• 제목/요약/키워드: medical management

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Clinical Manifestations in Orofacial Movement Disorders (구강안면 운동장애의 임상적 증상 발현)

  • Ryu, Ji-Won;Yoon, Chang-Lyuk;Cho, Young-Gon;Ahn, Jong-Mo
    • Journal of Oral Medicine and Pain
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    • 제33권4호
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    • pp.375-382
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    • 2008
  • This study was a preliminary study to establish diagnostic criterias and treatment for Orofacial Movement Disorders. The 33 Orofacial Movement Disorder patients who were visited in the department of Oral Medicine from September, 2007 to December, 2007 were selected for this study. We analyzed the age, sex, systemic diseases, the diagnosis and the cause of the patients' chief complaints, the self-consciousness and the types of orofacial movements. The obtained results were as follows : 1. Female were predominant in orofacial movement disorders(81.82% vs 18.18%) and mean age was 78.78(56 to 87) years. 2. They almost had systemic diseases(81.82%). Hypertenstion was the most common disease(22.41%) and diabetes mellitus(17.24%), depression(8.62%), gastritis(8.62%) in turns. 3. In clinical manifestation, temporomandibular disorder was the most frequently complained symptom(33.33%), and soft tissue disease(21.57%), burning mouth syndrome(17.65%), orofacial movement itself(15.69%), diffuse orofacial pain(6명, 11.76%) in turns. 4. Most orofacial movement disorders are idiopathic(72.73%), and related to prosthetic treatment(24.24%), related to antidepressant medication(3.03%) in turns. 5. The jaw-closing type was the most common type of orofacial movement disorders, and lateral type(33.33%), jaw-opening types(16.67%) in turns. 6. There were more patients who did not conscious of their orofacial movements than those who did.(54.55% vs 45.45%). In conclusion, dentists must be consider the orofacial movement disorders in patients who have orofacial pain. Also, dentists should obtain a proper history and perform a clinical examination to avoid misdiagnosis and inappropriate, irreversible treatment.

Clinical Investigation of Women with Asthma Worsened During Pregnancy (임신 중 천식의 악화로 내원한 환자의 임상적 고찰)

  • Kwon, Young-Hwan;Kim, Kyung-Kyu;Jung, Hye-Cheol;Lee, Sung-Yong;Kim, Je-Hyeong;Lee, So-Ra;Lee, Sang-Yeub;Lee, Sin-Hyeong;Cho, Jae-Yun;Shim, Jae-Jeong;Kang, Kyung-Ho;Yoo, Se-Hwa;In, Kwang-Ho
    • Tuberculosis and Respiratory Diseases
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    • 제46권4호
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    • pp.548-554
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    • 1999
  • Background : Asthma is the most common respiratory crisis encountered in clinical practice, occurring in up to 4% of all pregnancies. Pregnancy often appears to alter the course of asthma. But the mechanisms responsible for variable changes in the asthma course during pregnancy remain unknown. Poor control and exacerbations of asthma during pregnancy may result in serious maternal and fetal complications. To investigate the course of asthma during pregnancy in korean women, we did a retrograde study of 27 pregnant women who had been admitted to Korea University Hospital for asthma worsened. Method: Twenty seven pregnant women who had been visited to Korea University Hospital for asthma worsened were enrolled in our retrospective study. We reviewed medical recordings and interviewed patients with asthma. Results: Twenty seven pregnant women with asthma were evaluated, and 25 patients were enrolled to our study. Two patients experienced abortions at 6 weeks and 25 weeks gestation, respectively. The period of asthma worsened was commonly during weeks 20 to 28 of gestation. And all patients wosened were improved during the last 4 weeks of pregnancy. Twenty(80%) of 25 women whose asthma worsened during pregnancy reverted toward their prepregnancy status after delivery(p<0.002). The causes of asthma worsened during pregnancy are reduction or even complete cessaton of medication due to fears about its safety(40%), worsening after upper respiratory infection (28%), and unknown(32%). There were no adverse perinatal outcomes in 25 pregnant asthma subjects. Conclusions: A major problem of therapy for asthma during pregnancy is reduction or even complete cessation of medication due to fears of fetal effects. Therefore, maternal education and optimal clinical and pharmacologic management is necessary to mitigate maternal and fetal complications.

