• Title/Summary/Keyword: clinical examination

Search Result 3,509, Processing Time 0.03 seconds

Arm Morbidity after Breast Cancer Treatments and Analysis of Related Factors (유방암 환자의 상지 부작용과 관련 요인)

  • Chun Mi Son;Moon Seong Mi;Lee hye Jin;Lee Eun-Hyun;Song Yeoung Suk;Chung Yong Sik;Park Hee Bung;Kang Seung Hee
    • Radiation Oncology Journal
    • /
    • v.23 no.1
    • /
    • pp.32-42
    • /
    • 2005
  • Purpose : To evaluate the incidence of arm morbidity following breast cancer surgery including axillary dissection and to identify related factors. Materials and Methods : One hundred and fifty nine patients were studied using a self-report questionnaire and a clinical examination. Lymphedema, reduction of range of motion in shoulder joint and subjective symptoms (pain, impaired arm movement, numbness, stiffness) were evaluated. As related factors, demographic, oncologic characteristics and types of treatment were analysed. Results : The incidence of lymphedema ($\geqq$2 cm difference comparing to unaffected arm) was $6.3\%$, $10.7\%$, $22.5\%$ and $23.3\%$ at each 10 cm, 20 cm, 30 cm, and 40 cm from wrist. Reduction of range of motion in shoulder joint ($\geqq$ 20 degree difference comparing to unaffected arm) was noted In more than 1/3 patients for flexion, abduction and internal rotation. Especially the reduction of range of motion in internal rotation was severe ($>50\%$ reduction) in 1/3 patients. Approximately 50 to $60\%$ of patients complained impaired arm movement, numbness, stiffness and pain. Body mass index (BMI) was the significant risk factor for lymphedema. Conclusion : Lymphedema was present in 1/3 of patients and the common sites of edema were 30 cm 40 cm proximal from the wrist. Also most severe reduction of range of motion in shoulder joint was with internal rotation. There needs weight control for lymphedema because BMI was the significant risk factor for lymphedema. Also rehabilitation program for range of motion especially internal rotation In shoulder joint should be developed.

A Study on Job Stress and Job Satisfaction of Dental Hygienists Working in Dental Clinics (치과의원에 근무하는 치과위생사의 직무 스트레스와 직무만족에 관한 연구)

  • Jung, Jung-Ock;Song, Kwui-Sook
    • Journal of dental hygiene science
    • /
    • v.8 no.4
    • /
    • pp.305-312
    • /
    • 2008
  • This study was attempted to look into relation between job stress and job satisfaction perceived by clinical dental hygienists and the influencing factors for providing fundamental data to increase their job satisfaction. For this, mailed correspondence examination was conducted with questionnaire for dental hygienists who are engaged in dental hygiene duties at dental clinics in Seoul between June 19 and July 24, 2008. Total 180 questionnaires were distributed, and among these, 156 questionnaires were included in analysis except for 24 questionnaires having incomplete answers. The findings of this study are as follows: 1. The total mean of dental hygienists' job stress was found to be 3.46 points out of 5 points, and that of their job satisfaction to be 2.99. 2. For relation between general characteristics and job stress of dental hygienists, significant difference was found just in the motive to select dental hygienist (p < 0.001) and the expected period of engagement in dental hygienist duties (p < 0.05). 3. For relation between general characteristics and job satisfaction of dental hygienists, significant difference was found just in job experience(p < 0.05), current position (p < 0.05), average salary (p < 0.001), and the expected period of engagement in dental hygienist duties (p < 0.01). 4. For correlation between job stress and job satisfaction, negative correlation was shown generally (r=-0.222), such that the more was job stress, the less was job satisfaction. 5. As a result of multiple regression analysis to look into the job stress factors influencing dental hygienists' job satisfaction, it was found that the factors of excessive workload(p < 0.05) and improper treatment(p < 0.01) most influenced job satisfaction, and the descriptive power on the job stress factors influencing their job satisfaction was found to be 24.1%.

