• 대한심미치과학회지
• /
• 제30권2호
• /
• pp.102-111
• /
• 2021

전치부 영역에서 임플란트는 경, 연조직 조화가 필요하며 다양한 단계를 필요로 한다. 이 중 순측의 함몰은 연조직 이식을 통해 좋은 결과를 얻을 수 있다. 치은퇴축을 위한 피개가 아닌 함몰을 위한 연조직 이식은 공여부의 선택에 있어서 구개측에 비해 상악결절부위에서의 채득으로 연조직의 볼륨을 보다 증가시킬 수 있으며 출혈이나 술후 통증을 줄이고, 공여부의 치유를 빠르게 하는 장점이 있어 좋은 치료 선택이 될 수 있을 것이다.

• Clinics in Shoulder and Elbow
• /
• 제25권1호
• /
• pp.57-64
• /
• 2022

Background: There are various conservative treatment options for lateral epicondylitis (LE). The aim is to evaluate pain, daily functioning, and complications after ultrasound-standardized autologous blood injections in patients with LE. Methods: For this prospective cohort study, consecutive patients (>18 years) diagnosed with LE were included. Autologous blood was injected using a medical device containing an injection disposable with 12 small needles (Instant Tennis Elbow Cure [ITEC]) device. Patient-Rated Tennis Elbow Evaluation (PRTEE), subjective elbow score (SES), palpation and provocation pain, satisfaction, and complications of treatment were measured at baseline and two months after treatment. Paired t-tests and Fisher's exact tests were used for calculating the difference between pre- and post-treatment outcomes. Results: Fifty-five elbows were analyzed. Mean time between pre- and post-treatment was 11.1 weeks (standard deviation [SD], 8.9 weeks). The mean PRTEE score decreased from 68.2 (SD, 15.7) before surgery to 53.2 (SD, 25.9; p<0.001) after. The mean SES improved from 36.9 (SD, 20.8) to 51.7 (SD, 27.4; p<0.001). Despite this improvement, only 44.7% of patients showed relevant clinical improvement in PRTEE, and 37.3% showed significant clinical improvement based on SES. Four patients reported a complication and the injection disposable failed three times. Conclusions: Ultrasound-standardized autologous blood injection using the ITEC device is not an effective tool in reducing symptoms related to LE. This study showed that only half of all patients experienced a positive effect. In this heterogeneous cohort of patients, we showed no added value of ultrasound standardization.

• Clinics in Shoulder and Elbow
• /
• 제24권3호
• /
• pp.172-177
• /
• 2021

Background: This study aimed to evaluate the response rate to arthroscopic release treatment in adhesive capsulitis of the shoulder (ACS) for patients with refractory to conservative treatment. Methods: In this retrospective study, 51 patients (age mean, 49.1±5.6 years) with unilateral adherent capsule underwent arthroscopic releasing surgery for the shoulder capsule. Etiologies of the ACS in 30 patients were idiopathic: 10 patients were affected after surgery and 11 patients following trauma. The patients were evaluated in terms of shoulder function, satisfaction rate, pain intensity, and joint range of motion (ROM) based on a Constant score, a Simple Shoulder Test, the visual analog scale, and four movements, respectively. Results: The mean Constant score before surgery was 48.2±3.5 and reached 74.4±6 and 77.0±6.3 at 6 months and the final follow-up, respectively (p<0.001). The mean scores of pain intensity, a Simple Shoulder Test, and ROM showed significant improvement at all follow-ups (p<0.001). Sex, age, and diabetes did not have any significant effect on patient recovery. However, patients who experienced ACS after surgery had poorer results than others at all follow-up points. Conclusions: Arthroscopic releasing surgery of the shoulder in patients with ACS refractory to conservative treatment produces rare complications and an effective injury response. It seems that patients suffering ACS following surgery have a weaker response to the treatment.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제48권3호
• /
• pp.167-173
• /
• 2022

