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Psychosocial Impact of Chronic Orofacial Pain (만성 구강안면통증의 사회심리적 영향)

  • Yang, Dong-Hyo;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.34 no.4
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    • pp.397-407
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    • 2009
  • The aim of the study was to evaluate psychosocial impact of non-dental chronic orofacial pain (OFP) on daily living using the graded chronic pain (GCP) scale. It is also investigated the clinical profile such as demographics, event related to initiation of OFP and prior treatments for patients. During previous 6 months since September 2008, 572 patients (M:F=1:1.5, mean age=34.7 years) with non-dental OFP attended university-based specialist orofacial pain clinic (Dankook University Dental Hospital, Cheonan) to seek care although 63% of them already experienced related treatment for their OFP problem. They visited the most frequently general dental practitioner and orthopedic doctors due to their pain problem and medication was the most commonly employed modality. Most of the patients (89.2%) had TMD and the most common related event to initiation of their pain was trauma, followed by dental treatment. Almost half of the patients (46%) suffered from chronic pain(${\geq}6\;M$) and 40% of them exhibited relatively high disability due to chronic OFP. GCP pain intensity and disability days were significantly different for age and diagnosis (p<0.05) but not for gender and duration. GCP grades were affected by all the factors including gender, age, pain duration and diagnosis.(p=0.000) Female gender, elders, and long lasting pain were closely related to high disability. The patients with neuropathic Pain and mixed OFP rather than TMD were graded as being highly disabled. Conclusively, a considerable percentage of chronic OFP patients reports high pain-related disability in their daily, social and work activity, which suggest a need for psychosocial support and importance of earlier referral for appropriate diagnosis and tailored management.

Added Value of Magnetic Resonance Imaging in Staging of Malignant Pleural Mesothelioma (악성흉막중피종의 병기판정에서 자기공명영상의 진단적 유용성 평가)

  • Lee, Eunsol;Chae, Eun Jin;Kang, Sunji;Yeom, Yoo Kyeong;Lee, Hyun Joo;Park, Jong Chun;Shin, So Youn;Choi, Yoon Young;Choi, Joon Ho;Do, Kyung-Hyun
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.3
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    • pp.232-238
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    • 2013
  • Purpose : We investigated the possible added value of magnetic resonance imaging (MR) in staging of malignant pleural mesothelioma (MPM) compared to computed tomography (CT). Materials and Methods: We retrospectively enrolled 20 patients (M;F = 14:6; mean age, 53.5 yrs) who diagnosed as MPM by histology and underwent CT and MR at initial evaluation from Jan 1997 to Dec 2012. Two radiologists performed clinical staging by using CT alone or MR alone in consensus. In patients underwent surgery (n = 13), we evaluated the diagnostic accuracy of CT and MR in terms of staging compared to surgical staging. In all patients, we compared clinical staging of CT only and CT with MR. Results: The diagnostic accuracy for T staging of CT only was 23.1% (3/13) and that of combined CT and MR was 38.5% (5/13), respectively. Among 13 patients underwent surgery, surgical stage was higher than combined CT and MR stage in 5 patients, but lower in 3 patients. CT only and combined CT and MR agreed in 85.0% (17/ 20). In cases of disagree (15.0%, 3/20), combined CT and MR showed higher stage than CT only. Conclusion: Combined CT and MR increases the diagnostic accuracy in staging of MPM compared to CT only and is important in determining the appropriate treatment in patients being considered for surgery.

