• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.2
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• pp.145-153
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• 2022

Background: Postoperative analgesia (POA) is an important determinant of successful treatment. Dexmedetomidine (DEX) has recently gained attention as a promising adjuvant to local anesthetics (LA). The present study aimed to evaluate the efficacy and safety of levobupivacaine (LB) as an adjuvant during inferior alveolar nerve block (IANB) in the extraction of lower impacted third molars (LITM). Methods: A prospective, randomized, placebo-controlled, triple-blind, parallel-arm, and clinical study was performed on 50 systemically healthy participants who required removal of an asymptomatic LITM. Using a 1:1 distribution, the participants were randomized into two groups (n = 25). Group L (control group) received 1.8 mL of 0.5% LB and 0.2 mL normal saline (placebo) and Group D (study group) received a blend of 1.8 mL of 0.5% LB and 0.2 mL (20 ㎍) DEX. The primary outcome variable was the duration of POA and hemodynamic stability, and the secondary variable was the total number of analgesics required postoperatively for up to 72 h. The participants were requested to record the time of rescue analgesic use and the total number of rescue analgesics taken. The area under the curve was plotted for the total number of analgesics administered. The pain was evaluated using the visual analog scale. Data analysis was performed using paired students and unpaired t-test, Mann-Whitney U test, Chi-square test, and receiver operating characteristic analysis. Statistical significance was set at P < 0.05. Results: The latency, profoundness of anesthesia, and duration of POA were statistically significant (P < 0.05). The differences between mean pain scores at 6, 12, 24, 48, and 72 h were found to be significant (each P = 0.0001). Fewer analgesics were required by participants in group D (2.12 ± 0.33) than in L (4.04 ± 0.67), with a significant difference (P = 0.0001). Conclusion: Perineurally administered LA with DEX is a safe, effective, and therapeutic approach for improving latency, providing profound POA, and reducing the need for postoperative analgesia.

• The Journal of Internal Korean Medicine
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• v.43 no.1
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• pp.1-21
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• 2022

Purpose: The standard tool for the pattern identification is used for identifying patterns in patients using a questionnaire. The purpose of this study is to reorganize the standard tool for the pattern identification of gastroesophageal reflux disease (GERD) developed in 2017 and to analyze the reliability and validity of the standard tool for pattern identification by applying it to GERD patients. Methods: To reorganize the standard tool for the pattern identification of GERD developed in the previous study, we searched the literature in the main databases, OASIS (Oriental Medicine Advanced Searching Integrated System) and CNKI (China National Knowledge Infrastructure). We added the search results to the data used in the previous study and went through the reorganizing courses, such as evaluating the validity of the translation, the Delphi technique, and a small survey. After reorganization, the patients who visited the Kyunghee University Korean Medicine Center for GERD symptoms were provided the questionnaire, including the reorganized standard tool for pattern identification. We analyzed the survey results to evaluate their reliability and validity. Results: Fifty patients completed the questionnaire. Reliability analysis results showed a pattern identification match rate of 86%, Cronbach's α coefficient of 0.834, and intraclass correlation coefficient of 0.907. The Mann - Whitney U test and logistic regression were implemented to check the relations between the survey questions and pattern identification results; the Pearson correlation, compared with other scales, showed a moderate score. Conclusion: We reorganized the standard tool for the pattern identification of GERD to be updated on current issues and so that it is easily used. The analysis results of the questionnaire showed that the reorganized standard tool had high reliability and moderate validity.

• Journal of Environmental Health Sciences
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• v.48 no.2
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• pp.116-122
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• 2022

