“Clinical Practice Guideline for Stroke Rehabilitation in Korea 2016” is the 3rd edition of clinical practice guideline (CPG) for stroke rehabilitation in Korea, which updates the 2nd edition published in 2014. Forty-two specialists in stroke rehabilitation from 21 universities and 4 rehabilitation hospitals and 4 consultants participated in this update. The purpose of this CPG is to provide optimum practical guidelines for stroke rehabilitation teams to make a decision when they manage stroke patients and ultimately, to help stroke patients obtain maximal functional recovery and return to the society. The recent two CPGs from Canada (2015) and USA (2016) and articles that were published following the 2nd edition were used to develop this 3rd edition of CPG for stroke rehabilitation in Korea. The chosen articles' level of evidence and grade of recommendation were decided by the criteria of Scotland (2010) and the formal consensus was derived by the nominal group technique. The levels of evidence range from 1++ to 4 and the grades of recommendation range from A to D. Good Practice Point was recommended as best practice based on the clinical experience of the guideline developmental group. The draft of the developed CPG was reviewed by the experts group in the public hearings and then revised. “Clinical Practice Guideline for Stroke Rehabilitation in Korea 2016” consists of ‘Chapter 1; Introduction of Stroke Rehabilitation’, ‘Chapter 2; Rehabilitation for Stroke Syndrome, ‘Chapter 3; Rehabilitation for Returning to the Society’, and ‘Chapter 4; Advanced Technique for Stroke Rehabilitation’. “Clinical Practice Guideline for Stroke Rehabilitation in Korea 2016” will provide direction and standardization for acute, subacute and chronic stroke rehabilitation in Korea.
Canada ; Consensus ; Consultants ; Humans ; Korea* ; Practice Guidelines as Topic ; Rehabilitation* ; Scotland ; Specialization ; Stroke*

Most ingested foreign bodies pass readily throughout intestinal tract if they reach the stomach. In some cases, foreign bodies may be impacted behind a luminal constriction but are rare in colon. Here, we report the case of a 59-year-old man who did laparoscopic anterior resection due to sigmoid colon cancer 2 years ago and ischemic colitis was repeated on the anastomosis site. He initially presented with symptoms of abdominal pain 3 months before and melena 1 day before admission. Abdomen computerized tomography showed a 3.2 cm segment of luminal narrowing of the proximal colon involving upstream foreign material stasis. Sigmoidoscopic approaches revealed near complete obstruction on the anal verge of 20 cm and scope passing failed. Balloon dilatations were done on the obstruction site four times all and a foreign body impacted above the obstruction site was removed by an alligator without any complications. The foreign body removed looks like plastic or a shell, about 20 mm in size.
Abdomen ; Abdominal Pain ; Alligators and Crocodiles ; Colitis, Ischemic ; Colon* ; Constriction ; Constriction, Pathologic* ; Dilatation* ; Foreign Bodies* ; Humans ; Melena ; Middle Aged ; Phenobarbital ; Plastics ; Sigmoid Neoplasms ; Stomach

"Clinical Practice Guideline for Stroke Rehabilitation in Korea 2012" is a 2nd edition of clinical practice guideline (CPG) for stroke rehabilitation in Korea, which updates the 1st edition published in 2009. After 1st stroke rehabilitation CPG, many studies concerning stroke rehabilitation have been published and the necessity for update has been raised. The Korea Centers for Disease Control and Prevention supported the project "Development of Clinical Practice Guideline for Stroke Rehabilitation" in 2012. Thirty-two specialists in stroke rehabilitation from 18 universities and 3 rehabilitation hospitals and 10 consultants participated in this project. The scope of this CPG included both ischemic and hemorrhagic stroke from the acute to chronic stages. The purpose of this CPG is to provide guidelines for doctors and therapists to make a decision when they manage stroke patients and ultimately, to help stroke patients obtain maximal functional recovery and return to the society. "Clinical Practice Guideline for Stroke Rehabilitation in Korea 2012" consists of 'Chapter 1; Introduction of Stroke Rehabilitation', 'Chapter 2; Rehabilitation for Stroke Syndrome, 'Chapter 3; Rehabilitation for Return to the Society', and 'Chapter 4; Advanced Technique for Stroke Rehabilitation'. Both the adaptation and de novo development methods were used to develop this 2nd edition of CPG. The appraisal of foreign CPGs was performed using 'Korean appraisal of guidelines for research and evaluation II' (K-AGREE II); moreover, four CPGs from Scotland (2010), Austrailia (2010), USA (2010), Canada (2010) were chosen for adaptation. For de novo development, articles that were published following the latest foreign CPGs were searched from the database system, PubMed, Embase, and Cochrane library. Literatures were assessed in the aspect of subjects, study design, study results' consistency, language and application possibility in the Korean society. The chosen articles' level of evidence and grade of recommendation were decided by the criteria of Scotland (2010) and the formal consensus was derived by the nominal group technique. The levels of evidence range from 1++ to 4 and the grades of recommendation range from A to D. GPP (Good Practice Point) was recommended as best practice based on the clinical experience of the guideline developmental group. The draft of the developed CPG was reviewed by the experts group in the public hearings and then revised.
Canada ; Centers for Disease Control and Prevention (U.S.) ; Consensus ; Consultants ; Humans ; Korea* ; Practice Guidelines as Topic ; Rehabilitation* ; Scotland ; Specialization ; Stroke*

