• Title/Summary/Keyword: Clinical outcomes

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Porcine-derived soft block bone substitutes for the treatment of severe class II furcation-involved mandibular molars: a prospective controlled follow-up study

  • Jae-Hong Lee;Ji-Hoo Han;Seong-Nyum Jeong
    • Journal of Periodontal and Implant Science
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    • v.53 no.6
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    • pp.406-416
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    • 2023
  • Purpose: No evidence exists regarding the advantages of periodontal regeneration treatment for furcation defects using soft block bone substitutes. Therefore, this randomized controlled trial aimed to assess the clinical and radiographic outcomes of regenerative therapy using porcine-derived soft block bone substitutes (DPBM-C, test group) compared with porcine-derived particulate bone substitutes (DPBM, control group) for the treatment of severe class II furcation defects in the mandibular molar regions. Methods: Thirty-five enrolled patients (test group, n=17; control group, n=18) were available for a 12-month follow-up assessment. Clinical (probing pocket depth [PPD] and clinical attachment level [CAL]) and radiographic (vertical furcation defect; VFD) parameters were evaluated at baseline and 6 and 12 months after regenerative treatment. Early postoperative discomfort (severity and duration of pain and swelling) and wound healing outcomes (dehiscence, suppuration, abscess formation, and swelling) were also assessed 2 weeks after surgery. Results: For both treatment modalities, significant improvements in PPD, CAL, and VFD were found in the test group (PPD reduction of 4.1±3.0 mm, CAL gain of 4.4±2.9 mm, and VFD reduction of 4.1±2.5 mm) and control group (PPD reduction of 2.7±2.0 mm, CAL gain of 2.0±2.8 mm, and VFD reduction of 2.4±2.5 mm) 12 months after the regenerative treatment of furcation defects (P<0.05). However, no statistically significant differences were found in any of the measured clinical and radiographic parameters, and no significant differences were observed in any early postoperative discomfort and wound healing outcomes between the 2 groups. Conclusions: Similar to DPBM, DPBM-C showed favorable clinical and radiographic outcomes for periodontal regeneration of severe class II furcation defects in a 12-month follow-up period.

Clinical Usefulness of Gastric Residual Volume as An Indicator to Provide Approximately Enteral Nutrition for Patients in Intensive Care Units: A Systematic Literature Review (중환자의 경관영양 공급 지표로서 위 잔여량의 임상적 효용성: 체계적 문헌고찰)

  • Kim, Hyunjung;Chang, Sun Ju
    • Journal of Korean Biological Nursing Science
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    • v.16 no.4
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    • pp.267-275
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    • 2014
  • Purpose: The practice of enteral nutrition with gastric residual volumes (GRVs) as a clinical indicator is poorly standardized in intensive care units. This study aims to summarize the results from studies that evaluated the clinical outcomes related to the GRVs. Methods: This systematic review study analyzed 11 studies consisting of four randomized controlled trials, one non-randomized controlled trial, and six observational studies. Results: No consistent relationship between GRV thresholds and clinical outcomes was observed. Higher GRVs were not consistently correlated with clinical outcomes such as higher gastrointestinal complications, aspiration pneumonia, or mortality. Higher GRVs significantly generate complications more often. Findings show that a single GRV more than 200 mL or two consecutive GRVs more than 150 mL should raise concern about negative consequences. Conclusion: Critical care nurses need to monitor GRVs closely during their practice of enteral nutrition. For critically ill patients receiving enteral nutrition, a GRV threshold of 200 ml would be a desirable limit to provide safe and adequate nutrition with a conservative approach.

The Effect of the Immediate Postoperative Nutritional Status in Liver Transplant Recipients in SICU on Clinical Outcome (간이식 환자의 수술 후 영양상태가 건강상태에 미치는 영향)

