• Title/Summary/Keyword: clinical implication

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Influence of the Alveolar Cleft Type on Preoperative Estimation Using 3D CT Assessment for Alveolar Cleft

  • Choi, Hang Suk;Choi, Hyun Gon;Kim, Soon Heum;Park, Hyung Jun;Shin, Dong Hyeok;Jo, Dong In;Kim, Cheol Keun;Uhm, Ki Il
    • Archives of Plastic Surgery
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    • v.39 no.5
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    • pp.477-482
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    • 2012
  • Background The bone graft for the alveolar cleft has been accepted as one of the essential treatments for cleft lip patients. Precise preoperative measurement of the architecture and size of the bone defect in alveolar cleft has been considered helpful for increasing the success rate of bone grafting because those features may vary with the cleft type. Recently, some studies have reported on the usefulness of three-dimensional (3D) computed tomography (CT) assessment of alveolar bone defect; however, no study on the possible implication of the cleft type on the difference between the presumed and actual value has been conducted yet. We aimed to evaluate the clinical predictability of such measurement using 3D CT assessment according to the cleft type. Methods The study consisted of 47 pediatric patients. The subjects were divided according to the cleft type. CT was performed before the graft operation and assessed using image analysis software. The statistical significance of the difference between the preoperative estimation and intraoperative measurement was analyzed. Results The difference between the preoperative and intraoperative values were $-0.1{\pm}0.3cm^3$ (P=0.084). There was no significant intergroup difference, but the groups with a cleft palate showed a significant difference of $-0.2{\pm}0.3cm^3$ (P<0.05). Conclusions Assessment of the alveolar cleft volume using 3D CT scan data and image analysis software can help in selecting the optimal graft procedure and extracting the correct volume of cancellous bone for grafting. Considering the cleft type, it would be helpful to extract an additional volume of $0.2cm^3$ in the presence of a cleft palate.

Psychological Characteristics of Infant Outpatients and their Parents in Korean Traditional Clinic (한의원 내원 환아 및 보호자의 정신건강 특성 연구)

  • Lee, Soo-Jin;Byun, Soon-Im;Kim, Kyung-Seon;Kim, Hye-Jin;Yang, You-Jin;Gang, Ki-Rim;Kim, Myoung-Geun;Choi, Hyeon;Chae, Han
    • The Journal of Korean Medicine
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    • v.30 no.5
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    • pp.88-101
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    • 2009
  • Objectives: Since Korean traditional medicine has an integrative perspective by its nature, the patients' psychological and physical problems in a Korean traditional clinic may be resolved through a more integrative approach. The purpose of this study was to describe the latent characteristics of psychological health of child outpatients and their parents visiting Korean traditional clinic with physical complaints and was to propose an alternative curriculum to meet their needs based on their psychological and physical aspects. Methods: Subjects studied consisted of 100 outpatients (59 boys, 41 girls, mean age 55 months, age range 18 to 83 months) and their parents. Behavior characteristics for children were measured by Korean version of Child Behavior Checklist for Ages 1.5-5 (CBCL1.5-5) while parenting stress, depression, and anxiety for parent were measured by Korean-Parenting Stress Index-Short Form (K-PSI-SF), Center for Epidemiologic Studies Depression Scale (CES-D) and State-Trait Anxiety Inventory (STAI), respectively. The data of subjects were compared to those of standardized groups and then were compared according to child's gender within sample. Results: Child participants were reported to have significantly higher scores of all CBCL 1.5-5 subscales than the standardized group. When compared, no differences of K-PSI-SF, CES-D, and STAI was found between parents of participants and the standardized groups. However, parents of child participants with at-risk psychological problems showed significantly higher scores of all parenting stress subscales than those of all child participants. In addition, the mothers of boy participants demonstrated significantly higher anxiety, depression and parenting stress than those of girl participants irrespective of psychological severity. Conclusions: We discussed the implication of these results in clinical situation and make recommendations for curriculum of psychiatry and pediatrics with the aim of improving proper diagnosis, consulting and treatment.

