• Title/Summary/Keyword: post-operation

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Design and Implementation of Problem Based Learning in Training Ship (PBL(Problem Based Learning) 수업 방법을 활용한 실습선 수업 설계 및 운영)

  • Kim, Bu-Gi;Kim, Noo-Ree;Kim, Jun-Ho;Choi, Hyun-Jun
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.25 no.6
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    • pp.743-748
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    • 2019
  • This study suggested a process of redesigning and implementing problem based learning to enhance students' active and collaborative learning activities and learning outcomes. The results of this study are as follows. First, the ef ect of class participation, academic self-regulated learning, and academic self-efficacy were examined. As a result, first, the average of learning activity, class extension, and participation in class was high in the difference between before and after class. Second, the post average scores of all the factors except the 'evaluation' were higher than before. Third, academic self-efficacy showed a significant difference only in 'task preference'. Finally, students' satisfaction with the class was also high. The professor was also able to grasp the characteristics of individual students by designing and operating the classes using PBL, and it was confirmed that the interaction with students increased. Based on the results of this study, we discussed the limitations and educational implications of the problem based learning class and propose successful problem based learning design and operation of the classroom.

Treatment of velopharyngeal insufficiency in a patient with a submucous cleft palate using a speech aid: the more treatment options, the better the treatment results

  • Park, Yun-Ha;Jo, Hyun-Jun;Hong, In-Seok;Leem, Dae-Ho;Baek, Jin-A;Ko, Seung-O
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.19.1-19.6
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    • 2019
  • Background: The submucous cleft palate (SMCP) is a type of cleft palate that may result in velopharyngeal insufficiency (VPI). Palate muscles completely separate oral and nasal cavities by closing off the velopharynx during functional processes such as speech or swallow. Also, hypernasality may arise from anatomical or neurological abnormalities in these functions. Treatments of this issue involve a combination of surgical intervention, speech aid, and speech therapy. This case report demonstrates successfully treated VPI resulted from SMCP without any surgical intervention but solely with speech aid appliance and speech therapy. Case presentation: A 13-year-old female patient with a speech disorder from velopharyngeal insufficiency that was caused by a submucous cleft palate visited to our OMFS clinic. In the intraoral examination, the patient had a short soft palate and bifid uvula. And the muscles in the palate did not contract properly during oral speech. She had no surgical history such as primary palatoplasty or pharyngoplasty except for tonsillectomy. And there were no other medical histories. Objective speech assessment using nasometer was performed. We diagnosed that the patient had a SMCP. The patient has shown a decrease in speech intelligibility, which resulted from hypernasality. We decided to treat the patient with speech aid (palatal lift) along with speech therapy. During the 7-month treatment, hypernasality measured by a nasometer decreased and speech intelligibility became normal. Conclusions: Surgery remains the first treatment option for patients with velopharyngeal insufficiencies from submucous cleft palates. However, there were few reports about objective speech evaluation pre- or post-operation. Moreover, there has been no report of non-surgical treatment in the recent studies. From this perspective, this report of objective improvement of speech intelligibility of VPI patient with SMCP by non-surgical treatment has a significant meaning. Speech aid can be considered as one of treatment options for management of SMCP.

STUDY OF PATENCY RATE IN VARIABLE MICROVASCULAR ANASTOMOSIS (다양한 방법으로 적용한 미세혈관문합술간의 개존율연구)

  • Kim, Uk-Kyu;Kim, Yong-Deok;Byun, June-Ho;Shin, Sang-Hun;Chung, In-Kyo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.29 no.5
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    • pp.349-357
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    • 2003
  • Several microvascular anastomotic techniques have been described with methodical effectiveness, patency rates, healing state of microscopic findings. This experimental study presents the comparison of three types of arterial microvascular anastomotic techniques: end-to-end(ETE) anastomosis, end-in-end(EIE) anastomosis, and continuous technique. Sixty male Sprague-Dawley rats, 60 femoral arteries were used for this study. Twenty rats per each technique were used and sacrificed at post-operation 1 day, 3 days, a week, 2 weeks for scanning electromicroscopic findings. The patency was monitored by miniDoppler throughout total experimental periods. The anastomotic time on each method was measured to compare the technical effectiveness. The final results were as follows: 1. The anastomotic time for the end-in-end technique was significantly shorter than another techniques. The average time for each technique was measured as 15 minutes on EIE technique, 20 minutes on continuous technique and 25 minutes on ETE technique. 2. The patency rate for the end-in-end technique at 2 weeks also was superior to another techniques. The patency rate for each technique was demonstrated as 90 % on EIE technique, 85 % on ETE technique and 80 % on continuous technique. 3. The scanning electromicroscopic findings on healing condition of vessel endothelium during the observation period showed that the end results of EIE technique, ETE technique and continuous technique in sequence were good. The end-in-end technique proved to be the superior with regard to anastomotic time and patency rate when compared to end-to-end technuqe, so EIE techniqe might be well available for the case of large discrepancy of vessel size. The patency rate, microscopic healing findings in continuous technique were seen as the lowest level among the three anastomotic techniques, therefore the application of continuous technique was recommended only on the inevitable case.

