• Clinics in Shoulder and Elbow
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• 제25권1호
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• pp.49-56
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• 2022

Background: The treatment approach for proximal humeral fractures is determined by various factors, including patient age, sex, dominant arm, fracture pattern, presence of osteoporosis, preexisting arthritis, rotator cuff status, and medical comorbidities. However, there is a lack of consensus in the literature regarding the optimal treatment for displaced proximal humeral fractures. This study aimed to assess and quantify the decision-making process for either conservative or surgical treatment and the choice of surgical method among shoulder surgeons when treating proximal humeral fractures. Methods: Forty sets of true anteroposterior view, scapular Y projection view, and three-dimensional computed tomography of proximal humeral fractures were provided to 12 shoulder surgeons along with clinical information. Surveys regarding Neer classification, decisions between conservative and surgical treatments, and chosen methods were conducted twice with an interval of 2 months. The factors affecting the treatment plans were also assessed. Results: The inter-rater agreement was fair for Neer classification (kappa=0.395), moderate for the decision between conservative and surgical treatments (kappa=0.528), and substantial for the chosen method of surgical treatment (kappa=0.740). The percentage of agreement was 71.1% for Neer classification, 84.6% for the decision between conservative and surgical treatment, and 96.4% for the chosen method of surgical treatment. The fracture pattern was the most crucial factor in deciding between conservative and surgical treatments, followed by age and physical activity. Conclusions: The decision between conservative and surgical treatment for proximal humeral fractures showed good agreement, while the chosen method between osteosynthesis and arthroplasty showed substantial agreement among shoulder surgeons.

• 구강회복응용과학지
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• 제26권3호
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• pp.339-347
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• 2010

이전에 존재하던 컴포지트와 새로운 컴포지트 사이의 결합강도의 강화는 미세 기계적 유지를 증진하기 위한 표면 거칠기의 증가가 필요하다. 이 연구는 시효처리 후의 레진 컴포지트의 repair 결합강도에 다른 표면처리의 효과를 평가하는 것이다. 알루미늄 옥사이드를 이용한 air abrasion, chair-side silica coating한 그룹들에서 대조군과 불산 적용에 비하여 유의하게 높은 결합강도를 보였다. 레진 수복물의 repair시에 air abrasion의 사용은 필요한 것으로 보이며 부가적으로 silane의 적용은 결합강도에 긍정적 영향을 미치는 것으로 보인다.

• Restorative Dentistry and Endodontics
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• 제21권2호
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• pp.585-601
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• 1996

The purpose of this study was to elucidate the effect of blood-and saliva-contamination during dentin pretreatment procedure on tensile bond strength, and to investigate the effect of contaminant-removing treatments on the recovery of bond strength of dentin bonding agents. Dentin specimens prepared from freshly extracted bovine mandibular anterior teeth were divided into non-contaminated control and contaminated experimental groups. The specimens of the contaminated group were contaminated with saliva or blood after etching or priming procedure, followed by contaminant-removing treatments. All the specimens were bonded with All Bond$^{(R)}$ 2 dentin bonding agent and Bisfil$^{TM}$ composite resin or Scotchbond$^{TM}$ Multipurpose and Z100. After all the bonded specimens were stored in $37^{\circ}C$ distilled water for 24 hours, tensile bond strengths were measured. The contaminated dentin and fractured dentin surfaces were examined under the scanning electron microscope. The results were as follows : Contaminated specimens showed lower bond strength than non-contaminated ones regardless of the kind of contaminant, contamination time and contaminant-removing treatments, except specimens which were acid-etched following saliva contamination after etching in All Bond$^{(R)}$ 2 groups (p<0.05). Blood contaminant resulted in much bond strength decrease than saliva ones (p<0.01), and contamination after priming resulted in much decrease in bond strength than after etching (p<0.01). Re-etching resulted in increase of bond strength in the specimens contaminated with saliva after etching but not in blood contaminated ones. Re-priming resulted in increase of bond strength in the specimens contaminated after priming regardless of the kind of contaminant.

