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Clinical factors affecting the longevity of fixed retainers and the influence of fixed retainers on periodontal health in periodontitis patients: a retrospective study

  • Han, Ji-Young;Park, Seo Hee;Kim, Joohyung;Hwang, Kyung-Gyun;Park, Chang-Joo
    • Journal of Periodontal and Implant Science
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    • v.51 no.3
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    • pp.163-178
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    • 2021
  • Purpose: The aim of this study was to evaluate clinical factors affecting the longevity of fixed retainers and the influence of fixed retainers on periodontal health in periodontitis patients. Methods: In total, 52 patients with at least 2 years of follow-up after periodontal and orthodontic treatment were included in this study. After scaling and root planing, orthodontic treatment with fixed appliances or clear aligners was performed. Fixed retainers with twist-flex stainless steel wires were bonded to the palatal or lingual sides of anterior teeth. Changes in clinical parameters, including the plaque index, gingival index, calculus index (CI), probing pocket depth, and radiographic bone levels, were evaluated before bonding of fixed retainers and at a 12-month follow-up. Cumulative survival rates (CSRs) for retainer failure were evaluated according to sex, site, CI, stage of periodontitis, and the severity of the irregularity with the log-rank test and hazard ratios (HRs). Results: Twelve months after bonding of fixed retainers, improvements were observed in all clinical parameters except CI and radiographic bone gain. The overall CSR of the retainers with a CI <1 at the 12-month follow-up after bonding of fixed retainers was significantly higher than that of the retainers with a CI ≥1 at the 12-month follow-up (log-rank test; P<0.001). Patients with stage III (grade B or C) periodontitis had a higher multivariate HR for retainer failure (5.4; 95% confidence interval, 1.22-23.91; P=0.026) than patients with stage I (grade A or B) periodontitis. Conclusions: Although fixed retainers were bonded in periodontitis patients, periodontal health was well maintained if supportive periodontal treatment with repeated oral hygiene education was provided. Nonetheless, fixed retainer failure occurred more frequently in patients who had stage III (grade B or C) periodontitis or a CI ≥1 at 12-month follow-up after bonding of fixed retainers.

Does the Use of Asthma-Controller Medication in Accordance with Guidelines Reduce the Incidence of Acute Exacerbations and Healthcare Costs?

  • Lee, Suh-Young;Kim, Kyungjoo;Park, Yong Bum;Yoo, Kwang Ha
    • Tuberculosis and Respiratory Diseases
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    • v.85 no.1
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    • pp.11-17
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    • 2022
  • Background: In asthma, consistent control of chronic airway inflammation is crucial, and the use of asthma-controller medication has been emphasized. Our purpose in this study is to compare the incidence of acute exacerbation and healthcare costs related to the use of asthma-controller medication. Methods: By using data collected by the National Health Insurance Review and Assessment Service, we compared one-year clinical outcomes and medical costs from July 2014 to June 2015 (follow-up period) between two groups of patients with asthma who received different prescriptions for recommended asthma-controller medication (inhaled corticosteroids or leukotriene receptor antagonists) at least once from July 2013 to June 2014 (assessment period). Results: There were 51,757 patients who satisfied our inclusion criteria. Among them, 13,702 patients (26.5%) were prescribed a recommended asthma-controller medication during the assessment period. In patients using a recommended asthma-controller medication, the frequency of acute exacerbations decreased in the follow-up period, from 2.7% to 1.1%. The total medical costs of the controller group decreased during the follow-up period compared to the assessment period, from $3,772,692 to $1,985,475. Only 50.9% of patients in the controller group used healthcare services in the follow-up period, and the use of asthma-controller medication decreased in the follow-up period. Conclusion: Overall, patients using a recommended asthma-controller medication showed decreased acute exacerbation and reduced total healthcare cost by half.

Mid-term outcomes of bony increased offset-reverse total shoulder arthroplasty in the Asian population