OBJECTIVES: This study investigated on the severity of dry mouth in the hansen people and the association between dry mouth(low, moderate and high) with pre and post wearing denture satisfaction. METHODS: Data were obtained from a cross-sectional survey of 104 hansen people(mean age=69.3). Data were collected by means of a personal interview from April 30 through to Jane 20, 2014. Pre and post wearing denture satisfaction was measured by the 24-items and dry mouth was measured by the 4-items. The data was analysed with t-test, One-way ANOVA, and Logistic regression using the SPSS program. RESULTS: Regarding perception of dry mouth, the subjects achieved a mean of 6.13 out of a maximum 12 points. Scores were categorised as high(8~12), medium(5~7) or low(1~4) and the proportion were 24.5%(9.56), 42.2%(5.81) and 33.3%(4.00) respectively. Those who were older and had fewer natural teeth felt that their perception of dry mouth was more severe. A logistic regression analysis showed that the subjects perception of dry mouth had a significant impact on their gender (OR=2.73), comfort (OR=0.21), aesthetic appreciation (OR=7.56) satisfaction. CONCLUSIONS: Based on the findings, the perception of dry mouth has a significant and negative impact on denture satisfaction. These results suggest that oral health promotion should be considered various factors related dry mouth in the elderly with removable denture.
Aged ; Cross-Sectional Studies ; Dentures* ; Humans ; Logistic Models ; Mouth* ; Oral Health ; Tooth

Although compressed gas (CO2) blowers have been used safely to aid accurate grafting during off-pump coronary bypass surgery, hemodynamic collapse due to gas embolism into the right coronary artery may occur. Supportive measures to facilitate gas clearance by increasing the coronary perfusion pressure have been reported to be successful in restoring hemodynamic stability. However, right ventricular dysfunction and atrioventricular nodal ischemia may hinder effective systemic delivery of the vasoactive medications, even when performing resuscitative measures such as direct cardiac massage. We herein report a case of cardiac arrest that was caused by a right coronary gas embolism and that could not be restored by cardiac resuscitation. When supportive measures fail, direct aortic injection of epinephrine to increase the coronary perfusion pressure can be attempted before initiating cardiopulmonary bypass, and this approach may be life-saving in situations that limit systemic drug delivery from the venous side despite the performance of direct cardiac massage.
Aorta ; Cardiopulmonary Bypass ; Coronary Artery Bypass, Off-Pump ; Coronary Vessels ; Embolism* ; Embolism, Air ; Epinephrine* ; Heart Arrest* ; Heart Massage ; Hemodynamics ; Ischemia ; Perfusion ; Resuscitation* ; Transplants ; Ventricular Dysfunction, Right

