• The Korean Journal of Pain
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• v.34 no.1
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• pp.106-113
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• 2021

Background: We aimed to investigate the analgesic efficacy of an erector spinae plane block (ESPB) in immediate breast reconstruction (IBR) with a tissue expander. Methods: Adult women undergoing IBR with a tissue expander after mastectomy were randomly assigned to either intravenous patient-controlled analgesia (IV-PCA) alone (group P) or IV-PCA plus ESPB (group E). The primary outcome was the total amount of opioid consumption during 24 hours postoperatively between the two groups. Secondary outcomes were patient satisfaction, pain score at rest and on shoulder movement using numerical rating scale, incidences of postoperative nausea and vomiting (PONV), and a short form of the brief pain inventory (BPI-SF) at 3 and 6 months after surgery between the groups. Results: Fifty eight patients completed the study. At 24 hours postoperatively, total opioid consumption was significantly less in group E than in group P (285.0 ± 92.0, 95% confidence interval [CI]: 250.1 to 320.0 vs. 223.2 ± 83.4, 95% CI: 191.5 to 254.9, P = 0.005). Intraoperative and cumulative PCA fentanyl consumption at 3, 6, 9, and 24 hours were also less in group E than in group P (P = 0.004, P = 0.048, P = 0.020, P = 0.036, and P < 0.001, respectively). Patient satisfaction was higher in group E (6.9 ± 1.8 vs. 7.8 ± 1.4, P = 0.042). The incidences of PONV was similar. Conclusions: The ESPB decreased postoperative opioid consumption and increased patient satisfaction without significant complications after IBR with a tissue expander after mastectomy.

• Journal of Korea Entertainment Industry Association
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• v.15 no.1
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• pp.171-180
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• 2021

The present study investigated the effects of dynamic tubing gait (DTG II) program on the balancing ability for the promotion of life care of patients with chronic stroke. In the study, 25 sessions of DTG II program (30 minutes per session, 5 sessions per week, for a total of 5 weeks) were applied to 10 patients with chronic stroke. To determine the effects of DTG II program for improving balance, surface electromyography(external oblique, erector spinae, iliopsoas, gluteus maximus), symmetry index test on three pelvic axes, and dynamic gait index test were performed before and after the intervention. The results showed statistically significant differences between preand post-intervention measurements of the gluteus maximus muscle at early and mid-stance phases(p<.05). The pelvic symmetry index differed significantly between pre- and post-intervention measurements of diagonal and rotational movement(p<.05). Comparison of dynamic gait index also showed statistically significant differences between pre- and post-intervention measurements(p<.05). Based on these findings, it was determined that the DTG II program was able to improve the balancing ability of patients with chronic stroke by activating their trunk muscles and improving the symmetry of diagonal pelvic movement and rotation. Therefore, DTG II program is recommended as an interventional method to improve life-care through improving the balancing ability of patients with chronic stroke.

• 한국노년학
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• v.40 no.4
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• pp.659-689
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• 2020

This study focuses on the process of internalizing the perception of negative discrimination among elderly people who have experienced age discrimination. The grounded theory method was used to identify the age discrimination experienced by the elderly in their daily lives and to explore the consequences of such discrimination through self-ageism. According to the analysis results, the elderly respond not only to explicit discrimination but also to implicit discrimination. In this process, the stronger the pain of old age (poverty, disease, ignorance, and solitude) and the stronger the memory of failing to respond to discrimination, the higher the level of self-ageism. "Self-ageism" has internalized the negative image of the elderly, who have been discriminated against by age, resulting in disadvantages in terms of quality of life through various reject/separate/suspension actions in reality. In the presence of supportive resources such as health, institutional support, and caregivers, the elderly have room to overcome self-ageism through more active ways. However elderly people who cannot motivate themselves and they lack these resources, elderly are trapped in negative reflux caused by self-ageism and sustained a depressed and shrinking life. In this state, it is not easy to motivate themselves and make physical, cognitive, emotional and social responses. Therefore, in this analysis, we specifically noted two aspects, contextual conditions and interventional conditions, and proposed programs for synchronizing senior citizens and improving resiliency from a microscopic point of view, and argued for the need to develop systems such as supplementing welfare and health service systems related to the entire life cycle, expanding accessibility and 'age-integration' through 'Community Care', awareness improvement and anti-discrimination laws.