  • PDF

Effective Management Interval Focused on Professional Mechanical Tooth Cleaning (전문가 치면세균막관리 중심의 예방관리프로그램의 효과적인 관리주기)

  • Cho, Min Jeong
    • Journal of dental hygiene science
    • /
    • v.17 no.6
    • /
    • pp.508-515
    • /
    • 2017
  • This study was conducted to investigate the optimal management interval in 33 healthy adults by observing changes in oral health on the basis of the plaque control index and gingival index. When plaque control score was compared according to the period, it was found that oral hygiene management was the best in the fourth visit (p<0.05). Improved oral hygiene status was observed during the 3- and 6-month follow-up (p<0.05). Regarding gingival index, the fourth visit showed the healthiest gingival status (p<0.05). At the 3-month follow-up, the gingival index worsened, but a healthy gingival status was attained by 6-month follow-up (p<0.05). The plaque control score according to interest in dental health showed that the 'interested' group had good oral hygiene management (p<0.05). As a motivation for oral hygiene status and gingival health, examination with a 'phase contrast microscope' in the first visit and calculation of the 'evaluation index' in the follow-up visit tended to improve the patients' ability for oral hygiene management (p>0.05). The questionnaire survey showed, that the optimal management interval was 1, 3, and 6 months. As a result, with the effective management interval for the preventive management program focused on professional mechanical tooth cleaning, which was administered weekly, the maximum ability for oral hygiene management was attained at the fourth visit. The effective management period was 1 month. The use of a phase contrast microscope and the calculation of the evaluation index for oral hygiene management could influence the motivation to improve oral hygiene management.

The Radiation Therapy for Spinal Cord Compression in Hematologic Malignancy (혈암에서 발생한 척추압박증상의 방사선 치료)

  • Kim In Ah;Choi Ihl Bohng;Chung Su Mi;Kang Ki Mun;Kay Chul Seong;Choi Byung Ok;Jang Ji Young;Shinn Kyung Sub;Kim Chun Choo
    • Radiation Oncology Journal
    • /
    • v.12 no.3
    • /
    • pp.393-399
    • /
    • 1994
  • Spinal cord compression, an oncologic emergency, is a rare complication of hematologic malignancy Our experience was obtained with a series 32 Patients following retrospective analysis for assessing the role of radiation therapy and identifying the prognostic factors affecting on treatment outcome. Diagnosis was usually made by means of radiologic study such as myelography or computerized tomography (CT) or magnetic resonance imaging (MRI) and neurologic examination. Five cases were diagnosed by subjective symptom only with high index of suspicion. In 31 cases, the treatment consisted in radiation therapy alone and the remained one patient had laminectomy before radiation therapy because of diagnostic doubts. Total treatment doses ranged from 800 cGy to 4000 cGy with median of 2000 cGy. Initially large fraction size more than 250 cGy were used in 13 patients with rapidly progressed neurologic deficit. The clinical parameters considered in evaluating the response to treatment were backache, motor-sensory performance and sphincter function. Half of all patients showed good response. Partial response and no response were noted in $37.5\%$ and $12.5\%$, respectively. Our results showed higher response rate than those of other solid tumor series. The degree of neurologic deficit at that time of diagnosis was the most important predictor of treatment outcome. The elapsed time from development of symptoms to start of treatment was significantly affected on the outcome. But histology of primary tumor total dose and use of initial large fraction size were not significantly affect on the outcome. These results confirmed the value of early diagnosis and treatment especially in radiosensitive hematologic malignancy.

  • PDF

The Study of the Diet Style and Relationships among Vitamin and Nutrient Supplement Intakes, Serum Lipid Levels, Blood Sugar and Blood Pressure of Adult Female (채식 성인여성의 식사형태 및 비타민, 영양제 복용과 혈중 지질, 혈당, 혈압과의 관련성에 관한 비교연구)

  • 차복경;최원경
    • Journal of the Korean Society of Food Science and Nutrition
    • /
    • v.31 no.2
    • /
    • pp.306-314
    • /
    • 2002
  • The purpose of this study is to examine the relation between vegetarian diet and the risk factors of cardiovascular disease. The subjects of the study were 127 Buddhist nuns (age: 23 ~79 yr) for vegetarians and 235 healthy female adults (age: 23 ~79 yr) for non-vegetarians. This study covers food consumption survey, anthropometric measurement, amount of energy expenditure, physical activity and clinical examination. Average body mass index (BMI) of vegetarians and non-vegetarians were 22.47 and 21.08, waist/hip ratio (WHR) was 0.85 and 0.84, percentage of body fat (%BF) was 28.79 and 26.55, respectively. Average duration of vegetarian diet of the vegetarians was 13.16 years. The triglyceride levee of the vegetarians was significantly lower for those who take nutrient tablet compared to those who either take vitamins or who do not take any nutrient supplement. Taking vitamins or nutrient tablet did not give any significant difference in total-cholesterol and LDL-cholesterol for vegetarians, while significantly high triglyceride was observed for the non-vegetarians taking nutrient tablet than the ether non-vegetarians. Taking vitamins or nutrient tablet did not affect the lever of HDL-cholesterol for either vegetarians or non-vegetarians. Athrogenic index (AI) was lower for the vegetarian group tailing nutrient tablet and for the non-vegetarian group not taking vitamins and nutrient tablet, than the other respective groups. Blood sugar of the vegetarians who take nutrient tablet was significantly lower than those tailing vitamins, while blood sugar of the non-vegetarians not taking any nutrient supplement was significantly lower than those taking nutrient tablet.

