• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제38권4호
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• pp.195-203
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• 2012

Dental implants using titanium have greatly advanced through the improvement of designs and surface treatments. Nonetheless, the anatomical limits and physiological changes of the patient are still regarded as obstacles in increasing the success rate of implants further, even with the enhancement of implant products. So there have been many efforts to overcome these limits. The intrinsic potential for bone regeneration can be stimulated through adjuvant treatments with the continuous improvement of implant properties, and this can play an important role in achieving optimum osseointegration toward peripheral bone tissue and securing ultimate long-term implant stability in standard surgical procedures. For this purpose, various chemical, biological, or biophysical measures were developed such as bone grafts, materials, pharmacological agents, growth factors, and bone formation proteins. The biophysical stimulation of bone union includes non-invasive and safe methods. In the beginning, it was developed as a method to enhance the healing of fractures, but later evolved into Pulsed Electromagnetic Field, Low-Intensity Pulsed Ultrasound, and Low-Level Laser Therapy. Their beneficial effects were confirmed in many studies. This study sought to examine bone-implant union and its latest trend as well as the biophysical stimulation method to enhance the union. In particular, this study suggested the enhancement of the function of cells and tissues under a disadvantageous bone metabolism environment through such adjunctive stimulation. This study is expected to serve as a treatment guideline for implant-bone union under unfavorable circumstances caused by systemic diseases hampering bone metabolism or the host environment.

• Advances in pediatric surgery
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• 제7권1호
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• pp.42-45
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• 2001

The major complications of Meckel's diverticulum (MD) are bleeding, intestinal obstruction, infection, umbilical fistula and perforation. Although the relative incidences vary between authors, bleeding is the most common complication in children. The aim of our study is to show the symptomatic guideline for the diagnosis of the bleeding MD. Eight cases with bleeding MD which were operated upon at the department of Pediatric Surgery, Yeungnam University Hospital from April 1985 to April 2001 were reviewed. Half of the patients were under 2 years of age and all patient s we re male. All patients were preoperatively diagnosed by previous history of intestinal bleeding (melena, hematochezia) and 99mTc pertechnetate MD scan. Segmental resection and end-to-end anastomosis was performed in 6 patients and diverticulectomy in 2 patients. Heterotropic gastric mucosa was found in 6 patients. Postoperative complication was not observed in any cases. In conclusion, in any male children with obscure intestinal bleeding, especially less than 2 years of age, bleeding MD must be suspected. It seems to us that 99mTc pertechnetate MD scan is a useful tool to diagnose bleeding MD.

• 생물정신의학
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• 제14권1호
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• pp.14-20
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• 2007

Objectives : The diagnosis of depression is based on a highly variable set of symptoms. Therefore, depression should not be viewed as a single disease, but a heterogenous syndrome comprised of different pathophysiologies. There are several subtypes of depression which were already incorporated in DSM-IV. This article provides a systematic review of pharmacological treatments of two recognized subtypes of depression-dysthymic disorder and atypical depression. Methods : Systematic search of relevant literatures on dysthymic disorder and atypical depression was performed by proposed search strategy of the Clinical Research Center for Depression of Korean Health 21 R&D Project. All identified literatures were carefully reviewed and classified according to SIGN grading system and summarized in a narrative manner. Results : For the treatment of dysthymic disorder and atypical depression, selective serotonin reuptake inhibitors( SSRIs) and moclobemide have more evidence than the other antidepressants. SSRIs and moclobemide showed superior tolerability than tricyclic antidepressants. Conclusions : The authors proposed treatment recommendations for dysthymic disorder and atypical depression by the methods of evidence-based medicine(EBM). However, guideline developing methods of EBM also have several inevitable limitations. Therefore, in the absence of clear and significant differences in efficacy, the choice of medication must be individualized for a particular patient based on psychiatrist's own clinical decision.

• 대한한방소아과학회지
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• 제27권1호
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• pp.15-25
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• 2013

Objectives Scoliosis is that spine's arrangement was changed to be curved. Mostly scoliosis was found at childhood and recently rate of scoliosis is increasing. Causes of scoliosis were very various, but the patients are due to idiopathic reasons. Scoliosis was treated by conservative treatment or surgery treatment. If scoliosis is diagnosed early enough, it can be treated with conservative treatment. Methods We are searching PubMed by keywords and found 47 theses complied with requirements. Results Studies of conservative treatment of Scoliosis were active. Conservative treatments are considered before surgery treatment and there was a set guideline of conservative treatment. Also, there were several studies about effectiveness of conservative treatment and quality of life, mental stress. Studies about various kinds of conservative treatment were found as well. There were brief studies about introduction of new brace, effectiveness of several braces, and case studies. Conclusions Conservative treatment is very effective choice before surgery treatment at Scoliosis patient.

• 중환자간호학회지
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• 제4권1호
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• pp.11-24
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• 2011

Purpose: The purpose of this study was to grasp the subjectivity of the nurses toward DNR (Do not resuscitation) order. Methods: Q methodology was employed to explore the nurses' subjectivity. Q population consisted of 292 statements that were obtained through individual in-depth interviews targeting 30 employees(nurses, doctors, staff members) and literature review. Finally, 30 nurses classified 34 statements using a 9 point scale. Results: The current survey that probed into the subjectivity of the nurses relative to DNR order abstracted four categories. The first type (restrictive acceptance type) perceived the determinants of DNR as the patient's hopeless state. The second type (evidence-based type) emphasized the decision based on the guideline. The third type (medical personnel-centered type) showed the characteristic that depends passively on the professional judgement. The fourth type (rationalistic type) emphasized rational characteristic that DNR decision needs to be made by considering several situations such as economic and psychological burden of family and the quality of life. Conclusion: These types of nurse's perception need to be considered in the nurses' continuing educational program in order to confront affirmatively and positively with ethical dilemma.

