• 제목/요약/키워드: Clinical stress

검색결과 1,847건 처리시간 0.03초

Force Assessment of Thermoformed and Direct-printed Aligners in a Lingual Bodily Movement of a Central Incisor Over Time: A 14-day In Vitro Study

  • Mary Linda Remley;Gabriel Ferreira Pessoa Carvalho Miranda ;Brent Bankhead;Julie McCray;Ki Beom Kim
    • Journal of Korean Dental Science
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    • 제16권1호
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    • pp.23-34
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    • 2023
  • Purpose: This study aims to investigate the force delivery profile of thermoformed aligners (TFA) compared with direct-printed aligners (DPA) and to explore the effect of different activation amounts on forces and moments of respective groups. A secondary objective is to observe the amount of stress relaxation that occurs over the 7~14 days when aligners are maintained in a simulated intraoral environment. Materials and Methods: An in vitro setup was created to quantify forces and moments. It consisted of a three dimensional-printed base plate and segmented maxillary teeth, placed in a semi-enclosed chamber to maintain a temperature of 37℃. Ninety clear aligners were divided into nine groups of ten aligners each based on material types (Zendura, ATMOS, TC-85) and activation amounts. Aligners were created with 0.00, 0.25- and 0.50-mm activations for lingual bodily movement of the upper left central incisor and kept on models in the "stressed" position in a 37℃ water bath. Three force components acting on the upper left lateral incisor, upper left central incisor, and upper right central incisor were measured for each time point, beginning from the initial baseline measurement, 8 hours, 16 hours, 24 hours, 2 days, 3 days, 4 days, 5 days, 6 days, 7 days, and lastly, 14 days. Result: TC-85 aligners in every activation group showed less force on teeth than Zendura and ATMOS. Significant force levels from 0.0 mm activation were present and stayed consistent over the course of 14 days. Comparisons made for baseline measurements to 7-days and 14-days showed statistically significant change from the baseline force level. Conclusion: TC-85 aligners demonstrated lower, more consistent forces with fewer side effects. Aligners can generate forces even when no activation is programmed. No major decreases in force levels over time were observed; the intra-oral clinical simulated environment and length of observation time could contribute to this.

Application of Patient-Specific 3D-Printed Orthopedic Splint for Bone Fracture in Small Breed Dogs

  • Kwangsik Jang;Eun Joo Jang;Yo Han Min;Kyung Mi Shim;Chunsik Bae;Seong Soo Kang;Se Eun Kim
    • 한국임상수의학회지
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    • 제40권4호
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    • pp.268-275
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    • 2023
  • In this paper, we designed 3D-printed orthopedic splint models for patient-specific external coaptation on fracture healing and analyzed the stability of the models through finite element method (FEM) analysis under compressive load conditions. Polylactic acid (PLA) and acrylonitrile-butadiene-styrene (ABS) based 3D splint models of the thicknesses 1, 3, 5 and 7 mm were designed, and Peak von Mises stress (PVMS) and maximum displacement (MD) of the models were analyzed by FEM under compressive loads of 50, 100, 150, and 200 N. The FEM results indicated that PVMS and MD values, regardless of material, had a negative correlation with the thickness of the models and a positive correlation with the compressive load. There was a risk of splint deformation under conditions more extreme than 100 N with 5 mm thickness. For successful clinical application of 3D-printed orthopedic splints in veterinary medicine, it is recommended that the splint should be produced not less than 5 mm thickness. Also, it is expected to be stable when the splint is applied to situations with a compressive load of 100 N or less. There is an advantage of overcoming the limitations of the existing bandage method through 3D-printing technology as well as verifying the stability through 3D modeling before application. Such 3D printing technology will be widely used in veterinary medicine and various fields as well as orthopedics.

