic meningitis were noted. Fisher's exact test was performed to assess risk factor association with specific complications. Results : Incisional CSF leak rate was 8.3% and non-incisional CSF leak rate was 3.6%. Incidence of aseptic meningitis was 7.1% and all cases resolved with steroids alone. Incidence of palpable and symptomatic pseudomeningocele in follow-up was 10.7% and 3.6% respectively. Postoperative infection rate was 4.8%. Previous surgery was associated with pseudomeningocele development (p<0.05). Conclusion : When primary dural closure after posterior fossa surgery is undesirable or not feasible, non-watertight dural reconstruction with collagen matrix resulted in incisional CSF leak in 8.3%. Incidence of pseudomeningocele, aseptic meningitis, and wound infection were within acceptable range. Data from this study may be used to compare alternative methods of dural reconstruction in posterior fossa surgery.

Analysis of prognostic factors through survival rate analysis of oral squamous cell carcinoma patients treated at the National Cancer Center: 20 years of experience

  • Choi, Yong-Seok;Kim, Min Gyeong;Lee, Jong-Ho;Park, Joo-Yong;Choi, Sung-Weon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제48권5호
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    • pp.284-291
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    • 2022
  • Objectives: This study aimed to analyze the clinicopathological prognostic factors affecting the survival of patients with oral squamous cell carcinoma (OSCC). Materials and Methods: A retrospective study was conducted on patients with OSCC who received treatment at the Oral Oncology Clinic of the National Cancer Center (NCC) from June 2001 to December 2020. The patients' sex, age, primary site, T stage, node metastasis, TNM staging, perineural invasion (PNI), lymphovascular invasion (LVI), differentiation, surgical resection margin, smoking, and drinking habits were investigated to analyze risk factors. For the univariate analysis, a Kaplan-Meier survival analysis and log-rank test were used. Additionally, for the multivariable analysis, a Cox proportional hazard model analysis was used. For both analyses, statistical significance was considered when P<0.05. Results: During the investigation period, 407 patients were received surgical treatment at the NCC. Their overall survival rate (OS) for five years was 70.7%, and the disease-free survival rate (DFS) was 60.6%. The multivariable analysis revealed that node metastasis, PNI, and differentiation were significantly associated with poor OS. For DFS, PNI and differentiation were associated with poor survival rates. Conclusion: In patients with OSCC, cervical node metastasis, PNI, and differentiation should be considered important prognostic factors for postoperative survival.

잠재력훈련 집단상담이 성인 간질환자의 치욕감에 미치는 효과 (The Effect of Human Potential Seminars on the Perceived Stigma of Adults with Epilepsy)

  • 김은자
    • 대한간호학회지
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    • 제28권4호
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    • pp.1003-1012
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    • 1998
  • The purpose of this research was to identify the effect of human potential seminars on the perceived stigma of adults with epilepsy. The research employed a quasi experimental design and unequivalent control group pre-post design. The test was conducted on 15 adults with epilepsy attending one psychiartric out-patient clinic in Masan City, Korea. The stigma questionnaire was used as a pre-test to these patients. HPS was done ten times for five weeks from May 6, to July 26, 1996. The stigma questionnaire was again given, but this time as a post test. The control group of 14 adults with epilepsy were receiving medication at the same clinic. The human potential seminars were structured by McHolland(1972) and translated by Lee, Hae Seung(1990). The stigma research tool was modified and revised to be appropriate to Korean culture. It consisted of 15 sentences. The internal consistency was 0.92 with Cronbach's α. Research results are as follows. 1) To determine the homogenity of the experimental and control groups, the pre-stigma results were used and democratic-sociologic characteristics, job characteristics and disease related variables were compared. There was no significant difference between the two groups. 2) To identify the relationship between stigma and patient characteristics a pre-test was done. The study used both Mann-Whitney U-test and ANOVA test for statistical analysis. The variables related to stigma were the reason of unemployment and age at onset of epilepsy. 3) The test results of the effect of the human potential seminars on stigma in the patients with epilepsy, showed that stigma in the experimental group was lower than in the control group. The statistical method used to determine the difference between pre and post stigma results was the Wilcoxon signed rank test. The test results were statistically significant at the one percent level. 4) As a follow-up evaluation ten more patients(66.7% of the total) were additionally tested. In order to investigate if the stigmas were different between the pre, post and follow-up, Repeated measure ANOVA was used. The test results showed that the stigma scores were statistically different between the three groups at the one percent level(F=10.06, d.f.=2, p=0.00).

