• Journal of Acupuncture Research
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• v.23 no.5
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• pp.219-228
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• 2006

Objectives : To observe the effect of acupuncture treatment on Digital Infrared Thermographic Imaging(DITI) in frozen shoulder patients. Methods : 17 voluntary patients received acupuncture treatment on LI15, TE14, GB21 and Master Dong's acupuncture points, Shin-gwan and Gyun-joong, twice a week for 4 weeks. The patients were instructed to practice self exercise during their daily lives. Evaluations were made before treatment, after 1 week of treatment, after 2 weeks, 3 weeks and after 4 weeks of treatment. Constant Shoulder Assessment(CSA), Shoulder Pain and Disability Index(SPADI), Range of Motion(ROM) and the patient's satisfaction concerning the treatment was measured by Visual Analogue Scale(VAS). DITI was measured before treatment and after 4weeks of treatment. The obtained data was analyzed. Results : CSA, SPADI, VAS, adduction and extension showed significant(p<0.05) improvement. Abduction and flexion both improved after 4 weeks of treatment, but the improvement was statistically insignificant(p>0.05). DITI showed improvement but the improvement was insignificant(p>0.05). Conclusion : 4 weeks of acupuncture treatment significantly improved CSA, SPADI, VAS, adduction and extension in frozen shoulder patients(p<0.05). The improvement of abduction and flexion after 4 weeks of acupuncture treatment was insignificant(p>0.05). DITI results improved after 4 weeks of acupuncture treatment. But the change of thermal difference was insignificant(p>0.05).

• Journal of Periodontal and Implant Science
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• v.30 no.1
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• pp.11-27
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• 2000

The purpose of this study was to evaluate the clinical effects of Dipotassium glycyrrhizinate, Allantoin, Hinokitiol, Cetylpyridinium chloride containing gel($Dentheth^{(R)}$) on periodontitis. 41 patients with sites having pocket depth of 4-6mm were selected for the study. We classified 2 groups which consisted of 21 patients in the test group(exp.) and 20 patients in the control(placebo) respectively. Following a baseline examination, plaque and calculus were removed and then the experimental gel were handed out to the patients and topical application regimens were initiated. During the 4-week experimental period, pocket depth, bleeding on probing, gingival index, plaque index as a clinical parameters were measured in the baseline, 2 weeks, 4 weeks respectively. A questionnaire was delivered to each patients in 2 weeks, 4 weeks respectively. The results were as follows : 1. Probing pocket depth showed a significant difference in the Exp. group compared with the control group in the changes from baseline to 2 weeks(p<0.05), but there was no significant difference between the groups in the changes from baseline to 4 weeks, from 2 weeks to 4 weeks(p<0.05). 2. The Exp. group showed a significant difference compared with the control group in the changes from baseline to 2 weeks, from baseline to 4 weeks, from 2 weeks to 4 weeks in bleeding on probing(p<0.05). 3. The gingival index showed a significant difference compared with the control group in the changes from baseline to 2 weeks, from baseline to 4 weeks, from 2 weeks to 4 weeks after 4 weeks use of a gel(p<0.05). 4. The plaque index showed a significant difference in the Exp. group compared with the control group in the changes from baseline to 2 weeks(p<0.05), but there was no significant difference between the groups in the changes from baseline to 4 weeks, from 2 weeks to 4 weeks(p<0.05). 5. A questionnaire was consisted of 5 kinds as to bleeding, pus discharge, pain, burning sensation, patient's satisfaction and all of the questions showed a significant difference compared with the control group in the changes from 2 weeks to 4 weeks(p<0.05). 6. During the 4-week experimental period, important side-effects were not finded out, but each groups had one patient appealed nausea or discomfort respectively. These results indicate that application of periodontitis medical gel was useful as an additional aid of mechanical treatment.