• Archives of Reconstructive Microsurgery
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• 제20권2호
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• pp.102-107
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• 2011

Purpose: As clinical manifestations of thoracic outlet syndrome are vague pain or symptoms in upper extremity, the diagnosis of the disease is delayed or misdiagnosed as cervical HNP, shoulder pathologies, or peripheral neuropathies. In that reason, many patients spend time for unnecessary or ineffective treatments. We report the results of our thoracic outlet syndrome cases, which were treated by conservative care or surgical treatment. Materials & Methods: Twenty five cases, diagnosed as thoracic outlet syndrome since 1999, were reviewed retrospectively. Physical examinations including Adson's and reverse Adson's test, hyperabduction test, costoclavicular maneuver, and Roo's test, plain radiography of shoulder and cervical spine, MRI of neck or brachial plexus, and EMG were checked. If subjective symptoms were not improved after conservative treatments over three months, surgical treatment were performed. Nine patients were performed operative treatment and the others had conservative treatment in outpatient clinic. Postoperative improvement of symptoms and the follow up period, and the results of conservative care were reviewed. Results: Among five physical examinations, mean 1.75 tests were positive, and EMG has little diagnostic value. MRI were performed in twenty cases and compression of brachial plexus were found in 6 cases (30%). Ten patients out of 16 conservative treatment group had excellent improvement of symptoms, and 5 had good results. Eight patients out of 9 operative treatment group had excellent improvement with mean 5.1 months of follow-up period. Conclusion: Diagnosis of thoracic outlet syndrome is difficult due to bizarre and vague symptoms. However if the diagnosis is suspected by careful physical examinations, radiologic studies, or nerve conduction studies, conservative care should be done as initial treatment and at least after three months, reassess the patient's condition. If the results of conservative treatment is not satisfactory and still the thoracic outlet syndrome is suspected, surgical treatment should be considered. Conservative treatment and operative technique are the valuable for the treatment of this disease.

• Journal of Oral Medicine and Pain
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• 제32권2호
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• pp.241-250
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• 2007

측두하악장애 재발 환자의 증상과 보존적 치료결과에 대하여 알아보고자 1994년부터 2002년까지 부산대학병원 구강내과에 내원하여 측두하악장애로 진단되어 약물요법, 물리치료, 교합안정장치 등 보존적 치료를 받은 환자 104명(원발군, 대조군)과 1991년부터 2001년까지 부산대학병원 구강내과에 내원하여 측두하악장애로 진단되어 보존적 치료를 받은 후에 증상이 재발하여 1992년부터 2002년에 걸쳐 보존적인 방법으로 재치료를 받은 환자 54명(재발군, 실험군)을 대상으로 서로 비교하여 다음과 같은 결과를 얻었다. 1. 원발군과 재발군은 모두 보존적 처치로 증상이 현저히 개선되었다. 2. 원발군과 재발군의 초진시 증상은 통증, 개구제한, 최대 편이개구량은 차이가 없었으나 관절잡음은 원발군에서 높았다. 3. 원발군과 재발군의 치료 종결시 증상은 통증, 개구제한, 최대 편이개구량은 차이가 없었으나 관절잡음은 재발군에서 높았다. 4. 원발군과 재발군 모두 치료방법, 성, 병명에 따른 치료결과의 차이는 없었다. 5. 원발군은 치료기간이 6개월 이상 일수록, 치료횟수가 10회 이상일수록 치료결과가 양호하였다.

• 대한한방소아과학회지
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• 제27권1호
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• pp.15-25
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• 2013

Objectives Scoliosis is that spine's arrangement was changed to be curved. Mostly scoliosis was found at childhood and recently rate of scoliosis is increasing. Causes of scoliosis were very various, but the patients are due to idiopathic reasons. Scoliosis was treated by conservative treatment or surgery treatment. If scoliosis is diagnosed early enough, it can be treated with conservative treatment. Methods We are searching PubMed by keywords and found 47 theses complied with requirements. Results Studies of conservative treatment of Scoliosis were active. Conservative treatments are considered before surgery treatment and there was a set guideline of conservative treatment. Also, there were several studies about effectiveness of conservative treatment and quality of life, mental stress. Studies about various kinds of conservative treatment were found as well. There were brief studies about introduction of new brace, effectiveness of several braces, and case studies. Conclusions Conservative treatment is very effective choice before surgery treatment at Scoliosis patient.

