• Title/Summary/Keyword: Patients' Evaluation

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Evaluation of Myocardial Damage during Open Heart Surgery (enzymatic and electrocardiographic evaluation) (개심술시의 심근손상에 관한 고찰)

  • Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.13 no.1
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    • pp.41-47
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    • 1980
  • Fifty one consecutive patients undergoing open heart surgery, twenty eight congenital and twenty three acquired heart disease, were studied between May and August 1979 in Dept. of Thoracic and Cardiovascular Surgery SNUH. During the same time 10 patients of PDA were included in this study as control group. Four out of fifty one OHS patients, two ASD and two pulmonic stenosis patients, were operated without aortic cross-clamp. In all patients, serial determination of total level of creatine phosphokinase [CPK], lactic dehydrogenase [LDH], glutamic oxaloacetic transaminase [SGOT] were made preoperatively, operative day [immediate post-op], and post-operative days up to 7th day. Electrocardiograms were also evaluated serially. Open heart surgery patients were divided into two groups; Group A was aorta clamp time beyond SO minutes, and Group B was below 50 minutes. The peak level of each enzyme was compared, and electrocardiographic changes were also compared between groups. Although the electrocardiographic changes were more frequent in Group A [50%] than Group B [24%], the peak levels of each enzymes were almost same in Group A and Group B.

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A CLINICAL STUDY ON THE SATISFACTION OF COMPLETE DENTURE PATIENTS (총의치 환자의 만족도에 대한 연구)

  • Kim, Hyung-Woo;Kim, Chang-Whe;Kim, Yung-Soo
    • The Journal of Korean Academy of Prosthodontics
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    • v.33 no.3
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    • pp.440-452
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    • 1995
  • A success of complete denture prosthesis can be determined by the satisfaction degree of the dentist and the patient. There are many factors influencing on the satisfaction of the complete denture patients. The purpose of this study is to analyze the correlation between the masticatory satisfaction and clinical evaluation, and the speech satisfaction and clinical evaluation in complete denture patients. 79 patients(total 119 complete dentures) were examined in this study who were treated in Seoul National University Dental Hospital. Through clinical evaluation, 2 examiners evaluated sex, age, edentulous period, the years of having used present complete denture, the number of the previous dentures, the state of the opposite arch, retention, stability, support, occlusion, vertical dimension of the complete denture and the condition of the residual alveolar ridge. Through questionnaires concerned with mastication and speech, examiners evaluate the satisfaction degree of the patients. This study led to the conclusion that : 1. The satisfaction degree of the mastication was lower in older patients(p<0.001) and in patients whose present complete denture period was shorter(p<0.05). The satisfaction degree of the mastication in male was higher than in female patients(p<0.01). 2. The satisfaction degree of the mastication was high when the retention of the complete denture was good(p<0.05), and when the condition of the residual alveolar ridge was good(p<0.05). 3. The satisfacion degree of the speech was high when the retention of the complete denture was good(p<0.01). 4. The satisfaction degree of the mastication was higher in patients with upper and lower complete denture than in patients with single complete denture whose oppsite arch was unilateral partial denture(p<0.05).

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Does Simultaneous Computed Tomography and Quantitative Computed Tomography Show Better Prescription Rate than Dual-energy X-ray Absorptiometry for Osteoporotic Hip Fracture?

  • Ko, Jae Han;Lim, Suhan;Lee, Young Han;Yang, Ick Hwan;Kam, Jin Hwa;Park, Kwan Kyu
    • Hip & pelvis
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    • v.30 no.4
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    • pp.233-240
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    • 2018
  • Purpose: This study aimed to evaluate the efficacy of simultaneous computed tomography (CT) and quantitative CT (QCT) in patients with osteoporotic hip fracture (OHF) by analyzing the osteoporosis detection rate and physician prescription rate in comparison with those of conventional dual-energy X-ray absorptiometry (DXA). Materials and Methods: This study included consecutive patients older than 65 years who underwent internal fixation or hip arthroplasty for OHF between February and May 2015. The patients were assigned to either the QCT (47 patients) or DXA group (51 patients). The patients in the QCT group underwent QCT with hip CT, whereas those in the DXA group underwent DXA after surgery, before discharge, or in the outpatient clinic. In both groups, the patients received osteoporosis medication according to their QCT or DXA results. The osteoporosis evaluation rate and prescription rate were determined at discharge, postoperative (PO) day 2, PO day 6, and PO week 12 during an outpatient clinic visit. Results: The osteoporosis evaluation rate at PO week 12 was 70.6% (36 of 51 patients) in the DXA group and 100% in the QCT group (P<0.01). The prescription rates of osteoporosis medication at discharge were 70.2% and 29.4% (P<0.001) and the cumulative prescription rates at PO week 12 were 87.2% and 60.8% (P=0.003) in the QCT and DXA groups, respectively. Conclusion: Simultaneous CT and QCT significantly increased the evaluation and prescription rates in patients with OHF and may enable appropriate and consistent prescription of osteoporosis medication, which may eventually lead to patients' medication compliance.

