• Title/Summary/Keyword: 치료 방법

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Comparative Study of Open Reduction and Internal Fixation and Primary Subtalar Arthrodesis for Sanders Type 4 Intra-Articular Calcaneal Fractures (Sanders 4형 종골 골절에 대한 관혈적 정복술 및 내고정술과 일차성 거골하 관절 유합술의 치료 결과 비교)

  • Woo, Seung Hun;Chung, Hyung-Jin;Bae, Su-Young;Kim, Sun-Kyu
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.49-58
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    • 2017
  • Purpose: To compare clinical outcome of Sanders type IV intra-articular calcaneal fracture treated with open reduction and internal fixation (ORIF) versus ORIF and primary subtalar arthrodesis (PSTA). Materials and Methods: Between March 2003 and November 2013, 22 patients with 22 Sanders type 4 intra-articular calcaneal fractures were included in this study. Of these, 11 were treated with ORIF (ORIF group), and 11 were treated with ORIF and PSTA (PSTA group). The mean follow-up period was 34.6 months (range, 18-72 months). Clinical outcomes were assessed along with the American Orthopedic Foot and Ankle Society's ankle-hindfoot scale (AOFAS score), and the visual analogue scale pain score (VAS score) at 6-month, 12-month, and last follow-up. Patient satisfaction, return to previous occupation and postoperative complications were also investigated. Results: The results for ORIF did not differ from those for PSTA based on the last follow-up AOFAS scores or the VAS scores (p>0.05). However, patient satisfaction was significantly higher in the PSTA group (p=0.008). Secondary subtalar arthrodesis was conducted in five patients (45.5%) of the ORIF group within 2 years postoperatively. Conclusion: We were unable to demonstrate a significant difference in clinical outcomes between ORIF and PSTA; however, the patient satisfaction was higher in the PSTA group. PSTA may be a suitable choice for patients who need fast recovery to daily activity and to prevent the need for secondary subtalar arthrodesis.

Characteristics of User's Behavior across Generations for space planing in General Hospital (종합병원 환경계획을 위한 세대별 종합병원 이용행태 특성분석)

  • Park, Hey Kyung;Oh, Ji Young
    • Korea Science and Art Forum
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    • v.28
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    • pp.105-116
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    • 2017
  • This study is a basic research to suggest user-centered general hospital environmental design guidelines, which aims to analyze user's behavior characteristics across generation in general hospital. For this purpose, this study constructed an analysis tool through the literature review with regard to generation and behavior characteristics in general hospital. Besides, an online survey regarding user's behavior in general hospital was conducted targeting from 20s to 60s, 300 persons for each group, total 1,500 persons for about 3 weeks since September 1, 2016. The results of this study are as follows: (1) Based on the generation, there were significant differences in relevant categories of their visiting frequency, visiting purpose, visiting hour, transportation, companion, behavior during the wait and selection of a general hospital. (2) In all generation, they responded that they have visited once or twice per year. People in 20s and 30s responded that their visit for the hospital is to receive specific treatment, while other people in 40s, 50s and 60s visit the hospital majorly for routine check-ups. Therefore, it is imperative for a health check-up center to design an environmental plan that reflects the characteristics of elders in 40s, 50s and 60s. (3) People in 40s, 50s and 60s usually visit a general hospital in the mornings of weekdays, while generations in 20s and 30s responded that they mostly visit the hospital in the mornings of weekend. (4) When they visit a general hospital, people in their 20s are usually using public transportations, while people in their 30s to 60s are using their own vehicle. (5) People in their 20s majorly visited 'lobby'. In older generations, they tend to visit 'outpatient clinic'. Therefore, it is necessary to build an outpatient clinic environment that considers the elderly. (6) Patients majorly responded that they are using their cell phone, while waiting for their clinic call. In elder generations, they responded that they are more likely watching TVs, reading books/magazines or doing nothing. Therefore, it is essential to provide cell-phone related services and environmental supports. Visually attractive media can be utilized for this purpose.