• The Journal of Korean Academy of Prosthodontics
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• v.48 no.1
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• pp.41-47
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• 2010

Purpose: The purpose of this study was to compare the functional abilities of the low bulb obturators with those of high bulb obturators in terms of patients' evaluation. Material and methods: This study included 11 maxillectomy patients who underwent postoperative prosthodontic rehabilitations. Two obturators of the same design except for different bulb heights, were fabricated for each of the maxillectomy patient. After two months of alternate use, the functions of the obturators were measured by investigating the patients' subjective evaluations in terms of convenience, speech, nasality, leakage, and mastication and identifying their preferred prostheses. Wilcoxon signed rank test was used as a statistical method (P < .05). Results: There were no significant differences in patient evaluations of low and high bulb obturators (P >.05). And patients' preferences varied. Conclusion: In extreme situation such as in mouth opening limitation, the use of low bulb obturators can be recommended and result in comparable speech function to that of obturators with high lateral walls.

• Archives of Plastic Surgery
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• v.38 no.4
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• pp.477-484
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• 2011

Purpose: Retro-orbicularis oculi fat (ROOF) and preseptal fat pad (PSF) are deep fat structures of frontal and supraorbital area, that encounter galeal fat pad (GFP). If galeal wall is weakened by aging process, GFP loses its anchoring structure, moved downward pushing ROOF and PSF. This especially occur in lateral brow area. As a result of drooping, eyebrow affects the eyelid covering PSF as a sac descended to a lateral hooding and ptotic eyelid simultaneously. Consequently, in the case of lateral hooding and brow ptosis, besides the skin, deep fat structures (ROOF and PSF) should be corrected as well. Methods: ROOF-PSF repositioning technique in subbrow resection were performed. 21 cases of patients from April, 2007 to January, 2008. Before surgery, all patients were examined carefully to evaluate the degrees of dermatochalasia, drooping of the eyebrow, marginal reflex distance 1 (MRD1), eyelid crease height. Surgery was performed under local anesthesia, then excised the drooped eyelid skin by lateral subbrow resection, removed proper amount of ROOF, repositioned ROOF-PSF at the supraorbital rim, and fix it on periosteum. During follow up periods, the patients were surveyed of the satisfaction of surgery, and postoperative MRD1 was evaluated. Results: One patient had a hematoma on left eyebrow, and another one patient had a numbness on left forehead for two months. Except for these two patients, all patients had good results without any significant complications. The mean follow up period was about 5 months, and the position of lateral eyebrow maintained above the supraorbital rim in all cases. Postoperatively, MRD1 increased by 0.8 mm in 5-months mean follow up period. Conclusion: In patient with lateral brow ptosis and lateral hooding, the ROOF-PSF repositioning technique in sub-brow resection could be a good operative option.

• Archives of Plastic Surgery
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• v.38 no.5
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• pp.602-608
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• 2011

Purpose: Nasal bone fracture is the most common type of facial bone fracture and most of nasal bone fracture is combined with septal fracture frequently. Nasal septum is important to support the distal nose and to maintain the nasal airway. But nasal septal fractures are usually unrecognized and untreated at the time of operation. Recently, various materials were using for nasal packing after closed reduction, however these materials are not focused on the correction of nasal bone and nasal septal fracture and many patients are suffered from nasal packing materials. Thus, the purpose of this study is to compare routine packing materials and rolled silastic sheet with respect to postoperative effect of correction of nasal bone fracture and discomfort of nasal packing materials. Methods: We examined 320 patients treated nasal bone fracture from January 2008 to December 2010. For Group I (n=92), $Merocel^{(R)}$ was used for nasal packing, for Group II (n=152) vaseline gauze was used, and Rolled silastic sheet (RSS) with vaseline gauze packing (VGP) was used for Group III (n=76). Under the general anesthesia, all patients were operated by closed reduction and nasal packing was done using three kinds of packing materials. At the time of postoperative 7 days, packing material was removed and studied for pt's satisfaction and postop. complications. Results: In patients with RSS with VGP, the complaints (nasal obstruction, foreign compressive sensation and discomfort during food ingestion) of keeping the nasal packing were decreased ($p$ <0.05) and the postoperative complication (deviation) were decreased comparing to vaseline gauze packing and $Merocel^{(R)}$ packing, however, these differences were not statistically significant ($p$ >0.05). Conclusion: Postoperative nasal packing with RSS with VGP was more comfortable to the patients and it was more effective method to correct the nasal bone fracture and nasal septal fracture.

