• Journal of Dental Anesthesia and Pain Medicine
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• 제21권4호
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• pp.269-282
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• 2021

This review aimed to assess and compare the outcomes of the anesthetic efficacy of inferior alveolar nerve block (IANB) and Gow-Gates mandibular nerve block (GGMNB) in patients with symptomatic irreversible pulpitis. A descriptive systematic review of quantitative research was conducted wherein the "Preferred Reporting Items for Systematic Reviews (PRISMA)" was adopted, and the Problem/Patient/Population, Intervention/Indicator, Comparison, Outcome (PICO) criteria were used to structure the research question. A literature search was performed using PubMed/Medline, Cochrane Library, Google Scholar, and Ovid. Selection criteria were applied for populations over nine years of age, of either sex, with irreversible pulpitis, and articles published in English regarding conventional IANB or IANB and Gow-Gates techniques between 2009 and 2019. Prospective randomized clinical trials or randomized controlled trials were included in the review, in which anesthetic efficacy or success was measured. After screening, four articles were included. Three studies were randomized clinical trials, and two were randomized controlled trials. The validity and reliability of the individual studies were examined. There was evidence of the higher efficacy of the GGMNB technique than that of the IANB technique. However, both techniques can be mastered through training.

• 대한간호학회지
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• 제49권2호
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• pp.161-170
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• 2019

Background: Quality ratings could provide vital information to help people in choosing a nursing home. Purpose: This study investigated factors aligned with quality ratings of nursing homes. Methods: We employed a cross-sectional descriptive design to assess publicly available data on 1,354 nursing homes with 30 or more beds in the Republic of Korea. After excluding 289 nursing homes with no reported quality-evaluation ratings, we analyzed the 2015 data of 1,065 nursing homes. To prevent multicollinearity among independent variables, we carefully selected the final set of variables based on clinical and theoretical meaningfulness to direct nursing care. Quality, the ordinal outcome, was scored from 1 to 5 with a higher score indicating higher quality of the organization. We constructed a multivariate ordered logistic regression model. Results: Higher quality ratings of nursing homes was significantly related to the number of unoccupied beds (OR=0.99, p=.024), registered nurses (RNs) (OR=1.30, p=.003), qualified care workers (OR=1.03, p=.011), cognitive-improvement programs (OR=1.05, p=.024), and other programs for residents' activities (OR=1.09, p<.001). Conclusion: The number of RNs had the strongest influence on the publicly reported quality rating, while the rating of qualified care workers demonstrated little effect and that of nursing assistants had no effect. The number of RNs could be used as a crucial indicator for high-quality homes; more resident-engaging programs also demonstrated better quality of nursing home care.

• Journal of Chest Surgery
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• 제43권3호
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• pp.285-291
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• 2010

배경: 흉부외상은 개발도상국인 나라에서 이환율과 사망률의 가장 많은 원인 중에 하나이다. 흉부둔상으로 발생하는 늑골골절은 외상의 중증도를 나타내는 중요한 지표이다. 연구의 목적은 늑골 골절을 치료시 이환율과 사망률을 확인 하고자 하였다. 대상 및 방법: 2002년 5월부터 2008년 12월까지 입원 후 3일 이내 타 병원으로 전원을 간 환자를 제외한 둔상으로 인한 늑골골절이 발생한 환자를 대상으로 후향적으로 연구하였다. 이 기간 동안 474명이 입원하였고, 454명이 연구에 포함되었다. 남자가 356명 여자가 9명이었고 평균나이는 53세(5~90세)였다. 결과를 예측하는 요소로 손상기전, 늑골 골절수, 중환자실 입원기간 그리고 ISS, 입원기간, 폐 합병증과 사망률을 조사 하였다. 결과: 외상의 기전으로 교통사고 189명(41.7%), 보행 중 넘어짐 103명(22.7%), 추락 85명(18.7%) 그리고 농기계 사고 30명(6.6%), 산업재해 32명(7.0%), 폭행 15명(3.3%)였다. 흉부내 손상으로 혈흉 269명(59.3%), 기흉 144명(31.7%) 폐좌상 95명(20.9%) 그리고 피하기종 29명(6.4%), 큰 혈관손상 5명(0.1%)이 있었다. 대부분의 환자는 보존적인 치료를 하였고, 흉관 삽관술 시행은 234명(51.5%)이었으며, 개흉술은 18명(4.0%)이었다. 평균 흉관삽관 기간은 $5.2{\pm}6.2$일이었다. 대부분의 환자는 일반 병동에서 치료를 하였으며, 평균 입원기간은 $22.5{\pm}20$일이었다. 평균 ISS 수치는 $14.8{\pm}10.9$ (3~75)였고 사망률은 4.9% (22명)였다. 입원기간에 영향을 주는 것은 늑골골절 수, 흉관삽관 기간, 폐질환 동반 그리고 산재보험 이었고, 사망에 영향을 미치는 요인으로는 폐좌상, ISS가 예후에 영향을 주는 주요한 요인이었다. 결론: 늑골 골절은 중증손상을 나타내는 지표이다. 합병증과 동반된 손상 때문에 늑골골절 환자들은 입원하여 치료하는 것이 좋다고 생각한다. 최근의 연구에서 40대 이하의 젊은 환자도 노년층의 환자와 같이 늑골골절로 인한 이환율과 사망률이 증가 한다고 한다. 우리의 연구에서는 ISS와 페좌상이 사망률에 영향을 주고 있다. 늑골골절이 1개 또는 이상인 늑골 골절만 있는 환자도 입원치료를 하는 것이 좋을 것으로 생각 한다.