• Journal of the Korean Society of Radiology
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• v.16 no.7
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• pp.935-942
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• 2022

In doing interventional treatment under the guidance of ultrasonography, the medical team detects the legion site with ultrasonic equipment at first, and insert angio needle. In this situation, if the position of legion and the depth of inserted needle on the ultrasonographic screen are different from real position and depth, the needle is likely to damage a major blood vessel or tissue. Accordingly, we had wondered how much such differences between screen image and reality, and so decided to examine them. Using five ultrasonographic equipments manufactured from different companies in different years, this study tried to compare the lengths of the needle on the screen images and real lengths of it, and find out the factors affecting skewness of them. This study used hog meat chunk to mimic human flesh, and sausages as the target of needle. It compared penetrating depths of the needle as the images on the five equipments using single sample t test in the SPSS 22 statistical program. It was found that all the errors were statistically significant(<.05). So, this study decided that it was wrong to evaluate performances of the equipments by the makers and ages of them. It is necessary to do periodic quality controls of equipments and improve the skillfulness of sonographers to reduce error rates between real treatment areas and the images of them.

• The Journal of the Korea Contents Association
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• v.22 no.9
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• pp.570-582
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• 2022

Nucleoplasty is a type of percutaneous disc decompression that has been developed to treat herniated intervertebral discs. Currently, in some clinics, researchers have also applied this procedure to patients with internal disc disruption, apart from the originally intended usage on herniated intervertebral discs. The purpose of this study is to evaluate the feasibility of this extended use based on medical logic. To achieve this, the author analyzed case studies on performing nucleoplasty on patients with internal disc disruption. The main points of the analysis are, first, the validity of the treatment evidence presented by the researchers and, second, the relevance of the patient selection criteria. As a result, it is judged that the therapeutic rationale of existing papers applying nucleoplasty to the treatment of internal disc disruption is unclear or inconsistent with general medical logic, and in the process of patient screening, discs that may be deemed inappropriate for percutaneous decompression are included. Therefore, the author believes that existing studies applying nucleoplasty to the treatment of internal disc disruption have the nature of somewhat adventurous experiments that are unnecessary or can cause potential side effects. In order to uphold patients' rights and improve the completeness of the study in the research process on this topic, the author thinks that it is essential to establish clearer therapeutic evidence than the current level of understanding and to have an elaborate patient screening process based on it.

• Journal of Industrial Convergence
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• v.20 no.8
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• pp.137-144
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• 2022

This study was conducted to provide the basis for psychological management direction of students ahead of their first field practice by grasping the degree of anxiety and confirming the relationship between departments satisfaction and practice expectations. A survey was conducted on dental hygiene students ahead of their first field practice and 135 people were selected as final analysis subjects. Data analysis investigated general characteristics, department satisfaction, field practice expectation and pre-education satisfaction and statistical analysis was conducted through mean(±SD), one-way ANOVA, and multiple linear regression analysis method. As a result, the anxiety level was high in the lower group of performance in the previous semester, and the department satisfaction and pre-education satisfaction were high in the group with low anxiety level. As a result of the correlation analysis, it was found that department satisfaction, field practice expectation, pre-education satisfaction, and anxiety were negatively correlated, and the higher the practice expectation, the lower the anxiety. Therefore, in order to lower the level of anxiety before field practice, it is necessary to come up with measures to increase interventional pre-education, department satisfaction and field practice expectation.

• The Korean Journal of Pain
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• v.36 no.1
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• pp.128-136
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• 2023

Background: The authors aimed to compare the effects of a one-time ultrasound (US)-guided subacromial corticosteroid injection and three-time ozone (O₂-O₃) injection in patients with chronic supraspinatus tendinopathy. Methods: Participants were randomly assigned to the corticosteroid group (n = 22) or ozone group (n = 22). Injections in both groups were administered into subacromial bursa with an US-guided in-plane posterolateral approach. Primary outcome measure was the change in the Western Ontario Rotator Cuff Index (WORC) score between baseline and 12-weeks post-injection. Secondary outcome measures included visual analog scale and Shoulder Pain and Disability Index scores. Assessments were recorded at baseline, and 4-weeks and 12-weeks post-injection. Results: Forty participants completed this study. Based on repeated measurement analysis of variance, a significant effect of time was found for all outcome measures in both groups. Both the groups showed clinically significant improvements in shoulder pain, quality of life, and function. Baseline, 4-week post-injection, and 12-week post-injection WORC scores (mean ± standard deviation) were 57.91 ± 18.97, 39.10 ± 20.50 and 37.22 ± 27.31 in the corticosteroid group, respectively and 69.03 ± 15.89, 39.11 ± 24.36, and 32.26 ± 24.58 in the ozone group, respectively. However, no significant group × time interaction was identified regarding all outcome measures. Conclusions: Three-time ozone injection was not superior to a one-time corticosteroid injection in patients with chronic supraspinatus tendinopathy. It might be as effective as corticosteroid injection at 4-weeks and 12-weeks post-injection in terms of relieving pain and improving quality of life and function.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.3
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• pp.163-171
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• 2023

