• 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.

• Journal of Technologic Dentistry
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• v.45 no.2
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• pp.31-38
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• 2023

Purpose: This in vitro study aimed to compare the trueness of 3-unit fixed dental provisional prostheses (FDPs) fabricated by three different additive manufacturing and subtractive manufacturing procedures. Methods: A reference model with a maxillary left second premolar and the second molar prepped and the first molar missing was scanned for the fabrication of 3-unit FDPs. An anatomically shaped 3-unit FDP was designed on computer-aided design software. 10 FDPs were fabricated by subtractive (MI group) and additive manufacturing (stereolithography: SL group, digital light processing: DL group, liquid crystal displays: LC group) methods, respectively (N=40). All FDPs were scanned and exported to the standard triangulated language file. A three-dimensional analysis program measured the discrepancy of the internal, margin, and pontic base area. As for the comparison among manufacturing procedures, the Kruskal-Wallis test and the Mann-Whitney test with Bonferroni correction were evaluated statistically. Results: Regarding the internal area, the root mean square (RMS) value of the 3-unit FDPs was the lowest in the MI group (31.79±6.39 ㎛) and the highest in the SL group (69.34±29.88 ㎛; p=0.001). In the marginal area, those of the 3-unit FDPs were the lowest in the LC group (25.39±4.36 ㎛) and the highest in the SL group (48.94±18.98 ㎛; p=0.001). In the pontic base area, those of the 3-unit FDPs were the lowest in the LC group (8.72±2.74 ㎛) and the highest in the DL group (20.75±2.03 ㎛; p=0.001). Conclusion: A statistically significant difference was observed in the RMS mean values of all the groups. However, in comparison to the subtractive manufacturing method, all measurement areas of 3-unit FDPs fabricated by three different additive manufacturing methods are within a clinically acceptable range.

• Imaging Science in Dentistry
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• v.53 no.2
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• pp.127-135
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• 2023

Purpose: This study assessed the intensity of artifacts produced by 2 metal posts, 2 cements, and different exposure parameters using 2 cone-beam computed tomography (CBCT) units. Materials and Methods: The sample was composed of 20 single-rooted premolars, divided into 4 groups: Ni-Cr/zinc phosphate, Ni-Cr/resin cement, Ag-Pd/zinc phosphate, and Ag-Pd/resin cement. Samples were scanned before and after post insertion and cementation using a CS9000 3D scanner with 4 exposure parameters (85/90 kV and 6.3/10 mA) and an i-CAT scanner with 120 kV and 5 mA. The presence of artifacts was assessed subjectively by 2 observers and objectively by a trained observer using ImageJ software. The Mann-Whitney, Wilcoxon, weighted kappa, and chi-square tests were used to assess data at a 95% confidence level(α<0.05). Results: In the subjective analyses, AgPd presented more hypodense and hyperdense lines than NiCr (P<0.05), and more hypodense halos were found using i-CAT (P<0.05) than using CS9000 3D. More hypodense halos, hypodense lines, and hyperdense lines were observed at 10 mA than at 6.3 mA (P<0.05). More hypodense halos were observed at 85 kV than at 90 kV (P<0.05). CS9000 3D presented more hypodense and hyperdense lines than i-CAT (P<0.05). In the objective analyses, AgPd presented higher percentages of hyperdense and hypodense artifacts than NiCr (P<0.05). Zinc phosphate cement presented higher hyperdense artifact percentages on CS9000 3D scans(P<0.05). CS9000 3D presented higher artifact percentages than i-CAT(P<0.05). Conclusion: High-atomic-number alloys, higher tube current, and lower tube voltage may increase the artifacts present in CBCT images.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.3
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• pp.125-134
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• 2023