Background: The recent COVID-19 pandemic is one of the worst disease outbreaks of the 21th century. Due to a lack of reliable antiviral therapeutics, wearing face masks is recommended to prevent airborne infection originating from virus-contaminated bioaerosols. Objectives: The aim of this study was to evaluate the filtration efficiencies of face masks that are commercially available in South Korea for a biological aerosol of Staphylococcus aureus (S. aureus) and murine coronavirus, a well-known surrogate for human coronaviruses. Methods: We collected six different kinds of commercial masks: two Korea Filter (KF)94 (KF94-1, KF94-2) masks, one surgical (Surgical-1) mask, one anti-droplet (KF-AD-1) mask, and two dust (Dust-1, Dust-2) face masks. S. aureus (ATCC 6538), a well-performing test bacteria and murine coronavirus (ATCC VR-764) were prepared under a suitable culture condition. Then, a mask biological filtration tester was used to examine the microbial filtration efficiencies of masks. Test microorganisms were quantitatively measured via cultivation methods and microbial filtration efficiencies were calculated appropriately. Results: All face masks showed over 99.6% filtration efficiency for S. aureus or murine coronavirus. There were no significant differences among the bacterial filtration efficiencies of the face masks. KF94-1 (99.97±0.08%) and Dust-1 mask (99.97±0.07%) showed the highest (over 99.9%) filtration efficiency for murine coronavirus. KF94-1 or Dust-1 masks showed a significant virus filtration efficiency compared to Surgical-1 mask (p<0.05; Mann-Whitney U test). Conclusions: All the commercially available face masks used in this study can filter S. aureus or murine coronavirus in bioaerosols efficiently, regardless of the mask type. Therefore, our results suggest that wearing a certified face mask is a reliable means to prevent the transmission of infectious airborne diseases via biological aerosols.

• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.5
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• pp.339-348
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• 2022

Background: To compare the anesthetic efficacy of supplemental buccal infiltration (BI) (1.7 ml) versus intraligamentary (IL) injection containing 0.4 ml of 4% articaine with 1:100.000 epinephrine after an inferior alveolar nerve block (IANB) with 1.7 ml 2% lidocaine in the first and second mandibular molars diagnosed with irreversible pulpitis (IP). Methods: One hundred subjects diagnosed with IP of either the mandibular first (n = 50) or second molars (n = 50) and failed profound anesthesia following an IANB were selected. They randomly received either the IL or BI techniques of anesthesia. Pain scores on a 170 mm Heft-Parker visual analog scale were recorded initially, before, and during supplemental injections. Furthermore, pulse rate was measured before and after each supplemental injection. During the access cavity preparation and initial filing, no or mild pain was assumed to indicate anesthetic success. The chi-square test, Mann-Whitney U test, and independent samples t-test were used for the analyses. Results: The overall success rates were 80% in the IL group and 74% in the BI group, with no significant difference (P = 0.63). In the first molars, there was no significant difference between the two techniques (P = 0.088). In the second molars, IL injection resulted in a significantly higher success rate (P = 0.017) than BI. IL injection was statistically more successful (P = 0.034) in the second molars (92%) than in the first molars (68%). However, BI was significantly more successful (P = 0.047) in the first molars (88%) than in the second molars (64%). The mean pulse rate increase was significantly higher in the IL group than in the BI group (P < 0.001). Conclusions: Both the IL and BI techniques were advantageous when used as supplemental injections. However, more favorable outcomes were observed when the second molars received IL injection and the first molars received BI.

• Journal of Korea Entertainment Industry Association
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• v.14 no.3
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• pp.333-342
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• 2020

The purpose of this study is to identify the mediating effects of family function in the relationship between depression and health promotion behavior among university students. Data were collected from December 1 to December 31, 2018 and the participants included 340 university students, who responded to the question regarding health promotion behavior, family function and depression. The data were analyzed by descriptive statistics, t-test, ANOVA, Spearman's correlation coefficients, and multiple regression, mediation regression analysis of Baron and Kenny using the SPSS/WIN 23.0 program. As a result, A negative correlation is found between health promotion behavior and depression (r=-.48, p<.001), and positive correlation is among family function (r=33, p<.001), negative correlation is found between depression and family function (r=-.45, p<.001). family function have a partial mediating effect on the relationship between depression and health promotion behavior (Sobel test: -2.53, p<.05). Results of this study suggest that it is important to manage family function to improve health promotion behavior caused by depression.

