Purpose: To evaluate the efficacy of antibiotic-loaded cement spacers (ALCSs) for the treatment of diabetic foot infections with osteomyelitis as a salvage procedure and to analyze the risk factors of treatment failure. Materials and Methods: This study reviewed retrospectively 39 cases of diabetic foot infections with osteomyelitis who underwent surgical treatment from 2009 to 2017. The mean age and follow-up period were $62{\pm}13years$ and $19.2{\pm}23.3months$, respectively. Wounds were graded using the Wagner and Strauss classification. X-ray, magnetic resonance imaging (or bone scan) and deep tissue cultures were taken preoperatively to diagnose osteomyelitis. The ankle-brachial index, toe-brachial index (TBI), and current perception threshold were checked. Lower extremity angiography was performed and if necessary, percutaneous transluminal angioplasty was conducted preoperatively. As a surgical treatment, meticulous debridement, bone curettage, and ALCS placement were employed in all cases. Between six and eight weeks after surgery, ALCS removal and autogenous iliac bone graft were performed. The treatment was considered successful if the wounds had healed completely within three months without signs of infection and no additional amputation within six months. Results: The treatment success rate was 82.1% (n=32); 12.8% (n=5) required additional amputation and 5.1% (n=2) showed delayed wound healing. Bacterial growth was confirmed in 82.1% (n=32) with methicillin-resistant Staphylococcus aureus being the most commonly identified strain (23.1%, n=9). The lesions were divided anatomically into four groups; the largest number was the toes: (1) toes (41.0%, n=16), (2) metatarsals (35.9%, n=14), (3) midfoot (5.1%, n=2), and (4) hindfoot (17.9%, n=7). A significant difference in the Strauss wound score and TBI was observed between the treatment success group and failure group. Conclusion: The insertion of ALCSs can be a useful treatment option in diabetic foot infections with osteomyelitis. Low scores in the Strauss classification and low TBI are risk factors of treatment failure.
Journal of Korea Entertainment Industry Association
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v.14
no.6
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pp.231-241
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2020
This study was conducted from April 2020 to June of the same year to identify the working skills, quality of life and depression on occupational therapists working at medical institutions in Gwangju, Jeollabuk-do and Jeollanam-do. Each function was evaluated using the WAI(Work Ability Index), the Korean version of WHOQOL and PHQ-9(Patient Health Questionnaire-9 Korean version) to evaluate the working ability, quality of life and depression level of depression. Studies have shown mo statistically significant differences in all areas of work capability, quality of life, or depression, depending on general characteristics. The correlation between work tretment worker's work ability, quality of life and depression showed a positive correlation between work ability and quality of life and a strong nehative correlation between quality of life and depression. This is a tesult of improved working ability, which improves the quality of life and lowers the level of depression if there is a positive change in the quality of life. It is hoped that research will be conducted considering the work ability and quality of life of occupational therapists who play an important role in rehabilitation and ways to reduce depression.
In this study, we investigated the psychological and physiological effects of experiences in real natural forests and virtual forests using artificially controllable VR. The experiment tested 60 adult college students in a natural forest and a graduate seminar room where external light was blocked. It evaluated the effects of the natural and the VR forest environments by comparing the psychological and physiological recovery of the subjects. Psychometric testing using the PANAS psychological index showed increased positive emotions and decreased negative emotions after experiencing forest scenery in the natural and VR forest environments. And a stress index, based on measuring cortisol in saliva, decreased significantly in the subjects in both environments. The experiment results can be used to support the creation of a psychological and physiological recovery environment with VR for those who cannot go to the natural forest due to certain restrictions such as physical distance, mobility difficulties, etc. It is expected that the results will be the basis for further research into the visual effects of forest healing and also for widening the use of VR, a technology of the fourth industry, in the field of forestry.
This study was carried out to investigate the effect of watching a two-dimensional (2D) forest video and a virtual reality (VR) forest video on stress reduction in adults. Experiments were conducted in an artificial climate room, and 40 subjects participated. After inducing stress in the subjects, subjects watched a 2D gray video, 2D forest video, or VR forest video for 5 mins. The autonomic nervous system activity was evaluated continuously in terms of measured heart rate variability during the experiment. After each experiment, the subject's psychological state was evaluated using a questionnaire. The 2D forest video decreased the viewer's stress index, increased HF, and reduced heart rate compared with the 2D gray video. The VR forest video had a greater stress index reduction effect, LF/HF increase effect, and heart rate reduction effect than the 2D gray video. Psychological measurements showed that subjects felt more comfortable, natural, and calm when watching the 2D gray video, 2D forest video or VR forest video. We also found that the 2D forest video and VR forest video increased positive emotions and reduced negative emotions compared to the 2D gray video. Based on these results, it can be concluded that watching the 2D forest and VR forest videos reduces the stress index and heart rate compared with watching the 2D gray video. Thus, it is considered that the 2D forest video increases the activity of the parasympathetic nervous system, and the VR forest video increases the activity of the sympathetic nervous system. The increased activity of the sympathetic nervous system upon watching the VR forest video is judged to be positive sympathetic nerve activity, such as novelty and curiosity, and not negative sympathetic activity, such as stress and tension. The results of this study are expected to be the basis for examining the visual effects of forest healing, with hope that the utilization of VR, the technology of the fourth industrial revolution in the forestry field, will broaden.
