• Title/Summary/Keyword: Patient repositioning

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Comparative Effects and Ranks of Repositioning for Pressure Ulcer Prevention in Adults: A Network Meta-analysis (욕창예방을 위한 체위변경 중재 효과의 비교순위: 네트워크 메타분석)

  • Ko, Ji Woon
    • Journal of muscle and joint health
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    • v.29 no.1
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    • pp.18-27
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    • 2022
  • Purpose: A network meta-analysis was conducted to assess the comparative effects and ranks of repositioning for pressure ulcer prevention in adults. Methods: A network meta-analysis was performed in a frequency method, using the "netmeta" package of R software version 4.1. The effects of repositioning intervention were confirmed by the odds ratio. The comparative ranking of the repositioning effects was confirmed using the cumulative probability (P-score). Results: Seven intervention studies were included in this study. Based on the P-score, the use of the repositioning system was ranked as the most effective among all interventions (P-score 78.7%). Next was 3~4-hour repositioning combined with memory foam mattress use (P-score 77.2%), use of wearable sensor (P-Score 61.4%), 2-hour repositioning combined with memory foam mattress use (P-score 59.1%), 2-hour repositioning combined with powered air pressure redistribution mattress use (P-score 18.0%), and 4-hour repositioning combined with powered air pressure redistribution mattress use (P-score 18.0%). Conclusion: This study provides information on the relative comparative value of various repositioning interventions to prevent pressure ulcers using network meta-analysis. This is expected to be useful for nurses' decision-making when applying repositioning interventions in clinical practice

In-House Developed Surface-Guided Repositioning and Monitoring System to Complement In-Room Patient Positioning System for Spine Radiosurgery

  • Kim, Kwang Hyeon;Lee, Haenghwa;Sohn, Moon-Jun;Mun, Chi-Woong
    • Progress in Medical Physics
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    • v.32 no.2
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    • pp.40-49
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    • 2021
  • Purpose: This study aimed to develop a surface-guided radiosurgery system customized for a neurosurgery clinic that could be used as an auxiliary system for improving the accuracy, monitoring the movements of patients while performing hypofractionated radiosurgery, and minimizing the geometric misses. Methods: RGB-D cameras were installed in the treatment room and a monitoring system was constructed to perform a three-dimensional (3D) scan of the body surface of the patient and to express it as a point cloud. This could be used to confirm the exact position of the body of the patient and monitor their movements during radiosurgery. The image from the system was matched with the computed tomography (CT) image, and the positional accuracy was compared and analyzed in relation to the existing system to evaluate the accuracy of the setup. Results: The user interface was configured to register the patient and display the setup image to position the setup location by matching the 3D points on the body of the patient with the CT image. The error rate for the position difference was within 1-mm distance (min, -0.21 mm; max, 0.63 mm). Compared with the existing system, the differences were found to be as follows: x=0.08 mm, y=0.13 mm, and z=0.26 mm. Conclusions: We developed a surface-guided repositioning and monitoring system that can be customized and applied in a radiation surgery environment with an existing linear accelerator. It was confirmed that this system could be easily applied for accurate patient repositioning and inter-treatment motion monitoring.

Case Report : Treatment of Disc Displacement without Reduction Patient Using ARS (전방재위치 교합장치를 이용한 비정복성 관절원판변위 환자의 치험례)

  • 진상배;홍정표
    • Journal of Oral Medicine and Pain
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    • v.23 no.3
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    • pp.277-280
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    • 1998
  • The treatment of anterior disc displacement without reduction patients needs speicific treatment methods different from other Craniomandibular Disorders. Those are manual manipulation, anterior repositioning splint; ARS and step-back. It is well known that the use of Anterior Repositioning Splint is effective on relief of TMJ symptom. But the side effect of long- term ARS wearing, which is irreversible posterior open bite induction, has made many clinicians avoid ARS treatment. This report introduces a clinical case recently proven part- time wearing ARS method for treatment of Disc Displacement without reduction patient' that can reduce side effects with good efficacy. But now clinical statistical studies and basical histophysiological studies are more needed.

