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Outcomes of Arthroscopic Assisted Reduction and Percutaneous Fixation for Tongue-Type Sanders Type II Calcaneal Fractures (설상형 Sanders 제 II형 종골 골절에 대한 관절경하의 정복 및 경피적 고정술의 결과)

  • Park, Jae Woo;Park, Chul Hyun
    • Journal of Korean Foot and Ankle Society
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    • v.21 no.4
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    • pp.144-150
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    • 2017
  • Purpose: To assess the clinical and radiographic results and complications of arthroscopy-assisted reduction and percutaneous fixation for patients with tongue-type Sanders type II calcaneal fractures. Materials and Methods: Between August 2014 and December 2015, 10 patients who underwent surgery using subtalar arthroscopic assisted reduction and percutaneous fixation for tongue-type Sanders type II calcaneal fractures were reviewed. The mean age was 50.8 years (36~62 years), and the mean follow-up period was 24 months (12~40 months). The clinical results were evaluated using the visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score at the regular follow-ups, and the foot function index (FFI) at the last follow-up. The subtalar range of motion (ROM) was evaluated and compared with the uninjured limb at the last follow-up. The radiographic results were assessed using the Bohler's angle from the plain radiographs and the reduction of the posterior calcaneal facet using computed tomography (CT). The postoperative complications were assessed by a chart review. Results: The VAS and AOFAS ankle-hindfoot score improved until 12 months after surgery. The FFI was 15 (1.8~25.9) and subtalar ROM was 75.5% (60%~100%) compared to the uninjured limb at the last follow-up. The $B{\ddot{o}}hler^{\prime}s$ angle was increased significantly from $2^{\circ}$ ($-14^{\circ}{\sim}18^{\circ}$) preoperatively to $21.8^{\circ}$ ($20^{\circ}{\sim}28^{\circ}$) at the last follow-up. The reduction of the posterior facet was graded as excellent in five feet (50.0%) and good in five (50.0%) on CT obtained at 12 months after surgery. One foot (10.0%) had subfibular pain due to a prominent screw head. One foot (10.0%) had pain due to a longitudinal tear of the peroneal tendon that occurred during screw insertion. Conclusion: Subtalar arthroscopic-assisted reduction of the posterior calcaneal facet of the subtalar joint and percutaneous fixation is a useful surgical method for tongue-type Sanders type II calcaneal fractures.

CHANGE OF LIP CANTING AFTER BIMAXILLARY ORTHOGNATHIC SURGERY (상하악 악교정수술 후 입술 기울기변화)

  • Lee, Jun-Hee;Hong, Jong-Rak;Kim, Young-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.6
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    • pp.643-647
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    • 2007
  • Purpose: The purpose of study was to investigate the correlationship between lip canting change and occlusal canting change after bimaxillary orthognathic surgery, and the ratio of lip canting change and occlusal canting change after the surgery. Patients and methods: The subjects for this study was obtained from a group of 25 patients who took bimaxillary orthognathic surgery for occlusal canting correction at the Department of the Oral and Maxillofacial Surgery, Samsung Medical Center in Seoul, Korea between January 2000 and December 2005 and a patient's chart had to contain a resting frontal facial photograph in natural head position and a corresponding PA cephalogram in occlusion on the same day before the surgery and post-op 6 months later. The lip canting change was assessed with the angle each labial commissure and the bipupilary reference line. And, the occlusal caning change in the frontal plane was assessed with the angle between the each maxillary first molar occulasal surface and the bi-frontozygomatic suture reference line. Results: In angular measurement, average occlusal canting change was $3.09^{\circ}$ and standard deviation was $1.05^{\circ}$, average lip canting change was $1.56^{\circ}$ and standard deviation was $1.05^{\circ}$. In linear measurement, average occlusal canting change was 2.41mm and standard deviation was 2.75mm, average lip canting change was 1.18mm and standard deviation was 0.43mm. Lip canting correction ration to occlusal canting correction was 51.5(${\pm}8.4$)% in angular measurement and 48.8(${\pm}9.1$)% in linear measurement. Under Pearson's correlation analysis, Pearson's correlation coefficient was 0.869 in angular measurement and 0.887 in linear measurement(p-value < 0.01). High correlationship was shown between occlusal canting change and lip canting change. Conclusion: First, Bimaxillary orthognathic surgery can correct lip canting as well as occlusal canting. Second, The average amount of lip canting correction is $51.5{\pm}8.4%,\;48.8{\pm}9.1%$ of occlusal canting correction in the study.