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Tooth size and arch parameters of normal occlusion in a Iarge Korean sample (한국인 정상교합자의 치아크키와 치열궁 계측치에 관한 연구)

  • Lee, Shin-Jae;Moon, Seong-Cheol;Kim, Tae-Woo;Nahm, Dong-Seok;Chang, Young-Il
    • The korean journal of orthodontics
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    • v.34 no.6 s.107
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    • pp.473-480
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    • 2004
  • The aim of this study was to establish normative data on the tooth size and arch parameters of Koreans with normal occlusion, This study employed the dental casts of 296 (male: 179; female 117) normal occlusion samples, who were selected from 15,836 adults through a community dental health survey. The mesiodistal diameters of teeth, arch width, and arch length were measured by digital electronic calipers(accurate to 0.01 mm) and Bolton's indices as well as intermaxillary arch width ratios were calculated. In order to ensure reliability, intra- and inter-examiner error were evaluated. Although our dimensional data showed overt differences between genders, the indices and intermaxillary ratios evaluated were the same. The resultant data obtained were compared with the previous data to reveal whether any changes have occurred over the time. The clinical implication of the present findings was also discussed. This biometric study seemed to provide a clinically applicable diagnostic criteria for an individual malocclusion patient.

Effects of Oketani Breast Massage on Breast Discomfort, Breast Milk Amount, and Breast Milk Total Protein (오케타니 유방마사지가 유방불편감, 모유량 및 모유 Total Protein에 미치는 효과)

  • Kim, Su-Mi;Jeon, Soon-Ie;Song, Seon-mi
    • The Journal of the Korea Contents Association
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    • v.18 no.1
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    • pp.493-503
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    • 2018
  • The purpose of this study was to measure the effects of Oketani breast massage on breast discomfort, The amount of the breast milk, and the total protein of the breast milk in early postpartum mothers. The design was a non-equivalent control group Quasi-experiment. In the nursing intervention, The Oketani breast massage was given to the experimental group twice after giving birth, and Self Mamma Care (SMC) training was given to the control group. The collected data were analyzed by $x^2-test$ and t-test. The results of the study showed that the Oketani breast massage was more effective than the SMC-treated control group because of decreasing breast discomfort and increasing the amount of breast milk and total milk protein. Therefore, the Oketani breast massage will help early postpartum mothers more easily breastfeed. For the implication for practice, this study suggests that Oketani breast massage can be used as the effective nursing intervention that facilitates breastfeeding of early postpartum mothers in clinical practice.

THE DEGREE OF EGO IMPAIRMENT IN ADOLESCENT PSYCHIATRIC PATIENT GROUPS (청소년 정신과 환자군을 대상으로 한 자아기능의 장애정도 비교 - Rorschach검사의 자아손상지표를 중심으로 -)

  • Oh, Youn-Hee;Kim, Zoung-Soul;Shin, Min-Sup
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.2
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    • pp.178-185
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    • 1999
  • Objective:This study was designed to examine the validity of the Ego Impairment Index(EII) in adolescent psychiatric patients(depression, depressive-conduct disorder, schizophrenia), and to explore the validity of the depressive-conduct disorder as a diagnostic entity. Method:19 depressives, 13 depressive-conduct disordered, and 10 schizophrenics with the age from 12 to 18 were selected based on DSM-IV and ICD-10 criteria, and their responses of the Rorschach and MMPI were analyzed. The EII was empirically developed by Perry and Viglione(1991) in order to assess the degree of ego impairment, and was derived from the Rorschach test. Results:It was founded that a single factor, ego impairment, was derived from the principal component analysis and explained 57.18% of total variances. The degree of ego impairment was grater in schizophrenics than in the other two groups, but there were no difference between depressives and depressive-conducts. Conclusions:These results offered support for the use EII as an empirical means of assessing the degree of ego impairment in adolescent patients. And these results suggest that depressive-conduct disorder group is more similar to the depressive group, implying that depressive-conduct disorder might correspond to so called masked depression. The clinical implication and limitation of present study were discussed.

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A Study of the Influence of 'the Separation of Prescribing and Dispensing Roles' Policy on Medical Institutions (의약분업실시에 따른 의료기관의 건강보험외래부문 순이익변화 추계)