The Recent Outcomes after Repair of Tetralogy of Fallot Associated with Pulmonary Atresia and Major Aortopulmonary Collateral Arteries (폐동맥폐쇄와 주대동맥폐동맥부행혈관을 동반한 활로씨사징증 교정의 최근 결과)

  • Kim Jin-Hyun;Kim Woong-Han;Kim Dong-Jung;Jung Eui-Suk;Jeon Jae-Hyun;Min Sun-Kyung;Hong Jang-Mee;Lee Jeong-Ryul;Rho Joon-Ryuang;Kim Yong-Jin
    • Journal of Chest Surgery
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    • v.39 no.4 s.261
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    • pp.269-274
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    • 2006
  • Background: Tetralogy of Fallot (TOF) with pulmonary atresia and major aortopulmonary collateral arteries (MAPCAS) is complex lesion with marked heterogeneity of pulmonary blood supply and arborization anomalies. Patients with TOF with PA and MAPCAS have traditionally required multiple staged unifocalization of pulmonary blood supply before undergoing complete repair. In this report, we describe recent change of strategy and the results in our institution. Material and Method: We established surgical stratagies: early correction, central mediastinal approach, initial RV-PA conduit interposition, and aggressive intervention. Between July 1998 and August 2004, 23 patients were surgically treated at our institution. We divided them into 3 groups by initial operation method; group I: one stage total correction, group II: RV-PA conduit and unifocalization, group III: RV-PA conduit interposition only. Result: Mean ages at initial operation in each group were $13.9{\pm}16.0$ months (group 1), $10.4{\pm}15.6$ months (group II), and $7.9{\pm}7.7$ months (group III). True pulmonary arteries were not present in f patient and the pulmonary arteries were confluent in 22 patients. The balloon angioplasty was done in average 1.3 times (range: $1{\sim}6$). There were 4 early deaths relating initial operation, and 1 late death due to incracranial hemorrhage after definitive repair. The operative mortalities of initial procedures in each group were 25.0% (1/4: group I), 20.0% (2/10: group II), and 12.2% (1/9: group III). The causes of operative mortality were hypoxia (2), low cardiac output (1) and sudden cardiac arrest (1). Definitive repair rates in each group were 75% (3/4) in group I, 20% (2/10, fenestration: 2) in group II, and 55.0% (5/9, fenestration: 1) in group III. Conclusion: In patients of TOF with PA and MAPCAS, RV-PA connection as a initial procedure could be performed with relatively low risk, and high rate of definitive repair can be obtained in the help of balloon pulmonary angioplasty. One stage RV-PA connection and unifocalization appeared to be successful in selected patients.

Surgical Treatment of Anomalous Origin of Coronary Artery from the Pulmonary Artery: Postoperative Changes of Ventricular Dimensions and Mitral Regurgitation (관상동맥-폐동맥 이상기시증(Anomalous Origin of Coronary Artery from Pulmonary Artery)의 수술적 치료: 중기 성적과 좌심실 및 승모판 기능의 변화 양상에 대한 연구)

  • Kang, Chang-Hyun;Kim, Woong-Han;Seo, Hong-Joo;Kim, Jae-Hyun;Lee, Cheul;Chang, Yoon-Hee;Hwang, Seong-Wook;Back, Man-Jong;Oh, Sam-Se;Na, Chan-Young;Han, Jae-Jin;Lee, Young-Tak;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.19-26
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    • 2004
  • Background: The aims of this study are to verify the result of the surgical treatment of ALCAPA and to identify the postoperative changes of left ventricular dimensions and mitral regurgitation (MR), Material and Method: Fifteen patients operated on since 1985 were included in the study. The patients operated on before 1998 (n=9) showed heterogeneous properties with various surgical strategies and cardiopulmonary bypass techniques. However, six patients were operated on with the established surgical strategy since 1998; 1) Dual perfusion and dual cardioplegic solution delivery through ascending aorta and main pulmonary artery, 2) Coronary transfer by rolled-conduit made of pulmonary artery wall flap, and 3) Additional mitral valvular procedure was not peformed. Result: Median age of the study group was 6 months (1 month to 34 years). The operative methods were left subclavian artery to left coronary artery anastomosis in 1, simple ligation in 2, Takeuchi operation in 2, and coronary reimplantation in 10 patients. The mean follow up period was 5.5<5.8 years (2 months 14 years), There were one early death (6.7%) and one late death. Overall 5-year survival rate was 85.6$\pm$9.6%. The Z-value of left ventricular end-diastolic and end-systolic dimensions were 6.4$\pm$3.0 and 5.1 $\pm$3.6 preoperatively, and decreased to 1.7$\pm$ 1.9 and 0.8$\pm$ 1.6 in 3 months (p<0.05). Significant preoperative MR was identified in 6 patients (40%) and all the patients showed immediate improvement of MR within f month postoperatively. There were 3 cases of reoperation due to coronary anastomosis site stenosis and recurrence of MR. However, there was no mortality nor late reoperation in the patients operated on after 1998. Conclusion: The surgical treatment of ALCAPA showed favorable survival and early recovery of ventricular dimensions and mitral valvular function. Although long-term reintervention was required in some cases of earlier period, all the cases after 1998 showed excellent surgical outcome without long-term problem.