• Journal of Trauma and Injury
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• 제25권4호
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• pp.223-229
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• 2012

Purpose: The arterial base deficit and the serum lactate level are widely recognized indicators of injury severity, adequacy of resuscitation and outcome. The purpose of this study is to evaluate the usefulness of the arterial base deficit as an injury-severity indicator in multiple-trauma patients with head injuries. Methods: Data were retrospectively collected from trauma patients over 18 years of age who had been admitted at the emergency center between October 2005 and July 2006. The patients were divided into head-injury and non-head-injury groups. These patients were then sub-divided into minor ($$ISS{\leq_-}15$$)-injury and major ($$ISS{\geq_-}16$$)-injury groups according to their injury severity scores (ISS). We analyzed the differences in the base deficits and the serum lactate levels between the major- and the minor-injury sub-groups in both the head-injury and the non-head-injury groups. Results: In the non-head-injury group, we found statistically significant differences in the arterial base deficit between the major-injury and the minor-injury sub-groups($-6.86{\pm}2.40mmol/L$ vs. $-1.37{\pm}0.73mmol/L$, p=0.010). In the head-injury group, no significant differences were noted between the two sub-groups($-2.50{\pm}1.28mmol/L$ vs. $-1.51{\pm}0.74mmol/L$, p=0.897). Moreover, the differences in arterial base deficit between the major-injury and the minor-injury sub-groups were not significant both for either single-head-trauma or multiple-head-trauma patients (p=0.643 vs. p=0.832). Conclusion: We conclude that neither the arterial base deficit nor the serum lactate level can be used to predict injury severity in multiple-trauma patients with head injuries.

• Journal of Trauma and Injury
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• 제37권1호
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• pp.13-19
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• 2024

Purpose: Trauma is an important public health concern, and it is important to increase the survival rate of patients with trauma and enable them to return to society in a better condition. Initial treatment in the emergency department (ED) is closely associated with the prognosis of patients with trauma. However, studies regarding laboratory biomarker tests that can help predict the prognosis of trauma patients are limited. Presepsin is a novel biomarker of inflammation that can predict a poor prognosis in patients with sepsis. This study aimed to determine whether presepsin could be used as a prognostic indicator in patients with polytrauma. Methods: The study included patients with trauma who had visited a single regional ED from November 2021 to January 2023. Patients who had laboratory tests in the ED were included and analyzed retrospectively through chart review. Age, sex, injury mechanism, vital signs, surgery, the outcome of ED treatment (admission, discharge, transfer, or death), and trauma scores were analyzed. Results: Overall, 550 trauma patients were enrolled; 59.1% were men, and the median age was 64 years (interquartile range, 48.8-79.0 years). Patients in a hypotensive state (systolic blood pressure, <90 mmHg; n=39) had higher presepsin levels (1,061.5±2,522.7 pg/mL) than those in a nonhypotensive state (n=511, 545.7±688.4 pg/mL, P<0.001). Patients hospitalized after ED treatment had the highest presepsin levels (660.9 pg/mL), followed by those who died (652.0 pg/ mL), were transferred to other hospitals (514.9 pg/mL), and returned home (448.0 pg/mL, P=0.041). Conclusions: Serum presepsin levels were significantly higher in trauma patients in a hypotensive state than in those in a nonhypotensive state. Additionally, serum presepsin levels were the highest in hospitalized patients with trauma, followed by those who died, were transferred to other hospitals, and returned home.

