• 제목/요약/키워드: A protocol for follow-up

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Unusual bone regeneration following resective surgery and decontamination of peri-implantitis: a 6-year follow-up (임플란트주위염의 삭제형 골수술 후 골재생 증례보고: 6년 추적관찰)

  • Kim, Hyun-Joo;Lee, Ju-Youn
    • Journal of Dental Rehabilitation and Applied Science
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    • v.38 no.3
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    • pp.171-177
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    • 2022
  • Peri-implantitis is an inflammatory lesion of the periodontium surrounding an endosseous implant, with progressive loss of the supporting peri-implant bone. The main purposes of treatment for peri-implantitis due to biological factors include addressing the inflammation and restoring a healthy but reduced periodontium around the implant, similar to the treatment of periodontitis in natural teeth. The proposed treatment protocol includes surgical treatment, mainly resective surgery, after non-surgical treatment such as oral hygiene instructions, mechanical cleansing of the fixture, and general or topical antiseptic or antibiotic application according to the extent of inflammation. In this article, we present a 6-year follow-up case showing unusual marginal bone regeneration after resective surgery and decontamination of an implant surface for the treatment of peri-implantitis and discuss the possible reasons.

Effects of adjunctive daily phototherapy on chronic periodontitis: a randomized single-blind controlled trial

  • Jung, Gyu-Un;Kim, Jin-Woo;Kim, Sun-Jong;Pang, Eun-Kyoung
    • Journal of Periodontal and Implant Science
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    • v.44 no.6
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    • pp.280-287
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    • 2014
  • Purpose: The purpose of this randomized single-blind controlled trial was to elucidate the clinical and antimicrobial effects of daily phototherapy (PT) as an adjunct to scaling and root planing (SRP) in patients with chronic periodontitis. Methods: The study was conducted from December 2013 to May 2014 at Ewha Womans University Mokdong Hospital, Seoul, Korea. Forty-one patients with mild to moderate chronic periodontitis were randomly divided into two therapeutic groups in a 1:1 ratio: SRP+PT and SRP (control) groups. All participants underwent full-mouth SRP. PT was performed thrice a day for a month by using electric toothbrushes with embedded light-emitting diodes. Plaque index, gingival index, probing pocket depth (PPD), clinical attachment level (CAL), and bleeding on probing were assessed before (baseline) and four weeks after (follow-up) the treatment. Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Prevotella intermedia, Fusobacterium nucleatum, Parvimonas micra, Campylobacter rectus, Eikenella corrodens, Streptococcus mutans, and Streptococcus sobrinus levels were detected by a real-time polymerase chain reaction at the same points in time. Results: The clinical parameters improved in both the groups. At the follow-up assessment, PPD was significantly decreased in the SRP+PT group (P=0.00). Further, PPD and CAL showed significantly greater changes in the SRP+PT group than in the SRP group (PPD, P=0.03; CAL, P=0.04). P. gingivalis and T. forsythia levels decreased in this group, but no significant intergroup differences were noted. Conclusions: Adjunctive PT seems to have clinical benefits, but evidence of its antimicrobial effects is not sufficient. Long-term studies are necessary to develop the most effective PT protocol and compare the effectiveness of PT with and without exogenous photosensitizers.

Diagnostic efficacy of specialized MRI & clinical results of arthroscopic treatment in ankle soft tissue impingement syndrome (족근 관절 연부조직 충돌 증후군에서 MRI의 진단적 의의 및 관절경적 치료 결과)