BACKGROUND & OBJECTIVE: The purpose of this study is to prove the effectiveness of professional maintenance care to the periodontal disease by non-surgical approach with the toothpick method to improve the periodontal health. METHODS: The patients of this study were composed of 46 patients( 18 men and 28 women), suffering from chronic adult periodontitis, who had visited the department of dental clinic center. All of the subjects were over 50years old and be treated just by non-surgical method. Professional maintenance care using the toothpick method was performed every 3 months, and evaluations were also done after 1, 2, and 3 year-professional maintenance care based on the indices such as plaque index(O' Leary index), periodontal probing pocket depth, bleeding on probing, tooth mobility, the number of tooth loss, and the rate of tooth loss representing the state of periodontal health. RESULTS: 1. The longer the maintenance care, the more the effectiveness of controlling plaque. The rate of decrease in the dental plaque index was 1.5%, 4.2%, and 6.5% in 1, 2, and 3 year maintenance groups respectively(P>0.05). 2. The periodontal pocket depth decreased depends on the severity of periodontal pocket depth in all groups the maintenance years(P<0.05). 3. On the evaluation of the bleeding tendency on probing, there was a significant difference in 1 year- maintenance group(P<0.05), but the other groups did not show any difference statistically(P>0.05). 4. Tooth mobility has decreased in the maintenance years, but did not show any difference statistically(P>0.05). 5. The number and the rate of tooth loss among the patients of 1year-maintenance group was 0.38, 1.44% respectively and that of 3 year-maintenance group was 0.44, 1.73% each. CONCLUSION: The results of this study mentioned above suggest that professional maintenance care should be operated effectively to prevent and to maintain the periodontal disease systematically on the purpose of proving the quality of life, and that it could be applied to the medical insurance system in other to try to make the most of the adult oral health care positively.
Adult ; Chronic Periodontitis ; Dental Clinics ; Dental Plaque Index ; Hemorrhage ; Humans ; Insurance ; Male ; Methods ; Oral Health ; Periodontal Diseases* ; Periodontal Pocket ; Periodontitis ; Quality of Life ; Tooth Loss ; Tooth Mobility

The upper and the lower master models of Class II mod.1 by the Kennedy of classification were duplicated to the dentists in the dental clinic Suncheon, and the status of the surveying procedure, the form and type of the major connector, the form and type of the direct retainer, the location and status of the indirect retainer, and the modification of abutment were surveyed and analyzed and were compared to the principles of the design rationale of the removable partial denture to evaluate whether or not each component of the removable partial denture framework designed by the dentists. The analyzed results were as follows: 1. The status with or without the surveying procedure was showed 7 cases(10.29%) and 61 cases(89.71%) respectively. 2. Single palatal strap, A-P bar, broad palatal plate, complete coverage palatal major connector, single palatal bar, U-shaped palatal connector, and the others without drawing of the major connector were 27 cases (38.57%), 25 cases(35.71%), 5 cases(7.01%), 4 cases(5.71%), 2 cases (2.86%), 1 cases(1.43%), 6 cases(8.57%) respectively in the design patterns of the maxillary major connectors, and lingual bar, linguoplate, and others without drawing of the major connector were 55 cases(80.88%), 11 cases(16.18%), 2 cases(2.84%), respectively in the pattern of the mandibular major connectors. 3. The direct retainer designed to the 1st bicuspid of the upper left and the lower right adjacent to the free-end edentulous area was that the design of bar clasp was 67.41% in the highest rate and that of Akers clasp was 23.36%. 4. The direct retainer designed to the 1st bicuspid of the upper right and the lower left was that the of Akers clasp was 56.62% in the highest rate and that of bar clasp was 33.82%. 5. The mesial rests of the 1st bicuspid of the upper left and the lower right adjacent to the free-end edentulous area were 77.46%, 66.20% respectively and the distal rests and mesial rests of the 1st bicuspid of the upper left and the lower right were 58.82%, 55.71%, 38.24%, 38.57% respectively and the mesial rests of the 2nd molar of the upper right and the lower left were 95.71%, 95.65% respectively, viewed from the location of the occlusal rest seat. 6. The cases without the design of the indirect retainer were 51.47% in the upper and the lower master models respectively. 7. The modification of abutments(surveyed crown) of upper and lower teeth were 8.82%, 8.82% respectively.
Bicuspid ; Dental Clinics ; Dentists ; Denture, Partial, Removable ; Humans ; Leprosy ; Molar ; Tooth

BACKGROUND/AIMS: The meaning of specialized intestinal metaplasia (SIM) in the diagnosis of Barrett's esophagus (BE) is not clear. This study was designed to determine the clinical significance of SIM in the diagnosis of Barrett's esophagus. MATERIALS AND METHODS: Biopsies were taken from 601 subjects with endoscopically suspected columnar-lined esophagus. Under light microscopy with Alcian-blue stain, SIM was identified. Demographic characteristics, gastroesophageal (GE) reflux symptoms and endoscopic findings were compared between the SIM-present group and the SIM-absent group. RESULTS: Among 601 subjects, 184 (30.6%) were confirmed by pathology to have SIM. Age over 40 years (P<0.001) and a medication history of proton pump inhibitor or H2 blocker were found more frequently in the SIM-present group (P=0.01) than in the SIM-absent group. Any of 7 GE reflux symptoms (heartburn, acid regurgitation, chest pain, hoarseness, globus sensation, cough and epigastric soreness) were more frequent in the SIM-present group than SIM-absent group (P<0.001). Specifically, heartburn, chest pain and cough were significantly more common in the SIM-present group. There was no clinically significant difference associated with endoscopic findings or other clinical characteristics. CONCLUSIONS: When subjects with endoscopically suspected BE are analyzed based on the presence or absence of SIM, the SIM-present group was significantly associated with GE reflux symptoms suggestive of frequent GE reflux. However, the presence of SIM did not correlate with endoscopic findings.
Barrett Esophagus ; Biopsy ; Chest Pain ; Cough ; Esophagus ; Gastroesophageal Reflux ; Heartburn ; Hoarseness ; Light ; Metaplasia ; Microscopy ; Prospective Studies ; Proton Pumps ; Sensation

