• Title/Summary/Keyword: Evidence-Based Treatment

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Review of root canal irrigant delivery techniques and devices (최신 근관 세척 방법과 기구에 대한 고찰)

  • Yoo, Yeon-Jee;Shin, Su-Jeong;Baek, Seung-Ho
    • Restorative Dentistry and Endodontics
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    • v.36 no.3
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    • pp.180-187
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    • 2011
  • Introduction: Eliminating the residual debris and bacteria in the root canal system is one of the main purposes of the endodontic treatment. However, the complexity on the anatomy of the root canal system makes it difficult to eliminate the bacterial biofilm existing along the root canal surface and necrotic pulp tissue by mechanical instrumentation and chemical irrigation. Recently, more effective irrigant delivery systems for root canal irrigation have been developed. The purpose of this review was to present an overview of root canal irrigant delivery techniques and devices available in endodontics. Review: The contents of this paper include as follows; - syringe-needle irrigation, manual dynamic irrigation, brushes - sonic and ultrasonic irrigation, passive ultrasonic irrigation, rotary brush, RinsEndo, EndoVac, Laser Conclusion: Though technological advances during the last decade have brought to fruition new agitation devices that rely on various mechanisms, there are few evidence based study to correlate the clinical efficacy of these devices with improved outcomes except syringe irrigation with needle and ultrasonic irrigation. The clinicians should try their best efforts to deliver antimicrobial and tissue solvent solutions in predictable volumes safely to working length.

Developing Evaluation Index and Item for Water Environment Improvement of Gyeongin ARA Waterway (경인 아라뱃길의 물환경 개선을 위한 오염원인 평가항목 및 지표 개발)

  • Lee, Kyung-Su;Kim, Tae-Hyeong
    • The Journal of the Korea Contents Association
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    • v.18 no.8
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    • pp.469-482
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    • 2018
  • This research has developed the criteria and index for systematically and objectively assessing the quality of river water by fixing the various factors that affect Gyeongin ARA waterway's water quality through analysis with the Delphi Technique and analytic hierarchy program (AHP) Method. Based on the results, the highest criteria are, in order of importance, physical and environmental factors 28%, administrative factors 26%, natural fixed factors 26% and finally, cultural and social factors 20%. The three dimensions of the criteria show that for the internal physical and environmental factors, the most important are the loss of self-purification capacity, and the external factors are Gulpocheon and the sludge deposit due to Gyulhweon-weir the bridge. The facility factor in management was affected by the coagulation and waste water disposal facilities. The problem for the policy and institutional factors was seen in the regulatory area. The aquatic ecology/ point pollution source for the natural fixed factors show that it is due to the polluted water of Gulpo-cheon and the living environment/ non-point pollution source is shown through the inflow water from other rivers. Cultural and social factors show that the economical causes were due to the cargo and passenger flight operations and the external factors of having a lack of sewage treatment equipment have an importance effect. In order to estimate the order of priority through logical evidence and objectivity, future research must be continued on the evaluation indexes to measure the specific methodology and technique needed to improve the Gyeongin ARA Waterway.

Analysis of Performance on Activities in Critical Pathway of Total Hip Replacement Surgery (고관절 전치환술 환자의 임상관리도 수행 정도)

  • Lim, You Jin;Jeong, Kyung In;Jeong, Ha Yun;Sun, JeongJu;Kim, Yun Kyung;Choi, Ji Kyung;Lee, Kum Lae;Kim, Jeong Suk;Yang, Jin Ju;Kim, Hye Ja;Jang, Keum Seong;Choi, Ja Yun
    • Korean Journal of Adult Nursing
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    • v.18 no.5
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    • pp.819-827
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    • 2006
  • Purposes: The purpose of this study was to evaluate the extent of performance on activities in critical pathway (CP) according to eight domains and six admission days on nursing records of patients who received total hip replacement surgery. Methods: We reviewed 90 nursing records of patients who received total hip replacement surgery from June, 2004 to July, 2005 at C University Hospital. Data were collected using Hong's CP (2002) and were analyzed using ANOVA. Results: The domain of diet was valued the highest in CP performance scoring, followed by the domains of assessment, activities, and test. There were differences in the performance scores according to the period of admission in all of the domains. Among 132 activities in the CP, 18 activities were completely performed, of which most included activities belonging to the domain of assessment on the admission day. Twelve activities were never performed, of which most included activities belonging to the domain of treatment on the day of operation and the first day after operation. Conclusions: Therefore, further studies on the development of a new system to increase CP utilization and on updating the contents of CP from the best practice based on evidence is recommended.