  • Ha, Ji Su;Choi-Kwon, Smi
    • Journal of Korean Biological Nursing Science
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    • v.15 no.4
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    • pp.193-201
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    • 2013
  • Purpose: The purpose of the study was to evaluate the effect of the immediate postoperative nutritional status and calorie adequacy on clinical outcomes in liver transplant recipients. Methods: A total number of 99 patients who received liver transplants were recruited from a tertiary university hospital. Demography, subjective global assessment, clinical outcomes and calorie adequacy were evaluated through personal interviews, electronic medical records and dietary records. Anthropometric measures, body mass index and percent of ideal body weight were also obtained. Results: At admission to the Surgical Intensive Care Unit (SICU), the triceps skinfold thickness and mid-arm muscle circumference were significantly lower in the malnourished group than in the well-nourished group (p<.05, respectively). In the clinical outcomes, transfusion of red blood cells, mechanically ventilated hours, length of stay in the Intensive Care Unit (ICU), length of stay in the hospital, and prothrombin time were significantly higher in the malnourished group than in the well-nourished group (p<.05, respectively). The mechanically ventilated hour was significantly higher in the group with less than 50% of their required energy intake (p<.05). Conclusion: Therefore, it is important to assess the nutritional status of immediate postoperative patients. Furthermore, studies on nutritional interventions are urgently needed to provide adequate nutritional care for patients in ICUs.

Outcomes of comprehensive fixed appliance orthodontic treatment: A systematic review with meta-analysis and methodological overview

  • Papageorgiou, Spyridon N.;Hochli, Damian;Eliades, Theodore
    • The korean journal of orthodontics
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    • v.47 no.6
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    • pp.401-413
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    • 2017
  • Objective: The aim of this systematic review was to assess the occlusal outcome and duration of fixed orthodontic therapy from clinical trials in humans with the Objective Grading System (OGS) proposed by the American Board of Orthodontics. Methods: Nine databases were searched up to October 2016 for prospective/retrospective clinical trials assessing the outcomes of orthodontic therapy with fixed appliances. After duplicate study selection, data extraction, and risk of bias assessment according to the Cochrane guidelines, random-effects meta-analyses of the mean OGS score and treatment duration were performed and 95% confidence intervals (CIs) were calculated. Results: A total of 34 relevant clinical trials including 6,207 patients (40% male, 60% female; average age, 18.4 years) were identified. The average OGS score after treatment was 27.9 points (95% CI, 25.3-30.6 points), while the average treatment duration was 24.9 months (95% CI, 24.6-25.1 months). There was no significant association between occlusal outcome and treatment duration, while considerable heterogeneity was identified. In addition, orthodontic treatment involving extraction of four premolars appeared to have an important effect on both outcomes and duration of treatment. Finally, only 10 (39%) of the identified studies matched compared groups by initial malocclusion severity, although meta-epidemiological evidence suggested that matching may have significantly influenced their results. Conclusions: The findings from this systematic review suggest that the occlusal outcomes of fixed appliance treatment vary considerably, with no significant association between treatment outcomes and duration. Prospective matched clinical studies that use the OGS tool are needed to compare the effectiveness of orthodontic appliances.

Direct Lateral Lumbar Interbody Fusion : Clinical and Radiological Outcomes

  • Lee, Young Seok;Park, Seung Won;Kim, Young Baeg
    • Journal of Korean Neurosurgical Society
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    • v.55 no.5
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    • pp.248-254
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    • 2014
  • Objective : According to the recent development of minimally invasive spinal surgery, direct lumbar interbody fusion (DLIF) was introduced as an effective option to treat lumbar degenerative diseases. However, comprehensive results of DLIF have not been reported in Korea yet. The object of this study is to summarize radiological and clinical outcomes of our DLIF experience. Methods : We performed DLIF for 130 patients from May 2011 to June 2013. Among them, 90 patients, who could be followed up for more than 6 months, were analyzed retrospectively. Clinical outcomes were compared using visual analog scale (VAS) score and Oswestry Disability Index (ODI). Bilateral foramen areas, disc height, segmental coronal and sagittal angle, and regional sagittal angle were measured. Additionally, fusion rate was assessed. Results : A total of 90 patients, 116 levels, were underwent DLIF. The VAS and ODI improved statistically significant after surgery. All the approaches for DLIF were done on the left side. The left and right side foramen area changed from $99.5mm^2$ and $102.9mm^2$ to $159.2mm^2$ and $151.2mm^2$ postoperatively (p<0.001). Pre- and postoperative segmental coronal and sagittal angles changed statistically significant from $4.1^{\circ}$ and $9.9^{\circ}$ to $1.1^{\circ}$ and $11.1^{\circ}$. Fusion rates of 6 and 12 months were 60.9% and 87.8%. Complications occurred in 17 patients (18.9%). However, most of the complications were resolved within 2 months. Conclusion : DLIF is not only effective for indirect decompression and deformity correction but also shows satisfactory mechanical stability and fusion rate.

