• Journal of Periodontal and Implant Science
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• 제52권6호
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• pp.466-478
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• 2022

Purpose: Coronally advanced split-or full-thickness (CAST or CAFT) flaps in combination with subepithelial connective tissue grafts (SCTGs) are commonly used in root-coverage procedures despite postoperative pain and bleeding from the graft donor site. Therefore, the modified vestibular incision subperiosteal tunnel access procedure (VISTAX) uses a novel collagen matrix (VCMX) instead of autogenous tissue to address the limitations associated with autogenous tissue grafting. This retrospective study compared the clinical outcomes of VISTAX to the results obtained after using a CAST or CAFT flap in combination with SCTG for root coverage. Methods: Patients with single or multiple adjacent recession I/II defects were included, with 10 subjects each in the VISTAX, CAFT, and CAST groups. Defect coverage, keratinized tissue width, esthetic scores, and patients' perceived pain and dentinal hypersensitivity (visual analogue scale [VAS]) were assessed at baseline, 3 months, and 6 months. Results: All surgical techniques significantly reduced gingival recession (P<0.0001). Defect coverage, esthetic appearance, and the reduction in dentinal hypersensitivity were comparable. However, the VAS scores for pain were significantly lower in the VISTAX group than in the CAFT and CAST groups, which had similar scores (P<0.05). Furthermore, the clinical results of VISTAX and CAFT/CAST generally remained stable at 6 months. Conclusions: The clinical outcomes of VISTAX, CAFT, and CAST were comparable. However, patients perceived significantly less pain after VISTAX, indicating a potentially higher patient acceptance of the procedure. A prospective trial with a longer follow-up period and a larger sample size should therefore evaluate VISTAX further.

• Journal of Korean Dental Science
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• 제16권2호
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• pp.218-226
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• 2023

Treatment of multiple gingival recession defects is usually more challenging than that of single gingival recession. Various techniques for the treatment of multiple gingival recession have been established. Recently, vestibular incision subperiosteal tunnel access (VISTA) technique has been considered to exhibit high predictive ability. Connective tissue graft (CTG) has also been considered a gold standard technique owing to its high predictability of root coverage. However, this technique requires a suitable donor site and has clinical disadvantages, such as additional pain. Thus, in this case presentation, platelet-rich fibrin (PRF) was used as an alternative material for CTG along with VISTA. We herein report cases of two patients with Miller's class I and III multiple gingival recession defects, respectively. These patients underwent VISTA along with the use of a PRF membrane. They were followed up for 12 months postoperatively, and their clinical parameters, including probing depth, depth of gingival recession, clinical attachment level, and width of attached gingiva at baseline and at 2, 6, and 12 months postoperatively, were assessed. The patient with class 1 recession defects exhibited a significant amount of root coverage, which remained stable during the follow-up period. Whereas the patient with class 3 recession defects had lesser amount of coverage compared to class 1 patient. The partial coverage observed may be attributed to not only anatomical factors but also the technique-sensitive nature of the procedure. Considering these results, the use of VISTA along with PRF is a viable option for treating gingival recession, as it does not cause discomfort to patients. However, various factors need to be considered during the surgical procedure.

• 중소기업융합학회논문지
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• 제5권4호
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• pp.17-23
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• 2015

정보통신 기술의 발전으로 인하여 헬스케어 서비스가 대중화되면서 환자의 바이오인포매틱스 저보를 활용한 다양한 서비스가 환자에게 제공되고 있다. 특히, 바이오인포매틱스 정보를 활용한 헬스케어 서비스는 다양한 의료서비스 트랜드로 변화하고 있다. 그러나, 환자의 바이오인포매틱스 정보를 이용한 헬스케어서비스는 질병의 복잡성과 새로운 질병(SARS, AIDS 등)의 등장으로 인하여 의료비용이 증가하고 있고 환자에게 건강 증진 서비스가 원활하게 제공되지 못하고 있다. 본 논문에서는 저비용의 의료 서비스와 빠른 환자의 바이오인포매틱스 정보 접근을 위한 의료 서비스 모델을 제안한다. 제안 모델은 환자의 바이오인포매틱스 정보를 빅 데이터화하여 환자가 언제/어디서나 자신의 질병 관리를 위해 가까운 병원이나 자택에서 의료서비스를 제공받을 수 있도록 한다. 특히, 제안 모델의 의료서비스는 환자의 질병 정보를 손쉽게 분석하여 의료기관에게 전달함으로써 의료기관의 업무 부담을 줄이고 업무 효율성을 향상시키는 특징이 있다.

