• 제목/요약/키워드: Hospital Evaluation

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Clinical evaluation of temporomandibular joint disorder after orthognathic surgery in skeletal class II malocclusion patients

  • Jang, Jin-Hyun;Choi, Sung-Keun;Park, Sung-Ho;Kim, Jin-Woo;Kim, Sun-Jong;Kim, Myung-Rae
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제38권3호
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    • pp.139-144
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    • 2012
  • This study was performed in order to evaluate the occurrence of temporomandibular joint disorder after surgical correction of skeletal class II malocclusion. Materials and Methods: This study included 21 patients who underwent orthognathic surgery for the correction of dentofacial deformities by a single surgeon at Mokdong Hospital, Ewha Womans University from 2000 to 2010. They underwent bilateral sagittal split ramus osteotomy for the treatment of undesirable mandibular advancement. The temporomandibular disorder (TMD) symptoms prior to surgery were recorded and the radiographic evaluation (panorama, bone scan, and magnetic resonance imaging [MRI]) of the post-surgery temporomandibular joint (TMJ) were assessed in order to evaluate condylar resorption, remodeling and disc displacement. The minimum follow-up period, including orthodontic treatment, was 12 months. Orthognathic procedures included 1-jaw surgery (n=8 patients) and 2-jaw surgery (n=13 patients). The monocortical plate was used for bilateral sagittal split ramus osteotomy fixation. Results: Among class II malocclusion patients with TMD symptom, clicking improved in 29.1%, and maximum mouth opening increased from $34.5{\pm}2.1$ mm to $37.2{\pm}3.5$ mm. The differences were not statistically significant, however. Radiographic changes in bone scan improved slightly based on the report by radiologist but not in TMJ dynamic MRI. Conclusion: No particular improvements were found in patients with joint sound only. Patients with limitation of mouth opening showed an increase in the degree of opening, but the difference was not statistically significant (P>0.05).

AHP를 이용한 공공병원 평가지표의 우선순위 및 가중치 개발 (Priority Analysis of Criteria for Evaluation of Public Hospital Using Analytic Hierarchy Process)

  • 심재선;권영대;이건세;양민희;박은영
    • 보건의료산업학회지
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    • 제7권4호
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    • pp.289-303
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    • 2013
  • This study looks at priorities in managing public hospitals by figuring out categories needed to examine the quality of each hospital. In order to analyze priorities and relative importance of valuation indicator in Seoul municipal hospitals, surveys were sent via e-mail to medical professionals who have participated in evaluation of municipal hospitals. The analytic hierarchy process (AHP) was conducted using the Expert Choice 11.5 program. The results show that 'providing public service' is considered to be the most important category for all kinds of public hospitals, followed by 'improving the quality of medical care', 'hospital management and governance', and 'efficient hospital management'. The importance of 'hospital management and governance' and 'efficient hospital management' is different depending on the types of hospitals, but the importance of 'providing public service' and 'improving the quality of care' remains the same regardless of the types of hospitals. Based on these results, the study comes to a conclusion that public hospitals should place high value on certain categories and their management purposes should differ depending on their specific fields and characteristics. This study will help furthering discussions on the identity and roles of public hospitals.

국내외 췌장염 관련 침구치료 연구 현황 (Current Research Trend on the Acupuncture and Moxibustion Treatment for Pancreatitis)

  • 강하라;이연선;김혜련;김은정;김경호;김갑성;정찬영;이준규
    • Korean Journal of Acupuncture
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    • 제35권2호
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    • pp.56-69
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    • 2018
  • Objectives : The aim of this study is to review the current research trend on the acupuncture and moxibustion treatment for pancreatitis. Methods : Through nine search engines, articles were collected, which had involved the use of acupuncture and moxibustion treatment for pancreatitis. Data were extracted from the selected articles regarding the year, country, type of pancreatitis, study design, evaluation variable, intervention, point for acupuncture and moxibustion, and effectiveness of treatment. Results : Total 56 articles were reviewed. The number of studies increased gradually every ten years. Fifty-one studies(91%) were conducted in China. Most of clinical studies and animal experimentations reported on acute pancreatitis. Thirty-nine studies were randomized controlled trials(RCTs), but most of them were assessed as uncertain in the risk of bias evaluation. The degree of overall improvement(79%) was used mainly as evaluation variable of clinical studies. In animal experimentations, the examination of pancreatitis tissue(77%) and blood test(77%) were used the most. Most of studies were conducted with the acupuncture, one with moxibustion. Among them, electroacupuncture was the most common intervention of treatment group. ST36 was the most frequently used acupuncture point in the included studies. Effective rate increased and serum amylase, clinical symptoms, recovery time of gastrointestinal function decreased statistically significantly in the treatment group of clinical studies. Conclusions : The result of this study could be used for the future practice and research about the acupuncture and moxibustion treatment for pancreatitis.