북한이탈주민의 고문으로 인한 외상 후 충격에 영향을 미치는 요인 (A Study on the recovery predictive factors for North Korean refugees with torture experience)

  • 김현경
    • 사회복지연구
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    • 제41권3호
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    • pp.81-106
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    • 2010
  • 본 연구는 고문을 경험한 북한이탈주민들을 대상으로 그들의 인구사회학적 요인, 정신건강·개인의 성격적 요인, 사회적·경제적 요인들이 고문으로 인한 외상 후 충격에 어떠한 영향을 미치는지 밝혀 봄으로써 난민이주자를 접촉하는 정신건강전문가로서 인식해야할 치료적 요인들을 확인하고 실천적 기술을 제시하고자 하였다. 결과적으로 여성인 경우, 연령이 많을수록, 북한에 자녀가 있는 경우, 만성질병의 수가 증가할수록, 과거 북한이나 중국에서 결혼 경험이 있는 경우 고문으로 인한 외상 후 충격에 유의한 차이를 보였다. 또한 우울, 반추, 자기효능감, 탄력성, 안정애착, 남한사람의 사회적 지지, 경제적 걱정이 고문으로 인한 외상 후 충격에 영향을 미치는 예측요인으로 밝혀졌다. 이러한 연구 결과를 바탕으로 정신건강전문가와 고문 외상을 경험한 북한이탈주민 클라이언트와의 치료적 관계 형성의 중요성과 치유과정을 함축적으로 제시하였다.

지지간호가 미숙아 어머니의 산후 우울에 미치는 효과 (The Effects of Supportive Nursing Management on Postpartum Depression of Mothers with Premature Infants)

  • 김은숙;김은영;이지연;김진경;이현주;이승희;김지영;원하연
    • 임상간호연구
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    • 제15권3호
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    • pp.157-170
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    • 2009
  • Purpose: This quasi-experimental study was conducted to investigate the effects of supportive nursing management on postpartum depression in the mothers with premature infants. Methods: The subjects were 21 mothers who delivered premature babies in a university hospital. The experimental group of 10 mothers was provided with supportive nursing management program by nurses in neonatal ICU and the control group of 11 mothers was provided with usual management only. The designed programs were given 4 times to the experimental group while their babies were hospitalized, and telephone consultation was provided 3 times after discharge. The stress, anxiety, identity, support from their husbands & family members, and postpartum depression were measured 3 times using Edinburgh Postnatal Depression Scale (the 4th day of premature's hospitalization, the day of discharge and the day of 4 weeks after discharge). Results: There was no significant difference in general characteristics and the influential factors of postpartum depression between the two groups, so they were homogeneous. There was no significant difference in depression (F=0.01, p=.917). However there was significant difference over time (F=6.74, p=.003) and the interaction between measurement time and treatment (F=3.59, p=.037). Conclusion: The supportive nursing management on postpartum depression of mothers with premature infants is considered effective and useful in reducing postpartum depression. Further research is warranted to investigate paternal depression and the program's long-term effects.

Effects of High-Frequency Treatment using Radiofrequency on Autonomic Nervous System and Pain in Women with Dysmenorrhea

  • Sungeon Park;Seungwon Lee;Inok Kim
    • Physical Therapy Rehabilitation Science
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    • 제11권4호
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    • pp.493-501
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    • 2022
  • Objective: The purpose of this study is to present basic data for appropriate therapeutic intervention by confirming changes in the autonomic nervous system and pain by applying high-frequency deep diathermy to the lower abdomen in patients with primary dysmenorrhea. Design: A randomized controlled clinical trial. Methods: Thirty-eight women aged 18-50 years who complained of regular menstrual cycles (24-32 days) and primary dysmenorrhea symptoms were randomly assigned to a high-frequency therapy group (5, 7, or 9 mins) and a superficial heat therapy group (20 min). High frequency treatment group: The subject was in a supine position, and radio frequency was applied to the lower abdomen below the umbilicus. The radio frequency therapy device used in this study uses a 300 kHz capacitive electrode and a 500 kHz resistive electric transfer to deliver deep heat. Superficial heat treatment Group: Subjects applied a hot pack to the lower abdomen for 20 minutes while lying on their back. Evaluations were made of Heart rate variability and Visual Analogue Scale. Results: In subjects with menstrual pain, there was a significant difference in pain between the high-frequency therapy group and the superficial heat therapy group (p=0.026). However, there was no significant difference between the autonomic nervous system and the stress resistance (p>0.05). Conclusions: As a result of this study, high-frequencytreatment using radiofrequency was effective in relieving pain because it can penetrate deeper tissues than conventional hot packs using superficial heat. In particular, it was found that the optimum effect was obtained when high frequency was applied forfive-seven minutes.