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Predictive Value of Xrcc1 Gene Polymorphisms for Side Effects in Patients undergoing Whole Breast Radiotherapy: a Meta-analysis

  • Xie, Xiao-Xue;Ouyang, Shu-Yu;Jin, He-Kun;Wang, Hui;Zhou, Ju-Mei;Hu, Bing-Qiang
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.12
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    • pp.6121-6128
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    • 2012
  • Radiation-induced side effects on normal tissue are determined largely by the capacity of cells to repair radiation-induced DNA damage. X-ray repair cross-complementing group 1 (XRCC1) plays an important role in the repair of DNA single-strand breaks. Studies have shown conflicting results regarding the association between XRCC1 gene polymorphisms (Arg399Gln, Arg194Trp, -77T>C and Arg280His) and radiation-induced side effects in patients undergoing whole breast radiotherapy. Therefore, we conducted a meta-analysis to determine the predictive value of XRCC1 gene polymorphisms in this regard. Analysis of the 11 eligible studies comprising 2,199 cases showed that carriers of the XRCC1 399 Gln allele had a higher risk of radiation-induced toxicity than those with the 399 ArgArg genotype in studies based on high-quality genotyping methods [Gln vs. ArgArg: OR, 1.85; 95% CI, 1.20-2.86] or in studies with mixed treatment regimens of radiotherapy alone and in combination with chemotherapy [Gln vs. ArgArg: OR, 1.60; 95% CI, 1.09-2.23]. The XRCC1 Arg399Gln variant allele was associated with mixed acute and late adverse reactions when studies on late toxicity only were excluded [Gln allele vs. Arg allele: OR, 1.22; 95% CI, 1.00-1.49]. In contrast, the XRCC1 Arg280His variant allele was protective against radiation-induced toxicity in studies including patients treated by radiotherapy alone [His allele vs. Arg allele: OR, 0.58; 95% CI, 0.35-0.96]. Our results suggest that XRCC1 399Gln and XRCC1 280Arg may be independent predictors of radiation-induced toxicity in post-surgical breast cancer patients, and the selection of genotyping method is an important factor in determining risk factors. No evidence for any predictive value of XRCC1 Arg194Trp and XRCC1 -77T>C was found. So, larger and well-designed studies might be required to further evaluate the predictive value of XRCC1 gene variation on radiation-induced side effects in patients undergoing whole breast radiotherapy.

Qualitative Study for Medication Use among Visually Impaired in Korea (국내 시각장애인의 의약품 안전사용 실태에 대한 심층면접조사)

  • Koo, Heejo;Jang, Sunmee;Oh, Jung Mi;Han, Nayoung;Han, Euna
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.1
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    • pp.24-32
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    • 2016
  • Objective: The visually impaired have limited access to health care services and related information, and thus, they can have serious hurdles against properly taking medications. Despite that it is important to improve self-care ability of the visually impaired for correct medication use, there have been few studies investigating their needs for health care services in Korea, particularly focusing on proper medication usage. This study is to explore safety-related issues regarding mediation usage among the visually impaired based on in-depth interview. We particularly focus on any obstacles for safe use of medicines including experience on medication-related adverse effects in order to provide preliminary evidence for policy measures to improve proper medication use among the visually impaired. Methods: Study sample was visually impaired individuals who resided in Seoul area and were registered in the National Association of Visually Impaired. The association helped the process of recruiting the study participants. In-depth interview for each study participants was conducted. Each interview was recorded and later converted into a written script to extract core contents for the analysis. Results: The study participants comprised of three women (42.9%) and four men (57.1%). One was in his 20's, and there were four participants in 30's and two in 40's. Fully impaired participants were majority (5 out of 7). Limitation to physical access to health care providers and health information were the key factors to hamper safe medication utilization among the study participants. Difficulty reading medication information and may take the wrong medication or incorrect doses of medication, resulting in serious consequences, including overdose or inadequate treatment of health problems. Visually impaired patients report increased anxiety related to medication management and must rely on others to obtain necessary drug information. Pharmacists have a unique opportunity to pursue accurate medication adherence in this special population. This article reviews literature illustrating how severe medication mismanagement can occur in the visually impaired elderly and presents resources and solutions for pharmacists to take a larger role in adherence management in this population. Conclusion: The visually impaired had difficulties reading medication information and identifying medicines, and took incorrect doses of medications. Public support for safe medication use and medication management among the visually impaired is necessary.