The Effects of Human Follicular Fluid on Embryonal Development of Mouse in In Vitro Culture (체외배양에서 인간 난포액이 생쥐의 배 발달에 미치는 영향)

  • Min, Bu-Kie;Choi, Ki-Wook;Kim, Kie-Suk;Lee, Hee-Sub;Hong, Ki-Yeon;Lee, Bong-Ju;Lee, Sun-Young;Park, Seung-Teak
    • Clinical and Experimental Reproductive Medicine
    • /
    • v.26 no.2
    • /
    • pp.171-178
    • /
    • 1999
  • The follicular fluid (FF) of ovary contains various biological active products which affected on the growth of follicles and the fertilization of oocyte in physiological reproductive process of mammals. This study was designed to determine the effects of human FF on fertilization of oocyte and embryonal development in vitro culture. The FF was prepared as clear without blood contamination by needle aspiration from mature follicles of human at the time of oocytes retrieval for in vitro fertilization (IVF). As the medium for culture in vitro of embryonal cells, human tubal fluid (HTF) supplemented with follicular fluids at concentrations of 10%, 40% and pure FF were used. These effects were compared to control group of cultured embryos in HTF supplemented with 0.4% BSA (bovine serum albumin). For IVF, 64 eggs in control group, 67 eggs in 10% FF, 57 eggs in 40% FF and 64 eggs in pure FF were respectively allocated. And the rates of fertilization were almost similar in all groups as resulting 82.81% in control, 85.07% in 10% FF, 87.71% in 40% FF and 81.25% in pure FF. On the examination for embryonal cleavage from fertilized eggs, the rates of developing to 4 cell stage was similar in all groups, as results 98.11% in control, 98.27% in 10% FF and 98% in 40% FF but 78.84% in pure FF. And the rates of developing to 8-16 cell stage were significantly reduced as 44% in 40% FF and 44.23% in pure FF (p<0.05) compare to 71.69% in control media. As likewise, the rates of developing to morular stage were also significantly reduced to 36% (p<0.05) and 21.15% (p<0.01) respectively in 40% FF and pure FF. And the rates to blastocystic stage of embryo was lowest as 7.69% in pure FF (Table 1). The quality of embryonal cells on cleavage to the 8-16 cell stage was poorer, higher concentrations of FF. The rates of grade 1 in pure FF, as 23.07%, was lowest compare to those of other groups, in which the rates of grade 1 in control, 10% FF and 40% FF were 58.49%, 47.36% and 34% respectively. And on the contrary, the rate of grade 4 in pure FF was highest as 23.07%, while those were 5.66% in control, 8.77% in 10% FF and 20% in 40% FF (Table 2). On the viability of embryos, the rate of embryonal cell death was more rise, at the higher concentrations as well as longer exposure in the follicular fluid. At 48 hours after in vitro culture of embryos, the rate of survival embryos in pure FF was markedly lowered as 44.23%, compare to that of control (p<0.05). But there was not significant difference between the rates of survival embryos in each group beside the pure FF, which the rates were 77.35% in control, 70.17% in 10% FF and 60% in 40% FF respectively. And at 72 hours after in vitro culture, the rates of survival embryos were also significantly dropped to 21.15% in pure and 36% in 40% at concentration of FF compare to 62.26% in control (p<0.05, p<0.01). Finally, the rate of embryonal death at 96 hours after in vitro culture was highest as 82.69% in pure FF among all groups which those were 35.84 in control, 56.14% in 10% FF and 64% in 40% FF respectively (Fig. 1, 2, 3). In conclusion, this study suggests that the FF has no effects, in particular, to the in vitro fertilization of oocytes but exerted a bad effect to the cleavage, quality and viability of the embryonal cells during in vitro culture. However, the FF is harmful on embryonal development at conditions in higher concentration and especially on the embryos after $8{\sim}16$ cell stage.