• Journal of People, Plants, and Environment
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• v.23 no.3
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• pp.305-320
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• 2020

Background and objective: The problem that follows the increase of dementia patients is the burden of caregivers caring for dementia patients. The purpose of this study was to examine the effects of horticultural therapy programs improving the quality of life and reducing the depression and burden of caregivers of the elderly with dementia. Methods: In this study, 19 caregivers of the elderly with dementia were selected, and the experiment was conducted by dividing the control group (n=9) and the experimental group (n=10) by random distribution. The experimental group was given eight horticultural therapy programs twice a week for a total of 4 weeks. Subjects were assessed using the depression(CES-D), quality of Life (WHOQOL-BREF), and care burden scales. The evaluation results were verified at a 95% significance level using descriptive statistics, the Mann-Whitney U test, and Wilcoxon signed-rank test. Results: In the case of depression, the control group's score tended to increase, and the experimental group's score appeared to decrease, but it was not a statistically significant change. In the quality of life, the control group was not statistically significant, but scores decreased overall. On the other hand, in the experimental group, the general quality of life increased significantly from 11.60 to 14.20 points (p = .02), and the total quality of life increased to a marginally significant level from 61.59 points to 68.85 points (p = .059). In the post-test of the total care burden score, a marginally significant difference was found between the control group (94.44 points) and the experimental group (82.50 points; p = .079). Conclusion: This study confirmed the applicability to reduce the burden of caregiving and improve the deterioration of quality of life of the caregivers. In particular, the results will serve as an opportunity to confirm accessibility in a new way to support the caregiver of dementia patients by demonstrating the applicability of horticultural therapy at a time when problems such as the burden of supporting the caregiver are emerging as social problems.

• The Korean Journal of Nuclear Medicine Technology
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• v.26 no.2
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• pp.32-36
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• 2022

Purpose There are reports that the COVID-19 vaccine causes false positive uptake of axillary lymph nodes. Therefore, this paper intends to evaluate the change in SUVmax of axillary lymph nodes with the period after the COVID-19 vaccination. Materials and Methods In 134 breast cancer patients who were tested for ¹⁸F-FDG PET/CT at Severance hospital, 3.7 MBq/kg of ¹⁸F-FDG was intravenously injected and scanned for 2 minutes per bed after 60 minutes. The equipment was Discovery 600 (GE Healthcare, MI, USA). The period was divided into four groups, 0 to 2 weeks, 3 to 6 weeks, 7 to 10 weeks, and 11 weeks or more. SUVmax was measured after checking the uptake of axillary lymph nodes on the ipsilateral side of vaccination and the Kruskal-Wallis test was performed using SPSS Statistics 28 (IBM Corp., Armonk, NY, USA). Results From 0 to 2 weeks groups to 11 weeks or more group, the average of SUVmax was measured in the order of 5.52, 2.85, 1.82, and 1.7. As a result of the Kruskal-Wallis test, there was a significant difference between 0 to 2 weeks group from all other groups (P < 0.05), and there was no significant difference between the remaining three groups. Conclusion The SUVmax of axillary lymph nodes decreased over the period after the COVID-19 vaccination and no significant difference was found after 3 weeks of vaccination. Therefore, it is recommended to record COVID-19 vaccination information before examination.

• Journal of Korean Foot and Ankle Society
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• v.27 no.2
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• pp.49-54
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• 2023

Purpose: The present study examined the effectiveness of the preoperative ischemia-modified albumin (IMA) levels in predicting the healing period of amputation wounds in patients with diabetes mellitus following a non-traumatic below-knee amputation (BKA). Materials and Methods: This study enrolled 41 diabetic foot ulcer patients who underwent BKA at the authors' hospital diabetic foot center from April 2016 to April 2022. Among the 41 patients, 29 (70.7%) were male and 12 (29.3%) were female. Their mean age was 64.54±11.38 years (41~81 years). The mean follow-up period was 19.48±5.56 weeks (14~48 weeks) after BKA. The patients were divided into two groups (high IMA group and normal IMA group), which evaluated the healing period, wound dehiscence, and revision operation rate using a Fisher's exact test and Mann-Whitney U test. Three orthopedic surgeons performed stump wound evaluation, and they were evaluated as healing when all sutures were fused without oozing. Results: Thirty patients (73.2%) (group A) showed a high level of IMA (median: 91.2 U/mL), and 11 (26.8%) patients (group B) showed a normal range of IMA (median: 82.7 U/mL). In group A, the median period for wound healing took 1.4 weeks longer, which was significant (p=0.001). No statistical relationship was observed between wound dehiscence, revision operation rate, and IMA value. There was no correlation between the other risk factors (estimated glomerular filtration rate, HbA1c) and the wound healing period. Conclusion: Although there was a limitation in using IMA as the sole factor to predict the healing period of amputation wounds in patients after BKA, this study revealed a significant positive correlation between IMA and the period of stump healing after BKA. Therefore, the preoperative IMA levels may help predict the period of stump healing after BKA.