Molecular biomarkers in extrahepatic bile duct cancer patients undergoing chemoradiotherapy for gross residual disease after surgery

  • Koh, Hyeon Kang;Park, Hae Jin;Kim, Kyubo;Chie, Eui Kyu;Min, Hye Sook;Ha, Sung W.
    • Radiation Oncology Journal
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    • v.30 no.4
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    • pp.197-204
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    • 2012
  • Purpose: To analyze the outcomes of chemoradiotherapy for extrahepatic bile duct (EHBD) cancer patients who underwent R2 resection or bypass surgery and to identify prognostic factors affecting clinical outcomes, especially in terms of molecular biomarkers. Materials and Methods: Medical records of 21 patients with EHBD cancer who underwent R2 resection or bypass surgery followed by chemoradiotherapy from May 2001 to June 2010 were retrospectively reviewed. All surgical specimens were reevaluated by immunohistochemical staining using phosphorylated protein kinase B (pAKT), CD24, matrix metalloproteinase 9 (MMP9), survivin, and ${\beta}$-catenin antibodies. The relationship between clinical outcomes and immunohistochemical results was investigated. Results: At a median follow-up of 20 months, the actuarial 2-year locoregional progression-free, distant metastasis-free and overall survival were 37%, 56%, and 54%, respectively. On univariate analysis using clinicopathologic factors, there was no significant prognostic factor. In the immunohistochemical staining, cytoplasmic staining, and nuclear staining of pAKT was positive in 10 and 6 patients, respectively. There were positive CD24 in 7 patients, MMP9 in 16 patients, survivin in 8 patients, and ${\beta}$-catenin in 3 patients. On univariate analysis, there was no significant value of immunohistochemical results for clinical outcomes. Conclusion: There was no significant association between clinical outcomes of patients with EHBD cancer who received chemoradiotherapy after R2 resection or bypass surgery and pAKT, CD24, MMP9, survivin, and ${\beta}$-catenin. Future research is needed on a larger data set or with other molecular biomarkers.

Effect of in vitro testicular spermatozoa culture on pregnancy outcomes: an experience at a single university hospital

  • Lee, Jisun;Yoo, Jung Hyeon;Lee, Jae Hun;Ahn, Hyun Soo;Hwang, Kyung Joo;Kim, Miran
    • Journal of Yeungnam Medical Science
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    • v.38 no.1
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    • pp.53-59
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    • 2021
  • Background: There are no guidelines for the optimal incubation time or temperature to improve pregnancy outcomes in testicular sperm extraction-intracytoplasmic sperm injection (TESE-ICSI) cycles. We aimed to evaluate whether a 24-hour in vitro culture of testicular spermatozoa affects pregnancy outcomes in TESE-ICSI cycles. Methods: This was a retrospective study of 83 TESE-ICSI cycles using testicular spermatozoa in 46 couples with male partners suffering from nonobstructive or obstructive azoospermia. Sperm retrieval was performed either on the oocyte retrieval (OR) day (65 cycles in 33 couples; group A) or on the day before OR (18 cycles in 13 couples; group B) followed by in vitro culture for 24 hours. The clinical characteristics and pregnancy outcomes, including the number of retrieved oocytes, fertilization rates, embryo transfer rates, implantation and clinical pregnancy rates, were compared between the two groups. Results: There were no differences in terms of clinical characteristics except for the levels of luteinizing hormone (LH) in males. Group B had higher LH levels than group A (4.56±1.24 IU/L vs. 3.67±1.07 IU/L, p= 0.017). Group B showed higher fertilization rate (72.4%±32.1% vs. 59.2%±21.7%, p=0.045), implantation rate (35.0%±34.1% vs. 14.0%±21.5%, p=0.010), pregnancy rate per cycle (80% vs. 39%, p=0.033), and clinical pregnancy rate per cycle (80% vs. 37.5%, p=0.024) than those of group A. Conclusion: Testicular sperm retrieval performed on the day before OR followed by in vitro culture can potentially improve pregnancy outcomes.