Factors Influencing the Use of Dental Services by Foreign Tourists in Thailand

  • Chongthanavanit, Papon;Kheokao, Jantima
    • Asian Journal for Public Opinion Research
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    • v.5 no.2
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    • pp.63-83
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    • 2018
  • This exploratory research investigated the factors that influence foreign tourists' decision to use dental services in Thailand. The questionnaire was used to collect data from foreign tourists who used dental services in a hospital or dental clinic in Thailand. Data from 233 respondents completed questionnaires were analyzed using frequency distribution, percentages, mean, and standard deviation. The findings revealed that respondents were most likely to be Asian (54.5%) followed by European (33.9%), females (64.8%) aged between 26-35 years (39.1%), business owners (45.9%), and came to Thailand with friends (47.6%). Regarding travel purposes and contact with dental services, most of them travel for pleasure (52.89%) and contact the clinic directly through the Internet(63.95%) The health/medical services used included health check-up (34.48%), dental services (29.22%), and day spa/massage (23.23%). The dental treatment that respondents had completed or planned to do included dental check-up (29.87%), tooth cleaning (26.68%), and tooth whitening (11.41%). Based on the influence of $_7P$ factors towards the respondent's decision to use the dental service, it was found that the average mean score range from 4.33-4.15 which were at the high to the very high level of influence to their decisions. The people factor had the highest average mean score (mean 4.33, SD= 0.604)followed by the price factor (mean 4.32, SD= 0.651), which both had the highest level of influence. The physical evidence factor had the lowest mean score (mean 4.15, SD+0.752) which was at the high level of importance. It should be noted that the factor concerning the modern technology and dental equipment (mean 4.33, SD=0.606) and factor on the quality of service (mean 4.43, SD= 0.598) had the highest mean score followed by the total cost of the trip including services being reasonable (mean 4.37, SD=0.582). Regarding the country factor, it was found that this factor also had highest influence level (mean 4.30, SD=0.67) and affordability had the highest mean score (mean 4.39, SD=0.614).

A Systematic Review of Constraint Induced Movement Therapy about Upper Extremity in Stroke (뇌졸중 환자의 상지 강제유도운동치료에 관한 체계적 고찰)

  • Park, Su-Hyang;Baek, Soon-Hyung;Shin, Joong-il
    • The Journal of the Korea Contents Association
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    • v.16 no.3
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    • pp.149-161
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    • 2016
  • The purpose of this study is provided to useful data to establish the Constraint Induced Movement Therapy(CIMT) in clinical plan to more specific for stroke patients. Also It is provided way for further study about CIMT. Methods used a systematic review. Systematic review is a research method that can be presented to the scientific evidence. Data were organized by PICO(Patient, Intervention, Comparison, Outcome). Research using the database Embase and Medline, It was searched for CIMT and Stroke. We selected for a total of 42 studies that meet the purpose of the present study. We was selected for a total of 42 studies that meet the purpose of the present study. Results was that the quality of the study is a systematic review, meta-analyzes, randomized controlled. CIMT studies was based on a high quality level of 50% of the total. The difference between the study period was 42.8%, more research was conducted prior to 2010. CIMT has been used more than mCIMT by to differ 40.5%. It is effective in over 75% of study, regardless of the CIMT intervention. In conclusion, CIMT has an effect on the upper limbs of stroke patients damaged, results will be used as a useful material to develop a CIMT in the clinical treatment plan. In future studies will need to validate studies on the effectiveness of the mCIMT, It will require a review of the effectiveness of validation studies.

Analysis of Studies on Ojeok-san for Establishment of Evidence Based Medicine (EBM 기반 구축을 위한 오적산 연구 논문 분석)

  • Lee, Nam-Hun;Ha, Hye-Kyung;Lee, Ho-Young;Jung, Da-Young;Choi, Ji-Yoon;Lee, Jun-Kyoung;Shin, Hyun-Kyoo
    • Herbal Formula Science
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    • v.16 no.2
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    • pp.1-9
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    • 2008
  • Objective : The purpose of this report was to provide the information about activity and safety of Ojeok-san by analyzing domestic/international papers about Ojeok-san. Methods : Domestic/international papers related to Ojeok-san were reviewed and analyzed. These papers were then classified by year, experimental method and subject. Results : The following results were obtained in this study. 1. The studies of Ojeok-san started from 1984 and has continuously increased. The studies were mainly focused on experimental models rather than clinical studies. 2. By subject, papers related to safety were most common with 5 papers among 20 papers. Besides there were papers related to efficacy of analgesic, anti-hyperlipidemic, anti-blood stasis and treatment for uterine myoma. 3. The papers related to safety were mainly focused on the effect of Okeok-san on liver function, renal function or metal concentration of organs such as blood, brain, liver, kidney and bone. Ojeok-san proved to be safe, but more clinical studies regarding the safety are needed hereafter. 4. Papers related to analgesic, anti-pyretic, anti-phlogistic activities of Ojeok-san were in vivo studies, and other papers were about anti-hyperlipidemic activity, apoptosis inducing activity on uterine myeloma cell line and anti blood static activity on hydrocortisone acetate induced blood statis model. 5. Case reports were about anti-lipidemia, analgesic effect for mastalgia/back pain and anxiety disorder due to climacteric changes. Conclusion : Ojeok-san is being used in various ways with analgesic, anti-pyretic, anti-phlogistic, anti-hyperlipidemic, anti-tumor or anti-blood statis activity. However, mechanism study should be conducted at the molecular biology level and more clinical studies on the efficacy of Ojeok-san are needed.