  • Lee, Jin-Woo;Moon, Eun-Su;Kim, Sung-Jae;Hahn, Soo-Bong;Kang, Eung-Shick
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.2
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    • pp.208-217
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    • 2003
  • Introduction: Soft-tissue impingement syndrome is now increasingly recognized as a significant cause of the chronic ankle pain. As a method to detect soft-tissue ankle impingement, a characteristic history and physical examination, routine MR imaging, and direct MR arthrography were used. The efficacy of routine MR imaging has been controversial for usefulness because of low sensitivity and specificity. Direct MR artrhography was recommaned for diagnosis because of the highest sensitivity, specificity and accuracy, but it requires an invasive procedure. The purpose of this study is to investigate the diagnostic accuracy of Fat suppressed, contrast enhanced, three-dimensional fast gradient recalled acquisition in the steady state with rediofrequency spoiling magnetic resonance imaging(CE 3D-FSPGR MRI) and to evaluate the clinical outcome of the arthroscopic treatment in assessing soft-tissue impingement associated with trauma of the ankle. Materials and Methods: We reviewed 38 patients who had arthroscopic evaluations and preoperative magnetic resonance imaging studies(3D-FSPGR MRI) for post-traumatic chronic ankle pain between January 2000 and August 2002. Among them, 24 patients had osteochondral lesion, lateral instability, loose body, malunion of lateral malleoli, and peroneal tendon dislocation. The patient group consisted of 23 men and 15 women with the average age of 34 years(16-81 years). The mean time interval from the initial trauma to the operation was 15.5 months(3 to 40 months), The mean follow-up duration of the assessment was 15.6months(12-48 months). MRI was simultaneously reviewed by two radiologists blinded to the clinical diagnosis. The sensitivity, specificity and accuracy of MRI was obtained from radiologic and arthroscopic finding. Arthroscopic debridement and additional operation for associated disease were performed. We used a standard protocol to evaluate patients before the operation and at follow-up which includes American Orthopedic Foot and Ankle Society Ankle-Hindfoot Score. Results: For the assessment of the synovitis and soft tissue impingement, fat suppressed CE 3D-FSPGR MR imaging had the sensitivity of 91.9%, the specificity of 84.4 and the accuracy of 87.5%. AOFAS Ankle-Hindfoot Score of preoperative state was 69.2, and the mean score of the last follow-up was 89.1. These were assessed as having 50% excellent(90-100) and 50% good(75-89). The presence of other associated disease didn't show the statistically significant difference(>0.05). Conclusion: Fat suppressed CE 3D-FSPGR MR imaging is useful method comparable to MR arthrography for diagnosis of synovitis or soft-tissue impingement, and arthroscopic debridement results in good clinical outcome.

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Cohort Study Protocol: A Cohort of Korean Atomic Bomb Survivors and Their Offspring

  • Seong-geun Moon;Ansun Jeong;Yunji Han;Jin-Wu Nam;Mi Kyung Kim;Inah Kim;Yu-Mi Kim;Boyoung Park
    • Journal of Preventive Medicine and Public Health
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    • v.56 no.1
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    • pp.1-11
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    • 2023
  • In 1945, atomic bombs were dropped on Hiroshima and Nagasaki. Approximately 70 000 Koreans are estimated to have been exposed to radiation from atomic bombs at that time. After Korea's Liberation Day, approximately 23 000 of these people returned to Korea. To investigate the long-term health and hereditary effects of atomic bomb exposure on the offspring, cohort studies have been conducted on atomic bomb survivors in Japan. This study is an ongoing cohort study to determine the health status of Korean atomic bomb survivors and investigate whether any health effects were inherited by their offspring. Atomic bomb survivors are defined by the Special Act On the Support for Korean Atomic Bomb Victims, and their offspring are identified by participating atomic bomb survivors. As of 2024, we plan to recruit 1500 atomic bomb survivors and their offspring, including 200 trios with more than 300 people. Questionnaires regarding socio-demographic factors, health behaviors, past medical history, laboratory tests, and pedigree information comprise the data collected to minimize survival bias. For the 200 trios, whole-genome analysis is planned to identify de novo mutations in atomic bomb survivors and to compare the prevalence of de novo mutations with trios in the general population. Active follow-up based on telephone surveys and passive follow-up with linkage to the Korean Red Cross, National Health Insurance Service, death registry, and Korea Central Cancer Registry data are ongoing. By combining pedigree information with the findings of trio-based whole-genome analysis, the results will elucidate the hereditary health effects of atomic bomb exposure.