Causes of Right Middle Lobe Syndrome -Recent Experience in Local Tertiary Hospital for Several Years- (우중엽증후군의 원인 -최근 수년간 지역 3차 병원의 경험-)

  • Kim, Hyun Ok;Ma, Jeong Eun;Lee, Seung Jun;Cho, Yu Ji;Jeong, Yi Yeong;Jeon, Kyoung-Nyeo;Kim, Ho Cheol;Lee, Jong Deok;Hwang, Young Sil
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.3
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    • pp.192-196
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    • 2007
  • Background: Right middle lobe syndrome (RMLS) is defined as transient or chronic and recurrent atelectasis of the right middle lobe. Although numerous conditions are associated with RMLS, there are very few recent reports in Korea. This study evaluated the causes of RMLS in a local tertiary hospitalover a period of 42 months. Method: Eighty-eight patients (M:F=64:22, mean age: $67.2{\pm}10.3years$), who had consistent chest radiography findings and underwent bronchoscopy in Gyeongsang University Hospital from January 2003 to July 2006, were enrolled in this study. The clinical characteristics and causes of RMLS in these patients were retrospectively reviewed. Results: The most common symptoms fo RMLS were cough, dyspnea and sputum. Tuberculosis was the most common cause (endobronchial tuberculosis in 22 and pulmonary tuberculosis in 1) The other causes were bronchial stenosis by benign fibrotic changes in 22 cases (25%), anthracofibrosis in 13 cases (14.8%), pneumonia in 11 cases (12.5%), lung cancer in 10 cases (11.4%), mucus impaction in 3 cases (3.4%), bronchiectasis in 2 cases (2.3%) and no demonstrable causes in 7 cases (8%). The bronchoscopy findings were mucosal edema with hyperemic changes in 38 cases (43.2%), mucosal edema with anthracotic pigmentation in 16 cases (18.2%), mucus impaction in 13 cases (14.8%), fibrotic stenosis in 13 cases (14.8%), a mass like lesion in 8 cases (9.1%), exudative necrotic material in 4 cases (4.5%), narrowing as a result of extrinsic compression in 2 cases (2.3%) and no demonstrable abnormalities in 12 cases (13.6%). Conclusion: Right middle lobe syndrome was observed more frequently in patients over the age of 65. The causes were mainly benign diseases with endobronchial tuberculosis being the most common.

Detection of Hepatic Lesion: Comparison of Free-Breathing and Respiratory-Triggered Diffusion-Weighted MR imaging on 1.5-T MR system (국소 간 병변의 발견: 1.5-T 자기공명영상에서의 자유호흡과 호흡유발 확산강조 영상의 비교)