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A Study on Relation among Habitual Isoflavone Intake, Blood Pressure, and Serum Lipid Parameters in Korean Men and Women over 20 Years Old (20세 이상 남녀의 일상 식이중 이소플라본 섭취와 혈압, 혈중 지질과의 관련성)

  • Choi Mi-Kyeong;Kim Mi-Hyun;Sung Chung-Ja;Lee Won-Young;Park Jung-Duck
    • Korean Journal of Community Nutrition
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    • v.10 no.4
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    • pp.493-500
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    • 2005
  • There is some evidence that soy isoflavone has beneficial effects on the concentration of blood lipids. In this study, we investigated habitual isoflavone intake levels and the relation among dietary isoflavone intake, blood pressure, and blood lipids of adult men (n = 149) and women (n = 205). Anthropometric measurements including blood pressure, dietary in-take assessment using 24-hour recall method, and biochemical assessment using blood were conducted. The average age, height, weight, and BMI were 54.7 years, 168.5 cm, 67.3 kg, and 24.5 $kg/m^2$ for men and 53.9 years, 153.8 cm, 59.2 kg, and 25.0 $kg/m^2$ for women, respectively. The mean daily intakes of total food and energy were 1219.1 g and 1740.9 kcal for men and 1071.3 g and 1432.6 kcal for women, respectively. The mean daily isoflavones (daidzein + genistein) intake of men and women were 20.0 mg and 14.2 mg, respectively. Blood pressure of the subjects was 128.3/75.5 mmHg for men and 124.1/73.7 mmHg for women. Serum lipids of men and women were 180.2 and 184.9 mg/dL for total cholesterol, 160.8 and 137.6 mg/dL for triglyceride, 41.5 and 44.7 mg/dL for HDL-cholesterol, 106.6 and 112.7 mg/dL for LDL-cholesterol, and 3.5 and 3.3 for atherogenic index, respectively. Serum triglyceride and atherogenic index of men were significantly higher than those of women. In men, isoflavone intake and the level of total serum cholesterol were negatively (p < 0.05) correlated, after adjusted age. In women, there were significant correlations between isoflavone intake and blood pressure (systolic and diastolic), after adjusted age (p < 0.05). Based on these results, we concluded that higher isoflavone intake seemed to be related to a better lipid profile in men and lower blood pressure in women. But more epidemiological studies and controlled clinical trials would help to confirm the optimal amount required for the prevention and treatment of cardiovascular disease.

Management of Contralateral Node Negative Neck in Oral Cavity Squamous Cell Carcinomas (구강 편평세포암종의 반대측 예방적 경부치료)

  • Koo Bon-Seok;Lee Wook-Jin;Rha Keong-Won;Jung Eui-Sok;Kim Yoo-Suk;Lee Jin-Seok;Lim Young-Chang;Choi Eun-Chang
    • Korean Journal of Head & Neck Oncology
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    • v.21 no.2
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    • pp.196-200
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    • 2005
  • Objectives: The purpose of this study was to evaluate the incidence and predictive factors of contralateral occult lymph node metastasis in oral cavity squamous cell carcinomas to form a rational basis for elective contralateral neck management. Materials and Methods: We performed a retrospective analysis of 66 N0-2 oral cavity cancer patients undergoing elective neck dissection for contralateral clinically negative necks from 1991 to 2003. Results: Clinically negative but pathologically positive contralateral lymph nodes occurred in 11%(7 of 66) . Of the 11 cases with a clinically ipsilateral node positive neck, contralateral occult lymph node metastases developed in 36%(4 of 10, in contrast with 5%(3/55) in the cases with clinically ipsilateral node negative necks(p<0.05). Based on the clinical staging of the tumor, 8%(3 of 37) of the cases showed lymph node metastases in T2 tumors, 25%(2 of 8) in T3, and 18%(2 of 11) in T4. None of the T1 tumors(10 cases) had pathologically positive lymph nodes. The rate of contralateral occult neck metastasis was significantly higher in advanced stage cases and those crossing the midline, compared to early stage or unilateral lesions(p<0.05). Patients with no evidence of contralateral nodal cancer had significantly improved disease-specific survival over patients with any pathologically positive nodes(5-year disease-specific survival rate was 79% vs. 43%, p<0.05). Conclusion: The risk of contralateral occult neck involvement in the oral cavity squamous cell carcinomas above the T3 stage or those crossing the midline with unilateral metastases was high. Therefore, we advocate an elective contralateral neck treatment with surgery or radiotherapy in oral cavity squamous cell carcinoma patients with ipsilateral node metastases or tumors that are greater than stage T3 or crossing the midline.