• 여성건강간호학회지
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• 제21권1호
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• pp.23-31
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• 2015

Purpose: The purpose of this study was to investigate the effect of dehydration from preoperative fasting on postoperative nausea and vomiting in patients who underwent gynecologic surgeries. Methods: Study design was a prospective descriptive study. A total of 75 patients in a university hospital were selected. Data were collected from March 17 to May 16, 2014 using self-report questionnaires and clinical electronic chart. Results: Factors influencing the development of postoperative nausea and vomiting were type of surgery (t=3.44, p=.001), use of PCA (t=-2.16, p=.034), and preoperative dehydration level (t=5.93, p<.001), and these variables accounted for 51.7% of postoperative nausea and vomiting. Among these variables, preoperative dehydration amount (${\beta}=.56$) showed the largest influence in the difference in postoperative nausea and vomiting. Conclusion: Reducing dehydration during preoperative fasting can prevent occurrence of postoperative nausea and vomiting. Development of a clinical guideline is necessary to give directions for the prevention of dehydration during preoperative fasting and to ensure the proper duration of fasting according to patient characteristics, type of surgery and time of surgery.

• 성인간호학회지
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• 제24권1호
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• pp.20-30
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• 2012

Purpose: This study was to explore the gap between awareness and performance toward evidence-based pain management in older adults for the purpose of establishing baseline data for evidence-based pain management protocol development and dissemination. Methods: The subjects were 290 staff nurses from three general hospitals. Self administered questionnaires were used to collect the data and the results of the study were analyzed with descriptive statistics, t-test, ANOVA and Pearson's correlation. Results: There were statistically significant differences between awareness and performance in pain assessment (t=17.31, $p$ <.001), patient and family education (t=17.33, $p$ <.001), pharmacologic management (t=12.99, $p$ <.001), non pharmacological management (t=16.28, p<.001), and evaluation of effectiveness (t=11.70, $p$ <.001). There were also statistically significant differences in awareness and performance according to the workplace, knowledge, and usual performance. Conclusion: The study showed that the hospital nurses' performance about evidence-based pain management in older adults was lower than their awareness level thus indicating significant gaps between evidence and actual practice. To ensure effective pain care, the factors contributing to these gaps need to be analyzed to identify the barriers. In addition, the evidence-based pain management guideline suitable for various clinical settings needs to be developed and disseminated.

• 성인간호학회지
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• 제17권2호
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• pp.208-218
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• 2005

This study was conducted to develop and evaluate guidelines for cancer patients' symptoms management such as nausea/vomiting, fatigue, constipation, diarrhea, and oral mucositis. Based on the literature review, assessment path to identify each stage of five symptoms were also developed. Guidelines for symptom management of each stage of the symptoms were developed. Guidelines then were evaluated by a panel of experts. Finally, 95 cancer patients were recruited and asked to use the guidelines for their symptom management. Levels of understanding of and satisfaction with assessment path and management guidelines were surveyed. Prevalence rate of five symptoms varied ranging from 20% (diarrhea) to 47% (nausea/vomiting). Regarding the level of understanding of each symptom most of the cancer patients indicated that they were easy and sufficient. Regarding the easiness of use of the symptom management guidelines, most of cancer patients indicated that they were easy to use. Regarding the nursing intervention on each symptom, most of cancer patients indicated that they were easy and helpful. More information was added with feedback from the patients. The result of this study has implications on development of customized patient education materials based on assessment path and symptom management guidelines.

• 성인간호학회지
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• 제15권1호
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• pp.116-125
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• 2003

Purpose: This study was to evaluate the importance of liver cancer patient's diet and to provide guideline materials for proper nursing intervention. Method: The hermeneutic phenomenological method of van Manen was applied for the in-depth interview of liver cancer patients and the cultural background studies including linguistic, literary and art works to enhance the insight and understanding, from which the meaning of the cognition and lesson of the experiences were extracted. The participants for this study were five male patients, who had been diagnosed with liver cancer, 5-15 years ago and had been treated with Transcatheter Arterial Embolization without chemotherapy. The repeated interview and close observation were carried out for nine months starting from January 2001 in Seoul, Korea. Result: Eight essential themes were emerged ; (1) confliction(frustration) with hospital treatment (2) trial of every possible remedies (3) liking unpolluted natural foods(4) faithful tolerance (5) experiencing diet effectiveness (6) discovering personal control methods (7) deepen their faith in God (8) searching for healthy new life. Conclusion: The alternative diet therapy influenced their life beyond the physical overcoming of cancer toward psychological and spiritual healing. The study evidenced the necessity for scientific research and education on the effectiveness and application of complementary and alternative diet therapy for the treatment of cancer in hospital practices.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1997년도 추계학술대회
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• pp.193-196
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• 1997

This paper proposes a new medical information management system to be used or small to medium sized clinics and hospitals. The system is designed to process, analyze and manage each patient's clinical record using database technique. The structure of the database was determined and implemented through careful and rigorous study of medical practices in Korea and, therefore, reflects the needs of information management in Korean medical community. Furthermore, a sophisticated inference engine that can deduce possible disease from the result of medical examination is added to the system to provide doctors with a guideline in medical diagnoses.