턱관절균형의학에서 편차발생현상의 신경과학 및 재료역학적 해석과 일반화 (Interpretation and Generalization by Neuroscience and Material Mechanics on Deviation in Temporomandibular Joint Balancing Medicine)

  • 지규용
    • 턱관절균형의학회지
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    • 제12권1호
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    • pp.1-6
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    • 2022
  • Objectives: For the deviation phenomenon occurring during the treatment process in temporo-mandibular balancing medicine (TBM), hypotheses were established regarding the cause and mechanism of formation from the perspective of neuro-science and material mechanics, and a verification method was proposed. Methods: The deviation phenomenon was theoretically analyzed based on the structure theories of material mechanics of the joint and the neurological pain mechanism. Results: Deviation occurs due to temporary yield by the accumulation of heterogeneous stress in the temporo-mandibular joint and the affected joint. Because the joint structures are corresponding with material mechanics showing compressive and tensile properties. The size of the deviation is expressed in terms of strain. The occlusal surface of the teeth is level with the axial joint. Since the magnitude of the deviation has a proportional relationship with the degree of abnormality of the temporo-mandibular joint, the magnitude of the deviation calculated by the balance measurement can be replaced by the strain. The major variables involved in the occurrence of deviations are the strength of joint structures and neurological conditions. Therefore plastic deformation and adaptation occur as a long-term depression of neural circuits is strengthened in different ways at different locations each time in various clinical situations. This is the reason why the sequence of the restoration process while correcting deviations is following reverse order of the accumulation in many layers in the muscular nervous system. Conclusions: From the above results, it can be inferred that the occurrence and correction of the deviations are corresponding with the plastic deformation and neuro-plasticity.

Supporting Resilience and the Management of Grief and Loss among Nurses: Qualitative Themes from a Continuing Education Program

  • Esplen, Mary Jane;Wong, Jiahui;Vachon, Mary L.S.
    • Journal of Hospice and Palliative Care
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    • 제25권2호
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    • pp.55-65
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    • 2022
  • Caring for patients with cancer is highly stimulating and rewarding, attracting health professionals to the field who enjoy the challenge of managing a complex illness. Health professionals often form close bonds with their patients as they confront ongoing disease or treatment impacts, which may be associated with multiple losses involving function and/or eventual loss of life. Ongoing exposure to patient loss, along with a challenging work setting, may pose significant stress and impact health professionals' well-being. The prevalence rates of burnout and compassion fatigue (CF) are significant, yet health professionals have little knowledge on these topics. A 6-week continuing education program consisting of weekly small-group video-conferencing sessions, case-based learning, and an online community of practice was delivered to health care providers providing oncology care. Program content included personal, organization and team-related risk and protective factors associated with CF, grief models, and strategies to mitigate against CF. Content analysis was completed as part of the program evaluation. In total, 189 participants (93% nurses) completed the program, which was associated with significant improvements in confidence and knowledge of CF and strategies to support self and team resilience. Qualitative themes and vignettes from experiences with the program are presented. Key themes included knowledge gaps, a lack of support related to CF and strategies to support resilience, organization-and team-based factors that can inhibit expression about the impacts of clinical work, the health professional as a "person" in caregiving, and the role of personal variables, self-skill practices, and recommendations for education and support for self and teams.

만져지는 경부 종괴로 나타난 현성 스파르가눔증: 증례 보고 및 문헌고찰 (Apparent Sparganosis Presenting as a Palpable Neck Mass: A Case Report and Review of Literature)

  • 황민희;백혜진;이상민
    • 대한영상의학회지
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    • 제81권5호
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    • pp.1210-1215
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    • 2020
  • 스파르가눔증은 스피로메트라 아속의 유충 감염에 의해 발생하는 드문 기생충 질환이다. 경부 스파르가눔증은 드문 질환이기 때문에 림프절 병증이나 연부 조직 종양으로 오인되어 진단이 어려울 수 있다. 저자들은 영상 소견이 진단에 중요한 역할을 하였던 53세 여성 환자의 현성 경부 스파르가눔증의 증례를 보고한다. 이 증례 보고를 통해 저자들은 만져지는 경부 종물이 있을 때 스파르가눔증을 감별진단으로 고려해야 하며, 정확한 진단을 위해서는 스파르가눔증에 대한 임상적 의심 및 영상의학적 소견에 대한 이해가 중요함을 강조하고자 한다.

