This study investigated the clinical effectiveness and safety of sealed bleaching compared to conventional in-office bleaching using a randomized clinical trial of split arch design. Ten participants received a chairside bleaching treatment on the upper anterior teeth, and each side was randomly designated as sealed or control side. A mixture of Brite powder (PacDent, Walnut, USA), 3% hydrogen peroxide and carbamide peroxide (KoolWhite, PacDent, Walnut, USA) were used as bleaching agent. The control side was unwrapped and the experimental side was covered with a linear low density polyethylene (LLDPE) wrap for sealed bleaching. The bleaching gel was light activated for 1 hour. The tooth shades were evaluated before treatment, after treatment, and at one week check up by means of a visual shade (VS) assessment using a value oriented shade guide and a computer assisted shade assessment using a spectrophotometer (SP). The data were analyzed by paired t-test. In the control and sealed groups, the visual shade scores after bleaching treatment and at check up showed statistically significant difference from the preoperative shade scores (p<.05). The shade scores of the sealed group were significantly lighter than the control immediately after bleaching and at the check-up appointment (p<0.05). Compared to prebleaching status, the ${\Delta}E$ values at post bleaching condition were $4.35{\pm}1.38\;and\;5.08{\pm}1.34$ for the control and sealed groups, respectively. The ${\Delta}E$ values at check up were $3.73{\pm}1.95\;and\;4.38{\pm}2.08$ for the control and sealed groups. ${\Delta}E$ values were greater for the sealed group both after bleaching (p<.05) and at check up (p<.05). In conclusion, both ${\Delta}E$ and shade score changes were greater for the sealed bleaching group than the conventional bleaching group, effectively demonstrating the improvement of effectiveness through sealing.
Park, Tai Soo;Hwang, Byeong-Wook;Park, Sang-Joon;Baek, Sun-Yong;Yoon, Sik
Anatomy & Biological Anthropology
/
v.29
no.4
/
pp.145-154
/
2016
The purpose of this study was to provide basic biometric data on Korean adults through magnetic resonance imaging (MRI)-based measurements of the distances between the apex of sacral hiatus (SH) and the termination of dural sac (DS), and between SH and conus medullaris (CM) because they are critical to the performance of epidural neuroplasty. A total of 200 patients(88 males and 112 females) with back pain, who had no spine fracture, significant spinal deformity, and spondyloisthesis were selected for this study. The subjects were of mean age 54.3 (20~84) years and mean height 161.3 cm (135~187). T2-weighted MRI images were used for correlation analysis to evaluate the relationships between the distances, and variables such as sex and height. In all patients, the mean distance between SH and DS was $62.8{\pm}9.4mm$ and the mean distance between SH and CM was $232.2{\pm}21.8mm$. The minimum distance and the maximum distance between SH and DS were 34.8 mm and 93.9 mm respectively, and the minimum distance and the maximum distance between SH and CM were 155.0 mm and 284.0 mm respectively. In female patients, both the distances between the SH and DS, and between SH and CM were shorter when compared to those of the male patients(p<0.05). Both the distances between SH and DS and between SH and CM showed a significant correlation with height(p<0.01). The results of this study will provide a useful biometric data on the distances between SH and DS and between SH and CM in Korean in ensuring clinical safety and in the development of more effective catheterization techniques for epidural neuroplasty in Korean.
