• Title/Summary/Keyword: Treatment Compliance

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Clinical efficacy of intermittent magnetic pressure therapy for ear keloid treatment after excision

  • Jun, Dongkeun;Shin, Donghyeok;Choi, Hyungon;Lee, Myungchul
    • Archives of Craniofacial Surgery
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    • v.20 no.6
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    • pp.354-360
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    • 2019
  • Background: Keloids are benign fibro-proliferative lesion, related to excessive inflammatory reactions in certain anatomical areas, including the auricles. Their specific etiology remains unclear; nonetheless they exhibit tumor-like characteristics of significant recurrence and cause emotional distress, even with various treatment strategies. We applied intermittent magnetic pressure therapy on ear keloids in combination with surgical excision, and present its effectiveness herein. Methods: Ear keloid patients were treated with surgical excision followed by magnetic pressure therapy. The keloid tissues underwent excision and keloid marginal flaps were utilized for wound closure. Intermittent magnetic pressure therapy was applied 2 weeks after the surgical procedure. The pressure therapy consisted of a 3-hour application and 2-hour resting protocol (9 hr/day), and lasted for 6 months. The results were analyzed 6 months after the therapeutic procedures, using the scar assessment scale. Results: Twenty-two ear keloids from 20 patients were finally reviewed. Among the keloids that completed the therapeutic course, 20 ear keloids out of 22 in total (90.9%) were successfully eradicated. Two patients (2 keloids) exhibited slight under-correction. Postoperative complications such as wound dehiscence or surgical site infection were not noted. The scar assessment scale demonstrated a significant improvement in each index. The intermittent pressure therapy led to patient compliance, and avoided pressure-related pain and discomfort. Conclusion: Excision followed by intermittent pressure application using a magnet successfully reduced the burden of fibro-proliferative keloids, and had good patient compliance. The role of intermittent pressure application and resting should be studied with regard to keloid tissue remodeling.

Q-Switched Nd YAG's SHG conversion techniques for a skin diseased treatment (피부질환 치료를 위한 Q-Switched Nd:YAG의 SHG 변환기술)

  • Kim, Whi-Young
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.13 no.6
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    • pp.1141-1149
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    • 2009
  • Pulse style Nd: YAG Laser is suitable in skin remaking treatment, in compliance with the ramp continuous oscillation until of course normal takeoff, the Q-switch and mode motive takeoff the takeoff form which is various is possible and it is coming to be widely used in microsurgery and skin remaking promotion. According to therapeutic objective very it is important to control a energy density. Control of energy density the method which controls the pulse repetition rate of Laser output is mainly used. From the research which it sees pulse style Nd: It will be able to control the pulse repetition rate of YAG, the 2nd harmonic occurrence Laser (second harmonic generation: SHG) with the energy part of the light-wave which is a footnote wave number will hold and nonlinear decision it propagates and is converted by energy of the light-wave which is a footnote wave number the actual condition which and it applies the second harmonic occurrence in compliance with a secondary nonlinearity it leads and until skin deep part therapeutic possibility is the thing it will be able to observe simply.

A Study on Nurses한 and Patients한 Perceptions of Psychotropic Medication (향정신성 약물치료에 대한 간호사와 환자의 지각 비교 연구)

  • 이평숙
    • Journal of Korean Academy of Nursing
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    • v.24 no.1
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    • pp.47-57
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    • 1994
  • The purpose of this study was to examine nurses’ perceptions of medication treatment for psychiatric patients and to compare these perceptions with the perceptions held by the patients. The methodology used in this study was a descriptive design with semi-structured and open-ended interviews. This study used a convenience sample of 112 nurses who worked in, and 209 patients who were under psychiatric treatment, in four hospitals attached to a university and one national mental hospital in the city of Seoul. The collected data were analyzed by SAS, using percentages for descriptive purposes, and t-test or x$^2$ for comparing the variables. The results were as follows : 1. There was no significant differences between nurses’ and patients’ perceptions on the extent to which patients complied with their medication treatment. Generally speaking, the mean compliance scores for both nurses and patients was high(nurse : (equation omitted)=3.70, Patient : (equation omitted)=3.76). 2. There was a significant difference in nurses’ and patients’ perceptions on the reasons why patients do not take medication. The nurse group indicated that the patients did not take medication because of the “worry about side effects or habituation(49.53%)”, “boredom from long-term use of medication(26.17%)” and “distrust toward medical staff(12.15% )”, but the patient group indicated that they “did not want to be dependent on medication (25%)”, “forgot to take medication(19.7%) and “worried about side effects or habituation(15.91%). 3. As for the necessity of medication, both groups showed some different responses. Even though both groups were aware of the necessity of taking medication, the patient group(21.53%) showed a more negative response. As (or the effects of medication, both groups (nurses and patients ) showed positive responses. However, the nurse group showed a higher positive response (91.07% ) than the patient group(74.16%), 5. Both the patient and nurse group indicated that the most helpful element for the patient’s life under psychiatric treatment was interviews and conversations with therapists and nurses. However, the nurse group showed a higher response(70.15%) than the patients group(47.15%). According to the patient group, family support for the patient was another important factor for psychiatric treatment and daily struggles. In conclusion, as there were differences between the perception of nurses and patients, the nurse must consider the patients’ subjective perceptions first. They should also revaluate their false belief and prejudice concerning the patients’ perceptions. Such information can provide a base to be applied by the nurses in devloping effective mutual relationships with patients which can in turn help in compliance with medication regimen. As it was confirmed that medication was the most important factor in the patients’ recovery, a thorough education program on the therapeutic effect of medication and the necessity of their continued use after discharge is also needed.