  • Park, Hye-Young;Cho, Hyeon-Je;Kim, Eun-Mi;Hur, Gham;Kim, Yong-Hoon;Lee, Byung-Hoon
    • Investigative Magnetic Resonance Imaging
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    • v.15 no.1
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    • pp.22-31
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    • 2011
  • Purpose : To compare free-breathing and respiratory-triggered diffusion-weighted imaging on 1.5-T MR system in the detection of hepatic lesions. Materials and Methods: This single-institution study was approved by our institutional review board. Forty-seven patients (mean 57.9 year; M:F = 25:22) underwent hepatic MR imaging on 1.5-T MR system using both free-breathing and respiratory-triggered diffusion-weighted imaging (DWI) at a single examination. Two radiologists retrospectively reviewed respiratory-triggered and free-breathing sets (B50, B400, B800 diffusion weighted images and ADC map) in random order with a time interval of 2 weeks. Liver SNR and lesion-to-liver CNR of DWI were calculated measuring ROI. Results : Total of 62 lesions (53 benign, 9 malignant) that included 32 cysts, 13 hemangiomas, 7 hepatocellular carcinomas (HCCs), 5 eosinophilic infiltration, 2 metastases, 1 eosinophilic abscess, focal nodular hyperplasia, and pseudolipoma of Glisson's capsule were reviewed by two reviewers. Though not reaching statistical significance, the overall lesion sensitivities were increased in respiratory-triggered DWI [reviewer1: reviewer2, 47/62(75.81%):45/62(72.58%)] than free-breathing DWI [44/62(70.97%):41/62(66.13%)]. Especially for smaller than 1 cm hepatic lesions, sensitivity of respiratory-triggered DWI [24/30(80%):21/30(70%)] was superior to free-breathing DWI [17/30(56.7%):15/30(50%)]. The diagnostic accuracy measuring the area under the ROC curve (Az value) of free-breathing and respiratory-triggered DWI was not statistically different. Liver SNR and lesion-to-liver CNR of respiratory-triggered DWI ($87.6{\pm}41.4$, $41.2{\pm}62.5$) were higher than free-breathing DWI ($38.8:{\pm}13.6$, $24.8{\pm}36.8$) (p value < 0.001, respectively). Conclusion: Respiratory-triggered diffusion-weighted MR imaging seemed to be better than free-breathing diffusion-weighted MR imaging on 1.5-T MR system for the detection of smaller than 1 cm lesions by providing high SNR and CNR.

Studies on the Chemical composition of Citrus fruits in Korea (III) -On the free amino acids , sugars and pectin content in main Varieties- (한국산(韓國産) 감귤류(柑橘類)의 화학성분(化學成分)에 관(關)한 연구(硏究)(III) -주요(主要) 감귤(柑橘) 품종별(品種別) 유리(遊離) amino acid, 당(糖) 및 pectin 함량(含量)에 관(關)하여-)

  • Park, H.;Yang, C.B.;Kim, Z.U.;Lee, C.Y.
    • Applied Biological Chemistry
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    • v.9
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    • pp.97-104
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    • 1968
  • A survey of the free amino acids and free sugars in the juice of fourteen citrus varieties was made by means of paper chromatography and the pectin content in the rind was detected The results of the survey are summarized as follows. 1) Sixteen aminoacids detecteu in fourteen varieties under the condition of this study were distributed with. different frequency as follow. Proline, gamma-amino-butyric acid, alanine, valine, serine, glutamic acid, aspartic acid (in 14 varieties), lysine(12), leucine threonine(11), isoleucine(10), arginine(9), glycine(6) ${\beta}-alanine$(4) asparagine(3) unknown(2). 2) Proline, gamma-amino-butyric acid were mostly abundant in all varieties and alanine was next in the amount. 3) The varieties in the decreasing order of number of amino acids container were C. grandis madow C. leiocarpa (14 acids), C. sulcata, C. hassaku. native citron, Fortunella japonica(13) C. grandis heiko, C. Tamurana iyo, C. nobilis(12) C. reticulata C. junos(11) C. natsudaidai(10) C. miyakawa unshiu, C. ohali unshiu(9). 4) The varieties which appear to contain all essential amino acids(6 acids)detected were C. grandis madow C. grandis heiko, C. sulcata, C. Tamurana iyo, C. hassaku and native citron, and C. natsudaidai, C. unshiu were the least (1-3 acids). 5) Glucose fructose, sucrose and maltose were detected in all varieties. 6) The pectin content in the rind ranged from 8.64% F.W.(C. junos) up to 17.0% for C, grandis madow and the mean was $11.63{\pm}2.69%$.