Purpose: To compare the clinical outcomes of single injection adductor canal block (SACB), continuous adductor canal block (CACB), and the concomitant use of transdermal buprenorphine after total knee arthroplasty (TKA). Materials and Methods: A total of 125 patients who underwent TKA were divided into three groups and the clinical results were retrospecitively compared. Group I was comprised of patients with pain controlled by SACB (n=41). Group II consisted of patients with pain controlled by both SACB and transdermal buprenorphine (10 ㎍/h) (n=44). Group III contained patients with pain controlled by CACB (n=40). The visual analogue scale (VAS) was used as the pain control indicator and the patients were measured on a VAS for resting on the bed (VAS-Rest) at 12 hours, 24 hours, and 48 hours after surgery. The VAS while doing continuous passive motion (VAS-CPM) on the first and second postoperative day was also measured. In addition, the total amount of medications used (Butopahn, Tridol, and Ketorac) for the intravenous patient controlled analgesia (PCA) was counted for 48 hours after surgery. As the indicator of the functional recovery outcome, the incidence of nausea and vomiting was observed for 48 hours after surgery. The maximum knee joint flexion range and maximum walking distance on the first and second postoperative day, and the total length of stay at the hospital were compared. Results: The VAS-Rest was similar in the three groups at 12 hours after surgery, but at 24 hours and 48 hours after surgery, group II and III a lower VAS-CPM and total amount of medications used for PCA than group I (p<0.05). The three groups showed a low incidence of nausea and vomiting, maximum knee joint flexion range, and similar walking distance and total length of stay at the hospital. Conclusion: The combination of SACB and transdermal buprenorphine has great pain control effect initially. On the other hand, it is not associated with catheter complications and it is convenient to use and safety toward the renal function. Therefore, the concomitant use of SACB and transdermal buprenorphine can be an effective pain control method after TKA.
Kim, Seong-Hoon;Huh, Hyun-Do;Choi, Sang-Hyun;Choi, Jin-Ho;Kim, Hyeog-Ju;Lim, Chun-Il;Shin, Dong-Oh
Progress in Medical Physics
/
v.20
no.4
/
pp.317-323
/
2009
The standard dosimetry systems based on an absorbed dose to water recommend to use a planeparallel chamber for the calibration of such a low-megavoltage electron beam as a nominal energy of 6 MeV. For this energy ranges of an electron beam a cylindrical chamber should not be used for the routinely regular beam calibration, but the feasibility of the temporary use of a cylindrical chamber was studied to give temporary solutions for special situations users meet. The PTW30013 chambers and the electron beam quality of $R_{50}=2.25\;g/cm^2$ were selected for this study. 10 PTW30013 chambers, a cylindrical type of chamber, were calibrated in KFDA, the secondary standards dosimetry laboratories, and given the absorbed dose-to-water calibration factors, respectively. A "temporary" $k_{Q,Q_0}$ for each chamber were calculated using the absorbed dose determined by a cross-calibrated planeparallel chamber, with the result of an average 0.9352 for 10 chambers. This value for PTW30013 chamber was used to determine an absorbed dose to water at the reference depth. The absorbed doses determined by PTW30013 chambers were in an agreement within 2% with that by ROOS chamber. In a certain situation where a cylindrical chamber be used instead of a planeparellel chamber, the value of 0.9352 might be useful to determine an absorbed dose to water in the same beam quality of electron beam as this study.
Park, Kwonoh;Lim, Hyoung Gun;Hong, Ji Yeon;Song, Hunho
Journal of Hospice and Palliative Care
/
v.17
no.3
/
pp.179-184
/
2014
Purpose: We investigated the safety and efficacy of peripherally inserted central catheters (PICCs) in terminally ill cancer patients. Methods: A retrospective review was conducted on patients who underwent PICC at the hospice-palliative division of KEPCO (Korea Electric Power Corporation) Medical Center between January 2013 and December 2013. All PICCs were inserted by an interventional radiologist. Results: A total of 30 terminally ill cancer patients received the PICC procedure during the study period. Including one patient who had had two PICC insertions during the period, we analyzed a total of 31 episodes of catheterization and 571 PICC days. The median catheter life span was 14.0 days (range, 1~90 days). In 25 cases, catheters were maintained until the intended time (discharge, transfer, or death), while they were removed prematurely in six other cases (19%; 10.5/1000 PICC days). Thus, the catheter maintenance success rate was 81%. Of those six premature PICC removal cases, self-removal due to delirium occurred in four cases (13%; 7.0/1000 PICC days), and catheter-related blood stream infection and thrombosis were reported in one case, each (3%; 1.8/1000 PICC days). Complication cases totaled eight (26%; 14.1/1000 PICC days). The time to complication development ranged from two to 14 days and the median was seven days. There was no PICC complication-related death. Conclusion: Considering characteristics of terminally ill cancer patients, such as a poor general condition, vulnerability to trivial damage, and a limited period of survival, PICC could be a safe intravenous procedure.