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Management of horizontal root fractures by fabrication of canine protected occlusion using composite resin

  • Shin, Joo-Hee;Kim, Ryan Jin-Young
    • Restorative Dentistry and Endodontics
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    • v.37 no.3
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    • pp.180-184
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    • 2012
  • Traumatic injuries of the face often involve root fractures especially in anterior teeth. The prognosis and the treatment of the root fracture depend on the extent of the fracture line, general health and patient compliance. This case report outlines a new conservative trial treatment modality to stabilize the maxillary central incisors with horizontal root fracture on the cervical to middle third by fabricating canine guidance to remove loading on the traumatized maxillary central incisors during eccentric movements and thus inducing spontaneous healing of the fractured line between the fragments. Radiographs after thirty months showed adequate healing with no signs of pathological changes including root resorption, ankylosis or displacement. Long term follow-up revealed that vitality, stability and aesthetics were maintained and the patient was satisfied with the outcome.

Drug Augmentation Strategies in the Treatment of Mood Disdorder (기분장애의 치료에 있어서 약물의 Augmentation Strategies)

  • Chung, Young In
    • Korean Journal of Biological Psychiatry
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    • v.5 no.2
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    • pp.155-161
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    • 1998
  • Mood disorder is a medical illness resulting from the disorder of CNS neurotransmission and its principal therapeutic tool is pharmacotherapy. Psychotherapeutic drugs for mood disorder have some clinical limitations which are due to no or partial response, decreased compliance for drug by the side effects, and delayed therapeutic effects. So, general hope of all clinicians that mood diorder will respond to a single psychotherapeutic agent may be the exception rather than the rule. Recently, combined drug treatments have become increasingly popular to overcome the clinical limitations of individual agent in mood disorder. Combined treatments are usually used for augmenting or initiating rapidly the effect of drug, and for treating different target symptoms or drug side effects. When combined treatments being tried, knowledge of the action mechanism, pharmacokinetics, and pharmacodynamics is crucial to cope with the possible adverse reactions of drugs.

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Treatment of Snoring and Obstructive Sleep Apnea with Oral Appliance (구강 내 장치를 활용한 코골이 및 수면무호흡증의 치료)

  • Kim, Ji Rak
    • The Journal of the Korean dental association
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    • v.57 no.5
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    • pp.288-295
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    • 2019
  • Sleep-disordered breathing (SDB) is defined as a disturbed breathing during sleep caused by repetitive upper airway collapse. Complete collapse causes a cessation of breathing, known as obstructive sleep apnea (OSA) and snoring can arise from partial collapse. Undiagnosed and untreated OSA means recurrent intermittent hypoxemia and leads to a variety of cardiovascular disorders, disturbed neurocognition, and excessive daytime sleepiness. Various behavioral modalities have been suggested for treating snoring and sleep apnea including changing the sleep position, avoiding alcohol, and weight loss. Until now continuous positive airway pressure (CPAP) therapy is one of effective treatment for patients with OSA, but its discomfort causes less tolerance and compliance. Therefore, clinical effectiveness and convenience for oral appliance have emerged and the role of dentists has become more important in the management of OSA.

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Prevention of delay in implant services using time schedule (타임스케줄을 이용한 임플란트 수술의 지연 개선)

  • Ji-Yeon, Park
    • Journal of Korean Academy of Dental Administration
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    • v.10 no.1
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    • pp.1-8
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    • 2022
  • This study introduces research on the quality of medical services, optimization of medical services, dental medical services, implant medical services, and time schedules, as well as the effective process of dental implant medical services, which is expensive and requires a long treatment period. For improvement, it is suggested to evaluate using a time schedule. In this method, a time schedule is prepared in which each step, starting from the patients appointment until the completion of the treatment process, is allotted a certain time. This schedule was finalized in consultation with the employees. When performing all implant operations, the starting time of each item was checked to evaluate the degree of compliance and to understand any reasons for delay in each step. After identifying the causes for delay at each step, suitable steps to rectify the drawbacks were developed, and an optimal plan for patient management was determined. Changes in waiting time and human resource utilization were shown as concrete data, suggesting that such a schedule is meaningful as a decision-making support tool.