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A study on some high school boys' practice of oral health control(around toothbrushing) and knowledge of decay and preferred taste (일부 남고생의 간식 선호맛과 구강관리실천(잇솔질 중심) 및 우식지식도 조사)

  • Choi, Yun-Hwa
    • Journal of Korean society of Dental Hygiene
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    • v.10 no.2
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    • pp.361-374
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    • 2010
  • Objectives : The purpose of this study was to provide some basic data for effective prevention and oral health education for oral health. For that purpose, a self-administered questionnaire was distributed to the boys of three high schools in Gyeonggi Province. Methods : The questionnaire consisted of items about the practice of oral health control and knowledge of decay according to grade, number of snacking, preferred taste, and toothbrushing. Total 487 questionnaires were put to analysis using the SPSS WIN 13.0 program. Results : 1. The biggest number of the boys brushed their teeth twice a day. The 10th graders brushed teeth three times a day, and the 11th and 12th graders tended to brush teeth twice a day(${\chi}^2$=18.21, p<.05). 2. As for the way of toothbrushing, 39.0% of the boys said they brushed teeth the way they felt like, being followed by those who said they brushed teeth turning the toothbrush up and down and brushing both the teeth and gums(32.6%). As for the number of snacking, those who had snacks three times a day or more brushed teeth turning the toothbrush up and down and brushing both the teeth and gums. Those who hardly had snacks more tended to brush teeth the way they felt like than those who had snacks(${\chi}^2$=21.28, p<.05). And as for preferred tastes, those who preferred a sweet and salty taste more tended to brush teeth the way they felt like than others. And those who preferred a hot taste brushed teeth turning the toothbrush up and down and brushing both the teeth and gums(${\chi}^2$=26.85, p<.01). 3. The respondents' percentage of correct answers for 'Decay is caused by bacteria' was 81.5%. Those who preferred a hot taste recorded the highest percentage of correct answers(${\chi}^2$=21.95, p<.00). 4. Their percentage of correct answers for 'Decay is accompanied by pain from the beginning' was 78.2%. The 12th graders had the highest rate of correct answers, and the 11th graders had the highest rate of wrong answers(${\chi}^2$=11.56, p<.00). 5. Their percentage of correct answers for 'Fluorine is helpful to the prevention of decay' was 75.4%. Those who hardly had snacks recorded the highest rate of correct answers(${\chi}^2$=10.05, p<.02). 6. Their percentage of correct answers for 'There is a way to supply fluorine into the waterworks' was 29.2%, which means the percentage of wrong answers was much higher. The percentage of wrong answers was the highest in the 11th grade(${\chi}^2$=7.06, p<.03). 7. The respondents' mean scores of knowledge of decay were 13.15 of total 18. While the 12th graders showed the highest level of knowledge of decay, the 11th graders were lower in the level of knowledge of decay than the other graders. And there were significant differences(F=5.41, p<.01) according to grade with no such differences according to the number of snacking and preferred taste. Conclusions : Oral health education should be applied to the boys all through their life to have a great effect, and it is important that they should always put the oral health education into practice to be a successful education.

Role of Catecholamines in Ventricular Fibrillation (Catecholamines에 관(關)하여 -제4편(第四編) : 심실전동발생(心室顫動發生)에 있어서의 catecholamines의 의의(意義)-)