Single Case Study: The Positive Impact of the Intensive Sensory Integration Intervention for the Sensory Defensiveness (감각통합기능장애에 대한 집중치료프로그램의 효과 : 사례보고)

  • Park, Ji-Hun;Noh, Jong-Su;Lee, Hyang-Sook;Cha, Jung-Jin
    • The Journal of Korean Academy of Sensory Integration
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    • v.7 no.2
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    • pp.63-76
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    • 2009
  • Objective : The purpose of this study was to identify effects of intensive sensory integration (SI) treatment and home-program for a child who has a sensory integration disorder. This study also examined whether the positive effect is long-lasting by a follow-up test. Method : A boy with sensory integration dysfunction underwent an intensive SI treatment for 2 weeks. The intervention was consisted of 9 sessions and duration of the each session was 40 minutes. Sensory diet and Wilbarger protocol was provided as home program. The child's sensory function was evaluated before and after the SI intervention. Five month later, re-evaluation was executed for follow-up purpose. Results : In the evaluation after the Si intervention, the child's sensory defensiveness was decreased. Praxis, visual perception, sensory regulation dysfunction (sleep function), affective stabilization and performance of activities of daily living are also improved. In the re-evaluation after the 5 month later, the self-regulation ability, especially sleep function, has been maintained and the visual perception was developing continually. However, the child showed some affective regulation such as bothering his mother and losing his temper. Conclusions : The intensive SI intervention showed positive effects in terms of SI function improvement and the effect lasted long without any additional therapeutic intervention.

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Efficacy and Safety of Electroacupuncture and Acupuncture in Postmenopausal Women with Overactive Bladder; a Pilot Study of Randomized Clinical Controlled Trial (폐경 여성의 과민성 방광에 대한 전침 치료와 침 치료의 유효성과 안전성 평가 ; 무작위 대조군 예비 임상시험)

  • Nam, Eun-Young;Jung, Seung-Hyun;Bae, In-Suk;Choi, Su-Ji;Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.31 no.1
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    • pp.84-98
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    • 2018
  • Objectives: The purpose of this pilot study was to examine the feasibility of recruiting women into a clinical trial designed to examine the effects of acupuncture and electroacupuncture in treating overactive bladder (OAB) in menopause women. We tried to determine if there was preliminary evidence to suggest that acupuncture may be effective in reducing OAB symptoms and improving disease-specific quality of life. We also tried to determine the appropriate treatment duration of OAB, with safety of performing acupuncture and electroacupuncture treatment. Methods: This study was a randomized clinical trial. 7 menopause women were randomly assigned to a electroacupuncture group (EA group) (n=4) or acupuncture group (AC group) (n=3) and received electroacupuncture or acupuncture treatment twice a week (16 sessions) in 8 weeks, and follow up assessment was performed after the end of treatment. Overactive Bladder Symptom Score (OABSS), 3-day bladder diary, and King's Health Questionnaire (KHQ) were performed 4 times (at baseline (visit 0), the middle of treatment (visit 8), after the end of treatment (visit 16), and at 4 weeks of follow-up (visit 17)) and analyzed. 2 subjects were dropped out, and finally 5 subjects completed the study. Statistical analysis was performed using SPSS 18.0 for window program. Results: There was an significant improvement in night-time frequency after the treatment (visit 17) in PP (Per-protocol) group analysis (p=0.042). In additional ITT (Inter-to-treat) group analysis, the OABSS (p=0.042) and night-time frequency (p=p=0.017) were improved significantly after the treatment (visit 17). But there was no significant difference of KHQ before and after the treatment. Also there was no significant difference between EA and AC group after the treatment (visit 16, 17). Conclusions: The results of this pilot study suggested that it was feasible to recruit subjects and perform the study procedures, after reconstructing several details of study protocol in performing further clinical trial.