BACKGROUND/AIMS: Chronic gastritis is a common finding during endoscopy and it is very important to describe it correctly. This study was designed to evaluate the distribution of endoscopic gastritis and the differences according to age, sex or area. MATERIALS AND METHODS: A clinical analysis was conducted on 25,536 subjects who had undergone an upper endoscopy for routine health check-up. Endoscopic gastritis was classified into four types, superficial gastritis, erosive gastritis, atrophic gastritis and intestinal metaplasia. The distribution of the four types of gastritis was evaluated according to sex, age and area. RESULTS: 51.6% of the patients had experienced at least one of the symptoms (epigastric pain or discomfort, soarness, dyspepsia, abdominal pain) on at least a few occasions during the previous year. The incidence of normal gastric finding was 3,593 (14.1%). 21,943 (85.9%) subjects have at least more than one of endoscopic gastritis. The number of cases with superficial gastritis was 7,983 (31.3%), erosive gastritis 6,054 (23.7%), atrophic gastritis 6,918 (27.1%), and intestinal metaplasia 1,181 (7.1%). Erosive gastritis, atrophic gastritis and intestinal metaplasia were more frequent in men than women (P<0.001) and in the older age group (> or =60 years) than younger age group (P<0.001). CONCLUSIONS: The prevalence of endoscopic gastritis was very common, 85.9%. In addition, erosive gastritis, atrophic gastritis and intestinal metaplasia were more frequent in men and in the older age group, which is similar to gastric cancer or peptic ulcer. Cautious regular endoscopic follow-up might be necessary regardless of gastrointestinal symptoms in Korea.
Dyspepsia ; Endoscopy ; Female ; Gastritis ; Gastritis, Atrophic ; Helicobacter pylori ; Humans ; Incidence ; Korea ; Male ; Metaplasia ; Peptic Ulcer ; Prevalence ; Stomach Neoplasms

BACKGROUND/AIMS: Chronic gastritis is a common finding during endoscopy and it is very important to describe it correctly. This study was designed to evaluate the distribution of endoscopic gastritis and the differences according to age, sex or area. MATERIALS AND METHODS: A clinical analysis was conducted on 25,536 subjects who had undergone an upper endoscopy for routine health check-up. Endoscopic gastritis was classified into four types, superficial gastritis, erosive gastritis, atrophic gastritis and intestinal metaplasia. The distribution of the four types of gastritis was evaluated according to sex, age and area. RESULTS: 51.6% of the patients had experienced at least one of the symptoms (epigastric pain or discomfort, soarness, dyspepsia, abdominal pain) on at least a few occasions during the previous year. The incidence of normal gastric finding was 3,593 (14.1%). 21,943 (85.9%) subjects have at least more than one of endoscopic gastritis. The number of cases with superficial gastritis was 7,983 (31.3%), erosive gastritis 6,054 (23.7%), atrophic gastritis 6,918 (27.1%), and intestinal metaplasia 1,181 (7.1%). Erosive gastritis, atrophic gastritis and intestinal metaplasia were more frequent in men than women (P<0.001) and in the older age group (> or =60 years) than younger age group (P<0.001). CONCLUSIONS: The prevalence of endoscopic gastritis was very common, 85.9%. In addition, erosive gastritis, atrophic gastritis and intestinal metaplasia were more frequent in men and in the older age group, which is similar to gastric cancer or peptic ulcer. Cautious regular endoscopic follow-up might be necessary regardless of gastrointestinal symptoms in Korea.
Dyspepsia ; Endoscopy ; Female ; Gastritis ; Gastritis, Atrophic ; Helicobacter pylori ; Humans ; Incidence ; Korea ; Male ; Metaplasia ; Peptic Ulcer ; Prevalence ; Stomach Neoplasms