Computed tomography evaluation and pretreatment for a safe nasotracheal intubation, avoiding nasal cavity injuries (Nasotracheal intubation시 비강 내 외상을 줄이기 위한 술전 computed tomography를 이용한 평가 및 전처지)

  • Kim, Han-Lim;Yun, Kyoung-In;Kim, Kyung-Soo;Kang, Hyun;Choi, Young-Jun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.3
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    • pp.197-201
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    • 2010
  • Introduction: In a surgery of the oral cavity, nasotracheal intubation is often carried out to secure the surgical field. By passing a tracheal tube through the nasal cavity to the pharynx, the nasotracheal intubation can lead to complications that do not occur with oral intubation, such as nasal bleeding and submucosal aberration etc. The purpose of this study is to examine the method of CT evaluation and pretreatment for a safe nasotracheal intubation. Materials and Methods: Among 30 patients who orthognathic surgery was performed at Chung-Ang University Hospital during the period August 2009 to October 2009, 30 patients were included. The 30 patients were divided into two groups; 15 patients intubated with CT evaluation with pretreatment, and the other 15 patients intubated with no pretreatment. We evaluated nasal bleeding of the two groups during nasotracheal intubation. Results: CT evaluation with pretreatment group had a significantly lower incidence of nasal bleeding than the group with no pretreatment. Conclusion: CT evaluation with pretreatment helps to minimize nasal bleeding during nasotracheal intubation.

Evaluation of dental status using a questionnaire before administration of general anesthesia for the prevention of dental injuries

  • Kyungjin Lee;Seo-Yul Kim;Kyeong-Mee Park;Sujin Yang;Kee-Deog Kim;Wonse Park
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.23 no.1
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    • pp.9-17
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    • 2023
  • Background: Dental evaluation and protection are important for preventing traumatic dental injuries when patients are under general anesthesia. The objective of the present study was to develop a questionnaire based on dentition-related risk factors that could serve as a valuable tool for dental evaluation and documentation. Methods: We developed a questionnaire for dental evaluation before administration of general anesthesia, investigated the association between patient-and-dentist responses and mouthguard fabrication, and assessed response agreement between 100 patients. Results: Protective mouthguards were fabricated for 27 patients who were identified as having a high risk of dental injury. There was a strong association between dentists' responses and mouthguard fabrication, depending on the general oral health status, use of ceramic prosthesis, presence of masticatory pain related to periodontal diseases, gingival edema, and implants (P < 0.05). Response agreement between patients and dentists for items related to dental pain, loss of dental pulp vitality, root canal therapy, dental trauma, aesthetic prosthesis, tooth mobility, and implant prosthesis was high (Cohen's kappa coefficient κ ≥ 0.6). Conclusions: A high agreement was observed between patient-dentist responses and a strong association with mouthguard fabrication for items pertaining to ceramic prosthesis, masticatory pain, and dental implants. Patients with a "yes" response to these items are recommended to undergo a dental evaluation and use a dental protective device while under general anesthesia.

Risk Factors for Cognitive Impairment in Intensive Care Unit Survivors (중환자실 퇴원환자의 인지장애 위험요인)

  • Kang, Ji Yeon;Yi, Bo Kyung
    • Journal of Korean Critical Care Nursing
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    • v.13 no.3
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    • pp.75-85
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    • 2020
  • Purpose : This study aimed to identify the prevalence and risk factors of cognitive impairment in survivors discharged from the intensive care unit (ICU). Methods : This secondary analysis study utilized data from a multicenter prospective cohort of post-ICU patients. We analyzed the data of 175 patients enrolled in the primary cohort who completed the cognitive function evaluation three months after ICU discharge. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) scale. The cut-off points for cognitive impairment were < 23 for face-to-face evaluation and < 18 for telephone evaluation. Results : The prevalence of cognitive impairment three months after ICU discharge was 32.6%. Significant risk factors for cognitive impairment were age ≥ 60 years (OR=10.52, 95% CI=3.65~30.33, p<.001), education < high school graduation (OR=2.53, 95% CI=1.07~6.01, p=.035), unplanned ICU admission (OR=4.01, 95% CI=1.45-11.14, p=.008), and delirium in the ICU (OR=4.33, 95% CI=1.08-17.23, p=.038). Conclusion : ICU nurses should use preemptive strategies to reduce post-ICU cognitive impairment of patients with risk factors. It is necessary to frequently assess and detect early delirium in critically ill patients, while attempting various non-pharmacological interventions.