• Journal of Yeungnam Medical Science
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• v.18 no.1
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• pp.59-66
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• 2001

Background: The purpose of this study was to determine the efficacy and safety of the anterior vaginal wall sling in the management of women with stress urinary incontinence. Materials and Methods: From January 1998 to December 1999, 42 patients(31 with genuine stress urinary incontinence and 11 with mixed urinary incontinence, 38 with anatomical incontinence and 4 with intrinsic sphincteric deficiency) underwent anterior vaginal wall sling at Yeungnam University Hospital were studied retrospectively. The mean age was 49.3 years(ranging from 34 to 66 years of age) and the mean follow-up period was 29.4 months(ranging from 16 to 40 months). Intra- and postoperative complication. success rate and patient's satisfaction were evaluated. Results: The mean operation time was 79 minutes(ranging from 65 to 124 minutes) and the mean hospital stay was 5.1 days(ranging from 4 to 10 days). Mean postoperative Foley catheter drainage was 2.1 days(ranging from 1 to 5 days). As a complication. bladder perforation occurred in one patient(2.4%). residual urine sensation developed in seven patients(16.7%), and suprapubic pain was complained in five patients(11.9%), which improved gradually. Vaginal epithelial inclusion cyst occurred in one patient(2.4%) at postoperative 31 months. Four(9.4%) patients with de novo instability were improved by anticholinergics medication. The success rate was 92.9% and 38 patients(90.5%) were satisfied with this procedure. Conclusion: We consider that the anterior vaginal wall sling to be a safe and effective surgical procedure for the treatment of female stress urinary incontinence, but a longer follow-up is necessary to determine long term effect.

• Journal of Hospice and Palliative Care
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• v.24 no.4
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• pp.204-213
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• 2021

Purpose: At the end of life, communication is a key factor for good care. However, in clinical practice, it is difficult to adequately discuss end-of-life care. In order to understand and analyze how decision-making related to life-sustaining treatment (LST) is performed, the shared decision-making (SDM) behaviors of physicians were investigated. Methods: A questionnaire was designed after reviewing the literature on attitudes toward SDM or decision-making related to LST. A final item was added after consulting experts. The survey was completed by internal medicine residents and hematologists/medical oncologists who treat terminal cancer patients. Results: In total, 202 respondents completed the questionnaire, and 88.6% said that the decision to continue or end LST is usually a result of SDM since they believed that sufficient explanation is provided to patients and caregivers, patients and caregivers make their own decisions according to their values, and there is sufficient time for patients and caregivers to make a decision. Expected satisfaction with the decision-making process was the highest for caregivers (57.4%), followed by physicians (49.5%) and patients (41.1%). In total, 38.1% of respondents said that SDM was adequately practiced when making decisions related to LST. The most common reason for inadequate SDM was time pressure (89.6%). Conclusion: Although most physicians answered that they practiced SDM when making decisions regarding LST, satisfactory SDM is rarely practiced in the clinical field. A model for the proper implementation of SDM is needed, and additional studies must be conducted to develop an SDM model in collaboration with other academic organizations.

• Archives of Plastic Surgery
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• v.50 no.5
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• pp.514-522
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• 2023

Background This is a prospective study on 118 patients who underwent lymphaticovenous anastomosis (LVA) due to secondary lower limb lymphedema between January 2018 and October 2020 to evaluate patients' quality of life (QOL) using the Quality of Life Measure for Limb Lymphedema (LYMQoL) questionnaire. Methods The outcome measurement included the LYMQoL leg scoring system tool evaluating the function, appearance, symptom, mood, and overall outcome. In addition, correlation analysis was performed for three factors: based on International Society of Lymphology (ISL) stages, disease duration, and amount of volume reduction. Results The LYMQoL tool overall satisfaction score significantly increased at all intervals from 4.4 ± 0.2 preoperative to 6.5 ± 0.3 postoperative at 12 months (p < 0.001). Significant findings were seen for each domain scores compared preoperatively and at 12 months: function score (18.6 ± 0.5 to 15.4 ± 0.6), appearance score (17.8 ± 0.5 to 16.0 ± 0.6), symptom score (11.8 ± 0.3 to 8.9 ± 0.4), and mood score (14.5 ± 0.4 to 11.4 ± 0.5; p < 0.05). The correlation analysis between improvement of the overall score and the ISL stage (p = 0.610, correlation coefficient [r] = -0.047), disease duration (p = 0.659, r = -0.041), and amount of limb volume reduction (p = 0.454, r = -0.070) showed no statistical significance. Conclusion The QOL of secondary lower limb lymphedema patients was significantly improved after LVA regardless of the severity of disease, duration of disease, and amount of volume reduction after LVA. Understanding the patient-reported outcome measurement will help the surgeons to manage and guide the expectations of the patients.