  • PDF

Comparison of Bite Forces between Pre- and Post-Treatment in Patients with Temporomandibular Disorders (측두하악장애 환자의 치료 전후 교합력 비교)

  • Lee, Sang-Il;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
    • /
    • v.32 no.2
    • /
    • pp.211-218
    • /
    • 2007
  • The purpose of this study was to compare the maximum bite forces between pre- and post-treatment related to specific diagnostic groups of TMD including masticatory muscle disorder (MMD), disc derangement (DD), joint inflammation (JI) and osteoarthritis (OA). Bite force between pre- and post-treatment was compared in 36 patients with unilateral TMD, successfully-managed in the Department of Oral Medicine, Dankook University Dental Hospital, for this study. The ratio of men to women was 7:29 and their mean age of $28.1{\pm}13.7$ years. The patients were categorized, through clinical and radiographic examination, into aforementioned 4 groups; MMD (N=18), DD (N=6), JI (N=5) and OA (N=7). The maximum bite force measurements were done at the antagonizing canines and 1st molars using a bite force recorder. Paired t-test, ANOVA, Multiple Comparison t-tests were used for statistical analysis. The results of this study showed that the maximum bite force before treatment increased after TMD treatment, which was noticeable at the canines (p=0.001 and p=0.000 for the affected and unaffected sides, respectively). In comparison related to the diagnostic groups of TMD, patients with osteoarthritis of TMJ exhibited the lowest strength while those with inflammatory disorder of TMJ had the highest strength on the affected sides. Increase of bite force after treatment was also found in each group. Significant difference between pre- and post-treatment was found at canines on the affected sides in MMD (p=0.045) and DD groups (p=0.009) while on the unaffected sides in OA group (p=0.003). Conclusively, the reduced bite force due to TMD could be recovered by conservative TMD treatment and that the difference of bite forces between pre- and post-treatment was noticeable at the canines.

Safety Evaluation of Ethanol Extract from Unripe Fruit of Bitter Melon (Momordica Charantia L.) in Sprague-Dawley Rats (랫드를 이용한 여주 추출물의 안전성 평가)

  • Ryu, Hyeon Yeol;Lee, Somin;Ahn, Kyu Sup;Yong, Yeon;Kim, Hye Jin;Kim, Seong-Eun;Lee, Hak Sung;Hong, Su-Young;Kim, Hyun-Kyu;Hwang, In Guk;Song, Kyung Seuk
    • Journal of the Korean Society of Food Science and Nutrition
    • /
    • v.46 no.4
    • /
    • pp.490-500
    • /
    • 2017
  • This study was performed to evaluate repeated dose oral toxicity upon administration of the test substance 1,2-benzisothiazolin-3-one for 90 days and to determine NOAEL (no observed adverse effect level) and target organs in Sprague-Dawley rats. Single, 2-week repeated, and 13-week repeated oral dose toxicity studies were conducted in Sprague-Dawley rats. The dose levels of groups were 1,250, 2,500, and 5,000 mg/kg/d. All dose groups were compared with the vehicle control group. The animals were observed for clinical signs and weekly body weight. Urinalysis, hematology, and serum biochemistry analyses were conducted. Subsequently, animals were sacrificed and subjected to histopathological examination. For the result, NOAEL of ethanol extract from unripe fruit of bitter melon had an optimal dose of 5,000 mg/kg/d and acceptable daily intake up to 3,000 mg/man. There was no target organ detected. Therefore, bitter melon, which contains a variety of bioactive substances, could be widely used as a health functional food ingredient.

The Comparison of Work of Breathing Between Before Extubation and After Extubation of Endotracheal Tube (기계 호흡 치료후 기관내관 제거 전후 호흡 일(Work of Breathing)의 비교)