Analysis of the perception degree on dental medical accident and dispute experience, psychological status and preventive education according to clinical career of dental hygienist (일부지역 치과위생사의 임상경력에 따른 치과 의료사고 및 분쟁 경험, 심리상태, 예방교육에 대한 인식정도 분석)

  • Yoon, Na-Na;Lee, Myung-Ju;Seong, Mi-Gyung
    • Journal of Korean Academy of Dental Administration
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    • v.5 no.1
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    • pp.13-21
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    • 2017
  • Objective: To understand the experience of medical accidents and disputes according to clinical career of dental hygienists. Methods: A self-administrated questionnaire survey was conducted from May 2012 to June 2012 targeting 313 dental hygienists in Gyeongsangnam-do, Republic of Korea. Data were analyzed by descriptive analysis, χ2-test, and one-way analysis of variance (ANOVA). Collected data were analyzed using SPSS 18.0. Results: 1) The group who had more than 6 years of clinical experience experienced complaints from patients (70.3%) and dental hygienists duty (30.7%); 2) Complaints were related to diagnosis, dental treatment instruments and materials, scaling, impression preparation, and prosthodontics. Pediatric patients had significantly more complaints compared to other patients. Overall, there were more frequent cases in the group with over 6 years of clinical career; 3) For the psychological state after experiencing patients' complaints, 'the process is difficult, but I forget after thinking it could be happen' had 160 respondents. Among them, 38.1% had clinical experience of more than 6 years, 37.5% had less than 3 years, and 24.4% had clinical career of 3~6 years; 4) About 73.6% of those had 3~6 years of clinical career answered that 'sometimes it is doubtful' on the issue of medical accidents and conflicts on prevention education of dental hygienists that 'there is a doubt about the issue of medical treatment or the occurrence of disputes'. About 60.0% of those who had less than 3 years of clinical experience answered that it was highly 'necessary but not urgent' on the necessity of preventive education, while 87.1% of those who had more than 6 years of clinical career answered that it was highly 'necessary but not urgent' on the necessity of preventive education. The difference between the two was not statistically significant. Conclusions: It is necessary and urgent to provide education related to prevention and countermeasures against malpractice disputes for dental hygienists.

Analysis of Factors Affecting the Length of Stay in Children(Aged 0 to 12) with Injuries: Centering Around the Data from the Korea National Hospital Discharge In-Depth Injury Surveys (어린이(0-12세) 손상환자의 재원일수에 미치는 요인분석: 퇴원손상심층자료를 중심으로)

  • Lee Chae Kyung
    • The Journal of the Convergence on Culture Technology
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    • v.9 no.3
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    • pp.137-143
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    • 2023
  • This study was conducted to analyze factors affecting the length of stay in children with injuries by determining relationships between length of stay and characteristics of children(aged 0 to 12) with injuries. 7,804 patients aged 0 to 12 who participated in the Korea Nation Hospital Discharge In-Depth Injury Surveys, got a diagnosis of sequelae of injuries and of other consequences of external causes(S00-T98), and were discharged between 1 January 2016 and 31 December 2020 were investigated. A frequency analysis, independent samples t-test, and ANOVA were performed. Also, to identify factors affecting the length of stay, a regression analysis was performed. The average length of stay for the patients investigated in this study was 5.5 days. The length of stay for school-age children(aged 7 to 12) and children who had either public or private coverage was higher than that for preschoolers(aged 0 to 6) and children who didn't have public or private coverage, respectively. The length of stay for children admitted to a hospital in a rural area(Jeolla-do or Gyeongsang-do) was higher than that for children admitted to a hospital in a metropolitan area and the length of stay for children admitted to a hospital that had 100-299 hospital beds was relatively long. However, children who first visited a hospital for outpatient care stayed relatively short in hospital and children who had been burned or injured in traffic crashes stayed relatively long in hospital. Children who got a secondary diagnosis and had a principal procedure or who died after being discharged were in hospital for a long time. The findings of this study shall be useful, as they identified characteristics related to the length of stay for Korean children with injuries and factors that determine the length of stay for those children by analyzing the national dataset, or more specifically, the data from the Korea National Hospital Discharge In-Depth Injury Surveys. The risk of child injuries can be easily reduced by taking actions to prevent them and providing safety education programs. The present study has provided essential baseline data for the provision of aggressive care for child injuries and the establishment of a range of policies for child injury prevention.