• Clinics in Shoulder and Elbow
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• v.26 no.4
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• pp.343-350
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• 2023

Background: Our purpose was to evaluate a custom reverse total shoulder arthroplasty glenoid baseplate for severe glenoid deficiency, emphasizing the challenges with this approach, including short-term clinical and radiographic outcomes and complications. Methods: This was a single-institution, retrospective series of 29 patients between January 2017 and December 2022 for whom a custom glenoid component was created for extensive glenoid bone loss. Patients were evaluated preoperatively and at intervals for up to 5 years. All received preoperative physical examinations, plain radiographs, and computed tomography (CT). Intra- and postoperative complications are reported. Results: Of 29 patients, delays resulted in only undergoing surgery, and in three of those, the implant did not match the glenoid. For those three, the time from CT scan to implantation averaged 7.6 months (range, 6.1-10.7 months), compared with 5.5 months (range, 2-8.6 months) for those whose implants fit. In patients with at least 2-year follow-up (n=9), no failures occurred. Significant improvements were observed in all patient-reported outcome measures in those nine patients (American Shoulder and Elbow Score, P<0.01; Simple Shoulder Test, P=0.02; Single Assessment Numeric Evaluation, P<0.01; Western Ontario Osteoarthritis of the Shoulder Index, P<0.01). Range of motion improved for forward flexion and abduction (P=0.03 for both) and internal rotation up the back (P=0.02). Pain and satisfaction also improved (P<0.01 for both). Conclusions: Prolonged time (>6 months) from CT scan to device implantation resulted in bone loss that rendered the implants unusable. Satisfactory short-term radiographic and clinical follow-up can be achieved with a well-fitting device. Level of evidence: III.

• Journal of Chest Surgery
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• v.32 no.8
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• pp.739-744
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• 1999

Background: This study was designed to evaluate the effectiveness of T3 sympathicotomy in treatment of palmar hyperhidrosis. Material and Method: During the period of June to December 1998, 50 patients (24 females and 26 males) suffering from palmar hyperhidrosis either in isolation (n=37) or in combination with axillary hyperhidrosis (n=13) were operated. The mean age of the patients was 20 years. The bilateral sympathetic trunks were severed on the 3rd rib (2nd and 3rd ganglia) for the isolated palmar hyperhidrosis and on the 3rd and 4th ribs for the combined type using electrocoagulation scissors. A linear analogue scale was used to assess the degree of sweating on the palms, face, trunk, and feet (ranged 0 to 10:0 = anhidrosis: 10 = excessive sweating) as well as the patient's satisfaction with the surgery (ranged 0 to 10:0 = regret; 10 = completely satisfied). Result: All of the patients were relieved from palmar hyperhidrosis. A mean palmar sweat production score after T3 sympathicotomy was $1.5\pm$0.8. Some degree of compensatory sweating had occurred in 39 patients (78%) with a mean score of 3.4$\pm$1.6. Gustatory sweating occurred in 2 patients (4%). The mean score of the patient's satisfaction after the surgery was 8.5$\pm$1.2. Conclusion: Palmar hyperhidrosis can be successfully relieved by the T3 sympathicotomy. When considering the advantages of T3 sympathicotomy with respects to a better preservation of facial sympathetic function, less occurrence of severe compensatory sweating, and lower incidence of gustatory sweating. We recommend T3 sympathicotomy as a treatment of choice for palmar hyperhidrosis.