  • Tankshali, Kirtan;Suh, Dong-Whan;Ji, Jong-Hun;Kim, Chang-Yeon
    • Clinics in Shoulder and Elbow
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    • v.24 no.3
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    • pp.125-134
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    • 2021
  • Background: To evaluate clinical and radiological outcomes of bony increased offset-reverse total shoulder arthroplasty (BIO-RSA) in the Asian population at mid-term follow-up. Methods: From June 2012 to August 2017 at a single center, 43 patients underwent BIO-RSA, and 38 patients with minimum 2 years follow-up were enrolled. We evaluated the clinical and radiological outcomes, and complications at the last follow-up. In addition, we divided these patients into notching and no-notching groups and compared the demographics, preoperative, and postoperative characteristics of patients. Results: Visual analogue scale, American Shoulder and Elbow Surgeons, University of California-Los Angeles Shoulder Scale, and Simple Shoulder Test scores improved significantly from preoperative (5.00, 3.93, 1.72, 3.94) to postoperative (1.72, 78.91, 28.34, 7.66) (p<0.05) outcomes. All range of motion except internal rotation improved significantly at the final follow-up (p<0.05), and the bone graft was well-incorporated with the native glenoid in all patients (100%). However, scapular notching was observed in 20 of 38 patients (53%). In the comparison between notching and no-notching groups (18 vs. 20 patients), there were no significant differences in demographics, radiological parameters, and clinical outcomes except acromion-greater tuberosity (AT) distance (p=0.003). Intraoperative complications included three metaphyseal fractures and one inferior screw malposition. Postoperative complications included ectopic ossification, scapular neck stress fracture, humeral stem relaxation, and late infection in one case each. Conclusions: BIO-RSA showed improved clinical outcomes at mid-term follow-up in Asian population. However, we observed higher scapular notching compared to the previous studies. In addition, adequate glenoid lateralization with appropriate humeral lengthening (AT distance) might reduce scapular notching.

Surgical Results of the Superior Vena Cava Intimal Layer-Only Suture Technique in Heart Transplantation

  • Sang-Uk Park;Kyungsub Song;Yun Seok Kim;In Cheol Kim;Jae-Bum Kim;Namhee Park;Woo Sung Jang
    • Journal of Chest Surgery
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    • v.56 no.5
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    • pp.322-327
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    • 2023
  • Background: Superior vena cava (SVC) stenosis during follow-up is a major concern after heart transplantation, and many technical modifications have been introduced. We analyzed the surgical results of the SVC intima layer-only suture technique in heart transplantation. Methods: We performed SVC anastomosis with sutures placed only in the intima during heart transplantation. We measured the area of the SVC at 3 different points (above the anastomosis, at the anastomosis, and below the anastomosis) in an axial view by freely drawing regions of interest, and then evaluated the degree of stenosis. Patients who underwent cardiac computed tomography (CT) at 2 years postoperatively between June 2017 and May 2020 were included in this study. Results: We performed heart transplantation in 41 patients. Among them, 24 patients (16 males and 8 females) underwent follow-up cardiac CT at 2 years postoperatively. The mean age at operation was 49.4±4.9 years. The diagnoses at time of operation were dilated cardiomyopathy (n=12), ischemic heart disease (n=8), valvular heart disease (n=2), hypertrophic cardiomyopathy (n=1), and congenital heart disease (n=1). No cases of postoperative bleeding requiring intervention occurred. The mean CT follow-up duration was 1.9±0.7 years. At follow-up, the mean areas at the 3 key points were 2.7±0.8 cm2, 2.7±0.8 cm2, and 2.7±1.0 cm2 (p=0.996). There were no SVC stenosis-related symptoms during follow-up. Conclusion: The suture technique using only the SVC intimal layer is a safe and effective method for use in heart transplantation.

Improvement Plan for Promotion System of Sustainable Rural Community Building (지속 가능한 마을만들기를 위한 추진체계 개선방안 - 김해시를 중심으로 -)

  • Choi, Young-Wan;Um, Min-Ho;Kim, Young-Joo
    • Journal of Korean Society of Rural Planning
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    • v.28 no.4
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    • pp.55-67
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    • 2022
  • In this study, the village development promotion system was reorganized for Gimhae-si, and improvement plans and post-operation management plans were prepared through expert surveys. Through the Village Development Project, the landscape and environment of the village were improved, and the village and residents were positively changed. The Village Development Project laid the foundation for regional revitalization, giving the next generation hope for the sustainable development of the village. While maintaining the framework of the existing Rural Development Projects guidelines through case analysis of other regions, we operate educational programs for each stage by reflecting regional characteristics, and utilize and communicate with intermediate support organizations, systematically operate, and actively intervene by Eup·Myeon administration. In addition, as a follow-up management program, various follow-up management programs were being operated, such as support for capacity building such as consulting, as well as facility maintenance and support for village managers. As a result of the expert survey to review the adequacy of the improvement plan, the improvement plan derived from the overall average of 4.28 points and the standard deviation of 0 to 0.94 points for the process is judged to be appropriate. In particular, the item of 'self-reliance stage follow-up management' was very important as all experts responded with 5 points. By establishing the village development performance goals, we tried to check whether the qualitative/quantitative goals were achieved by year, and to secure quantified status data in response to changes such as resetting performance goals or adding new performance indicators. In this study, in order to improve the capacity to achieve regional development in response to the rural agreement, we prepared our own sustainable village development promotion system, governance establishment, and follow-up management plan. In addition, it is expected to be used as a reference material for the selection of new districts and the follow-up management of completed districts by establishing the village development goals.