Effects of Bu-Zhong-Yi-Qi-Tang for the treatment of functional dyspepsia: a feasibility study protocol

  • Kim, Jihye;Kim, Hyunho;Kim, Keun Ho
    • Integrative Medicine Research
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    • v.6 no.3
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    • pp.317-324
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    • 2017
  • Background: Bu-Zhong-Yi-Qi-Tang (BZYQT) has long been used for the treatment of severe weakness caused by general fatigue, loss of appetite, or indigestion. The aim of this feasibility study is to assess the effectiveness and safety of BZYQT for the treatment of functional dyspepsia (FD) with spleen qi deficiency. Methods: This study will be conducted at a single center as a prospective, nonrandomized, nonblinded, single-arm feasibility study. A total of 30 participants diagnosed with FD in accordance with the Rome III criteria will be enrolled. All patients will receive BZYQT for 4 weeks. The primary outcome is the change in the Nepean Dyspepsia Index-Korean version (NDI-K) scores between the baseline and 4-week images. The secondary outcomes include the tongue coating thickness, blood parameters, and BZYQT Questionnaire score. The NDI-K score will be acquired four times, at Weeks 0 (baseline), 2 (during treatment), 4 (after treatment), and 8 (after follow-up). Written informed consent will be obtained from all study participants prior to enrollment. This study has been approved by the Institutional Review Board of Kyung Hee University Korean Medicine Hospital. This study protocol is registered with the national clinical trial registry of the World Health Organization International Clinical Trials Registry Platform. Results will be published in a journal and will be disseminated both electronically and in print. Discussion: The results of this study may serve as a guide for researchers seeking to effectively evaluate the effects of BZYQT.

Bright Light Therapy in the Morning or at Mid-Day in the Treatment of Non-Seasonal Bipolar Depressive Episodes (LuBi): Study Protocol for a Dose Research Phase I / II Trial

  • Geoffroy, Pierre Alexis;El Abbassi, El Mountacer Billah;Maruani, Julia;Etain, Bruno;Lejoyeux, Michel;Amad, Ali;Courtet, Philippe;Dubertret, Caroline;Gorwood, Philip;Vaiva, Guillaume;Bellivier, Frank;Chevret, Sylvie
    • Psychiatry investigation
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    • v.15 no.12
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    • pp.1188-1202
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    • 2018
  • Objective This study protocol aims to determine, using a rigorous approach in patients with bipolar disorder (BD) and non-seasonal major depressive episode (MDE), the characteristics of bright light therapy (BLT) administration (duration, escalation, morning and mid-day exposures) depending on the tolerance (hypomanic symptoms). Methods Patients with BD I or II and treated by a mood stabilizer are eligible. After 1 week of placebo, patients are randomized between either morning or mid-day exposure for 10 weeks of active BLT with glasses using a dose escalation at 7.5, 10, 15, 30 and 45 minutes/day. A further follow-up visit is planned 6 months after inclusion. Patients will be included by cohorts of 3, with at least 3 days of delay between them, and 1 week between cohorts. If none meet a dose limiting toxicity (DLT; i.e hypomanic symptoms), the initiation dose of the next cohort will be increased. If one patient meet a DLT, an additionnal cohort will start at the same dose. If 2 or 3 patients meet a DLT, from the same cohort or from two cohorts at the same dose initiation, the maximum tolerated dose is defined. This dose escalation will also take into account DLTs observed during the intra-subject escalation on previous cohorts, with a "Target Ceiling Dose" defined if 2 DLTs occured at a dose. Discussion Using an innovative and more ergonomic device in the form of glasses, this study aims to better codify the use of BLT in BD to ensure a good initiation and tolerance.