• Clinical and Experimental Reproductive Medicine
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• 제19권1호
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• pp.31-39
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• 1992

By means of the results of In vitro fertilization(IVF) of supernumerary oocytes, the possibility of predicting a pregnancy outcome following gamete intrafallopian transfer(GIFT) and the prognostic implications for future pregnancy were evaluated in 46 GIFT cycles excluding simultaneous program of GIFT and IVF from February, 1989 to July, 1991. IVF of supernumerary oocytes were identified in 21 cycles, but not in remaining 25 cycles. There was no significant difference in age, duration and etiologic factors of infertility, and serum levels of FSH, LH and $E_2$ on MCD #3 and $E_2$ on the day of hCG injection between fertilized(N=21) and unfertilized group(N=25). The number of oocytes retrieved was similar in both groups. The number of supernumerary oocytes available for IVF after transfer was $5.43{pm}2.95$ ranging from 2 to 12. The prenancy rate in fertilized group, 33.3%(7/21), was higher without statistical significance, compared with 8.0%(2/25) in unfertilized group. Using IVF of supernumerary oocytes as a test of pregnancy following GIFT, sensitivity was 77.8 %; specificity, 61.2%; positive predictive value(PPV), 33.3%; negative predictive value(NPV), 92%. The fertilization rate of supernumerary oocytes in pregnant group, $86.4{\pm}22.8%$ was significantly higher compared with $56.1{\pm}20.2%$ in nonpregnant group. In cases with fertilization rate ${\geq}80%$, pregnancy was expected with PPV of 85.7%. In conclusion, IVF of supernumerary oocytes in GIFT program can be a profitable method as a prognostic indicator of pregnancy following GIFT. More aggressive diagnostic and therapeutic measures should be performed in cases with failure in IVF of supernumerary oocytes.

• Journal of International Society for Simulation Surgery
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• 제1권1호
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• pp.7-12
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• 2014

Purpose Surgical correction of various occular problems which do not have visual problem in plastic surgical area is to normalize the appearance of the face by restoring the normal position of orbit and eyeball. With development of surgical technique, the orbit can be restored exactly in trauma patient and can be moved totally in hypertelorism, as an example of congenital disease. All these surgeries are based on the hypothesis that the position of oclular glove moves in the plane in a quantitatively predictable reationship to osseous orbit movement. However, no studies have critically evaluated between the change of periorbital soft tissue and the outcome of the surgical correction, because there is no method of objective, quantitave evaluation of the periorbital soft tissue. Method Author suggest the methodology for quantitative assessment of ocular and periocular fat changes using the manipulation of digital images of computed tomographic scan. Results The method was allowed to evaluate inter-dacryon distance, inter-centroid distance, movement of the medial orbital wall, movement of the lateral orbital wall, alteration of thickness of the lateral periorbital fat as indicator of movement of the orbital wall and orbit in the patient with congenital periorbital anomaly and postoperative periorbital surgery. The goal of surgical correction of various occular problems which do not have visual problem in plastic surgical area is to normalize the appearance of the face by restoring the normal position of orbit and eyeball. With development of surgical technique, the orbit can be restored exactly in trauma patient and can be moved totally in hypertelorism, as an example of congenital disease. All these sugeries are based on the hypothesis that the position of oclular glove moves in the plane in a quantitatively predictable relationship to osseous orbit movement. However, no studies have critically evaluated between the change of periorbital soft tissue and the outcome of the surgical correction, because there is no method of objective, quantitave evaluation of the periorbital soft tissue. In this report, author suggest the methodology for quantitative assessment of ocular and periocular fat changes using the manipulation of digital images of computed tomographic scan. Conclusion The method suggested is objective and accurate method in measurement of the orbital contents. It takes time and is not easy to do, however, this kind of measurement for fine structures will be more easily available in near future.