Efficacy of Ginger in Control of Chemotherapy Induced Nausea and Vomiting in Breast Cancer Patients Receiving Doxorubicin-Based Chemotherapy

  • Ansari, Mansour;Porouhan, Pezhman;Mohammadianpanah, Mohammad;Omidvari, Shapour;Mosalaei, Ahmad;Ahmadloo, Niloofar;Nasrollahi, Hamid;Hamedi, Seyed Hasan
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.8
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    • pp.3877-3880
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    • 2016
  • Nausea and vomiting are among the most serious side effects of chemotherapy, in some cases leading to treatment interruption or chemotherapy dose reduction. Ginger has long been known as an antiemetic drug, used for conditions such as motion sickness, nausea-vomiting in pregnancy, and post-operation side effects. One hundred and fifty female patients with breast cancer entered this prospective study and were randomized to receive ginger (500 mg ginger powder, twice a day for 3 days) or placebo. One hundred and nineteen patients completed the study: 57 of them received ginger and 62 received ginger for the first 3 chemotherapy cycles. Mean age in all patients was 48.6 (25-79) years. After 1st chemotherapy, mean nausea in the ginger and control arms were 1.36 (${\pm}1.31$) and 1.46 (${\pm}1.28$) with no statistically significant difference. After the $2^{nd}$ chemotherapy session, nausea score was slightly more in the ginger group (1.36 versus 1.32). After $3^{rd}$ chemotherapy, mean nausea severity in control group was less than ginger group [1.37 (${\pm}1.14$), versus 1.42 (${\pm}1.30$)]. Considering all patients, nausea was slightly more severe in ginger arm. In ginger arm mean nausea score was 1.42 (${\pm}0.96$) and in control arm it was 1.40 (${\pm}0.92$). Mean vomiting scores after chemotherapy in ginger arm were 0.719 (${\pm}1.03$), 0.68 (${\pm}1.00$) and 0.77 (${\pm}1.18$). In control arm, mean vomiting was 0.983 (${\pm}1.23$), 1.03 (${\pm}1.22$) and 1.15 (${\pm}1.27$). In all sessions, ginger decreased vomiting severity from 1.4 (${\pm}1.04$) to 0.71 (${\pm}0.86$). None of the differences were significant. In those patients who received the AC regimen, vomiting was less severe ($0.64{\pm}0.87$) comparing to those who received placebo ($1.13{\pm}1.12$), which was statistically significant (p-Value <0.05). Further and larger studies are needed to draw conclusions.

Surgical Treatment of Pulmonary Mucormycosis (폐 모균증의 외과적 치료)

  • Kim, Ju-Hyeon;Park, Seong-Sik;Sin, Yun-Cheol;Seong, Suk-Hwan
    • Journal of Chest Surgery
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    • v.29 no.3
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    • pp.350-354
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    • 1996
  • Pulmonary mucormycosis is a very rare but often fatal opportunistic fungal infection caused by the order Mucorales in class Zygomycetes. Reported overall mortality exceeds 70% and the diagnosis is often made post-mortem. We experienced 2 cases of typical form of pulmonary mucormycosis. One patient was a poorly controlled diabetic and the other suffered from acute Iymphocytic leukemia (ALL). The former was diagnosed by a bronchoscopic biopsy and the latter by a pathologic examination from the percutaneous drain of a subphrenic abscess. Both of them underwent a surgical excision of the involved lung tissue. The patient with diabetes mellitus was successfully treated by surgical resection and discharged without complications. The other with ALL underwent a second operation and was transferred to the department of internal medicine for further management of his relapse of lettkemia. Recent literat re suggests that early aggressive diagnostic effort and treatment including surgical resection in the case of localized forms of the disease results in a good prognosis.