Predictors of Continuity of Care after Inpatient Discharge of Patients with Bipolar Disorder : A Retrospective Chart Review Study in a University Hospital (양극성 장애 환자에서 퇴원 이후 외래 치료 유지에 영향을 미치는 예측인자 : 일 대학병원 후향적 의무기록 조사연구)

  • Wang, Hee Ryung;Jung, Young-Eun;Song, Hoo Rim;Jun, Tae-Youn;Kim, Kwang-Su;Bahk, Won-Myong
    • Mood & Emotion
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    • v.9 no.2
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    • pp.126-132
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    • 2011
  • Background and Objectives : This study aims to identify sociodemographic and disease-related variables which predicts continuity of outpatient treatment after discharge among bipolar patients. Materials and Method : The medical records of patients who discharged with the diagnosis of bipolar disorder from Department of Psychiatry, St. Mary's hospital from 2005 to 2009 were reviewed. Data on sociodemographic and disease-related variables were analyzed. Results : It showed older age, higher rate of male and higher rate of being married in 1-year follow-up group than in non-follow-up group. And it showed longer duration of index hospitalization, higher rate of previous psychiatric outpatient treatment within 3 months before index hospitalization, higher rate of involuntary admission in 1-year follow-up group than in non-follow-up group. The univariate logistic regression analysis revealed that older age, being male, previous psychiatric treatment and longer duration of index hospitalization were significantly related to an increased likelihood of 1-year follow-up visits. Conclusion : Age, sex, history of previous psychiatric treatment, and duration of hospitalization seems to have influence on continuity of outpatient treatment after discharge.

Additional Value of Integrated 18F-FDG PET/MRI for Evaluating Biliary Tract Cancer: Comparison with Contrast-Enhanced CT

  • Jeongin Yoo;Jeong Min Lee;Jeong Hee Yoon;Ijin Joo;Dong Ho Lee
    • Korean Journal of Radiology
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    • v.22 no.5
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    • pp.714-724
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    • 2021
  • Objective: To evaluate the value of 18F-fluorodeoxyglucose PET/MRI added to contrast-enhanced CT (CECT) in initial staging, assessment of resectability, and postoperative follow-up of biliary tract cancer. Materials and Methods: This retrospective study included 100 patients (initial workup [n = 65] and postoperative follow-up [n = 35]) who had undergone PET/MRI and CECT for bile duct or gallbladder lesions between January 2013 and March 2020. Two radiologists independently reviewed the CECT imaging set and CECT plus PET/MRI set to determine the likelihood of malignancy, local and overall resectability, and distant metastasis in the initial workup group, and local recurrence and distant metastasis in the follow-up group. Diagnostic performances of the two imaging sets were compared using clinical-surgical-pathologic findings as standards of reference. Results: The diagnostic performance of CECT significantly improved after the addition of PET/MRI for liver metastasis (area under the receiver operating characteristic curve [Az]: 0.77 vs. 0.91 [p = 0.027] for reviewer 1; 0.76 vs. 0.92 [p = 0.021] for reviewer 2), lymph node metastasis (0.73 vs. 0.92 [p = 0.004]; 0.81 vs. 0.92 [p = 0.023]), and overall resectability (0.79 vs. 0.92 [p = 0.007]; 0.82 vs. 0.94 [p = 0.021]) in the initial workup group. In the follow-up group, the diagnostic performance of CECT plus PET/MRI was significantly higher than that of CECT imaging for local recurrence (0.81 vs. 1.00 [p = 0.029]; 0.82 vs. 0.94 [p = 0.045]). Conclusion: PET/MRI may add value to CECT in patients with biliary tract cancer both in the initial workup for staging and determination of overall resectability and in follow-up for local recurrence.

Application of HPV DNA Testing in Follow-up after Loop Electrosurgical Excision Procedures in Northern Thailand