Bipolar Hemiarthroplasty in Unstable Intertrochanteric Fractures with an Effective Wiring Technique

  • Jae-Hwi Nho;Gi-Won Seo;Tae Wook Kang;Byung-Woong Jang;Jong-Seok Park;You-Sung Suh
    • Hip & pelvis
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    • 제35권2호
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    • pp.99-107
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    • 2023
  • Purpose: Bipolar hemiarthroplasty has recently been acknowledged as an effective option for treatment of unstable intertrochanteric fracture. Trochanteric fragment nonunion can cause postoperative weakness of the abductor muscle and dislocation; therefore, reduction and fixation of the fragment is essential. The purpose of this study was to perform an evaluation and analysis of the outcomes of bipolar hemiarthroplasty using a useful wiring technique for management of unstable intertrochanteric fractures. Materials and Methods: A total of 217 patients who underwent bipolar hemiarthroplasty using a cementless stem and a wiring technique for management of unstable intertrochanteric femoral fractures (AO/OTA classification 31-A2) at our hospital from January 2017 to December 2020 were included in this study. Evaluation of clinical outcomes was performed using the Harris hip score (HHS) and the ambulatory capacity reported by patients was classified according to Koval stage at six months postoperatively. Evaluation of radiologic outcomes for subsidence, breakage of wiring, and loosening was also performed using plain radiographs at six months postoperatively. Results: Among 217 patients, five patients died during the follow-up period as a result of problems unrelated to the operation. The mean HHS was 75±12 and the mean Koval category before the injury was 2.5±1.8. A broken wire was detected around the greater trochanter and lesser trochanter in 25 patients (11.5%). The mean distance of stem subsidence was 2.2±1.7 mm. Conclusion: Our wiring fixation technique can be regarded as an effective additional surgical option for fixation of trochanteric fracture fragments during performance of bipolar hemiarthroplasty.

Effectiveness of MR Urography in the Evaluation of Kidney which Failed to Opacify during Excretory Urography: Comparison with Ultrasonography

  • Sung-Il Hwang;Seung Hyup Kim;Young Jun Kim;Ah Young Kim;Jung Yun Cho;Joon Woo Lee;Hyung-Seok Kim;Kyung Mo Yeon
    • Korean Journal of Radiology
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    • 제1권3호
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    • pp.152-158
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    • 2000
  • Objective: The purpose of this study was to compare the effectiveness of MR urography (MRU) with that of ultrasonography (US) in the evaluation of urinary tract when this failed to opacify during excretory urography (EXU). Materials and Methods: Twelve urinary tracts in 11 patients were studied. In each case, during EXU, the urinary system failed to opacify within one hour of the injection of contrast media, and US revealed dilatation of the pelvocalyceal system. Patients underwent MRU, using a HASTE sequence with the breath-hold technique; multi-slice acquisition was then performed, and the images were reconstructed using maximal intensity projection. Each set of images was evaluated by three radiologists to determine the presence, level, and cause of urinary tract obstruction. Results: Obstruction was present in all twelve cases, and in all of these, MRU accurately demonstrated its level. In this respect, however, US was successful in only ten. The cause of obstruction was determined by MRU in eight cases, but by US in only six. In all of these six, MRU also successfully demonstrated the cause. Conclusion: MRU is an effective modality for evaluation of the urinary tract when this fails to opacify during EXU, and appears to be superior to US in demonstrating the level and cause of obstruction.