Purpose : This study was performed evaluate optimal dose for disimpaction, efficacy and safety of PEG 4000 in children with chronic functional constipation. Methods : Eighty six children with chronic functional constipation were enrolled in this prospective study at Konkuk university hospital March, 2003 through August, 2006. Success in disimpaction with PEG 4000 was defined as meeting at least two out of three criteria; resolution of chief complaint, getting easiness of defecation with respect to frequency of bowel movement and hardness of stool based on defecation diary, and decrease in fecal impaction on simple abdominal X-ray test. Adverse effects of PEG 4000 were monitored clinically and biochemically. Results : Eighty three out of 86 children completed the study, and success rate of disimpaction was 99% (82/83). The mean dose of PEG 4000 for disimpaction was $0.93{\pm}0.28g/kg/day$ (0.4-2.0 g/kg/day, Max.: 30 g/day). Frequency of bowel movement increased ($5.02{\pm}2.71/wk$ vs. $11.25{\pm}5.43/wk$) in most children (79/83). Fecal impaction on simple abdominal X-ray test improved with statistical significance in 25 children (P=0.0007). Because of adverse effect of PEG 4000, 3 children did not complete the study; urticaria, severe diarrhea, diarrhea and abdominal pain. One 6-year-old girl who completed the study complained tingling sensation in the hand and foot without laboratory abnormality (4/86, 4.7%). Laboratory test revealed hyperosmolality without clinical symptom in 1 child, and eosinophilia in 6 children. Conclusion : The average safe and effective dose of PEG 4000 for disimpaction was $0.93{\pm}0.28g/kg/day$ (0.4-2.0 g/kg/day, Max : 30 g/day) in children with chronic functional constipation.
Coronary artery bypass grafting on the beating heart is no longer a new methods for any cardiac surgeon. We evaluated the application of the off-pump coronary artery bypass procedure relative to safety and efficiency as measured by postoperative complication and operative mortality. Material and Method: We used our retrospective database to compare the patients having off-pump coronary surgery (n=100) with those having on-pump coronary surgery (n=100) between June, 1999 and August, 2002. Patients whom underwent associated valvular or aortic aneurysmal operation were excluded. Result: Neither groups showed any differences in the patient's risk factors and extent of coronary disease. Off-pump CABG group did not have significantly less mean operation time (295$\pm$73 min vs 323$\pm$83 min, p=ns) and mean hospital day (15.34$\pm$6.02 day vs 13.80$\pm$4.95 day, p=ns). However, off-pump CABG group had significantly shorter mean ventilation time (17.3$\pm$11.27 hour vs 24.98$\pm$16.1 hour, p<0.05). No patients were converted to on-pump CABG in off-pump CABG. Intraoperative hemodynamic instability in off-pump CABG were 6 cases, of whom 2 cases were in lateral wall approach and 4 cases in right coronary anastomosis. Postoperative mortality was 1 case in off-pump CABG and 2 cases in on-pump CABG. Intra-aortic ballon pump (IABP) was applied in 1 case with off-pump CABG and in 2 cases with on-pump CABG. No patients presented postoperative cerebral infarction & stroke in off-pump CABG but 2 patients in on-pump CABG. Postoperative arrhythmia presented in 4 cases with off-pump CABG and in 6 cases with on-pump CABG. Acute renal failure (ARF) was complicated in 3 cases with off-pump CABG and in 2 cases with on-pump CABG. Conclusion: This study documented the immediate safety and efficiency of the off-pump CABG procedure.