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Four Cases of Benign Paroxysmal Positional Vertigo Diagnosed as Damhun (담훈(痰暈)으로 변증된 양성 돌발성 체위성 현훈의 치험 4례)

  • Lee, Seoung-Geun;Lee, Jae-Hwa;Kim, Young-Eun
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.3
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    • pp.734-739
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    • 2009
  • Benign paroxysmal positional vertigo(BPPV) is the most common peripheral vestibular disorder clinically. It causes dizziness or vertigo, lightheadedness, imbalance, and nausea. by a change of position of the head with respect to gravity. BPPV is very well explained by mechanical consequences of loose debris within the inner ear and oriental medical theory of vertigo resulting from Phlegm(痰). Therefore, for treatment of BPPV, we can consider not only oriental medical therapy but also Canalith Repositioning Procedure. We report four improved cases of dizziness patient diagnosed BPPV and Dam Hun(痰暈) treated by canalith repositioning procedure and herbal medication and acupuncture.

Implant placement with inferior alveolar nerve repositioning in the posterior mandible

  • Doogyum Kim;Taeil Lim;Hyun-Woo Lee;Baek-Soo Lee;Byung-Joon Choi;Joo Young Ohe;Junho Jung
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.49 no.6
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    • pp.347-353
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    • 2023
  • This case report presents inferior alveolar nerve (IAN) repositioning as a viable approach for implant placement in the mandibular molar region, where challenges of severe alveolar bone width and height deficiencies can exist. Two patients requiring implant placement in the right mandibular molar region underwent nerve transposition and lateralization. In both cases, inadequate alveolar bone height above the IAN precluded the use of short implants. The first patient exhibited an overall low alveolar ridge from the anterior to posterior regions, with a complex relationship with adjacent implant bone level and the mental nerve, complicating vertical augmentation. In the second case, although vertical bone resorption was not severe, the high positioning of the IAN within the alveolar bone due to orthognathic surgery raised concerns regarding adequate height of the implant prosthesis. Therefore, instead of onlay bone grafting, nerve transposition and lateralization were employed for implant placement. In both cases, the follow-up results demonstrated successful osseointegration of all implants and complete recovery of postoperative numbness in the lower lip and mentum area. IAN repositioning is a valuable surgical technique that allows implant placement in severely compromised posterior mandibular regions, promoting patient comfort and successful implant placement without permanent IAN damage.

Anatomical repair of a bilateral Tessier No. 3 cleft by midfacial advancement

  • Oh, Ji-hyeon;Park, Young-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.40
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    • pp.9.1-9.4
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    • 2018
  • Background: Bilateral Tessier number 3 clefts are extremely rare, and their surgical treatments have not been well established. Case presentation: The authors describe the case of a patient with a right Tessier number 3, 11 facial cleft with microphthalmia, a left Tessier number 3 facial cleft with anophthalmia, and cleft palate. We repaired simultaneously the bilateral soft tissue clefts by premaxillary repositioning, cleft lip repair, facial cleft repair by nasal lengthening, midfacial advancement, and an upper eyelid transposition flap with repositioning both the medial canthi. Postoperatively, the patient showed an esthetically acceptable face without unnatural scars. Conclusions: We achieved good results functionally and esthetically by midfacial advancement with facial muscle reposition instead of traditional interdigitating Z-plasties. The surgical modality of our anatomical repair and 3 months follow-up results are presented.

Condylar repositioning using centric relation bite in bimaxillary surgery

  • Lee, Chang-Youn;Jang, Chang-Su;Kim, Ju-Won;Kim, Jwa-Young;Yang, Byoung-Eun
    • The korean journal of orthodontics
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    • v.43 no.2
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    • pp.74-82
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    • 2013
  • Objective: The purpose of this study was to evaluate displacement of the mandibular condyle after orthognathic surgery using a condylar-repositioning device. Methods: The patient group comprised 20 adults who underwent bimaxillary surgery between August 2008 and July 2011. The degree of condylar displacement was measured by pre- and postoperative tomographic analysis using centric relation bite and a wire during surgery. A sur vey assessing temporomandibular joint (TMJ) sound, pain, and locking was performed. The 20 tomographs and surveys were analyzed using the Wilcoxon signed-rank test and McNemar's test, respectively. Results: No significant changes were observed in the anterior, superior, or posterior joint space of the TMJ (p > 0.05). In addition, no significant change was observed in TMJ sound (p > 0.05). However, TMJ pain and locking both decreased significantly after surgery (p < 0.05). Conclusions: Due to its simplicity, this method may be fea sible and useful for repositioning condyles.