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The Outcomes of Treatment for Sacrococcygeal Teratoma: The 24-year Experiences (엉치꼬리 기형종에 대한 24년 간의 치료 경험 분석)

  • Gong, C.S.;Kim, S.C.;Kim, D.Y.;Kim, I.K.;Namgung, J.M.;Hwang, J.H.;Kim, J.J.
    • Advances in pediatric surgery
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    • v.19 no.2
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    • pp.81-89
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    • 2013
  • The purposes of this study was to describe the clinical correlation of mass size and gestational age, prognostic factors in sacrococcygeal teratoma (SCT) at a tertiary pediatric surgery, University of Ulsan College of Medicine and Asan Medical Center (AMC), Seoul, Korea. Fifty five patients admitted to the AMC with a SCT between May 1989 and April 2013 were included in this retrospective review. Mean follow up was 861 days. Mean maternal age at delivery was $30{\pm}2.7$ year, mean gestational age (GA) was $36.9{\pm}3.6$ wks, and preterm delivery was 21.8%. Birth body weight was $3182{\pm}644$ g and male vs. female ratio was 1:2.05. We can't find significant difference between Caesarean section and maternal age at delivery (p =0.817). But, caesarean section was favored by gestational age (p = 0.002), larger tumor size (p =0.029) or higher tumor weight fraction rate to birth body weight (p =0.024). Type I was 13, II 21, III 17, and IV 3 according to Altman et al. classification. The tumor component was predominantly cystic(> 50%) in 73.1 %. And the majority histological classification of tumors were mature teratoma (70.3%). The motality rate was 5.5%. Three patients expired because of postpartum bleeding, post-op bleeding related complication such as DIC. SCT recurred in four patients. The interval between first and second operation was $206.2{\pm}111.0$ d (range 53~325 d). In two patients, serum AFP levels were elevated at a regular checkup without any symptom, and subsequent imaging studies revealed SCT. The most common cause of death was bleeding and bleeding related complication. So Caesarean section and active peripartum and perioperative management will be needed for huge solid SCT. In the case of Yolk sac tumor or huge immature teratoma, possibility of recurrence have to be always considered, so follow up by serial AFP and MRI is important for SCT management.

Post Discharge Nursing Needs of Patients with Open Heart Surgery (개심술 환자의 퇴원후 간호요구에 대한 조사연구)

  • 김명희
    • Journal of Korean Academy of Nursing
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    • v.23 no.4
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    • pp.664-677
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    • 1993
  • The purpose of this study was to provide basic data for the development of educational material in Korean for patient3 being discharge after open heart surgery. The subjects were 45 adult patients who were seen in the out -patient department of the thoracic surgery unit of P University hospital between February 1993 and May 1993. The data were collected through a chart review and interview. Nursing needs, and the patients status related to diet, activity, medication, physical and psychoemotional limitations were analyzed. The results are summarized as follows ; 1. Mitral valve replacement was the most frequent type of surgery(91.2%). In most cases, a mechanical valve was used (91.0%) . The duration of admission after the operation was two to four weeks for most of the patients(48.9%). The follow-up period was between one and two years for 28.9% of the patients and below 6 years for all of the patients. 2. Many Patients didn’t know the importance of a low salt diet(57.8%), and did not get any education on low salt diet (66.7%). Gimchi was included as one of the most commonly ingested foods (77.8%). All of the patients indicated nursing needs related to education about low salt diets and further they indicated a major interest in foods that are harmful (57.7%) or foods that are safe(51.1% ). 3. Most patients did not recognize the need for limitations on physical activity(84.4%). Further, 31.1% of them could not return to work at the time of the study. All patients had nursing needs related to physical activity, with the most frequent questions being about the permissble degree of activity and special cautions dictated by their illness (60.0%). 4. Many patients were ignorant of the necessity of medication(55.6%) . Forty percent of the patients were taking additional drugs, usually herb drugs. The time and duration of medication and the side effects of drugs were common concerns (57.7%) related to nursing. needs about medication and were mentioned by all of the patients. 5. All of the patients complained of physical discomfort including the following : memory disturbance(62.2%), weight gain(60.0%), chest tightness (55.6%), hair loss(51.1%), sleep disturbance(46.7%) and other symptoms in that order of frequency. Nursing needs related to physical condition were a concern for all of them. The viability and function of the replaced valve(53.3%) and weight gain(60.0%) were mal or concerns. 6. Looking at their psychoemotional condition it was found that 36 patients(80.0%) were emotionally unstable. The causes were physical discomfort(17 patients), insufficient knowlege of open heart surgery(6 patients), fear of death(6 patients), familial over protection(2 patients ) and lack of support (5 patients).