The effects of surgical treatment and sclerotherapy for intramuscular venous malformations: a comparative clinical study

  • Kim, Yun Hyun;Ryu, Jeong Yeop;Lee, Joon Seok;Lee, Seok Jong;Lee, Jong Min;Lee, Sang Yub;Huh, Seung;Kim, Ji Yoon;Chung, Ho Yun
    • Archives of Plastic Surgery
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    • v.48 no.6
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    • pp.622-629
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    • 2021
  • Background Venous malformations (VMs) are the most common type of vascular malformations. Intramuscular venous malformations (IMVMs) are lesions involving the muscles, excluding intramuscular hemangiomas. The purpose of this study was to compare clinical outcomes between patients with IMVMs who were treated with sclerotherapy and those who were treated with surgical excision. Methods Of 492 patients with VMs treated between July 2011 and August 2020 at a single medical center for vascular anomalies, 63 patients diagnosed with IMVM were retrospectively reviewed. Pain, movement limitations, swelling, and quality of life (QOL) were evaluated subjectively, while radiological outcomes were assessed by qualified radiologists at the center. Complication rates were also evaluated, and radiological and clinical examinations were used to determine which treatment group (sclerotherapy or surgical excision) exhibited greater improvement. Results Although there were no significant differences in pain (P=0.471), swelling (P=0.322), or the occurrence of complications (P=0.206) between the two treatment groups, the surgical treatment group exhibited significantly better outcomes with regard to movement limitations (P=0.010), QOL (P=0.013), and radiological outcomes (P=0.017). Moreover, both duplex ultrasonography and magnetic resonance imaging showed greater improvements in clinical outcomes in the surgical excision group than in the sclerotherapy group. Conclusions Although several studies have examined IMVM treatment methods, no clear guidelines for treatment selection have been developed. Based on the results of this study, surgical excision is strongly encouraged for the treatment of IMVMs.

Effects of Action Learning Approaches on Learning Outcomes in Nursing Management Courses (액션러닝 기반 간호관리학 강의 및 실습 운영의 효과)

  • Jang, Keum Seong;Park, Soon Joo
    • Journal of Korean Academy of Nursing Administration
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    • v.18 no.4
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    • pp.442-451
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    • 2012
  • Purpose: The purpose of this study was to identify effects of action learning approaches on learning outcomes of students taking nursing management courses. Methods: The questionnaire surveys were completed between March 2011 and June 2012 by 109 undergraduate seniors in the nursing department of C University. Survey data were obtained 3 times: before, in and after the study of nursing management. The course consisted of lectures and clinical practices. Learning outcomes were measured through problem solving skills, team efficacy, and class satisfaction. Collected data were analyzed using repeated measures ANOVA with the SPSS 20.0 program Results: Scores for problem solving skills (F=13.67, p<.001) and team efficacy (F=4.49, p=.012) showed statistically significant increases after the course. The scores also increased significantly after the lectures for 5 of 9 problem solving skill subscales: analysis skill, divergent thinking, decision making, assessment, feedback, and after the clinical practices for 2 subscales: divergent thinking, and execution and risk taking. Class satisfaction score also increased after both the lectures and the clinical practices. Conclusion: The findings from this study suggest that an action learning approaches for nursing management courses would be a useful teaching and learning method to achieve learning outcomes.

Kimura's Disease - Clinical Characteristics and Treatment Outcomes - (기무라병의 임상특성과 치료성적)

  • Hong Soon-Gi;Choi Jin-Sub;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.10 no.1
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    • pp.7-12
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    • 1994
  • The clinical features and treatment outcomes of 20 patients with Kimura's disease treated from 1981 to 1993 were analyzed to determine proper therapeutic modalities. The mean age was 36.3 yrs old (range l4-53yrs) and the male to female ratio was 1.5:1 (male:female=12:8). Among 20 patients, 13 had multiple lesions and the remaining 7 had single lesion. Almost all lesions were found in the head and neck area(41 lesions) and only 7 in the other sites. The initial treatment modalities were excision, excision with immunotherapy, radiotherapy with immunotherapy, or immunotherapy(steroid, azathioprine). Among 17 patients who could be followed up, a recurrent or persistent disease was found in 13 patients. The retreatment modalities for patients with recurrent lesions were excision, excision with immunotherapy, or immunotherapy. The retreatment outcomes were also disappointing. The proper therapeutic modality of the Kimura's disease is not established yet, but the radiotherapy after excision or immunotherapy seems to be more effective than others.

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