• 디지털융복합연구
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• 제13권1호
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• pp.275-281
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• 2015

최근 헬스케어는 다양한 의료 서비스를 제공받으려는 사용자가 급격하게 증가하고 있으며, 환자의 정보가 제3자에게 쉽게 노출되어 악용될 수 있어 환자에 따라 병원 관계자(의사, 간호사, 약사 등)의 역할이 명확하게 분류될 필요가 있다. 본 논문에서는 헬스케어 환경에서 환자의 정보가 제3자로부터 안전하게 사용하기 위해서 환자의 속성정보를 분류하고, 병원 관계자는 역할에 따라 권한을 분류하여 계층적 다중 속성을 이용한 환자의 프라이버시 보호기법을 제안한다. 제안 기법은 환자의 프라이버시 속성정보(데이터 소비자, 시간, 센서, 목적, 의무, 위임 그리고 상황 등)를 수학적 모델로 표현하고, 제 3자로부터 환자 정보가 불법적으로 악용되는 것을 예방하기 위해서 환자와 병원관계자 사이의 속성정보를 동기화하여 환자의 프라이버시 정보의 유출을 예방한다.

• 대한치과보철학회지
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• 제38권3호
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• pp.360-365
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• 2000

The completely edentulous patient has few treatment options in conventional dentistry. When implants are considered, treatment plans range from a 2-implant overdenture to a completely implant-supported prosthesis. Fixed prosthesis is often the preferred selection of the edentulous patient. fixed full-arch cert amo-metal restorations can be a predictable implant treatment modality for the edentulous patient. Implant-supported fixed prosthesis has several advantages: predictability, fixedness, retrievability, improved function, lower maintenance of prosthesis, long-term published success. Edentulous patients with a severely resorbed mandible often experience problems with their dentures. Treatment concepts involving two to four implants for the support of an overdenture have been proposed. There seems to be no need to insert more than two endosteal implants to support an overdenture, however, long-term prospective studies are needed to support this notion. Using short endosseous implants and an overdenture in the extremely resorbed mandible is a justified treatment option because of the relative simplicity and low morbidity of this treatment strategy. Implant-supported overdenture has several advantages: Cost, retrievability, hygiene access, profile and contour control, increased retention and stability, implant installed in a predicted region(ant. mandible).

• 한국병원경영학회지
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• 제21권3호
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• pp.65-70
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• 2016

The Long-Term Care Hospital (LTCH) accreditation system was initiated in 2013 in the form of mandatory accreditation system in order to improve patient safety and the quality of medical service at LTCHs. By June 2016, the accredited LTCHs were 76.2%. This research was conducted to review the implementation process in the first cycle and to promote development of the second cycle of LTCH accreditation system. There are some changes which reinforced the accreditation standards, accreditation survey, and public access to accreditation results in order to strengthen patient safety in the first cycle LTCH accreditation system. LTCHs which participated in the accreditation system achieved certain outcomes in respect to patient safety and employee satisfaction. However, there are several urgent problems in placement criteria of night duty health care providers, reinforcement plans in the accreditation system, and incentives for accredited hospitals. In order to solve these problems, the most important thing is to clearly recognize the fact that the healthcare accreditation system is not the means for control and regulate hospitals but a system to induce hospitals to continue to strive for improvements in patient safety and medical service quality. In addition, it is required that LTCHs, accrediting agency and the Ministry of Health and Welfare compromise and cooperate to seek solutions every time issues related to the accreditation system arise.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제16권8호
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• pp.2772-2786
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• 2022