Effects of Tailored Occupational Activity Program applied to Patients with Dementia and Their Caregiver in Community (지역사회에 거주하는 치매환자와 보호자에게 적용한 맞춤형 작업 활동 프로그램의 효과)

  • Hwang, Yun-Jung;Lee, Kamg Sook;Lim, Hyun-Kook;Kim, Dai Jin;Jeong, Won-Mee
    • 한국노년학
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    • v.31 no.1
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    • pp.129-141
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    • 2011
  • This study aims to find out effects of a tailored occupational activity program(TOAP) on the activities of daily living(ADL), cognitive function, depressive mood, and caregiver burden, who live in the community. Method : From October 2009 to May 2010, the TOAP was applied to 15 dementia patients and 15 of their caregivers, who was visitors of the Y-city Center for Managing Dementia in Gyunggi-do. The TOAP was designed for habituating patients and caregivers to the techniques acquired through goal activities and task and making it capable of being routinized regularly. The TOAP was applied to dementia patients and their cvaregivers twice a week for 7 weeks(one-time home visit, one-time phone inspection), a total of 14 times. Results: Significant differences among pre-test and post-test were found in the AMPS motor skills(1.10±1.14 and 1.34±1.2 respectively) scores, AMPS process skills(0.32±0.55 and 0.77±0.66 respectively) scores, ACL(3.86±0.65 and 4.17±0.64 respectively) scores, MMSE-KC(17.33±4.6 and 19.33±4.97 respectively) scores, GDS(11.73±6.87 and 8.53±7.09 respectively) scores, and caregiver burden(31.80±20.06 and 26.13±18.07 respectively) scores(p<0.05). A significant effect was confirmed from the TOAP which ADL, cognitive function, reduced patient's depression and caregiver burden(p<0.05). Conclusion: From the above results that a TOAP has an effect on the improvement of the ability to ADL, cognitive function and reduced depression and caregiver burden of dementia patients living in community. The present author hopes that, in the future, more diverse community based on tailored occupational activity programs will be developed to improve the functions of dementia patients living in community.

Comparison of Factors Associated With Agitation Among Youngest-Old, Middle-Old, and Oldest-Old Hospitalized Patients Referred to the Psychiatric Department (정신건강의학과에 협진의뢰된 연소노인, 고령노인, 초고령노인 입원환자의 초조의 연관요인 비교)

  • Min-Suk Jang;Seo-Hyun Choi;Se-ri Maeng;Yang-Sik Kim;Jae-Nam Bae;Jeong-Seop Lee;Won-Hyoung Kim
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.2
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    • pp.89-99
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    • 2023
  • Objectives : In this study, elderly hospitalized patients aged 65 years or older who were admitted to a university hospital and referred to the department of psychiatry were classified into youngest-old, middle-old, and oldest-old. It was conducted to find out what factors contribute to the agitation pattern by age group, whether there is a difference in the factors, and whether there is a difference in the severity of the agitation pattern. Methods : From July 1, 2021 to December 31, 2021, the medical records of patients aged 65 years or older who were referred to the department of psychiatry were retrospectively reviewed. Age, gender, route of hospitalization, department of referral, reason for referral, treatment method, presence of internal and surgical diseases, and hematological test data were investigated. Results : There was a significant correlation with the RASS score in cases of surgery referral and high CRP levels for youngest-old aged 65 to 74 years, in cases of surgery referral, dementia and hyponatremia for middle-old aged 75 to 84 years, in case of dementia for oldest-old aged 85 years old or older. In addition, there were differences in the severity of agitation patterns between age groups. Conclusions : As the age group increases, the agitation of delirium patients becomes more severe, and various factors contributing to the agitation pattern also differ by age group. Therefore, when treating elderly patients with delirium, attention should be paid to factors that may affect agitation depending on age.