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Clinical Effects of Prothinoamide, Cycloserine, Para-Aminosalicylic Acid, Ofloxasine in Retreatment of Pulmonary Tuberculosis (폐결핵 재치료 환자에서 Prothionamide, Cycloserine, Paraminosalicylic acid, Ofloxasine을 이용한 경구 4제 요법의 임상 효과)

  • Hong, Jae-Rak;Yoo, Min-Kyu;Jeong, Jae-Man;Kim, Young-Jun;Son, Mal-Hyeon
    • Tuberculosis and Respiratory Diseases
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    • 제43권5호
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    • pp.693-700
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    • 1996
  • Background : Antituberculous therapy is set a short-term therpy used isoniazid(INH), rifampin(RFP), ethambutol(EMB), pyrazinamide(PZA) from 1970s' and treatment rate has been very improved. But drug interruption or irregular medication due to side effects and resistance of drug are serious problem to retreatment cases, specially. Ofloxasine(OFX), developed from Quinolone at 1980's is effective not only other respiratory infectious disease but also pulmonary tube rculosis. And this is useful drug instead of injection agents for retreatment patients who have side effects to other drugs, lived far distance from medical clinics. So, we will evaluate theffectiveness as four oral drugs involving OFX. Method : A retrospective study was made through the regular follow up of smear positive cases,who treated by four drug, namely, prothionamide (PTA) cycloserine(CS), OFX, paraminosalicylic acid(pAS). Results: 1) Out of 66case with positive sputum AFB smear, 42(64%)cases achieved the negative conversion. 2) Considering the negative conversion in all group, 34 case (52%) of sputum conversion occured within first 6 months, on the extent of diease was minimal, moderate, far advanced pulmonary tuberculosis, sputum AFB smear negative response to treatment was 100%, 78%, 46% respectively. 3) The roentgenological improvement occured in 38(58%), extent of diease was minimal, moderately, far advanced pulmonary tuberculosis, Roentgenological improvement to retreatment was 75%, 64%, 46%. 4) When the drnation of patients illness was less than 1 year, 1 to 3 years, 3 10 5 years and more than 5 years, sputum AFB smear negative response to retreatment was 100%, 88%, 80%, 52 %. 5) On side effects, major problems are gastrointestinal troubles, mild liver function abnormality, psychotic problemes, and skin problem(urticaria, itching sensation). Conclusion : The duration & extents of patients illness was shorter & minimal, sputum AFB smear negative response rate was better. Radiologic response is better as shorter duration and minimal extent of diease. But, as diease is longer duration & far advanced, sputum negative conversion & Roentgenological improvement is poor and limited. The adverse reaction was mainly observed gastrointestinal troubles(indigestion, abdominal pain, nausea, vomiting, diarrhea) and are well controled by symptomatic management in most patients, as regard to tolerance to the secondary drugs.

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Risk Factors of Recurrent Hemoptysis after Bronchial Artery Embolization (기관지동맥 색전술 후 객혈의 재발에 관한 연구)

  • Chung, Wou Young;Byun, Min Kwang;Park, Moo Suk;Hahn, Chang Hoon;Kang, Shin Myung;Lee, Do Yon;Kim, Young Sam;Kim, Se Kyu;Kim, Sung Kyu;Chang, Joon
    • Tuberculosis and Respiratory Diseases
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    • 제60권1호
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    • pp.65-71
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    • 2006
  • Background : Hemoptysis, when massive and untreated, has a mortality rate of over 50 percents, is considered as one of most dreaded of all respiratory emergencies and can have a variety of underlying causes. Bronchial artery embolization (BAE) has become an established procedure in the management of massive and recurrent hemoptysis, and its efficacy is widely documented thereafter by number of articles. However, the long-term success rate of BAE is known to be unfavorable. Risk factors influencing that control failure are inevitably needed. Materials and methods : Seventy-five patients underwent bronchial artery embolization due to massive hemoptysis in Severance Hospital from Jan. 2000 to Jan. 2005. Nine patients' data were not available and could not be contacted with. Finally 66 patients' (48 males, 18 females) medical records were analyzed retrospectively during a mean follow up period of 20.4 months (ranging from 1 month to 54 months). Results : Among 66 patients whose data were available, 23(34.9%) patients had recurrent major hemoptysis. Patients' age, sex, underlying disease, previous intervention history, and number of feeding vessels had no statistical validity as risk factors of recurred major hemoptysis. But bilaterality of lesion, amount of hemoptysis, and pleural thickening were revealed as meaningful factors for predicting relapse (p = 0.008, 0.018, and 0.001, respectively). Conclusion : According to our series, patients presenting with larger amount of hemoptysis, pleural thickening of chest radiography and bilateral lesion are associated with increased risk of major hemoptysis in patients treated with BAE.