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초음파 자궁형상진단을 이용한 자궁후굴증의 변증 진단 연구 (A Study for the Syndrome Differentiation of Retroverted Uterus Using Ultrasound)

  • 황덕상;이재성;정은정;이윤재;이경섭;장준복
    • 대한한방부인과학회지
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    • 제25권3호
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    • pp.85-94
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    • 2012
  • Objectives: We have studied the syndrome differentiation of ultrasound of retroverted uterus(RU) as the inspection in traditional Korean medicine. Methods: Eighty-four patients, who visited H clinic for infertility treatment, were recruited and evaluated by questionnaires and ultrasound, from April, 2012 to May, 2012. We used ultrasound(Logiq C3; GE Health care) for examination of RU. For statistics, we used Fisher's extract test to evaluate the RU and symptoms, and Chi-square test to evaluated the RU and syndrome differentiations, and Student T-test for the relationship between RU and each score of syndrome differentiation, using PASW Statistics(version 18.0.0) and GraphPad Prism(version 5.01). Results: 1. RU was correlated with moderate or severe dysmenorrhea and premenstrual lower abdominal pain. 2. In syndrome differentiation, blood stasis questionnaire was correlated with RU. 3. RU was related with dysmenorrhea, mass of low abdomen, pressure pain, clod of menstrual blood, dyspareunia. Conclusions: The ultrasound of RU might be related with the syndrome of blood stasis.

일부 요통환자들의 오스웨스터리요통장애지수 및 관련요인 (Oswestry Low Back Pain Disability Index and Related Factors in Patients with Low Back Pain)

  • 이승주
    • The Journal of Korean Physical Therapy
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    • 제20권4호
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    • pp.21-28
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    • 2008
  • Purpose: We measured the Oswestry Low Back Pain Disability Index (OLBPDI) and related factors in patients with low back pain. Methods: The sample consisted of 50 patients who received physical therapy at the physical therapy units of the Andong Seoul Sintong Clinic, St. Luke Clinic, and Yeongju Seoul Sintong Clinic in Andong and Yeongju city from October, 2007, to February, 2008. The OLBPDI questionnaire was administered by 5 physical therapists as a cross-sectional study. Student's t-test and analysis of variance (ANOVA/Tukey and Scheffe) were used to analyze OLBPDI score differences. We also used nonparametric statistic analysis (Wilcoxon rank sum test, Median test). Pearson correlation analysis (Spearman correlation analysis) was used to analyze the relationship between OLBPDI and the visual analogue scale (VAS). Multiple regression analysis was performed to determine the effects of independent variables on pain scores as defined by the OLBPDI. Results: The average patient age was 37.1 years (range: 18$\sim$78 years old), and time from onset was 21.7 months (1$\sim$180). OLBPD and VAS scores were 12.70 (3.0$\sim$28.0) and 5.14 (1$\sim$8), respectively. OLBPDI scores were 14.4 in patients taking medicine and 11.57 in those who did not. There was a statistically significant relationship between OLBPDI and VAS (r=0.54, p=0.0001; r=0.55, p=0.0001 by Spearman coefficient). Gender ($\beta$=6.14, p=0.0124), age ($\beta$=-2.01, p=0.0324), weight ($\beta$=0.31, p=0.0222), time from onset ($\beta$=1.54, p=0.0044), and VAS score ($\beta$=1.59, p=0.0004) were significantly associated with OLBPD by multiple regression analysis. Conclusion: Variables associated with OLBPD were gender, age, weight, time from onset, and VAS score. Collecting information on the pain index using OLBPDI was acceptable to patients with low back pain. Further research should explore the pain index by using larger sample sizes and longer follow-up periods.

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여드름 흉터의 치료방법에 대한 비교연구 (Comparative Study on Treatment of Acne Scar)

  • 이형기;조수영;김규남;최용훈;이정환;김정호
    • 한방안이비인후피부과학회지
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    • 제29권1호
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    • pp.93-102
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    • 2016
  • Objective : This study performed to evaluate that duration of acne scars effects on Qualitative Global Acne Scarring Grading System(QGASC) grade changing and treatment duration. Also this study performed to evaluate the relationship between dysmenorrhea and acne scars, and the effects of each treatment on treatment duration and Korean Acne Grading System(KAGS) and QGASC grade.Methods : 95 patients with acne scars were understood by medical records and case photos, and we evaluated pre and post acne scar grade based on KAGS and QGASC. We analyzed data by SPSS 22 for windows program, and figured out the relation between duration of acne and QGASC grade and treatment duration by Spearman correlation analysis, and performed Mann-Whitney U-test to figure out the relation between dysmenorrhea and QGASC grade. We performed Wilcoxon test to evaluate that treatment of acne scars effects on KAGS grade and QGASC grade, and performed Kruskal-Wallis test to figure out the difference of each treatment which effects on KAGS grade and QGASC grade, and performed Post-hoc analysis to figure out the group comparison.Results & Conclusions : QGASC grade depending on duration of acne was statistically significance. Subcision and Microneedle Therapy System(MTS) and pharmacopuncture were significantly improved acne scars. Other treatments were significantly more effective than subcision and pharmacopuncture combined treatment. Treatment duration of Subcision and MTS combined treatment was significantly most shortest than other treatment.