Purpose: The objective of this retrospective study is to evaluate the factors affecting the spread of odontogenic infection. Furthermore, this study was performed to apply to future treatments. Methods: A total of 65 patients, who had received treatment for odontogenic infections from 2010 to 2012 for 3 years, were enrolled in this study. The causes of infection, presence of systemic disease, and complications, durations of treatment, treatment methods, and inflammation levels were compared with the data. Results: Patients over 70 years with systemic disease required immediate drainage, systemic antibiotic therapy and hospitalization. We can determine the direction of the early diagnosis and treatment through blood tests (white blood cells, neutrophil, C-reactive protein [CRP]) and computed tomography. Patients over 70 years with systemic disease had the highest percentage. In addition, these patients showed high levels of inflammation index, such as CRP average of 24.8 and needed for a long-term treatment period and a wide range of surgical incision & drainage several times. Systemic diseases, particularly diabetes mellitus and hypertension, accelerate the spread of infection and had a negative effect that delays healing. Eventually, five of the 65 patients showed serious systemic complications. Conclusion: When evaluating cervico-facial infected patients due to odontogenic infection, the most important thing is deciding the appropriate diagnosis and degree of disease. Considering the patient's systemic status and age, we need to decide the treatment plan. Especially, those patients over 70 years with systemic disease should be treated with rapid surgical approach, and the use of a wide range of antibiotics and intensive care. If proper treatment principle does not apply, severe life-threatening complications will result, such as necrotizing fascitis, acute airway obstruction, mediastinitis, and others.
This study investigated the effect of community-based health intervention program to improve metabolic disease in Jeju island. There were 50 obese local residents in the experimental group (body mass index, $BMI{\geq}25kg/m^2$). They participated in cooking therapy with nutrition education (4 times), exercise program with proprioceptive neuromuscular facilitation (PNF) and stretching training (9 times), and alternative medicine program with healing touch massage (3 times) during a 3-week period. To evaluate the effectiveness of the program, body composition, blood lipid profiles, blood glucose, and waist circumference were assessed before and after the intervention program. After the program, the value of total cholesterol (TC), glycosylated hemoglobin (HbA1C), diastolic blood pressure, percent body fat, and waist circumference were decreased, and became the normal value. Especially, HbA1C, percent body fat, and waist circumference were significantly decreased (P<0.001) in the experimental group, while HbA1C, percent body fat, and waist circumference were significantly increased (P<0.001) in the control group (N=50), who had no intervention. Our results suggest that metabolic syndrome associated markers need intervention program for improving them. In conclusion, although this study did not analyze the effect of the health intervention program and cooking therapy separately, considering the result of this 3-week, short term program, the effect will be more profuse if cooking therapy and exercise program were performed concurrently.
Mustafa, Ebtihal H;Mahmoud, Huda T;Al-Hudhud, Mariam Y;Abdalla, Maher Y;Ahmad, Iman M;Yasin, Salem R;Elkarmi, Ali Z;Tahtamouni, Lubna H
Asian Pacific Journal of Cancer Prevention
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v.16
no.8
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pp.3213-3222
/
2015
Background: Cancer metastasis depends on cell motility which is driven by cycles of actin polymerization and depolymerization. Reactive oxygen species (ROS) and metabolic oxidative stress have long been associated with cancer. ROS play a vital role in regulating actin dynamics that are sensitive to oxidative modification. The current work aimed at studying the effects of sub-lethal metabolic oxidative stress on actin cytoskeleton, focal adhesion and cell migration. Materials and Methods: T47D human breast cancer cells were treated with 2-deoxy-D-glucose (2DG), L-buthionine sulfoximine (BSO), or doxorubicin (DOX), individually or in combination, and changes in intracellular total glutathione and malondialdehyde (MDA) levels were measured. The expression of three major antioxidant enzymes was studied by immunoblotting, and cells were stained with fluorescent-phalloidin to evaluate changes in F-actin organization. In addition, cell adhesion and degradation ability were measured. Cell migration was studied using wound healing and transwell migration assays. Results: Our results show that treating T47D human breast cancer cells with drug combinations (2DG/BSO, 2DG/DOX, or BSO/DOX) decreased intracellular total glutathione and increased oxidized glutathione, lipid peroxidation, and cytotoxicity. In addition, the drug combinations caused a reduction in cell area and mitotic index, prophase arrest and a decreased ability to form invadopodia. The formation of F-actin aggregates was increased in treated T47D cells. Moreover, combination therapy reduced cell adhesion and the rate of cell migration. Conclusions: Our results suggest that exposure of T47D breast cancer cells to combination therapy reduces cell migration via effects on metabolic oxidative stress.