Objectives: The purpose of this study was to estimate the minimal clinically important difference (MCID) of mouth opening (MO) and patient satisfaction in surgically treated oral submucous fibrosis (OSMF) patients. Materials and Methods: The status of MO was collected preoperatively (T0), postoperatively at 3 months (T1), and at a minimum of 6 months postoperatively (T2). MCID was determined through the anchor-based approach with the change difference method, mean change method, and receiver operator characteristic curve (ROC) method. Results: In this study, 35 patients enrolled and completed postoperative follow-up (T2) averaging a duration of 18.1 months. At T1, using the change difference method, MO was 14.89 mm and the ROC curve exhibited a 11.5 gain in MO (sensitivity 81.8% and specificity 100%, area under the curve [AUC] of 0.902) and was classified as MCID as reported by patients. At T2, MCID of MO was 9.75 mm using the change difference method and 11.75 mm by the mean change method. The ROC curve revealed that the MCID of MO at T2 was 10.5 mm with 73.9% sensitivity and 83.3% specificity (AUC of 0.873). The kappa value was 0.91, confirming reliability of the data. Conclusion: This study demonstrated MCID values that indicate the clinical relevance of surgical treatment of OSMF if the minimum possible gain in MO is approximately 10 mm.

• Archives of Plastic Surgery
• /
• 제49권2호
• /
• pp.184-194
• /
• 2022

The face and the external nose define an individual's physical appearance. Nasal deformities can cause facial disfigurement along with unwanted psychological repercussions. Nasal deformities range in severity, with the most severe cases being indications for a rhinectomy, due to the complexity of the nasal defect. According to published literature, there is no consensus among otolaryngologists and plastic surgeons on which technique or flap use is preferred in terms of complications, aesthetic outcome, or patient satisfaction. The goal of this study is to provide a comprehensive analysis of published studies on nasal reconstruction following rhinectomy. Using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines for writing systematic reviews, a systematic review was conducted. Four databases were searched using a search strategy. These articles were then imported into the COVIDENCE software and went screening and thorough article review. After screening 2,237 articles, 23 studies were then extracted for data collection analysis. We collected data from 12 case series, 4 case studies, 1 prospective case series, and 4 retrospective chart review studies. The most commonly reported flaps were forehead flaps, superior extended nasal myocutaneous island, forearm free flaps, anterolateral thigh (ALT) free flap, medial femoral condyle free flap (n = 8), and zygomaticus implants (n = 6), and retained nasal prosthesis. Although not specifically indicated by a certain number, the most common indication for the rhinectomy was malignancy, followed by traumas, postsurgical complications, radionecrosis, and congenital nasal malformations.

• 한방재활의학과학회지
• /
• 제32권4호
• /
• pp.73-82
• /
• 2022

Objectives The purpose of this study is to develop a case study protocol to complete final version of Korean medicine clinical pathway (CP) by applying Korean medicine CP based on carpal tunnel syndrome Korean medicine clinical practice guidelines developed by clinical experts to clinical field. Methods After applying previously developed CP, 10-point Likert scale questionnaires on satisfaction of CP, appropriateness and improvement on out patient department (OPD) treatments are carried out in the 2^nd week of OPD treatment. An open-ended questionnaire is also carried out to ask if there is any requirement to be added or improved among CP interventions. Results Final version of CP is going to be completed based on the questionnaire, excluding articles of which average or median value is less than 5 from 10-point Likert scale. Conclusions This evidence-based case study protocol is expected to contribute development of carpal tunnel syndrome clinical pathway.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제48권6호
• /
• pp.348-355
• /
• 2022

Objectives: To compare the vital sign stability and cost of two commonly used sedatives, midazolam (MDZ) and dexmedetomidine (DEX). Patients and Methods: This retrospective study targeted patients who underwent mandibular third molar extractions under intravenous sedation using MDZ or DEX. The predictor variable was the type of sedative used. The primary outcome variables were vital signs (heart rate and blood pressure), vital sign outliers, and cost of the sedatives. A vital sign outlier was defined as a 30% or more change in vital signs during sedation; the fewer changes, the higher the vital sign stability. The secondary outcome variables included the observer's assessment of alertness/sedation scale, level of amnesia, patient satisfaction, and bispectral index score. Covariates were sex, age, body mass index, sleeping time, dental anxiety score, and Pederson scale. Descriptive statistics were computed including propensity score matching (PSM). The P-value was set at 0.05. Results: The study enrolled 185 patients, 103 in the MDZ group and 82 in the DEX group. Based on the data after PSM, the two samples had similar baseline covariates. The sedative effect of both agents was satisfactory. Heart rate outliers were more common with MDZ than with DEX (49.3% vs 22.7%, P=0.001). Heart rate was higher with MDZ (P=0.000). The cost was higher for DEX than for MDZ (29.27±0.00 USD vs 0.37±0.04 USD, P=0.000). Conclusion: DEX showed more vital sign stability, while MDZ was more economical. These results could be used as a reference to guide clinicians during sedative selection.