  • Chung, Woo-Jin;Shin, Seung-Ho;Lee, Sun-Mi;Jung, Sang-Hyuk;Koh, Kwang-Wook;Park, Si-Woon;Shin, Eui-Chul;Lee, Sun-Hee;Hwang, Jin-Mee
    • Korea Journal of Hospital Management
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    • v.7 no.4
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    • pp.1-23
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    • 2002
  • This study examined the influence of the separation of prescribing and dispensing roles(SPD) policy implemented in Korea in July 2000, especially on the change in the net profit of medical institutions. Using the data set from the Korea's National Health Insurance and the previous research, this study elicited the following main results. First, tertiary care institutions was estimated to lose about 631 billion won after the SPD policy. Second, general hospitals and hospitals gained about 557 billion and 564 billion won, respectively. Third, it is shown that clinics also gained 389-659 billion won. Finally, however, the change in net profit of medical institutions after the SPD policy largely depends on different estimation models. Moreover, it also varies from the assumptions on the price differential of a reimbursable drug which worked as cross-subsidy to insufficient physician's fee before the SPD policy. Despite such limitations as lack of data outside of the National Health Insurance's coverage, this study differs from others. This is the first research to explore the effect of the SPD policy on different types of medical institutions and to attempt to purely focus on the SPD policy. In this study, we can draw the policy implication that preparing for a policy change, the government should set up the policy evaluation system to collect the concerned data and develop the methodologies in advance to the policy implementation.

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A Case of Rapid Cycling Secondary Bipolar Disorder Following Rt. Hemisphere Cerebral Infarction in a Patient with Preceeded Left Hemisphere Poststroke Depression (좌반구 뇌졸중후 우울증 환자에서 우반구 뇌경색이 수반된 급속 순환형 이차성 양극성장애 1례)

  • Chang, Ho-Kyun;Yi, Ho-Taek;Paik, Ju-Hee;Lee, Sang-Yeon
    • Korean Journal of Psychosomatic Medicine
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    • v.6 no.1
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    • pp.79-84
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    • 1998
  • Authors report a case of poststroke bipolar disorder that occurs much less frequently than poststroke depression(PSD). A MRI study performed to identify the etiology of a secondary manic episode in a patient with preceded PSD after left basal ganglia infarction revealed newly developed right basal ganglia infarction associated with poststroke bipolar disorder. It is interesting to note that (1) the temporal relationship was found between the occurrence of PSD after left hemisphere stroke and the occurrence of poststroke bipolar disorder following right hemisphere stroke, and that (2) the occurrence of PSD and the occurrence of poststroke bipolar disorder are associated with lesion location respectively. It has been reported that bipolar disorders were associated with subcortical lesions of the right hemisphere, whereas right-cortical lesions led to unipolar mania and that risk factors for mania included a family history of psychiatric disorders and mild subcortical atrophy. In this case, MR image shows subcortical lesions of the right hemisphere and mild subcortical atrophy. The investigation of the relationships among stroke lesion locations and potstroke mood disorders and risk factors for poststroke bipolar disorder may contribute to understanding the neurobiology of primary mood disorder. A clinical implication is that the risk of secondary bipolar disorder after cerebral infarction should be highlighted.

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A Study of Diaphoretic Therapy[汗法] in "Yumunsachin(儒門事親)" ("유문사친(儒門事親)"의 '한법(汗法)'에 관한 연구)