  • Lee, Woo-Choo
    • The Korean Journal of Pharmacology
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    • v.19 no.1
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    • pp.15-35
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    • 1983
  • Although it has been well known that ventricular fibrillation is the most important complication during hypothermia, much investigation has failed to show the exact nature of the etiology of ventricular fibrillation. Recently, there has been considerable research on the relationship between sympathetic activity and ventricular fibrillation under hypothermia. Cardiac muscle normally contains a certain amount of norepinephrine and the dramatic effect of this catecholamines on the cardiac muscle is well documented. It is, therefore, conceivable that cardiac catecholamines might exert an influence on the susceptibility of heart muscle to tachycardia, ventricular fibrillation and arrhythmia, under hypothermia. Hypothermia itself is stress enough to increase tonus of sympatheticoadrenal system. The normal heart is supplied by an autonomic innervation and is subjected to action of circulating catecholamines which may be released from the heart. If the reaction of the heart associated with a variable amount of cardiac catecholamines is. permitted to occur in the induction of hypothermia, the action of this agent on the heart has not to be differentiated from the direct effects of cooling. The studies presented in this paper were designed to provide further information about the cardio-physiological effects of reduced body temperature, with special reference to the role of catecholamines in ventricular fibrillation. Healthy cats, weighing about 3 kg, were anesthetized with pentobarbital(30 mg/kg) intraperitoneally. The trachea was intubated and the endotracheal tube was connected to a C.F. Palmer type A.C. respirator. Hypothermia was induced by immersing the cat into a ice water tub and the rate of body temperature lowering was $1^{\circ}C$ per 5 to 8 min. Esophageal temperature and ECG (Lead II) were simultaneously monitored. In some cases the blood pH and serum sodium and potassium were estimated before the experiment. After the experiment the animals were killed and the hearts were excised. The catecholamines content of the cardiac muscle was measured by the method of Shore and Olin (1958). The results obtained are summarized as follows. 1) In control animal the heart rate was slowed as the temperature fell and the average pulse rates of eight animals were read 94/min at $31^{\circ}C$, 70/min at $27^{\circ}C$ and 43/min at $23^{\circ}C$ if esophageal temperature. Ventricular fibrillation was occurred with no exception at a mean temperature of $20.3^{\circ}C(21-l9^{\circ}C)$. The electrocardiogram revealed abnormal P waves in each progressive cooling of the heart. there was, ultimately, a marked delay in the P-R interval, QRS complex and Q-T interval. Inversion of the T waves was characteristic of all animals. The catecholamines content of the heart muscle excised immediately after the occurrence of ventricular fibrillation was about thirty percent lower than that of the pre-hypothermic heart, that is, $1.0\;{\mu}g/g$ wet weight compared to the prehypothermic value of $1.41\;{\mu}g/g$ wet weight. The changes of blood pH, serum sodium and potassium concentration were not remarkable. 2) By the adrenergic receptor blocking agent, DCI(2-3 mg/kg), given intramuscularly thirty minutes before hypothermia, ventricular fibrillation did not occur in one of five animals when their body temperature was reduced even to $16^{\circ}C$. These animals succumbed at that low temperature, and the changes of heart rate and loss of myocardial catecholamines after hypothermia were similar to those of normal animals. The actual effect of DCI preventing the ventricular fibrillation is not predictable. 3) Administration of reserpine(1 mg/kg, i.m.) 24 hours Prior to hypothermia disclosed reduced incidence of ventricular fibrillation, that is, six of the nine animals went into fibrillation at an average temperature of $19.6^{\circ}C$. By reserpine myocardial catecholamines content dropped to $0.045\;{\mu}g/g$ wet weight. 4) Bretylium pretreatment(20 mg/kg, i.m.), which blocks the release of catecholamines, Prevented the ventricular fibrillation under hypothermia in four of the eight cats. The pulse rate, however, was approximately the same as control and in some cases was rather slower. 5) Six cats treated with norepinephrine(2 mg/kg, i.m.) or DOPA(50 mg/kg) and tranylcypromine(10 mg/kg), which tab teen proved to cause significant increase in the catecholamines content of the heart muscle, showed ventricular fibrillation in all animals under hypothermia at average temperature of $21.6^{\circ}C$ and the pulse rate increased remarkably as compared with that of normal. Catecholamines content of cardiac muscle of these animals markedly decreased after hypothermia but higher than control animals. 6) The functional refractory periods of isolated rabbit atria, determined by the paired stimulus technique, was markedly shortened by administration of epinephrine, norepinephrine and isoproterenol. 7) Adrenergic beta-blocking agents, such as pronethalol, propranolol and sotalol(MJ-1999), inhibited completely the shortening of refractory period induced by norepinephrine. 8) Pretreatment with either phenoxftenbamine or phentolamine, an adrenergic alphatlocking agent, did not modify the decrease in refractory period induced by norepinephrine. From the above experiment it is possible to conclude that catecholamines play an important role in producing ventricular fibrillation under hypothermia. The shortening of the refractorf period of cardiac muscle induced by catecholamines mar be considered as a partial factor in producing ventriculr fibrillaton and to be mediated by beta-adrenergic receptor.