  • Jung, Bock-Hyun;Koh, Youn-Suck;Lim, Chae-Man;Choe, Kang-Hyeon;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
    • /
    • v.44 no.2
    • /
    • pp.329-337
    • /
    • 1997
  • Background : Since endotracheal tube is the most important factor involved in the imposed work of breathing during mechanical ventilation, extubation of endotracheal tube is supposed to reduce respiratory work of patient. However, some patients show labored breathing after extubation despite acceptable blood gases. We investigated the changes of work of breathing before and after extubation and the factors involved in the change of WOB after extubation. Methods : The subjects were 34 patients(M : F = 20 : 14, mean age = $61{\pm}17yre$) who recovered from respiratory failure after ventilatory support and were considered to be ready for extubation. The patients with clinical or radiologic evidences of upper airway obstruction before endotracheal intubation for mechanical ventilation were excluded. Vital sign, physical examination, chest X-ray, work of breathing and other respiratory mechanic indices were measured prior to, immediately, 6, 24 and 48 hours after extubation serially. Definition of weaning failure after extubation was resumption of ventilatory support or reintubation of endotracheal tube within 48 hour after extubation because of respiratory failure. The patients were classified into group 1(decreased work of breathing), group 2(unchanged work of breathing) and group 3(increased work of breathing) depending on the statistical difference in the change of work of breathing before and after extubation. Results : Work of breathing decreased in 33%(11/34, group 1), unchanged in 41%(14/34, group 2) and increased in 26%(9/34, group 3) of patients after extubation compared with before extubation. Weaning failure occurred 9%(1/11) of group, 1, 28.6%(4/14) of group 2 and 44%(4/9) of group 3 after extubation(p = 0.07). The change of work of breathing after extubation was positively correlated with change of mean airway resistance(mRaw). (r = 0.794, p > 0.01). In three cases of group 3 whose respiratory indices could be measured until 48 hr after extubation, the change in work of breathing paralleled with the sequential change of mRaw. The work of breathing was peaked at 6 hr after extubation, which showed a tendency to decrease thereafter. Conclusions : Reversible increase of work of breathing after extubation may occur in the patients who underwent extubation, and the increase in mRaw could be responsible for the increase in work of breathing. In addition, the risk of weaning failure after extubation may increase in the patients who have increased WOB immediately after extubation.

  • PDF

The Diagnosis of Pneumoniae Following Bone Marrow Transplantation by Bronchoscopy (골수이식후 기관지내시경을 이용한 폐렴의 진단)

  • Kim, Tae-Yon;Yoon, Hyeong-Kyu;Moon, Hwa-Sik;Park, Sung-Hak;Min, Chang-Ki;Kim, Chun-Choo;Jung, Jung-Im;Song, Jeong-Sup
    • Tuberculosis and Respiratory Diseases
    • /
    • v.49 no.2
    • /
    • pp.198-206
    • /
    • 2000
  • Background : Pulmonary complications following bonemarrow transplantation (BMT) are common and associated with a high mortality rate. We investigated the yield, safety, and impact of fiberoptic bronchoscopy (FOB) for diagnosis of postBMT pneumoniae. Methods : From May 1997 to April 2000, 56 FOBs were performed in 52 post BMT patients for clinical pneumoniae. BMT patients with respiratory symptoms and/or pulmonary infiltrates had a thoracic HRCT(high resolution computed tomography) and bronchoscopic examination including BAL (bronchoalveolar lavage), TBLB (transbronchial lung biopsy), PSB (protected specimen brush). Results : The characteristics of the subjects were as follows : 37 males, 15 females, mean age of 31.3 years(l7-45), 35 sibling donor allogenic BMTs, 15 nonrelated donor allogenic BMTs, and 2 autologous BMTs. Fiftynine percent of FOBs (33 FOBs, 31 patients) were diagnostic. Isolated pathogens included the following : 12 cytomegalovirus (CMV) (21.4 %), 7 pneumocystis carinii (PC) (12.5 %), 11 CMV with PC (19.6 %), 2 Mycobacaterium tuberculosis (3.6%), and 1 streptococcus (1.8%). Most of the radiographic findings were diffuse interstitial lesions. CMV pneumoniae had mainly diffuse interstitial nodular lesion, and PC pneumoniae had diffuse, interstitial ground glass opacity(GGO). When CMV was accompanied by PC, a combined pattern of nodular and GGO was present. Of the 56 cases (23.2%), 13 died of CMV pneumoniae (n=2), PCP (n=2),mixed infection with CMV and PC (n=3), underlying GVHD (n=1), underlying leukemia progression (n=1), or respiratory failure of unknown origin (n=4). There was no major complication by bronchoscopy. Only 3 cases developed minor bleeding and 1 episode temporary hypoxemia. Conclusion : Based on our findings, CMV and PC are the major causes of postBMT pneumoniae. In addition, BAL can be considered a safe and accurate procedure for the evaluation of pulmonary complications after BMT.

  • PDF