We had researched an automatic authentication-supported medical information platform[6]. The proposed automatic authentication consists of user authentication and mobile terminal authentication, and the authentications are performed simultaneously in patients' emergency conditions. In this paper, we studied on finding emergency conditions for the automatic authentication by applying big data processing and AI mechanism on the extended medical information platform with an added edge computing system. We used big data processing, SVM, and 1-Dimension CNN of AI mechanism to find emergency conditions as authentication means considering patients' underlying diseases such as hypertension, diabetes mellitus, and arrhythmia. To quickly determine a patient's emergency conditions, we placed edge computing at the end of the platform. The medical information server derives patients' emergency conditions decision values using big data processing and AI mechanism and transmits the values to an edge node. If the edge node determines the patient emergency conditions, the edge node notifies the emergency conditions to the medical information server. The medical server transmits an emergency message to the patient's charge medical staff. The medical staff performs the automatic authentication using a mobile terminal. After the automatic authentication is completed, the medical staff can access the patient's upper medical information that was not seen in the normal condition.

• 한국인터넷방송통신학회논문지
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• 제16권5호
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• pp.117-123
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• 2016

최근 개인건강기록(PHR)은 환자중심의 건강정보교환 모델로 각광받고 있다. PHR 소유자는 언제 어디서나 쉽게 자신의 기록을 저장하고 회수할 수 있는 접근 권한을 누릴 수 있다. 하지만, PHR의 민감성과 신뢰성 특성 때문에 PHR은 개인이 접근할 수 있는 권한을 결정할 수 있도록 안전하게 유지되어야 한다. 본 논문에서는 응급상황에서 사용자의 PHR에 접근할 수 있는 시스템을 제안하였다. 환자가 의식이 없는 응급상황에서 응급센터요원은 PHR에 대해 미리 정의된 권한에 의하여 PHR 서버에 응급접근을 요청한 응급 정보를 사용할 수 있다. 제안된 시스템에서 PHR 사용자는 응급상황에서 좀 더 정교한 접근제어를 명세화 할 수 있다.

• 한국콘텐츠학회논문지
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• 제9권4호
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• pp.247-253
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• 2009

PACS(Picture archiving communication system)란 의료영상정보를 디지털 영상으로 획득, 저장하여 외래나 병동에서 언제든지 검색 및 조회가 가능한 시스템을 의미 하지만 휴일과 야간에는 의료영상정보에 대한 접근이 공간적으로 제한되어 있어서 환자의 검사결과에 대한 정보를 조회 할 수 없는 문제점이 있다. 이에 대한 해결 방안은 무선 LAN과 CDMA 전화기가 내장된 PDA를 이용하여 판독의사나 수술의사 등이 원외에서도 의료영상정보에 접근하여 환자의 처치 등에 관하여 원격으로 처방 할 수 있는 서비스 방식이 유용하다. 이런 방식은 PDA와 무선랜의 하드웨어적 특성상 JPEG 파일 형태로 서비스 할 수밖에 없는데 10:1 압축 방식에서 진단가치를 잃지 않으면서도 최대의 효과를 낼 수 있었다. 또한 추후 네트워크 속도와 하드웨어적 사양이 개선된다면 DICOM 무손실 이미지의 조회도 구현 가능함을 알 수 있었다.

• 보건행정학회지
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• 제30권3호
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• pp.399-408
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• 2020

Background: The purpose of this study was to examine the impact of the regional characteristics on the accessibility of emergency care and the impact of emergency medical accessibility on the patients' prognosis and the emergency medical expenditure. Methods: This study used the 13th beta version 1.6 annual data of Korea Health Panel and the statistics from the Korean Statistical Information Service. The sample included 8,119 patients who visited the emergency centers between year 2013 and 2017. The arrival time, which indicated medical access, was used as dependent variable for multi-level analysis. For ordinal logistic regression and multiple regression, the arrival time was used as independent variable while patients' prognosis and emergency medical expenditure were used as dependent variables. Results: The results for the multi-level analysis in both the individual and regional variables showed that as the number of emergency medical institutions per 100 km² area increased, the time required to reach emergency centers significantly decreased. Ordinal logistic regression and multiple regression results showed that as the arrival time increased, the patients' prognosis significantly worsened and the emergency medical expenses significantly increased. Conclusion: In conclusion, the access to emergency care was affected by regional characteristics and affected patient outcomes and emergency medical expenditure.