Nutritional Assessment and Nutritional Management for GI Cancer Patients

  • Mi Hyang Um;Yoo Kyoung Park
    • Journal of Digestive Cancer Research
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    • v.2 no.1
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    • pp.15-20
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    • 2014
  • Cancer, especially GI cancer itself and any associated treatments have profound effect on the patient's nutritional status. It is therefore very important to understand various nutritional issues in GI cancer patients for the cure and for increasing the compliance during the course of the treatment. Screening and identification of nutritional risk for the GI cancer patients is very essential and is plays a critical part of the treatment to help improve patient outcomes. Maintaining optimal nutritional status is an important goal in the management of individuals diagnosed, treated with cancer. Maintenance of adequate nutritional intake is important whether patients are undergoing active therapy, recovering from cancer therapy, or are in remission and striving to avoid cancer recurrence. The goals of nutrition therapy are to prevent or reverse nutrient deficiencies, preserve lean body mass, help patients better tolerate treatments and minimize nutrition-related side effects and complications, etc. Recent interest in clinical settings is also in maximizing quality of life of the patients which can also be modulated by appropriate nutrition.

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A Study on the Efficacy and Compliance of Oral Appliances according to the Severity of Apnea in the Treatment of Snoring and Obstructive Sleep Apnea (코골이와 폐쇄성수면무호흡증 환자에서 무호흡 심도에 따른 구강내 장치의 치료효과 및 환자의 적응도에 관한 연구)

  • 안홍균;이광호;정성창
    • Journal of Oral Medicine and Pain
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    • v.23 no.4
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    • pp.419-432
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    • 1998
  • The purpose of this Study was to examine the efficacy and compliance of a mandibular advancement device(MAD) according to the severity of sleep apnea in the snorers and obstructive sleep apnea patients. Fifty-four patients (45 males, 9 females, aged 20 - 68years ) who visited Seoul National Uiversity Dental Hospital(SNUDH) to seek for the treatment of snoring and sleep apnea were classified into four groups according to the results of the nocturnal polysomnography and they were instructed to wear MAD regularly which was designed to increase the size of the upper airway by advancing the mandible. The evaluation of the efficacy and compliance of the MAD according to the severity of apnea and the duration after the usage of MAD ( 1week, 1month, 3months, 6months, 12months) was made by using quesionnaires mad in Department of Oral Medicine and Oral diagnosis, SNUDH. The obtained results were as follows : 1. All subjects results were habitual snoreres and 43 patients(79.6%) complained the loudness of snoring that can be heard out of the room. 2. Apnea index(AI) of the total subjects was mean 29.4$\pm$26.9 and respiratory disturbance index(RDI)was mean 37.6$\pm$28.0. And there was nodifference in the efficacy and the compliances of MAD according to the severity of apnea. 3. The severityi of apnea by the questionnaires significantly corresponded with the results of nocturnal polysomnography, and this fact potentiated the diagnostic value of the questionnaire. 4. after the usage of MAD, there was significant improvement in the frequency of snoring, the loudness of snoring, frequency of apnea, daytime sleepiness nad the refreshment after sleep(p<0.001) regardless of the apnea index(AI) and respiratory distrubance index(RDI). 5. The degree of the satisfaction with MAD was mean 74.4$\pm$18.4% and that of the discomfort with the MAD was 31.4$\pm$19.6%. But there was no serious complication in occlusion and temporomandibular joint with the usage of MAD and the duration of the discomfort was mean 3.3$\pm$2.2 weeks. 6. Forty-one patients(75.9%) continued the usage of MAD but thirteen patients(24.1%) stopped the use of MAD because of the discomforts and insufficient results with it.

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Discomfort caused by the circumferential comfortable retainer (CCR) as a removable maxillary retainer (상악 가철식 보정장치인 circumferential comfortable retainer (CCR)에 대한 불편감 평가)

  • Choi, Jin-Hugh;Moon, Cheol-Hyun
    • The korean journal of orthodontics
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    • v.40 no.5
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    • pp.325-333
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    • 2010
  • Objective: The aim of this study was to illustrate the circumferential comfortable retainer (CCR) as a removable maxillary retainer with good potential patient compliance and to evaluate the discomfort of the retainers including distorted speech, gagging sensation and appliance discomfort. Methods: Sixty-six orthodontic patients (male, 23; female, 43; mean age, $23.42{\pm}10.19$ years) who received orthodontic treatment with fixed orthodontic appliances were randomly assigned to two groups after debonding, a conventional wraparound retainer (CWR) group that fully covers the palate with an acrylic plate and a highly polished surface, and a circumferential comfortable retainer (CCR) group which has a horseshoe shaped base plate with three folds on the anterior region. A questionnaire that had a visual analog scale (VAS) which consists of a 100-mm horizontal line with 2 end-points labeled "no discomfort" on the left and "worst discomfort" on the right, with regard to distorted speech, gagging sensation and discomfort, was administered to patients after 4 weeks of retainer wear. The Mann-Whitney test was used to test the hypothesis that there was no difference between the two retainers. Results: Comparing distorted speech and discomfort, the CCR group significantly had lower values than the CWR group ($p$ < 0.05). Comparing gagging sensation, the CCR group had lower values than the CWR group but there were no statistically significant differences between groups ($p$ = 0.146). Conclusions: In conclusion, the results suggest that the circumferential comfortable retainer (CCR) might facilitate patient compliance and thereby improve the maintenance of the fixed orthodontic treatment outcome.