  • Khunamornpong, Surapan;Settakorn, Jongkolnee;Sukpan, Kornkanok;Kietpeerakool, Chumnan;Tantipalakorn, Charuwan;Suprasert, Prapaporn;Siriaunkgul, Sumalee
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.6093-6097
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    • 2015
  • Background: HPV DNA testing has been recently introduced as an adjunct test to cytology in the follow-up of patients after treatment for cervical lesions using the loop electrosurgical excision procedure (LEEP). The aim of this study was to evaluate the role of HPV testing in the detection of persistent or recurrent disease after LEEP in patients with cervical epithelial lesions in northern Thailand. Materials and Methods: Patients who underwent LEEP as a treatment for histological low-grade (LSIL) or high-grade squamous intraepithelial lesion (HSIL) or worse at Chiang Mai University Hospital between June 2010 and May 2012 were included. Follow-ups were scheduled at 6-month intervals and continued for 2 years using co-testing (liquid-based cytology and Hybrid Capture 2 [HC2]) at 6 months and 24 months and liquid-based cytology alone at 12 and 18 months. Results: Of 98 patients included, the histological diagnoses for LEEP included LSIL in 16 patients, and HSIL or worse in 82 patients. The LEEP margin status was negative in 84 patients (85.7%). At follow-up, 10 patients (10.2%) had persistent/recurrent lesions; 4 among LSIL patients (25.0%) and 6 in the group with HSIL or worse (7.3%). Only 2 of 82 patients (2.4%) with HSIL or worse diagnoses had histological HSIL in the persistent/recurrent lesions. Using histologically confirmed LSIL as the threshold for the detection of persistent/recurrent disease, cytology had a higher sensitivity than HC2 (90.0% versus 70.0%). At the 6-month follow-up appointment, combined cytology and HC2 (co-testing) had a higher sensitivity in predicting persistent/recurrent disease (80.0%) compared with that of cytology alone (70.0%) and HC2 (50.0%). Conclusions: After LEEP with a negative surgical margin, the rate of persistent/recurrent lesions is low. The addition of HPV testing at the 6-month visit to the usual cytology schedule may be an effective approach in the follow-up after LEEP.

Comparative Analysis of the Results between the Early Period and the Midterm Period of a Single Surgeon's Experience in the Treatment of Hallux Valgus Using Scarf Osteotomy (단일 수술자에 의한 초기와 중기에 시행한 무지외반증에 대한 Scarf 절골술의 결과 비교)

  • Lee, Yeong-Hyeon;Nam, Il-Hyun;Lee, Tae-Hun;Ahn, Gil-Yeong;Lee, Yong-Sik;Hwang, Sung-Hyun;Lee, Kyung-Jin
    • Journal of Korean Foot and Ankle Society
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    • v.24 no.4
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    • pp.135-141
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    • 2020
  • Purpose: This study evaluated the results of two groups-the early group and midterm group-comparatively in the treatment of hallux valgus using a scarf osteotomy. Materials and Methods: From January 2005 to December 2009 (Group 1) and from January 2010 to December 2013 (Group 2), this study compared hallux valgus cases treated by a scarf osteotomy by a single surgeon with at least a five-year follow-up. Results: The average ages of Group 1 and Group 2 were 50.5 and 51.7 years old, respectively. The average follow-up of Groups 1 and 2 were 7.4 and 6.2 years, respectively. Groups 1 and 2 had 86 cases (53 patients) and 93 cases (64 patients) with at least a five-year follow-up, respectively. The average hallux valgus angle (HVA) and 1-2 intermetatarsal angle (IMA) of Group 1 were improved from 31.3° and 13.9° preoperatively to 11.3° and 6.8° at the final follow-up, respectively (p<0.001). The average HVA and 1-2 IMA of Group 2 were improved from 31.7° and 13.4° preoperatively to 8.9° and 6.6° at the final follow-up, respectively (p<0.001). The mean American Orthopaedic Foot and Ankle Society (AOFAS) score of both groups increased from 48.5 and 45.0 points preoperatively to 73.7 and 82.4 points at the final follow-up, respectively. The numbers of patient-assessed subjective satisfaction of Groups 1 and 2 at the final follow-ups were as follows: excellent, 27 and 36 (31.4%, 38.7%); good, 34 and 49 (39.5%, 52.7%); fair, 13 and 5 (15.1%, 5.4%); poor, 12 and 3 (13.9%, 3.2%); respectively. Neither troughing nor stress fractures occurred in both groups. Conclusion: Scarf osteotomy for treating hallux valgus is an excellent surgical method with a relatively low incidence of complications. The results in Group 2 were better than those in Group 1, showing that more surgical experience and evolution of the techniques provided better results.

The Spontaneous Regression of Lumbar Disc Herniation: 3 Cases Report (요추간판 탈출의 자연적 축소(3례 증례보고))

  • Kwon, Won-An;Kim, Han-Soo
    • The Journal of Korean Physical Therapy
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    • v.20 no.3
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    • pp.69-74
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    • 2008
  • Purpose: The majority of patients with radiculopathy caused by a herniated nucleus pulposus (HNP) heal spontaneously without surgery. The aim of this report is to describe the spontaneous regression of lumbar disc herniation and the results of clinical follow-up. Methods: Three patients with radiating low back pain presented with an extruded intervertebral disc on magnetic resonance imaging (MRI). We performed follow-up with conservative treatment (epidural injection, medication, physical therapy, exercise) and clinical assessments on the 6th, 10th and 22nd months. Results: The extruded intervertebral disc almost complete regressed, and correlated with clinical improvement and follow-up MRI. Conclusion: Conservative treatment can be an effective approach for a herniated lumbar discs if no neurological deficits are present.

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