Purpose: We analysis the outcome and complications of treatment of lesser toe brachymetatarsia. Materials and Methods: We analysed 28 patients 35 cases of lesser toe brachymetatarsia. Mean post operative follow up period was 2 years 8 months. All of the patients were female and mean age at operation was 21 years old. 2 cases of third metatasal bone and 33 cases of fourth metatarsal bone were operated. 8 metatarsal bones were treated using one staged lengthening with tricortical bone graft and 27 metatarsal bones were treated using callotasis with monofixator. Results: The average amount of lengthening was 13.3mm(12mm-15mm) in one staged lengthening, while 14.4mm(4mm-23mm) in callotasis. Average percentile increase was 28.9%(26%-34%) in one staged lengthening and 32%(18%-46%) in callotasis. The average healing index of callotasis was 76 days/cm (41 days/cm-166 days/cm). Satisfied outcomes in 4 cases of 8 cases (50%) after one staged lengthening and 17 cases of 27 cases (63%) after callotasis. 6 complications in 4 cases were occurred after one staged lengthening; insufficient length gain in 3 cases, fracture on the junction of graft bone and metatarsal bone in 1 case, plantar bowing deformity in 1 case and bony fusion of metatarsophalangeal joint in 1 case. 17 complications in 10 patients were occurred after callotasis ; metatarsophalangeal joint stiffness in 8 cases, metatarsophalangeal joint subluxation in 2 cases, overlengthened metatarsal bone in 2 cases, tapering of callus in 1 case, fracture of callus in 1 case, premature consolidation of callus in 1 case, osteomyelitis of metataral head in 1 case and plantar bowing deformity in 1 case. Conclusion: Although one staged lengthening and gradual lengthening using callotasis are effective treatment for lesser toe brachymetatarsia, complications not rarely occured after lengthening. Insufficient lengthening are most common complication after one staged lengthening while metatarsophalangeal joint stiffness lire most common complication after callotasis.
Journal of Dental Rehabilitation and Applied Science
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v.28
no.1
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pp.37-46
/
2012
The ultimate goal of periodontal therapy is the regeneration of supporting tissues. It is recommended to avoid probing until 6~9 months following the regenerative therapy because the probing may jeopardize the newly formed tissues. We can measure tooth mobility objectively using Periotest. The purpose of this study is to investigate whether Periotest can be used to evaluate the treatment results alternatively, and whether there are the correlations between the changes of Periotest value (PTV) and other clinical parameters. Regenerative treatments have been performed on 29 teeth of twenty five patients, at Department of Periodontology, Pusan National University Hospital. We measured the tooth mobility by Periotest and other parameters at the baseline, 6 and 12 months after regenerative treatment. Compared to the baseline, there were the statistically significant improvements in all the parameters at 6 months and 12 months. There were statistically significant correlations among the probing depth, attachment level, gingival recession and PTV at baseline, 6 months, and 12 months. Also there was the correlation between changes in PTV and in the attachment level at each time of observation period. We may conclude that regenerative therapy would improve the clinical parameters and periodontal status and PTV would be an alternative index to evaluate the healing process after regenerative surgery.
Black, Cara K;Zolper, Elizabeth G;Walters, Elliot T;Wang, Jessica;Martinez, Jesus;Tran, Andrew;Naz, Iram;Kotha, Vikas;Kim, Paul J;Sher, Sarah R;Evans, Karen K
Archives of Plastic Surgery
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v.46
no.5
/
pp.462-469
/
2019
Background Incisional hernia is a common complication following visceral organ transplantation. Transplant patients are at increased risk of primary and recurrent hernias due to chronic immune suppression and large incisions. We conducted a retrospective review of patients with a history of liver or kidney transplantation who underwent hernia repair to analyze outcomes and hernia recurrence. Methods This is a single center, retrospective review of 19 patients who received kidney and/or liver transplantation prior to presenting with an incisional hernia from 2011 to 2017. All hernias were repaired with open component separation technique (CST) with biologic mesh underlay. Results The mean age of patients was $61.0{\pm}8.3years\;old$, with a mean body mass index of $28.4{\pm}4.8kg/m^2$, 15 males (78.9%), and four females (21.1%). There were seven kidney, 11 liver, and one combined liver and kidney transplant patients. The most common comorbidities were hypertension (16 patients, 84.2%), diabetes (9 patients, 47.4%), and tobacco use (8 patients, 42.1%). Complications occurred in six patients (31.6%) including hematoma (1/19), abscess (1/19), seroma (2/19), and hernia recurrence (3/19) at mean follow-up of $28.7{\pm}22.8months$. With the exception of two patients with incomplete follow-up, all patients healed at a median time of 27 days. Conclusions This small, retrospective series of complex open CST in transplant patients shows acceptable rates of long-term hernia recurrence and healing. By using a multidisciplinary approach for abdominal wall reconstruction, we believe that modified open CST with biologic mesh is a safe and effective technique in the transplant population with complex abdominal hernias.
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