Facial Flap Repositioning in Posttraumatic Facial Asymmetry

  • Byun, Il Hwan;Byun, Dahn;Baek, Woo Yeol
    • Archives of Craniofacial Surgery
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    • v.17 no.4
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    • pp.240-243
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    • 2016
  • Perfect facial and body symmetry is an important aesthetic concept which is very difficult, if not impossible, to achieve. Yet, facial asymmetries are commonly encountered by plastic and reconstructive surgeons. Here, we present a case of posttraumatic facial asymmetry successfully treated with a unique concept of facial flap repositioning. A 25-year-old male patient visited our department with severe posttraumatic facial asymmetry. There was deviated nasal bone and implant to the right, and the actual facial appearance asymmetry was much more severe compared to the computed tomography, generally shifted to the right. After corrective rhinoplasty, we approached through intraoral incision, and much adhesion from previous surgeries was noted. We meticulously elevated the facial flap of both sides, mainly involving the cheeks. The elevated facial flap was shifted to the left, and after finding the appropriate location, we sutured the middle portion of the flap to the periosteum of anterior nasal spine for fixation. We successfully freed the deviated facial tissues and repositioned it to improve symmetry in a single stage operation. We conclude that facial flap repositioning is an effective technique for patients with multiple operation history, and such method can successfully apply to other body parts with decreased tissue laxity.

Transdural Nerve Rootlet Entrapment in the Intervertebral Disc Space through Minimal Dural Tear : Report of 4 Cases

  • Choi, Jeong Hoon;Kim, Jin-Sung;Jang, Jee-Soo;Lee, Dong Yeob
    • Journal of Korean Neurosurgical Society
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    • v.53 no.1
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    • pp.52-56
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    • 2013
  • Four patients underwent lumbar surgery. In all four patients, the dura was minimally torn during the operation. However, none exhibited signs of postoperative cerebrospinal fluid leakage. In each case, a few days after the operation, the patient suddenly experienced severe recurring pain in the leg. Repeat magnetic resonance imaging showed transdural nerve rootlets entrapped in the intervertebral disc space. On exploration, ventral dural tears and transdural nerve rootlet entrapment were confirmed. Midline durotomy, herniated rootlet repositioning, and ventral dural tear repair were performed, and patients' symptoms improved after rootlet repositioning. Even with minimal dural tearing, nerve rootlets may become entrapped, resulting in severe recurring symptoms. Therefore, the dural tear must be identified and repaired during the first operation.

Comparison Between Stroke Patients and Normal Persons for Trunk Position Sense and It's Relation to Balance and Gait (정상인과 뇌졸중 환자의 체간 위치감각 비교 및 보행과 균형에 미치는 영향)

  • Yang, Hea-Duck;Kim, Chang-beom;Choi, Jong-Duk;Moon, Young
    • Physical Therapy Korea
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    • v.27 no.3
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    • pp.178-184
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    • 2020
  • Background: Stroke patients have reduced trunk control compared to normal people. The ability to control the trunk of a stroke patient is important for gait and balance. However, there is still a lack of research methods for the characteristics of stroke control in stroke patients. Objects: The aim of this research was to determine whether trunk position sense has any relation with balance and gait. Methods: This study assessed trunk performance by measuring position sense. Trunk position sense was assessed using the David back concept to determine trunk repositioning error in 20 stroke patients and 20 healthy subjects. Four trunk movements (flexion, extension, lateral flexion, rotation) were tested for repositioning error and the measurement was carried out 6 times per move; these parameters were used to compare the mean values obtained. Subjects with stroke were also evaluated with clinical measures of balance and gait. Results: There were significant differences in trunk repositioning error between the stroke group and the control group in flexion, lateral flexion to the affected side, lateral flexion to the unaffected side, rotation to the affected side, and rotation to the unaffected side. Mean flexion error: post-stroke: 7.95 ± 6.76 degrees, control: 3.32 ± 2.27; mean lateral flexion error to the affected side: 6.13 ± 3.79, to the unaffected side: 5.32 ± 3.15, control: 3.57 ± 1.92; mean rotation error to the affected side: 8.25 ± 3.09, to the unaffected side: 9.24 ± 3.94, control: 5.41 ± 1.82. There was an only significant negative correlation between the repositioning error of lateral flexion and the Berg balance scale score to the affected side (-0.483) and to the unaffected side (-0.497). A strong correlation between balance and gait was found. Conclusion: The results of this study indicate that stroke patients exhibit greater trunk repositioning error than age-matched controls on all planes of movement except for extension. And lateral flexion has correlation with balance and gait.