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하악 과두하 골절시 구강내 접근의 문헌 고찰과 임상 연구 (THE LITERACTURE REVIEW AND CLINICAL EVALUATION OF INTRAORAL APPROACH FOR SUBCONDYLAR FRACTURE)

  • 서현수;홍순민;유승은;박준우
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제34권6호
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    • pp.644-648
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    • 2008
  • Purpose: The aim of this study was to investigate the clinical cases of subcondylar fracture with intraoral approach. Material and Method: Fifteen patients with unilateral subcondylar fracture were treated in the department of oral and maxillofacial surgery, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University between 2006 and 2007. Each patients was examined by computed tomography(CT) and panorama. 3D-CT taken when fractured segment was displaced and comminuted. Patients was done intermaxillary fixation to occlusal stability and prevent displacement of fractured segment before general operation. Open reduction and internal fixation(ORIF) accomplished under general anesthesia and used to intraoral approach. We examinated the state of occlusion, maximum opening. Evaluation of the state of occlusion was divided in patient`s subjective evaluation that compare pre-traumatic occlusion with postoperative occlusion, and estimator`s objective evaluation that use articulating paper. Examination was done at 2 weeks, 1, 3, 6 month postoperative by follow up. Result: The ORIF through intraoral approach was good in all patients. In the state of occlusion, all patients recovered pre-traumatic occlusion in 6 month postoperation. Maximum opening was gradually increased. In 3 month postoperative, maximum opening was excessed 40mm. Conclusion: Our study indicate that the intraoral approach is a good technique for subcondylar fracture. Intraoral approach prevent complication that facial nerve damage, scar formation caused by extraoral approach. So, we recommend intraoral approach when subcondylar fracture.

종합병원 환자 당뇨식의 찬반에 대한 심층적 분석 (The Indepth Analysis of Plate Waste for DM Diet Served in General Hospital)

  • 양일선;이해영;김정려;차지아
    • Journal of Nutrition and Health
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    • 제35권3호
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    • pp.394-401
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    • 2002
  • The purpose of this study was to : (a) examine diabetic patients' sensory evaluation and food preferences, (b) analyze the portion sizes & plate wastes, (c) investigate the factors affecting plate wastes, and (d) determine the nutritional & mometary values of the plate wastes. A questionnaire for determining food preference and sensory evaluation was developed. Thirty-three diabetic patients who were hospitalized in Sanggye Paik hospital in Seoul were studied. Serving sizes and plate wastes were weighed by using an electric scale, and the CAN-Pro program was used to evaluate the nutritional value or the food consumed. The data were analyzed using the SAS package program for descriptive analysis, t-test, ANOVA, and the Pearson correlation. Using a five-point Likeu-type scale, the temperature s[ore ranged from 3.1 to 3.3 (1 : very poor, 5 : excellent), the preference store was 3.0-3.2 (1 : very dislike, 5:very like), the taste score was 2.9-3.2 (1 : very poor, 5 : excellent), and the amount of food served score was 2.8-3.0 (1 : too little, 5 : too much). Serving sizes were considered insufficient by patients because most of the DM diet was low in calories. Average plate waste for the DM diet was 26.2% of the total served, by weight, and was lower than that for patients consuming a normal diet, which was 30.3%, found in previous research. Those subjects who had been previously hospitalized and who wished to participate in a campaign for food waste reduction produced less plate waste than other groups (p<.05). Plate wastes of the DM diet were negatively correlated with taste, temperature, and preference, and were positively correlated with the amount served: however, these results were not statistically significant. It was found that diabetic patients consumed adequate levels of energy, protein, Ca, Fe, Vitamin B$_1$, Vitamin B$_2$, and niacin, but inadequate levels of Phosphorus, Vitamin A and Vitamin C. The plate wastes were calculated to be 26.2% of the total cost (₩ 3,489), which is ₩9l5. This represents a significant wastage of resources from the hospital. The results of this study could assist foodservice managers in both controlling food wastage, and improving the quality of hospital food services.

응급의료기관 평가에서 구조영역과 과정영역의 평가기준 관계 분석 (The Relationship Between Evaluation Criteria of Structure and Process in Evaluation of an Emergerncy Medical Services)

  • 김민지;이선희;정유민;이수정
    • 한국병원경영학회지
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    • 제23권1호
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    • pp.1-15
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    • 2018
  • Recently, the importance of emergency medical services has emerged, as rapid advances in urbanization and industrial development. Accordingly, the need for effective emergency medical services is increasing, and the evaluation of an emergengy medical services centers is conducted to meet these policy needs. The purpose of this study was to analyse the relationship between the structure and the process domain of the evaluation of an emergency medical services center based on the Donabedian's model and to verify the validity as an index of quality evaluation through the results. As a result of the analysis, there were some indicators that showed a different direction than expected, but generally there was a significant correlation between the structure and process domains of the evaluation of an emergency medical services center. This suggests that the process can be improved by improving the structure. In conclusion, as structure and process indicators in evaluation of an emergency medical services center show significant relationship, it can be evaluated as validity as a tool to measure the quality of emergency medical services.