Usefulness of the Blink Reflex Study as a Preoperative Evaluation in the Orbitozygomatic Complex Fracture (안와관골 복합체 골절에서 술전 평가로서 눈깜박반사 검사의 유용성)

  • Kang, Dae-Il;Park, Sang-Woo;Choi, Jae-Hoon
    • Archives of Plastic Surgery
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    • v.37 no.6
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    • pp.779-782
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    • 2010
  • Purpose: As the evaluation of the preoperative sensibility in the orbitozygomatic complex fracture, used by most surgeons, depends on the patient's subjective judgements, it is difficult to make generalization and to use it as an objective evaluation method. We used the blink reflex study to objectively evaluate injury to the infraorbital nerve. Methods: From December 2008 to November 2009, a total of 16 patients underwent the patient's subjective report on sensory symptoms and the blink reflex study preoperatively. Among patients having orbitozygomatic complex fracture of type III or more according to Henderson's classification and simultaneously suspected as being injured along the infraorbital nerve pathway, patients who had difficulty in checking preoperative sensibility and said 'normal sensibility' were selected as candidates. Results: Fifteen patients showed abnormal R1 on the fracture side. These results suggested that most of patients had injury to the infraorbital nerve. Conclusion: Contrary to the existing tests, the blink reflex study is a useful diagnostic tool in reflecting injury to the infraorbital nerve objectively.

A Literature Review of Return-to-Work Interventions for Cancer Survivors (암 생존자 직장복귀 중재 프로그램 연구 고찰)

  • Bae, Ka Ryeong;Cho, Juhee;Jeon, Seo Heui
    • Korean Journal of Occupational Health Nursing
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    • v.28 no.2
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    • pp.83-93
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    • 2019
  • Purpose: Cancer patients are at a higher risk of being unemployed or facing difficulty in returning to work (RTW) than individuals without health concerns. The aim of this study is to identify and describe interventions developed specifically to assist cancer patients to RTW after treatment. Methods: A comprehensive search was conducted from September to October 2018 in different international databases: PubMed, Medline, and Embase. Studies using qualitative, quantitative, or mixed designs were included if they satisfied the following criteria: (a) described an intervention to assist cancer patients to RTW during or after treatment; (b) conducted on patients aged 18 and over and diagnosed with cancer; (c) written in English; (d) published in peer-reviewed journals. Results: Fourteen studies met the inclusion criteria. Counseling with physical activity intervention, behavioral training to reduce fatigue, and multi-disciplinary rehabilitation programs were found to be effective. Conclusion: Interventions adopting a multidisciplinary approach were effective for RTW in cancer patients. This literature review emphasizes the need for more tailored interventions based on survivors' needs and characteristics in the RTW field.

Preoperative risk evaluation and perioperative management of patients with obstructive sleep apnea: a narrative review

  • Eunhye Bae
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.23 no.4
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    • pp.179-192
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    • 2023
  • Obstructive sleep apnea (OSA) is a common sleep-breathing disorder associated with significant comorbidities and perioperative complications. This narrative review is aimed at comprehensively overviewing preoperative risk evaluation and perioperative management strategies for patients with OSA. OSA is characterized by recurrent episodes of upper airway obstruction during sleep leading to hypoxemia and arousal. Anatomical features, such as upper airway narrowing and obesity, contribute to the development of OSA. OSA can be diagnosed based on polysomnography findings, and positive airway pressure therapy is the mainstay of treatment. However, alternative therapies, such as oral appliances or upper airway surgery, can be considered for patients with intolerance. Patients with OSA face perioperative challenges due to difficult airway management, comorbidities, and effects of sedatives and analgesics. Anatomical changes, reduced upper airway muscle tone, and obesity increase the risks of airway obstruction, and difficulties in intubation and mask ventilation. OSA-related comorbidities, such as cardiovascular and respiratory disorders, further increase perioperative risks. Sedatives and opioids can exacerbate respiratory depression and compromise airway patency. Therefore, careful consideration of alternative pain management options is necessary. Although the association between OSA and postoperative mortality remains controversial, concerns exist regarding adverse outcomes in patients with OSA. Understanding the pathophysiology of OSA, implementing appropriate preoperative evaluations, and tailoring perioperative management strategies are vital to ensure patient safety and optimize surgical outcomes.

Long-term Evaluation of Occlusal Adjustment in Patients with Temporomandibular Disorders (측두하악장애환자의 교합교정에 관한 장기평가)

  • Myung Yun Ko;Ki Hong Kwon;Jeom Il Choi
    • Journal of Oral Medicine and Pain
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    • v.11 no.1
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    • pp.29-35
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    • 1986
  • 18 TMD patients who received occlusal adjustment in PNUH though Jan.1984 to 1985 were followed up for short-term(2-6yrs.) and long-term(1-2yrs.) evaluation. The obtained results were as follows : 1. Pain index showed gradual decrease after occlusal adjustment and significant change on long-term evaluation. 2. Noise index had no significant change throughout the all follow-up evaluation. 3. Opening limitation index showed gradual decrease after occlusal adjustment and significant change on both long-term and short-term evaluation. 4. Maximum comfortable opening exhibited more and more increase and significant change on long-term evaluation.

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