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Development of Water Quality Management System in Daecheong Reservoir Using Geographic Information System (GIS를 이용한 저수지의 수질관리시스템 구축)

  • 한건연;백창현
    • Spatial Information Research
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    • v.12 no.1
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    • pp.13-27
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    • 2004
  • The current industrial development and the increase of population in Daecheong Reservoir basin have produced a rapid increase of wastewater discharge. This has resulted in problem of water quality control and management. Although many efforts have been carried out, reservoir water quality has not significantly improved. In this sense, the development of water quality management system is required to improve reservoir water quality. The goal of this study is to design a GIS-based water quality management system for the scientific water quality control and management in the Daecheong Reservoir. For general water quality analysis, WASP5 model was applied to the Daecheong Reservoir. A sensitivity analysis was made to determine significant parameters and an optimization was made to estimate optimal values. The calibration and verification were performed by using observed water quality data for Daecheong Reservoir. A water quality management system for Daecheong Reservoir was made by connecting the WASP5 model to ArcView. It allows a Windows-based Graphic User Interface(GUI) to implement all operation with regard to water quality analysis. The proposed water quality management system has capability for the on-line data process including water quality simulation, and has a post processor far the reasonable visualization for various output. The modeling system in this study will be an efficient NGIS(National Geographic Information System) far planning of reservoir water quality management.

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A clinical study on the dental emergency patients visiting an University Hospital emergency room (대학병원 응급실로 내원한 치과 응급환자에 관한 임상적 연구)

  • Jang, Chang-Su;Lee, Chang-Yeon;Kim, Ju-Won;Yim, Jin-Hyuk;Kim, Jwa-Young;Kim, Young-Hee;Yang, Byoung-Eun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.6
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    • pp.439-447
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    • 2011
  • Introduction: In today's society, the rapid and appropriate care of the dental emergency patients is much more important. So, a retrospective study on the characteristics of emergency dental injuries and diseases will be very meaningful. Materials and Methods: This retrospective clinical study was carried by reviewing the radiographic films and emergency chart of 11,493 patients who had visited the emergency room of Hallym Sacred heart Hospital and were treated in the Department of Oral and Maxillofacial Surgery from January 2006 to December 2010. Results: The male to female ratio was 1.9:1. The highest monthly incidence was observed in May (10.4%) and June (8.9%) and the peak age distribution was the first decade (56.0%), followed by the second decade (16.0%). Trauma was the most common cause in dental emergency patients, followed in order by toothache, odontogenic infection, temporomandibular joint (TMJ) disorder and oral hemorrhage. Soft tissue injury was most prevalent in the trauma group, followed by tooth injury and facial bone fractures. In the tooth injury group, tooth fracture (56.7%) showed the highest incidence followed in order by tooth subluxation (18.2%), tooth concussion (16.9%), tooth avulsion (11.5%) and alveolar bone fractures (3.7%). In the facial bone fracture group, mandibular fractures (81.8%) showed the highest incidence followed in order by maxilla fractures (15.7%), nasal bone fractures (9.0%), zygomaticomaxillary complex fractures (5.4%), orbital bone fractures (2.5%). In mandibular bone fractures, the most common location was the symphysis (70.1%), followed in order by the mandibular angle (33.0%), mandibular condyle (22.8%) and mandibular body (13.6%). In the infection group, a submandibular space abscess (46.2%) was most common followed in order by a buccal space abscess (17.4%), canine space abscess (16.9%) and submental space abscess (12.3%). TMJ dislocation (89.3%) showed the highest incidence in the TMJ disorder group, followed by TMJ derangement (10.7%). In the other group, a range of specific symptoms due to post operation complications, trigeminal neuralgia, chemical burns and foreign body aspiration were reported. Conclusion: For the rapid and appropriate care of the dental emergency patients, well-organized system should be presented in oral and maxillofacial surgery. And it is possible under analysis of pattern and the variation of the dental emergency patients.

A Study on the Improvement of Pedestrian Environment for Greenways Construction (그린웨이 구축을 위한 보행환경 개선방안)

  • Han, Yujin;Kang, Junmo
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.31 no.1D
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    • pp.157-166
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    • 2011
  • This study is to mention necessity of building Green-way by foreign theoretical backgrounds and analyzing cases of internal and external, and is purposed on assessment of projects in operation internal by above necessity. For these assessments, looking into cases of green-way plan of external and defining issues by comparing with internal cases to suggest solutions. Green-way planning methods can be classified in physical and non-physical aspects. From among these, for case of non-physical method, its environments of each nation, region, local are all different from each other and can not be turned into a numerical value and quantification, as well. Therefore, analyzing and suggesting the directions on the basis of physical method. Understanding the improvements degree of physical environment of before and after implementation of projects by using successful cases of external similar to actual state of internal. By these process, inflecting to suggest a seek way of applied to internal projects. Local aspects, doesn't have the specific analyzed data of improvement of pedestrian environment and building green-way and are shortage of implementation of projects also. For that reason this study is to look into the status and plans of building green-way in Seoul and analyzing the 7 completed region cases. And suggesting issues of projects and the direction of national and local green-way projects.