• 한방재활의학과학회지
• /
• 제33권2호
• /
• pp.57-76
• /
• 2023

Objectives This study aims to develop Korean Medicine Clinical Pathway (CP) based on Clinical Practice Guideline of carpal tunnel syndrome to improve quality of treatment and reduce medical cost to maximize the quality of patient management. Methods A draft version of CP for carpal tunnel syndrome is developed by expert agreement and a prospective case study was carried out based on the draft CP. Twenty experts working at various medical institution answered validity verification survey of developed CP. Fifteen patients enrolled in the prospective case study answered survey on demand and satisfaction. Qualification and adjustment process of the draft CP was conducted based on results of both surveys. Results Final version of CP for carpal tunnel syndrome is confirmed after qualification and adjustment on the draft version. Conclusions CP for carpal tunnel syndrome will provide patients with standardized, high-quality Korean medicine treatment and also reduce financial burden of health insurance by reducing medical cost.

• 대한통합의학회지
• /
• 제11권3호
• /
• pp.69-78
• /
• 2023

Purpose : Establishing competency in person-centered care is crucial for providing high-quality nursing care in diverse clinical settings and adapting to changing roles in different situations. This study aimed to explore the level of transcultural self-efficacy, cultural empathy, and person-centered care competency among nursing students, as well as identify the factors influencing their person-centered care competency. The findings will serve as fundamental data to enhance person-centered care competency. Methods : A questionnaire consisting of items on general characteristics, person-centered care competency, transcultural self-efficacy, and cultural empathy was administered to 175 nursing students in G city. Data were collected from March 5, 2023, to March 20, 2023. The collected data were analyzed using the SPSS 23.0 program. Pearson's correlation coefficients were used to examine the correlation among transcultural self-efficacy, cultural empathy, and person-centered care competency. Multiple regression analysis was employed to determine the factors influencing person-centered care competency. Results : The person-centered care competency scores were above the average level and varied according to department satisfaction (F=13.79, p<.001), subjective well-being (t=3.34, p=.015), and interpersonal relations (F=5.74, p=.001). Person-centered care competency exhibited a significant positive correlation with cultural empathy (r=.51, p<.001) and transcultural self-efficacy (r=.49, p<.001). Regression analysis confirmed that cultural empathy (β=.39, p<.001) and transcultural self-efficacy (β=.22, p<.001) were influential factors for nursing students' person-centered care competency, with the model explaining 37 % of the variance. Conclusion : Cultural empathy and transcultural self-efficacy are significant factors influencing the person-centered care competency of nursing students. It is crucial to encourage nursing students to develop person-centered care competency by fostering cultural empathy and transcultural self-efficacy. Further research is needed to identify additional factors affecting person-centered care competency among nursing students. Additionally, the development of education programs aimed at enhancing person-centered care competency is necessary.

• 대한한방부인과학회지
• /
• 제22권3호
• /
• pp.205-222
• /
• 2009

Purpose: The aim of this study was to review systemically journals on the studies for Complementary and Alternative Medicine in the treatment of breast cancer. Methods: Through medical websites, foreign clinical literatures about complementary and alternative medicines of breast cancer were searched. The cite used was http://www.Pubmed.gov. And then they were divided into three groups. Medication, Non-medication therapies and questionnaire reports. Results: 1. We researched 23 papers about herb medicines. Most of papers were about single herb and there were rarely about mixed composition. And there were papers about Ocimum gratissimum, elliptilimba, seeds of Livistona chinensis, golden feverfew which were not commonly used in Korea. 2. We researched 16 papers about acupuncture. Acupuncture had a possitive effect on such symptoms like flushing, nausea and vomitting and pain on upper limb caused by anticancer therapy or tamoxifen or surgery. 3. We researched 36 papers about questionnaire study. Most were about research for women who diagnosed as breast cancer or women after breast cancer surgery. Subjects were about proportion of using CAM, purpose of using it, most popular CAM therapy, satisfaction degree, and relation with age, aducation and social position. And most conclusion were that patient-doctor communication was needed. Conclusion: Afterwards we have to focus on realisitic clinical studies about breast cancer patients, especially postsurgery and people who takes anticancer therapy. And we have to be interest in acupuncture therapy on breast cancer patients.