Mitral Valve Reconstruction in Patients with Moderate to Severe Left Ventricular Dysfunction (중등도 이상의 좌심기능부전 환자에서 승모판성형술)

  • Baek, Man-Jong;Na, Chan-Young;Oh, Sam-Sae;Kim, Woong-Han;Whang, Sung-Wook;Kim, Soo-Cheol;Lim, Cheong;Kim, Wook-Sung;Lee, Young-Tak;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • 제36권11호
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    • pp.812-819
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    • 2003
  • Background: Left ventricular dysfunction is one of the important prognostic factors of early mortality and long-term survival after valve operation. We studied the intermediate term results of mitral valve reconstruction in patients with moderate to severe left ventricular dysfunction. Material and Method: Forty four patients who underwent mitral valve reconstruction with a left ventricular ejection fraction (EF) of <45% or less (20∼45%) from April 1995 through July 2001 were reviewed retrospectively. Ages ranged from 10 to 67 years (46∼14 years) and 32 patients were in NYHA class III-IV. The mitral valve diseases were regurgitation (MR) in 28 patients, stenosis(MS) in 10, and mixed lesion in 5. The etiologies of mitral valve disease were rheumatic in 20 patients, degenerative in 14, ischemic in 5, annular dilatation in 2, congenital in 2, and endocarditis in 1. Operatively, all patients had annuloplasty and/or various valvuloplasty techniques, and a total of 52 procedures were concomitantly performed. Total cardiopulmonary bypass and aortic crossclamp time were 160$\pm$57 minutes and 112$\pm$45 minutes respectively. Result: Two operative deaths occurred as a result of left ventricular failure (4.5%). After the mean follow-up of 39 months (range, 10∼83 months), there was no late death. Transthoracic echocardiography revealed no or grade I of MR in 29 patients (72.5%) and no or mild MS in 35 patients (87.5%). The actuarial survival at 5 years was 100%. Four patients required mitral valve replacement due to progressive mitral valvular disease. The actuarial freedom from valve-related reoperation at 5 years was 84$\pm$9%. Conclusion: This study suggests that mitral valve reconstruction in patients with moderate to severe left ventricular dysfunction offers good early and intermediate survival and acceptable freedom from valve-related reoperation, and it is the strategy for effective management for these patients.

An analysis on the characteristics of Sa-sang constitution - centering on the body measures and diagnosis results - (신체계측(身體計測) 및 검사소견(檢査所見)을 중심으로 한 사상인(四象人)의 특징(特徵)에 대한 분석(分析))

  • Lee, Su-Kyung;Lee, Ui-Ju;Hong, Seok-Cheol;Ko, Byung-Hee
    • Journal of Sasang Constitutional Medicine
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    • 제8권1호
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    • pp.349-376
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    • 1996
  • In orther to find the characteristics of each constitution, the examinee of Kyung Hee medical center was diagnosed constitution, and resulted body measures and diagnosis. That was considered and the results are as follows 1. The Diagnosis result of Sa-sang Constitutional Medicine is that there are 110 persons of Taeum-In(56. 1%), 58 persons of Soum-In(29.6%), 28 persons of Soyang-In(14. 3%). 2. The distribution of occupation, there are many of Taeum-In who are engaged in business, administeration, and management and many of Soeum-In who are engaged in reserch. 3. QSCC(I) has a tendency that other constitutions diagnose to Taeyang-In, the quastionare 1 has the accuracy of 76. 4% to diagnose Soeum-In. 4. Taeum-In sweats easily but Soeum-In doesn't sweat easily, Taeum-In has a good appetite and likes cold food and digests well, but Soeum-In has a poor appetite and like hot food and digest poorly. 5. The degree of obesity is the highest in Taeum-In. 6. The systoric blood pressure and diastolic blood pressure is high in Taeum-In and the high blood pressure are frequent in Taeum-In. 7. Triglyceride is the highest in Taeum-In and the Hyperlipidemia is the most frequent in Taeum-In, but Total cholesterol has no difference among constitutions. 8. GPT GGT is higher in Taeum-In than Soyang-In, but GOT has no difference among constitutions. 9. The frequency of fatty liver is the highest in Taeum-In.