Transaxillary Capsulorrhaphy with Reimplantation to Correct Bottoming-Out Deformity in Breast Mycobacterial Periprosthetic Infection: A Case Report with Literature Review

  • Tsung-Chun Huang;Jian-Jr Lee;Kuo-Hui Yang;Chia-Huei Chou;Yu-Chen Chang
    • Archives of Plastic Surgery
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    • 제50권6호
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    • pp.557-562
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    • 2023
  • Augmentation mammoplasty is one of the most popular cosmetic surgeries, but there is a high reoperation rate (29.7%) commonly due to capsular contracture, implant malpositioning, infection, and unsatisfactory size. Although infection only accounts for 2% of cases, its management is very challenging, especially with nontuberculous mycobacteria (NTM) infection. Breast prosthetic NTM infection is a rare but is a disastrous condition with an incidence of approximately 0.013%. Immediate salvage reimplantation is usually not suggested, and most studies recommend a gap of 3 to 6 months after combination antibiotics therapy before reimplantation. However, delayed reimplantation often leads to great psychological stress and struggle between the doctor and patient. We present the case report of successful reimplantation in treating prosthetic NTM infections in a 28-year-old female. We discuss a novel technique "transaxillary capsulorrhaphy" to correct the bottoming-out deformity. One year after the combination of antibiotics and surgery, the follow-up computed tomography scan showed complete remission of NTM without recurrence. We discuss the surgical technique in detail. The 1-year follow-up assessment (photos and dynamic video) revealed good cosmesis and reliable correction using the new technique. This report is the first formal description and discussion of one-stage reimplantation following NTM infections. Transaxillary capsulorrhaphy allows for a successful salvage operation when an implant is displaced. This approach provides highly favorable result in eastern women undergoing revision augmentation mammoplasty. This study reflects level of evidence V, considering opinions of respected authorities based on clinical experience, descriptive studies, or reports of expert committees.

Retinoic acid loaded with chitosan nanoparticles improves spermatogenesis in scrotal hyperthermia in mice

  • Fatemeh Mazini;Mohammad-Amin Abdollahifar;Hassan Niknejad;Asma Manzari-Tavakoli;Mohsen Zhaleh;Reza Asadi-Golshan;Ali Ghanbari
    • Clinical and Experimental Reproductive Medicine
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    • 제50권4호
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    • pp.230-243
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    • 2023
  • Objective: High temperatures can trigger cellular oxidative stress and disrupt spermatogenesis, potentially leading to male infertility. We investigated the effects of retinoic acid (RA), chitosan nanoparticles (CHNPs), and retinoic acid loaded with chitosan nanoparticles (RACHNPs) on spermatogenesis in mice induced by scrotal hyperthermia (Hyp). Methods: Thirty mice (weighing 25 to 30 g) were divided into five experimental groups of six mice each. The groups were as follows: control, Hyp induced by a water bath (43 ℃C for 30 minutes/day for 5 weeks), Hyp+RA (2 mg/kg/day), Hyp+CHNPs (2 mg/kg/72 hours), and Hyp+RACHNPs (4 mg/kg/72 hours). The mice were treated for 35 days. After the experimental treatments, the animals were euthanized. Sperm samples were collected for analysis of sperm parameters, and blood serum was isolated for testosterone measurement. Testis samples were also collected for histopathology assessment, reactive oxygen species (ROS) evaluation, and RNA extraction, which was done to compare the expression levels of the bax, bcl2, p53, Fas, and FasL genes among groups. Additionally, immunohistochemical staining was performed. Results: Treatment with RACHNPs significantly increased stereological parameters such as testicular volume, seminiferous tubule length, and testicular cell count. Additionally, it increased testosterone concentration and improved sperm parameters. We observed significant decreases in ROS production and caspase-3 immunostaining in the RACHNP group. Moreover, the expression levels of bax, p53, Fas, and FasL significantly decreased in the groups treated with RACHNPs and RA. Conclusion: RACHNPs can be considered a potent antioxidative and antiapoptotic agent for therapeutic strategies in reproductive and regenerative medicine.