Severe Human Rhinovirus Lower Respiratory Tract Infections in Young Children

  • Doo Ri Kim;Kyung-Ran Kim;Hwanhee Park;Esther Park;Joongbum Cho;Jihyun Kim;Hee Jae Huh;Kangmo Ahn;Nam Yong Lee;Yae-Jean Kim
    • Pediatric Infection and Vaccine
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    • v.30 no.3
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    • pp.111-120
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    • 2023
  • Purpose: Human rhinovirus (HRV) infections can result in lower respiratory tract infections (LRTIs). We aimed to investigate the characteristics of severe HRV LRTI in young children. Methods: Medical records were reviewed retrospectively in patients who were hospitalized for HRV LRTIs from 2016 to 2020 at the Samsung Medical Center in Seoul, Korea. Patients aged 90 days or older and younger than 5 years were included. Patients with co-infections with other respiratory pathogens were excluded. Severe HRV LRTI was defined as the following: the need for high-flow oxygenation, mechanical ventilation, or intensive care unit admission. Results: A total of 115 cases were identified. The median age was 17 months (range, 3-56 months) and the median hospital days were 4 days (range, 2-31 days). Of the 115 cases, 18 patients (15.7%) developed severe HRV LRTI. The median age was younger in the severe group compared to the non-severe group (9.5 months vs. 19.0 months, P=0.001). Of 18 patients with severe HRV LRTI, 11 (61.1%) had underlying diseases - chronic lung diseases accounted for the largest proportion (63.6%). Six patients (33.3%) required mechanical ventilation. Of note, 7 previously healthy children were diagnosed with severe HRV LRTI. Of those 7 children, 4 of them were diagnosed with asthma later. When the 115 cases were divided into previously healthy (n=60) and underlying disease (n=55) groups, severe courses of HRV LRTI were observed in 11.7% and 20.0% of children, respectively (P=0.219). Conclusions: HRV can cause severe LRTI even in previously healthy children as well as in children with comorbidities.

The influence of fitness and type of luting agents on bonding strength of fiber-reinforced composite resin posts (섬유강화 복합레진 포스트의 결합강도에 대한 포스트 공간 적합도 및 접착 시멘트의 영향)

  • Kkot-Byeol Bae;Hye-Yoon Jung;Yun-Chan Hwang;Won-Mann Oh;In-Nam Hwang
    • Journal of Dental Rehabilitation and Applied Science
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    • v.39 no.4
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    • pp.187-194
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    • 2023
  • Purpose: A mismatched size in the post and post space is a common problem during post-fixation. Since this discordance affects the bonding strength of the fiber-reinforced composite resin post (FRC Post), a corresponding luting agent is required. The aim of this study was to evaluate the bonding strength of the FRC post according to the fitness of the fiber post and the type of luting agent. Materials and Methods: Thirty mandibular premolar were endodontic-treated and assigned to two groups according to their prepared post space: Fitting (F) and Mismatching (M). These groups were further classified into three subgroups according to their luting agent: RelyX Unicem (ReX), Luxacore dual (Lux), and Duolink (Duo). A push-out test was performed to measure the push-out bond strengths. The fractured surfaces of each cross-section were then examined, and the fracture modes were classified. Results: In the ReX and Duo subgroups, the F group had a higher mean bond strength; however, the Lux subgroup had no significant difference between the F and M groups. In the analysis of the failure modes, the ReX subgroup had only adhesive failures between the cement and dentin. Conclusion: The result of this study showed that the bond strength of an FRC post was influenced by the type of luting agent and the mismatch between the diameter of the prepared post space and that of the post.