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A Hybrid Forecasting Framework based on Case-based Reasoning and Artificial Neural Network (사례기반 추론기법과 인공신경망을 이용한 서비스 수요예측 프레임워크)

  • Hwang, Yousub
    • Journal of Intelligence and Information Systems
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    • v.18 no.4
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    • pp.43-57
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    • 2012
  • To enhance the competitive advantage in a constantly changing business environment, an enterprise management must make the right decision in many business activities based on both internal and external information. Thus, providing accurate information plays a prominent role in management's decision making. Intuitively, historical data can provide a feasible estimate through the forecasting models. Therefore, if the service department can estimate the service quantity for the next period, the service department can then effectively control the inventory of service related resources such as human, parts, and other facilities. In addition, the production department can make load map for improving its product quality. Therefore, obtaining an accurate service forecast most likely appears to be critical to manufacturing companies. Numerous investigations addressing this problem have generally employed statistical methods, such as regression or autoregressive and moving average simulation. However, these methods are only efficient for data with are seasonal or cyclical. If the data are influenced by the special characteristics of product, they are not feasible. In our research, we propose a forecasting framework that predicts service demand of manufacturing organization by combining Case-based reasoning (CBR) and leveraging an unsupervised artificial neural network based clustering analysis (i.e., Self-Organizing Maps; SOM). We believe that this is one of the first attempts at applying unsupervised artificial neural network-based machine-learning techniques in the service forecasting domain. Our proposed approach has several appealing features : (1) We applied CBR and SOM in a new forecasting domain such as service demand forecasting. (2) We proposed our combined approach between CBR and SOM in order to overcome limitations of traditional statistical forecasting methods and We have developed a service forecasting tool based on the proposed approach using an unsupervised artificial neural network and Case-based reasoning. In this research, we conducted an empirical study on a real digital TV manufacturer (i.e., Company A). In addition, we have empirically evaluated the proposed approach and tool using real sales and service related data from digital TV manufacturer. In our empirical experiments, we intend to explore the performance of our proposed service forecasting framework when compared to the performances predicted by other two service forecasting methods; one is traditional CBR based forecasting model and the other is the existing service forecasting model used by Company A. We ran each service forecasting 144 times; each time, input data were randomly sampled for each service forecasting framework. To evaluate accuracy of forecasting results, we used Mean Absolute Percentage Error (MAPE) as primary performance measure in our experiments. We conducted one-way ANOVA test with the 144 measurements of MAPE for three different service forecasting approaches. For example, the F-ratio of MAPE for three different service forecasting approaches is 67.25 and the p-value is 0.000. This means that the difference between the MAPE of the three different service forecasting approaches is significant at the level of 0.000. Since there is a significant difference among the different service forecasting approaches, we conducted Tukey's HSD post hoc test to determine exactly which means of MAPE are significantly different from which other ones. In terms of MAPE, Tukey's HSD post hoc test grouped the three different service forecasting approaches into three different subsets in the following order: our proposed approach > traditional CBR-based service forecasting approach > the existing forecasting approach used by Company A. Consequently, our empirical experiments show that our proposed approach outperformed the traditional CBR based forecasting model and the existing service forecasting model used by Company A. The rest of this paper is organized as follows. Section 2 provides some research background information such as summary of CBR and SOM. Section 3 presents a hybrid service forecasting framework based on Case-based Reasoning and Self-Organizing Maps, while the empirical evaluation results are summarized in Section 4. Conclusion and future research directions are finally discussed in Section 5.