  • Kim, Ki-Wook;Park, Hyun-Kuk;Jung, Kyung-Ho
    • Journal of Korean Medical classics
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    • v.21 no.1
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    • pp.1-11
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    • 2008
  • Jangjahwa(張子和) was influenced by "Hwangjenaegyeong(黃帝內經)" and Yuhagan(劉河間)'s theory, and other classics. Also, his clinical experience was helpful to theorize his thought. Thus, he improved medical theory by combining previous medical theory and his own experience. The essence of his thought is the importance of pathogenic Gi[邪氣] as the cause of disease and is Sambeop(三法) of Hantoha(汗吐下) as the methodology for removing pathogenic Gi[邪氣] away. He regarded pathogenic Gi as the cause of disease, and eliminated pathogenic Gi for the remedy. Namely, Sambeop(三法) of Hantoha(汗吐下) was selected as the best efficient method for driving pathogenic Gi away. Sambeop of Jangjahwa(張子和) have different meaning from previous one. Traditionally, Diaphoretic Therapy[汗法] was regarded as therapy for exogenous disease[外感病], and its effect was regarded as Balhanhaepyo(發汗解表). Emetic therapy[吐法] was throwing up Dameumsuksik(痰飮宿食) of stomach and above diaphragm. Purgation therapy[下法] means Tongbyeon(通便), Hajeok(下積), Sasil(瀉實), Chuksu(逐水) were regarded as therapy for Yangmyeongsiljeung(陽明實證) of Sanghan(傷寒). He submitted a new extensive concept of Sambeop adding traditional one, and expanded the application range of Sambeop. All methods, can cause circulation of Gihyeol(氣血) by opening the 'Hyeonbu(玄府)', like Moxibution therapy[灸薰], Steaming[蒸], Washing[洗],Heat therapy[慰], Cauterization[烙], Acupuncture therapy[鍼刺], Stone needling, Physical and breathing exercise[導引], Massage[按摩] were regarded as Diaphoretic Therapy[汗法]. Especially, he thought that Diaphoretic Therapy and venesection[瀉血] have same medical implication. If we examine the process of pushing out pathogenic Gi[邪氣] by means of Sambeop(三法), we can find the intermediation, that is circulation of Gihyeol(氣血). Its meaning is implied in the word of 'opening Hyeonbu(玄府)'. He thought that the circulation of Gihyeol(氣血) is the key to control health. Gihyeol(氣血) was circulated well under the physiological balance, but it was not circulated well under the invasion of pathogenic Gi[邪氣]. In other words, pathogenic Gi is the immediate cause of bad circulation of Gihyeol(氣血) and disease. Naturally, the doctor must remove pathogenic Gi that cause bad circulation for healing by means of Sambeop(三法). In my opinion, because the ultimate goal of Jangjahwa(張子和) was circulation of Gihyeol(氣血) by removing pathogenic Gi[邪氣], the concept of Sarnbeop(三法) could be expanded.

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Mediating and Moderating Effects of Self-esteem, Social Participation and Discrimination Experience in the Relationship between Acceptance of Disability and Social Competence in Adults with Physical Disabilities (지체장애인의 장애수용과 사회적 유능감 간의 관계에서 자존감, 사회참여, 차별경험의 매개 및 조절효과)

  • Kim, Do-Hee
    • Journal of Digital Convergence
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    • v.17 no.7
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    • pp.377-386
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    • 2019
  • The purpose of this study is to identify effective strategies for promoting psycho-social adjustment by examining the mediating effects of self-esteem (SE) and moderating effects of social participation (SP) and discrimination experience (DE) in predicting social competence (SC) with acceptance of disability (AD). The subjects of the study were 1943 adults with a physical disability (1338 males and 605 females) and 233 adults with brain lesions (160 males and 73 females) aged between 19 and 65 years. Data were analyzed using SPSS and Process macro software, and conditional process analysis (model 18) in which the degree and onset of disability were controlled was performed. The results are as follows. First, SE was found to partially mediate the relationship between AD and SC. Second, the relationship between SE and SC was found to be moderated by SP but not by DE, and the relationship between SP and SC was found to be moderated by DE. In addition, the mediating effects of SE, which was moderated by SP, were found to not be moderated by DE. The clinical implication and suggestion for future research is discussed.

The Effect of Leukoaraiosis on the Severity and Course of Delirium (백질변성이 섬망의 심각도 및 경과에 미치는 영향)

  • Choi, Won-Jung;Seok, Jeong-Ho;Oh, Seung-Taek;Chung, Tae-Sub;Kim, Jae-Jin
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.2
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    • pp.194-200
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    • 2018
  • Objectives : The significance of leukoaraiosis on brain magnetic resonance imaging (MRI) is uncertain, but it is often seen with vascular risk factors or in the context of cognitive impairment. We aimed to investigate the effect of leukoaraiosis on the severity and course of delirium. Methods : Periventricular hyperintensity and deep white matter hyperintensity on brain MRI were rated in 42 patients with delirium by semiquantative visual rating scale. Correlations between their grades and the scores of Korean version of Delirium Rating Scale-Revised-98 (K-DRS-R-98) were analyzed, and the interaction effects between the groups according to the levels of leukoaraiosis and two evaluation points were also analyzed. Results : The grade of deep white matter hyperintensity in the occipital lobe was positively correlated with the scores on the total, severity items, cognitive items, and non-cognitive items of K-DRS-R-98. The cognitive items scores of K-DRS-R-98 in the low grade group of periventricular hyperintensity showed significantly steeper decrease than the high grade group. Conclusions : A difference in severity or recovery speed of delirium according to the level of leukoaraiosis may result from disruption in brain functional connectivity. Our results have a clinical implication in that the severity and course of delirium can be possibly predicted using the level of leukoaraiosis.