Objectives: The aim of the study was to quantify and compare craniofacial asymmetry in subjects with and without symptoms of temporomandibular joint disorders (TMDs). Materials and Methods: A total of 126 adult subjects were categorized into two groups (63 with a TMDs and 63 without a TMDs), based on detection of symptoms using the Temporomandibular Joint Disorder-Diagnostic Index (TMD-DI) questionnaire. Posteroanterior cephalograms of each subject were traced manually and 17 linear and angular measurements were analyzed. Craniofacial asymmetry was quantified by calculating the asymmetry index (AI) of bilateral parameters for both groups. Results: Intra- and intergroup comparisons were analyzed using independent t-test and Mann-Whitney U test, respectively, with a P<0.05 considered statistically significant. An AI for each linear and angular bilateral parameter was calculated; higher asymmetry was found in TMD-positive patients compared with TMD-negative patients. An intergroup comparison of AIs found highly significant differences for the parameters of antegonial notch to horizontal plane distance, jugular point to horizontal plane distance, antegonial notch to menton distance, antegonial notch to vertical plane distance, condylion to vertical plane distance, and angle formed by vertical plane, O point and antegonial notch. Significant deviation of the menton distance from the facial midline was also evident. Conclusion: Greater facial asymmetry was seen in the TMD-positive group compared with the TMD-negative group. The mandibular region was characterized by asymmetries of greater magnitude compared with the maxilla. Patients with facial asymmetry often require management of temporomandibular joint (TMJ) pathology to achieve a stable, functional, and esthetic result. Ignoring the TMJ during treatment or failing to provide proper management of the TMJ and performing only orthognathic surgery may result in worsening of TMJ-associated symptoms (jaw dysfunction and pain) and re-occurrence of asymmetry and malocclusion. Assessments of facial asymmetry should take into account TMJ disorders to improve diagnostic accuracy and treatment outcomes.

• The Journal of KAIRB
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• v.5 no.2
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• pp.51-58
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• 2023

Purpose: To validate the effectiveness of obtaining consent education on errors in the consent process and to develop the education program for researchers. Methods: From February 2019 to February 2022, a 30-minute, 1:1 face-to-face consent education developed using the ADDIE model was conducted on 78 nurses as principal investigators. An informed consent audit tool, which includes 6 items developed by Asan Medical Center Human Research Protection Center, was used to analyze errors in obtaining informed consent process. Data analysis was performed using the SPSS ver. 25.0, and the Mann-Whitney U-test and χ²-test were utilized to verify the difference in errors between the experimental and control groups. Results: The participants consisted of 42 in the experimental group and 36 in the control group, with no statistically significant difference between the 2 groups. Both 2 groups showed the highest frequency of documentation errors, followed by format errors, errors related to a suitability of investigator, participant, or participant's legally acceptable representative, witness and confidentiality issues. After education, there was a significant decrease in both format errors (p=0.002) and documentation errors (p<0.001) in the experimental group. The proportion of participants without any errors in all items was higher in the experimental group (35.7%) compared to the control group (5.6%), and this difference was statistically significant (p=0.001). Conclusion: The obtaining consent education program was found to be effective in reducing informed consent errors. This study emphasizes the importance of education, suggesting the need for its expansion and accessibility, as well as the necessity for all researchers conducting clinical studies to receive the obtaining consent education.

• Journal of Oriental Neuropsychiatry
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• v.35 no.2
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• pp.163-175
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• 2024

Objectives: To investigate the relationship between rehabilitation treatment, mental state and resilience of stroke patients undergoing rehabilitation by examining the correlation between The Core Seven Emotions Inventory-Short Form (CSEI-s) and the Korean version of the Connor-Davidson Resilience Scale (K-CD-RISC). Methods: All 104 participants (44 diagnosed with stroke who were receiving rehabilitation and 60 without stroke or psychiatric history) completed the CSEI-s, K-CD-RISC, and Questionnaire for stroke symptoms. All data were analyzed using by Statistical Package for the Social Sciences (SPSS) ver. 27.0. Descriptive statistics, chi-square test, t-test, Mann-Whitney U test, Kruskal-Wallis H test, and Pearson correlation coefficient were used for data analysis. Results: As a result of the CSEI-s, compared to the control group, the stroke group showed significantly lower Joy (喜) scores and significantly higher scores for Depression (憂) and Sorrow (悲). With a morbidity period of 12 months or less, the Thought (思) score was significantly higher. The Fear (恐) score was significantly higher when the rehabilitation was initiation more than 4~8 weeks after than that when the treatment was started immediately. Meanwhile, the K-CD-RISC score was significantly higher when rehabilitation was started immediately. In the stroke group, the K-CD-RISC score was positively correlated with Joy (喜) but negatively correlated with Depression (憂) and Fear (恐). In the control group, K-CD-RSIC showed a positive correlation with Joy (喜) but negative correlations with Depression (憂), Sorrow (悲), and Fear (恐). Conclusions: In addition to early rehabilitation treatment, mental approach through Korean medicine psychotherapy is crucial for enhancing the resilience of stroke patients.