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Radiation Therapy Results of Invasive Cervical Carcinoma Found After Inappropriate Hysterectomy (부적절한 수술루 침윤성 자궁경부암의 방사선치료 결과)

  • Choi Doo Ho;Kim Eun Seog;Nam Kae Hyun;Huh Seung Jae
    • Radiation Oncology Journal
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    • 제14권3호
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    • pp.211-219
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    • 1996
  • Purpose : Hysterectomy without lymph node dissection was considered an inadequate treatment method for invasive uterine cervix cancer. Usually the procedure was performed inadvertently on patients who were thought to have benign or premalignant conditions preoperatively. We analysed radiotherapy results of such patients to evaluate survival rates, failure patterns and prognostic factors according to various conditions. Materials and Methods : Sixty one patients undergoing hysterectomy in the presence of invasive cervical carcinoma were reviewed retrospectively. Preoperative diagnosis were carcinoma in situ (38 cases), severe dysplasia (2), myoma (6), uterine bleeding (4), uterine prolapse (2). and early invasive cervix cancer (10) (One patient had myoma and carcinoma in situ coincidently). Patients received postoperative megavoltage radiotherapy from August 1985 to December 1993, and minimum follow-up period was 24 months. Eight patients received ICR only, 6 patients ICR and external radiation, and 47 patients received external radiation therapy only. Results : Overall 5-year survival rate and relapse-free survival rate werer $83.8\%$, $86.9\%$ respectively. For patients with retrospective stage IA, IB, IIB (gross residual after surgery), and vaginal cuff recurrence were $90.9\%$, $88.8\%$, $38.4\%$, and $100\%$ respectively There were 8 cases of treatment failure, most of them (5/8) were in patients with gross residual disease, other patients were full thickness involvement of cervix wall (2/8) except one. Patients with early vaginal cuff recurrence and microinvasive cervical cancer (stage IA) had no treatment related failure Prognostic factors affecting survival by univariate analysis were status of residual disease, tumor histology and retrospective stage. Conclusion : Adjuvant radiotherapy appeared to be effective treatment method for patients with presumed stage IA, IB and early local recurrent disease after inadvertent hysterectomy Survivals for patients with gross disease remained after inappropriate hysterectomy was poor, So, early cancer detection and Proper management with precise pretreatment s1aging is necessary to avoid inadherent hysterectomy especially in the cases of gross residual disease.

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Can 3-year Disease-free Survival be Substituted for 5-year Overall Survival in Curatively Resected Gastric Cancer? (치유 절제술을 받은 위암 환자에서의 3년 무병생존이 5년 전체생존을 대치할 수 있는가?)

  • Kwon, Sung-Joon;Kim, Hyoung-Ju;Kim, Mi-Kyung
    • Journal of Gastric Cancer
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    • 제5권3호
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    • pp.174-179
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    • 2005
  • Purpose: The 5-year survival rate is the most useful parameter for evaluating the effect of management on most malignant tumors. Recurrence after a curative resection for gastric cancer occurs mostly within 3 years of the operation, which caused us to evaluate whether a 3-year disease-free survival (3DFS) can be substituted for a 5-year overall survival (5OS). Materials and Methods: We reviewed the medical records of 656 consecutive patients who had undergone a curative resection for gastric cancer To assess whether 3DFS represents 5OS, we used a simple linear regression with survival probability calculated by using the survival function. Results: Recurrence was found in 175 cases during the follow-up periods. The accumulative frequencies of recurrence at postoperative 1 year, 3 years, and 5 years were 46% (81 cases), 89% (156 cases), and 97% (170 cases), respectively. The correlation coefficient (r) and the coefficient of determination $(r^2)$ between 3DFS and 5OS were 0.87 and 0.76, respectively, and the regression equation was $5OS=0.18+(0.80{\times}3DFS)$. The r and $R^2$ according to the type of recurrence were 0.89 and 0.80 in peritoneal seeding, 0.88 and 0.78 in hematogeneous metastasis, and 0.86 and 0.73 in local recurrence, respectively. The r (0.77) and $r^2$ (0.60) were relatively lower in low stages (stage I and II) compared to r (0.88) and $r^2(0.77)$ in high stages (stage III and IV). Conclusion: The 3DFS is an excellent predictor of 5OS. Therefore, if we use the former as the treatment evaluating method, 2-year time reduction in assessing and reporting treatment results is expected.