• 척추신경추나의학회지
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• 제6권1호
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• pp.129-139
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• 2011

Objectives : The propose of this study is to find out the clinical application of conservative treatment for SLAP lesion. Methods : We examined 2 patients with SLAP lesion who admitted Jaseng Hospital of Oriental Medicine. The patients were treated by conservative treatments including herbal mixture, acupuncture, pharmacupuncture. Results : In this study, in the end of continuous conservative treatment, patient's shoulder pain has improved. Visual Analog Score(VAS) were also decreased. Conclusions : A conservative treatment for SLAP lesion was effective in restore of functional activities, but usefulness of this treatment needs more study.

• Restorative Dentistry and Endodontics
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• 제24권3호
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• pp.473-481
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• 1999

This study evaluated the shear bond properties of IPS Empress glass ceramic to enamel and dentin surfaces with three ceramic surface treatments, and three resin cements. The influence of thermocycling was also investigated. The purpose of this study was to investigate the influences of resin cements, ceramic surface treatments, and thermocycling on shear bond properties. Ninety freshly extracted, noncarious human molars were selected for this study. The surface treatments of ceramic were etching <5.0% hydrofluoric acid, application of silane coupling agents(Tokuso Ceramic Primer, Clearfil porcelain bond, Monobond-S), and the combination of the two methods. Empress cylinders were bonded to enamel and dentin surfaces with three kinds of resin cements(Bistite resin cement, Panavia 21, Variolink). The specimens were aged in $37^{\circ}C$ distilled water for 24 hours. Half of the specimens were then thermocycled 500times between $5^{\circ}C$ and $55^{\circ}C$ with a dwell time of 15 seconds. Each specimen was debonded in shear mode and measured shear bond properties by using the universal testing machine(Zwick 020, Germany). The data were analyzed by SPSS/PC+(one-way ANOVA, Scheffe' s test and t-test). The results were as follows : 1. Without thermocyling, there was significant difference of shear bond strength to enamel surface between Bistite Resin Cement and Panavia 21 in case of etched and silane-treatment(p<0.05). 2. Without thermocyling, the shear bond strength of a group treated with silane and etching was significantly higher than that of a group treated with silane or etching with the application of Panavia 21 and Variolink(p<0.05). 3. A group treated with etching with the application of Variolink only showed a decrease of shear bond strength after thermocycling(p<0.05).

• 척추신경추나의학회지
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• 제5권1호
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• pp.111-124
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• 2010

Objectives: The purpose of this study is to report clinical effects of oriental medicine w~h conservative treatments including acupuncture, Chuna treatment and herbal medicine on a patient with low back pain and lower limb numbness caused by HIVD and schwannoma. Methods: The patient was diagnosed with HIVD and schwannoma through the MRI scan. This case was treated with acupuncture, Chuna treatment and herbal medicine during the whole admission period. We evaluated the progress of the symptoms with objective criteria such as NRS(Numerical Rating Scale), SLRT(Straight Leg Raising Test), ODI(Oswestry Disability Index) score and MMT(Manual Muscle Testing). Results and Conclusions: After weeks of conducting conservative treatment on patient with low back pain and lower limb numbness caused by HIVD and schwannoma occurred at the lumbar spine, significant improvements of the symptoms were seen. These results suggest that in the case of low back pain and lower limb numbness caused by HIVD and schwannoma, conservative treatments can be considered as one of the options of treating the symptoms beside surgical way.

• 한국전문물리치료학회지
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• 제6권3호
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• pp.110-120
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• 1999

Lymphedema, regardless of etiology, is essentially incurable but different treatment approaches which serve to contain swelling exist. The objectives of treatment are to reduce swelling, restore shape, educate about the self-maintenance methods, and prevent inflammatory episodes, eg, recurrent cellulitis. The purpose of this report is to provide therapists and other medical staff with a general guideline through the example treatment procedure of two patients with lymphedema admitted to Samsung Medical Center. This study demonstrates the effects of the various treatments used and how they helped to achieve improvement in mobility and reduction in swelling of the lower limbs. The basic conservative treatments were sequential intermittent pneumatic pumps, elevation, and CDP (complex decongestive physiotherapy). The surgical procedures (Homan's operation) were carried out after maximal volume reduction through conservative programs. In these cases, we can see greater than 50% reduction in the lymphedema in those treated by conservative and surgical procedures. This presents a simple, reliable, variable method yielding satisfactory cosmetic and functional results for patients suffering from chronic both-leg lymphedema. Futhermore, I suggest that the outcomes are best when treatment is administered by a multidisciplinary team including a physiotherapist, surgeon, nurse, et al.