Purpose: This study was aimed to evaluate the efficacy and safety of of intravenous iron sucrose ($Venoferrum^{(R)}$) for treating the perioperative anemic gastrectomy patients. Materials and Methods: From September 2006 to February 2007 at Seoul National University Hospital, the gastrectomy patients who displayed perioperative anemia (7.0 g/dl $\leq$ hemoglobin levels (Hb) < 11.0 g/dl) and who were admitted or visited the outpatient clinic of the Department of surgery, were divided into two groups. The preoperative (${\leq}\;2{\sim}3$ weeks before gastrectomy) or postoperative ($\geq$ 1 month after gastrectomy) patients without evidence of acute bleeding were included into Group 1. The immediate postoperative (< 1 month after gastrectomy) patients with stable vital signs were included into Group 2. The age, gender, diagnosis, Hb, hematocrit (Hct), mean corpuscular volume (MCV), serum ferritin (SF), total iron binding capacity (TIBC), serum iron and reticulocyte counts (RC) were evaluated before and after intravenous iron sucrose administration. The adverse effects of drugs were investigated. Results: The number of patients of group 1 and group 2 was 79 and 46, respectively. In group 1, there was a statistically significant difference in the Hb, Hct, MCV, SF, RC and TIBC with each mean change of 1.3 g/dl, 4.1%, 3.1ft, 195 ng/ml, 0.2% and -86.4 ug/dl, respectively. In group 2, there was a statistically significant difference in the Hb, Hct, MCV, SF and RC with each mean change of 1.8 g/dl, 6.1%, 3.4fl, 260 ng/ml and 0.3%, respectively. Two patients (1.6%) suffered local thrombophlebitis as an adverse effect. Conclusion: Intravenous iron sucrose for the perioperative anemia of gastrectomy patients was efficacious in the short period without significant adverse effects.
Purpose : Although oseltamivir is widely used for treatment of influenza, few clinical studies of its efficacy and resistance have been performed in Korea. We evaluated the safety, side effects, and efficacy of oseltamivir treatment in Korean pediatric patients. Methods : We analyzed 321 children diagnosed with influenza at Busan St. Mary's Medical Center, Korea, between January 2008 and June 2008 (first study period) and November 2008 and January 2009 (second study period). Patients were divided into two groups: those receiving oseltamivir treatment for 5 days and those receiving only symptomatic treatment. We investigated clinical symptoms, side effects, and resistance to oseltamivir. We also identified influenza strains and evaluated resistance to oseltamivir using an influenza virus culture. Results : One hundred eighty-six patients were assigned to the treatment group, and 135 were assigned to the control group. The treatment group showed shorter admission duration (4.4 days) compared with controls (5.0 days) (P =0.000) and had fewer lower respiratory tract complications compared with controls (P <0.05). No significant statistical difference in the virus antigenic type was observed between the groups. In the first study period, virus culture showed influenza B (41.7% vs. 49.6%), A/H3N2 (7.9% vs. 8.4%), and A/H1N1 (9.4% vs. 6.5%). In the second study period, only A/H1N1 (55.3% vs. 50.0%) was isolated, except for one case of A (H3N2) in the treatment group. No differences in short- and long-term side effects, including neuropsychologic side effects, were noted between groups. There was no resistance to oseltamivir before or after treatment in the first study period. Conclusion : Based on our results, we suggest that osetalmivir therapy in pediatric patients is effective.
Purpose: Rotavirus vaccine (RV) was introduced in Korea since 2007, and intussusception (IS) remains an important safety concern. This study investigated the trend of IS occurrence related to RV as well as the temporal relevance between vaccination and IS in children. Methods: We collected data of the patient aged ${\leq}18$ years with IS admitted to Gachon University Gil Medical Center, 2003 to 2015. For the patients that have occurred since 2008, the immunization records of RV were collected. The proportion of cases <1 year was calculated by the year and the temporal relationship between vaccination and IS occurrence was analyzed. Results: A total of 696 IS cases were noted. The cases <1 year were 30.7% (214/696). Although the incidence of all IS has increased over the 13-year period (from 74.1 in 2003 to 89.5 in 2015, linear by linear association, P=0.003), the incidence of IS <1 year has not increased (from 56.9 in 2003 to 53.3 in 2015, P=0.910), and the proportion of cases <1 year has decreased (from 35.4 in 2003 to 18.8 in 2015, P=0.000). Of 128 cases <1 year since 2008, 53.9% received RV. In the vaccinated group, 10 cases of IS occurred within 30 days, and eight cases did within 31 to 60 days. Numbers of IS after first, second, and third dose were three, 10, and five cases, respectively. Conclusions: Occurrence of IS in children <1 year of age did not increase since the introduction of RV. Further monitoring is essential for evaluation of vaccine safety.
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