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Healthy Korea 2010 : Role of the Health Educator (Healthy Korea 2010추진과 보건교육 인력 활용 전략)

  • Choi, Eun-Jin
    • Proceedings of The Korean Society of Health Promotion Conference
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    • 한국보건교육건강증진학회 2004년도 국제학술대회
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    • pp.89-109
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    • 2004
  • The Korean Government has produced the Health Plan 2010 aimed at setting up healthy Korea objectives, policies on preventing chronic diseases, reshaping the country's health and medical infrastructure. The policy goal targets the people's healthy life expectancy at 75 by 2010, and includes healthy life practice measures including health education, health improvement services, and disease management measures, in achieving the objectives. Also, the plan provides life cycle-based health improvement and disease prevention services, as well as pushes ahead with projects with greater ripple effects in each area. To this end, the government is simultaneously pushing to operate an experts-centered health promotion committee and establishing the infrastructure including the augmentation of national health improvement funds. Through its Health Plan 20 I 0, the Korean Government will exert efforts to achieve its policy objectives as addressed in the measures by enhancing the national potential health and providing systematic disease prevention services.

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Clinical Investigation of Childhood Epilepsy (소아간질의 임상적 관찰)

  • Moon, Han-Ku;Park, Yong-Hoon
    • Journal of Yeungnam Medical Science
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    • 제2권1호
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    • pp.103-111
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    • 1985
  • Childhood epilepsy which has high prevalence rate and inception rate is one of the commonest problem encountered in pediatrician. In contrast with epilepsy of adult, in childhood epilepsy, more variable and varying manifestations are found because the factors of age, growth and development exert their influences in the manifestations and the courses of childhood epilepsy. Moreover epileptic children have associated problems such as physical and mental handicaps, psychologicaldisorders and learning disability. For these reasons pediatrician who deals with epileptic children experiences difficulties in making diagnosis and managing them. In order to improve understanding and management of childhood epilepsy, authors reviewed 103 cases of epileptic patients seen at pediatric department of Yeungnam University Hospital retrospectively. The patients were classified according to the type of epileptic seizure. Suspected causes of epilepsy, associated conditions of epileptic patients, age incidence and the findings of brain CT were reviewed. Large numbers of epileptic patients (61.2%) developed their first seizures under the age of 5. The most frequent type of epileptic seizure was generalized ionic-clonic, tonic, clonic seizure (49.5%), followed by simple partial seizure with secondary generalization (17.5%), simple partial seizure (7.8%), a typical absence (5.8%) and unclassified seizure (5.8%). In 83.5% of patients, we could not find specific cause of it, but in 16.5% of cases, history of neonatal hypoxia (4.9%), meningitis (3.9%), prematurity (1.9%), small for gestational age (1.0%), CO poisoning (1.0%), encephalopathy (1.0%), DPT vaccination (1.0%), cerebrovascular accident (1.0%) and neonatal jaundice (1.0%) were found, 30 cases of patients had associated diseases such as mental retardation, hyperactivity, delayed motor milestones or their combinations. The major abnormal findings of brain CT performed in 42 cases were cortical atrophy, cerebral infarction, hydrocephalus and brain swelling. This review stressed better designed classification of epilepsy is needed and with promotion of medical care, prevention of epilepsy is possible in some cases. Also it is stressed that childhood epilepsy requires multidisplinary therapy and brain CT is helpful in the evaluation of epilepsy with limitation in therapeutic aspects.

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