• Journal of Korean Academy of Nursing
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• v.53 no.4
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• pp.468-479
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• 2023

Purpose: This study aimed to evaluate the use of the respiratory rate oxygenation (ROX) index, ROX-heart rate (ROX-HR) index, and saturation of percutaneous oxygen/fraction of inspired oxygen ratio (SF ratio) to predict weaning from high-flow nasal cannula (HFNC) in patients with respiratory distress in a pediatric intensive care unit. Methods: A total of 107 children admitted to the pediatric intensive care unit were enrolled in the study between January 1, 2017, and December 31, 2021. Data on clinical and personal information, ROX index, ROX-HR index, and SF ratio were collected from nursing records. The data were analyzed using an independent t-test, χ² test, Mann-Whitney U test, and area under the curve (AUC). Results: Seventy-five (70.1%) patients were successfully weaned from HFNC, while 32 (29.9%) failed. Considering specificity and sensitivity, the optimal cut off points for predicting treatment success and failure of HFNC oxygen therapy were 6.88 and 10.16 (ROX index), 5.23 and 8.61 (ROX-HR index), and 198.75 and 353.15 (SF ratio), respectively. The measurement of time showed that the most significant AUC was 1 hour before HFNC interruption. Conclusion: The ROX index, ROX-HR index, and SF ratio appear to be promising tools for the early prediction of treatment success or failure in patients initiated on HFNC for acute hypoxemic respiratory failure. Nurses caring for critically ill pediatric patients should closely observe and periodically check their breathing patterns. It is important to continuously monitor three indexes to ensure that ventilation assistance therapy is started at the right time.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.2
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• pp.75-85
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• 2023

Objectives: Suspending bisphosphonates (BPs) to reduce the risk and severity of medication-related osteonecrosis of the jaw (MRONJ) remains controversial. In this study, we quantitatively evaluated the clinical significance of BP suspension before surgery in osteoporosis patients with MRONJ. Materials and Methods: We analyzed 24 osteoporosis patients with MRONJ who were treated from 2012 to 2020 at Seoul National University Dental Hospital and compared the treatment outcomes of those who suspended BPs with those who did not. The number of surgical interventions, follow-up panoramic radiographs for relative bone density measurement, and laboratory blood tests including white blood cells, erythrocyte sedimentation rate, absolute neutrophil count, hemoglobin, hematocrit, and alkaline phosphatase were analyzed. ANOVA, Student's t-test, and Mann-Whitney U tests were used to compare results. Fisher's exact test was used to discover the association between treatment outcome and BP suspension, and Pearson's correlation test was used to measure the statistical relationship between the changes in serum inflammatory markers. Results: The number of interventions was significantly higher in the non-drug suspension group due to recurrence (P<0.05). The relative bone density in patients who suspended BPs was significantly different over time (P<0.05), with the highest density at one-year follow-up. Fisher's exact test shows an association between successful treatment outcomes and BP suspension. The alkaline phosphatase and erythrocyte sedimentation rate levels decreased significantly in the BP-suspended group, and a positive correlation was found between these elevated markers. Conclusion: A significant increase in bone density throughout follow-up and a lower number of interventions were found in the BP suspension group compared to the non-drug suspension group. Also, BP suspension decreased inflammatory markers in the serum after surgery, resulting in good treatment outcomes. BP suspension is a prognostic factor for MRONJ and should be implemented before surgery.