• 한국임상수의학회지
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• 제27권6호
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• pp.713-717
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• 2010

추간판 탈출증은 개에서 일반적인 신경학적 질병이다. 수의 신경학 임상에서 흉요추 추간판 탈출증의 비수술적 치료 또는 수술적 치료의 결과는 잘 보고되어 있다. 그러나 경추 추간판 탈출증의 비수술적 치료 또는 수술적 치료의 결과에 대해서는 상대적으로 적게 알려져 있다. 우리의 목적은 경추 추간판 탈출증을 가진 개에서의 수술적 치료와 비수술적 치료후의 결과에 대해 체계적으로 조사하는 것이다. 수술적 치료를 실시한 개의 치료 성공률(100%, 25/25) 이 비수술적 치료를 실시한 개의 치료 성공률(51.4%, 18/35) 에 비해 유의적으로 높았다. 비수술적 치료군에서 치료 성공률과 척수 압박률과는 부정적인 상관관계가 있음을 확인하였다. 본 연구에서는 경추 추간판 탈출증을 가진 개에서의 수술적 치료는 비수술적 치료에 비해 더 효과적이었다. 또한 CT 또는 MRI 상에서 확인된 척수압박의 정도는 비수술적 치료에서 유용한 예후의 지표가 되었다.

• 치위생과학회지
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• 제3권2호
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• pp.83-88
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• 2003

치과의료기관의 질관리를 위한 환자만족도 조사의 측정도구를 개발하고 평가하기 위하여 3회의 설문조사를 실시하였다. 51개소의 치과의료기관이 조사에 참아하였으며, 1017명이 응답하였고, 의료기관의 유형과 자료수집 방법에 따라 5개의 표본 집단으로 분류되었다. 표본 집단과 응답자의 특성에 따른 측정값, 신뢰도, 응답편견의 차이와 효과를 비교하기 위하여 정규성검정, t 검정, 분산분석, 카이스케어 검정, Kruscal-Wallis 검정을 실시하였다. 응답 편견과 균형척도에 의한 신뢰도, 타당도, 척도판별력의 저하효과가 추정되었다. 1. 측정 도구 문제를 평가하기 위한 독립 표본의 신뢰도를 비교한 결과 4개의 표본 집단의 내적 일관성의 신뢰도는 비슷한 수준을 보이고 있다. 2. 두 항목의 균형 척도에 대한 긍정 응답 편견률은 20%이며, 교육 수준에 따라 유의한 차이가 나타났다(P<0.05). 3. 환자 관점의 질 평가 척도의 측정값은 독립 표본 사이에 유의한 차이가 나타나지 않았으며, 연령에 따라 20대와 60대 사이에 유의한 차이가 나타나고 있다(P<0.01). 4. Likert 5점 척도로 구성된 총화평정척도의 평균은 4.16으로 좌측으로 편이되고 중앙값에 집중된 높은 첨도의 분포를 보였다. 5. 하위척도 사이의 평균차, 삼사분위값 대 일사분위값의 평균차가 95%의 신뢰구간에 포함되어 측정도구의 판별력은 매우 낮았다.

• Asian Pacific Journal of Cancer Prevention
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• 제13권9호
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• pp.4541-4544
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• 2012

Background: Breast cancer is the most common malignancy with the highest incidence rates among women worldwide. Triple-negative breast cancer (TNBC) disease is diagnosed more frequently in younger women, and is associated with a poor prognosis. Elevated levels of serum haptoglobin protein (Hp) are observed in many malignant diseases including breast cancer. We evaluated the expression and prognostic value of Hp among patients with TNBC. Materials and Methods: Serum Hp levels were determined by Elisa in 41 patients with TNBC and 10 normal individuals. Hp status was correlated with other clinico-pathological parameters including patient survival. Results: Of the 41 patients with TNBC, Hp over expression was detected in 24 (59%) by Elisa. Hp up-regulation was confirmed by Elisa based quantification in the serum of 41 TNBC patients against lower grades and 10 normal individuals. Survival analysis revealed that Hp ($p=2.016{\times}10^{-5}$), stage ($p=2.166{\times}10^{-5}$), distant metastasis ($p=2.217{\times}10^{-5}$), tumor size ($p=1.053{\times}10^{-5}$), and tumor grade (p=0.001), correlated with patient survival on univariate analysis. Multivariate analysis revealed that Hp (p=0.001), and grade of the disease (p=0.008) were independent predictors of survival. Conclusion: Our results indicate that serum levels of Hp may play a role as a potential serum biomarker and prognostic indicator among TNBC patients. Thus, Hp may present a new promising prognostic biomarker in TNBC patients, but independent validations are now necessary for confirmation.