Background: Surgical extraction of impacted mandibular third molars is the most common procedure performed by oral surgeons. The procedure cannot be performed effectively without achieving profound anesthesia. During this procedure, patients may feel pain during surgical bone removal (at the cancellous level) or during splitting and luxation of the tooth, despite administration of routine nerve blocks. Administration of intraosseous (IO) lignocaine injections during third molar surgeries to provide effective anesthesia for pain alleviation has been documented. However, whether the anesthetic effect of lignocaine is the only reason for pain alleviation when administered intraosseously remains unclear. This conundrum motivated us to assess the efficacy of IO normal saline versus lignocaine injections during surgical removal of impacted mandibular third molars. The aim of this study was to assess the efficacy of IO normal saline as a viable alternative or adjunct to lignocaine for alleviation of intraoperative pain during surgical removal of impacted mandibular third molars. Methods: This randomized, double-blind, interventional study included 160 patients who underwent surgical extraction of impacted mandibular third molars and experienced pain during surgical removal of the buccal bone or sectioning and luxation of the tooth. The participants were divided into two groups: the study group, which included patients who would receive IO saline injections, and the control group, which included patients who would receive IO lignocaine injections. Patients were asked to complete a visual analog pain scale (VAPS) at baseline and after receiving the IO injections. Results: Of the 160 patients included in this study, 80 received IO lignocaine (control group), whereas 80 received IO saline (study group) following randomization. The baseline VAPS score of the patients and controls was 5.71 ± 1.33 and 5.68 ± 1.21, respectively. The difference between the baseline VAPS scores of the two groups was not statistically significant (P > 0.05). The difference between the numbers of patients who experienced pain relief following administration of IO lignocaine (n=74) versus saline (n=69) was not statistically significant (P > 0.05). The difference between VAPS scores measured after IO injection in both groups was not statistically significant (P >0.05) (1.05 ± 1.20 for the control group vs. 1.72 ± 1.56 for the study group) Conclusion: The study demonstrates that IO injection of normal saline is as effective as lignocaine in alleviating pain during surgical removal of impacted mandibular third molars and can be used as an effective adjunct to conventional lignocaine injection.

• The Journal of the Convergence on Culture Technology
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• v.9 no.5
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• pp.185-192
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• 2023

Currently, the number of Long-Term Care Hospital in Korea is continuously increasing with the increase in the elderly population. Patients admitted to Long-Term Care Hospital are mainly elderly with chronic diseases, and because they are for long-term care, they often die in Long-Term Care Hospital, and the importance of end-of-life care is gradually increasing. In spite of these characteristics Studies on end-of-life care for nurses in Long-Term Care Hospital are mainly quantitative studies, and there is a limit to in-depth understanding of end-of-life care experiences. Therefore, The purpose of this study is to understand the meaning of Long-Term Care Hospital nurses' nursing experienceof end-of-life patients through a phenomenological method, and to describe and understand the meaning of the phenomenon in depth. The subjects of this study were 7 nurses who had worked for more than 6 months at a nursing hospital located in C city. The research method was in-depth interviews, and data were collected from December 2021 to March 2022. The interview date were analyzed by Giorgi's phenomenological method. As a result of the study, 'nurses' attitude toward end-of-life care', 'ambivalence toward life prolongation', 'reality of end-of-life care in Long-Term Care Hospital', and 'reflection on life and death' were found. Therefore, it is thought that End-of-life nursing Continuing educationand interventional education programs should be developed to change Long-Term Care Hospital nurses' end-of-life care attitudes and improve coping skills.

• Pediatric Infection and Vaccine
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• v.31 no.1
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• pp.55-63
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• 2024

Purpose: A 2-dose varicella vaccination strategy has been introduced in many countries worldwide, aiming to increase vaccine effectiveness (VE) against varicella infection. In this network meta-analysis, we aimed to provide a comprehensive evaluation and an overall estimated effect of varicella vaccination strategies, via a Bayesian model. Methods: For each eligible study, we collected trial characteristics, such as: 1-dose vs. 2-dose, demographic characteristics, and outcomes of interest. For studies involving different doses, we aggregated the data for the same number of doses delivered into one arm. The preventive effect of 1-dose vs. 2-dose of varicella vaccine were evaluated in terms of the odds ratio (OR) and corresponding equal-tailed 95% confidence interval (95% CI). Results: A total of 903 studies were retrieved during our literature search, and 25 interventional or observational studies were selected for the Bayesian network meta-analysis. A total of 49,265 observed individuals were included in this network meta-analysis. Compared to the 0-dose control group, the OR of all varicella infections were 0.087 (95% CI, 0.046-0.164) and 0.310 (95% CI, 0.198-0.484) for 2-doses and one-dose, respectively, which corresponded to VE of 69.0% (95% CI, 51.6-81.2) and VE of 91.3% (95% CI, 83.6-95.4) for 1- and 2-doses, respectively. Conclusions: A 2-dose vaccine strategy was able to significantly reduce varicella burden. The effectiveness of 2-dose vaccination on reducing the risk of infection was demonstrated by sound statistical evidence, which highlights the public health need for a 2-dose vaccine recommendation.