Malignancy in Patients With Inborn Errors of Immunity Beyond Infectious Complication: Single Center Experience for 30 Years

  • Doo Ri Kim;Kyung-Ran Kim;Hwanhee Park;Joon-sik Choi;Yoonsun Yoon;Sohee Son;Hee Young Ju;Jihyun Kim;Keon Hee Yoo;Kangmo Ahn;Hee-Jin Kim;Eun-Suk Kang;Junhun Cho;Su Eun Park;Kihyun Kim;Yae-Jean Kim
    • Pediatric Infection and Vaccine
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    • v.30 no.3
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    • pp.129-138
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    • 2023
  • Purpose: Cancer incidence is known to be higher in patients with inborn errors of immunity (IEI) compared to the general population in addition to traditionally well-known infection susceptibility. We aimed to investigate cancer occurrence in patients with IEI in a single center. Methods: Medical records of IEI patients treated at Samsung Medical Center, Seoul, Korea were retrospectively reviewed from November 1994 to September 2023. Patients with IEI and cancer were identified. Results: Among 194 patients with IEI, seven patients (3.6%) were diagnosed with cancer. Five cases were lymphomas, 4 of which were Epstein-Barr virus (EBV)-associated lymphomas. The remaining cases included gastric cancer and multiple myeloma. The median age at cancer diagnosis was 18 years (range, 1-75 years). Among patients with cancer, underlying IEIs included X-linked lymphoproliferative disease-1 (XLP-1, n=3), activated phosphoinositide 3-kinase delta syndrome (APDS, n=2), and cytotoxic T-lymphocyte antigen 4 (CTLA-4) haploinsufficiency (n=2). Seventy-five percent (3/4) of XLP-1 patients, 40.0% (2/5) of APDS patients, and 50.0% (2/4) of CTLA-4 haplo-insufficiency patients developed cancer. Patients with XLP-1 developed cancer at earlier age (median age 5 years) compared to those with APDS and CTLA-4 (P<0.001). One patient with APDS died during hematopoietic cell transplantation. Conclusions: Cancer occurred in 3.6% of IEI patients at a single center in Korea. In addition to infectious complications and inflammation, physicians caring for IEI patients should be aware of the potential risk of cancer, especially in association with EBV infection.

Association between Texture Analysis Parameters and Molecular Biologic KRAS Mutation in Non-Mucinous Rectal Cancer (원발성 비점액성 직장암 환자에서 자기공명영상 기반 텍스처 분석 변수와 KRAS 유전자 변이와의 연관성)

  • Sung Jae Jo;Seung Ho Kim;Sang Joon Park;Yedaun Lee;Jung Hee Son
    • Journal of the Korean Society of Radiology
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    • v.82 no.2
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    • pp.406-416
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    • 2021
  • Purpose To evaluate the association between magnetic resonance imaging (MRI)-based texture parameters and Kirsten rat sarcoma viral oncogene homolog (KRAS) mutation in patients with non-mucinous rectal cancer. Materials and Methods Seventy-nine patients who had pathologically confirmed rectal non-mucinous adenocarcinoma with or without KRAS-mutation and had undergone rectal MRI were divided into a training (n = 46) and validation dataset (n = 33). A texture analysis was performed on the axial T2-weighted images. The association was statistically analyzed using the Mann-Whitney U test. To extract an optimal cut-off value for the prediction of KRAS mutation, a receiver operating characteristic curve analysis was performed. The cut-off value was verified using the validation dataset. Results In the training dataset, skewness in the mutant group (n = 22) was significantly higher than in the wild-type group (n = 24) (0.221 ± 0.283; -0.006 ± 0.178, respectively, p = 0.003). The area under the curve of the skewness was 0.757 (95% confidence interval, 0.606 to 0.872) with a maximum accuracy of 71%, a sensitivity of 64%, and a specificity of 78%. None of the other texture parameters were associated with KRAS mutation (p > 0.05). When a cut-off value of 0.078 was applied to the validation dataset, this had an accuracy of 76%, a sensitivity of 86%, and a specificity of 68%. Conclusion Skewness was associated with KRAS mutation in patients with non-mucinous rectal cancer.