1 year follow-up results of prenatally diagnosed unilateral hydronephrosis according to renal sonographic findings at 1 month of age (산전 초음파로 발견된 일측성 수신증의 생후 1개월 때의 초음파 소견에 따른 1년 추적 결과)

  • Yoon, Hoe-Soo;Yum, Mi Sun;Lee, Joo Hoon;Park, Young Seo;Kim, Kun Seok;Yoon, Chong Hyun;Moon, Dae Hyuk;Hahn, Hyewon
    • Clinical and Experimental Pediatrics
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    • v.49 no.1
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    • pp.64-70
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    • 2006
  • Purpose : The natural courses of prenatally diagnosed hydronephrosis(HN) are diverse. Our purpose was to determine if the findings of renal ultrasonography(USG) in patients with prenatal HN at 1 month of age can predict the 1 year follow-up results and determine the guideline of follow-up study. Methods : Among 462 hydronephrotic patients registered between 1996 and 2004, 153 unilateral hydronephrotic renal units were enrolled in this study, bilateral HN, vesicoureteral reflux and other associated anomaly were excluded. These were classified into four groups respectively, according to anterior posterior pelvic diameter(APPD) or Society for Fetal Urology(SFU) grading by USG findings at 1 month after birth. Renal USG and $Tc^{99m}$-mercaptoacetyl triglycerine(MAG3) scan were done according to a set protocol. Results : Most cases improved or remained stationary. No one underwent an operation SFU grade 1,2 groups and only one case of SFU grade 3 group was operated. Thirty two cases(64 percent) were operated on among the 50 cases of SFU grade 4 group. 0/2(0 percent), 5/11(45.5 percent), 11/17(64.7 percent) and 16/20(80 percent) were operated on in each group with APPD <10, 10-19, 20-29, >30 mm, and the operation risk is higher as the APPD is increased. Conclusion : In group with SFU grade below 3 and APPD below 10 mm, we can delay the follow-up study beyond existing set protocol. Operations are recommended immediately if diuretic renogram show the obstructive pattern or decreased renal function in SFU grade 4 group with APPD over 10 mm.

Impact of Dual-Hemisphere Transcranial Direct Current Stimulation Combined with Modified Constraint-Induced Movement Therapy on Upper Limb Function in Chronic Stroke: A Single Blinded Randomized Controlled Trial (수정된 강제 유도 운동치료와 결합된 이중 반구 경두개 직류 자극이 만성 뇌졸중의 팔 기능에 미치는 영향 : 단일 맹검 무작위 통제 시험)

  • Kim, Sunho
    • Journal of The Korean Society of Integrative Medicine
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    • v.8 no.2
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    • pp.11-20
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    • 2020
  • Purpose : The purpose of this study was to research the effects of dual-hemisphere transcranial direct current stimulation (dual tDCS) and modified constraint-induced movement therapy (mCIMT) to improve upper extremity motor function after stroke. Methods : The study period was from August 2019 to November 2019, and included 24 patients who met the selection criteria. Participants were divided into 2 groups: dual tDCS and mCIMT, and sham dual tDCS and mCIMT group. Dual tDCS and mCIMT group performed mCIMT immediately after applying dual tDCS for 20 minutes, and sham dual tDCS and mCIMT group performed mCIMT immediately after applying sham tDCS for 20 minutes without turning on the power source. Total interventions were conducted 5 times per week for 4 weeks, and mCIMT was conducted for 30 minutes per session for both experimental and control groups. Fugl-Meyer assessment (FMA) and Motor Activity Log scale (MAL) were analyzed before and after 4 weeks of intervention. Results : Both experimental and control groups showed significant changes in FMA, Amount of Use (AOU), and Quality of Movement (QOM) of MAL. When the differences between groups was compared using ANCOVA, the experimental group showed a greater improvement in FMA and AOU of MAL than the control group. Conclusion : In order to enhance the effect of improving upper limb function of stroke patients, dual tDCS could be applied to provide more effective treatment in the clinical setting. Further studies will be needed in larger groups of stroke patients, including long-term follow-up, and multi-group comparisons through the establishment of anodal tDCS and mCIMT, cathodal tDCS, and mCIMT groups to clarify the effects of dual tDCS. In addition, research is needed to establish a protocol for tDCS, and this evidence-based intervention protocol is expected to be used in the clinical setting as an interventional method for various purposes.