Screening Colonoscopy from a Large Single Center of Thailand - Something Needs to be Changed?

  • Aswakul, Pitulak;Prachayakul, Varayu;Lohsiriwat, Varut;Bunyaarunnate, Thirapol;Kachintorn, Udom
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1361-1364
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    • 2012
  • Background: Results of screening colonoscopy from Western countries reported adenoma detection rates (ADRs) of 30-40% while those from Asia had ADR as low as 10%. There have been limited data regarding screening colonoscopy in Thailand. The objectives of this study were therefore to determine polyp and adenoma detection rates in Thai people, to evaluate the incidence of colorectal cancer detected during screening colonoscopy and to determine the endoscopic findings of the polyps which might have some impact on endoscopists to perform polypectomy. Materials & Methods: This study was a retrospective electronic chart review of asymptomatic Thai adults who underwent screening colonoscopy in our endoscopic center from June 2007 to October 2010.Results: A total of 1,594 cases were reviewed. The patients had an average age of $58.3{\pm}10.5$ years (range 27-82) and 55.5% were female. Most of the cases (83.8%) were handled by staff who were endoscopists. A total of 488 patients (30.6%) were reported to have colonic polyps. Left-sided colon was the most common site (45.1%), followed by right-sided colon (36.5%) and the rectum (18%). Those polyps were removed in 97.5% of cases and 88.5 % of the polyps were sent for histopathology (data lost 11.5%). Two hundred and sixty three cases had adenomatous polyps, accounting for 16.5 % ADR. Advanced adenomas were detected in 43 cases (2.6%). Hyperplastic polyps were mainly located distal to the splenic flexure of the colon whereas adenomas were found throughout the large intestine. Ten cases (0.6%) were found to have colorectal cancer. Four advanced adenomas and two malignant polyps were reported in lesions ${\leq}$ 5 mm. Conclusion: The polyp detection rate, adenoma detection rate, advanced adenoma detection rate and colorectal cancer detection rate in the screening colonoscopy of Thai adults were 30.9%, 16.5%, 2.6% and 0.6% respectively. Malignant transformation was detected regardless of the size and location of the polyps. Therefore, new technology would play an important role indistinguishing polyps.

A Statstical Analysis of the Question Categories concerning 'Sasang Constitutional Characteristics of Mind' (성격 특성에 관한 체질판별 문진항목의 통계적 분석)

  • Kim, Hong-Gie;Kim, Jong-Yeol
    • Journal of Sasang Constitutional Medicine
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    • v.15 no.3
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    • pp.124-138
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    • 2003
  • Objectives : To evaluate the properness and effectiveness of the question categories concerning 'sasang constitutional characteristics of mind', used in Iksan Wonkwang Oriental Medicine. Methods : We statistically analyzed data from those 1335 patients focussing on 'relative discrimination ability' to sasang constructions and 'response ratio'. Patients included in this research are only those who had been well treated in Iksan Wonkwang Oriental Medicine during the Period of three years from 2000 to 2002. The data are obtained through the electronic chart developed by Kim Jong-Yeal, and analyzed using the statistical Package SPSS. Results: In total characteristics of mind, the question category of 'timid' has high discriminating power and effectiveness to Soeum type, more in women than men, and especially with an age of 21 or more; The category of 'hasty-tempered' to Soyang type in women with all ages and men with ages 21-40; The category of 'broad-minded' to Taeum type with ages 41 or more; The category of 'timid and broad-minded' to Soyang type, and especially high to women with ages 41 or more. Question categories concerning response type in anger were estimated to have different response patterns to sasang constructions only for ages 21 or more by $X^2$2 test. The question category of 'bear and last long' has high discriminating power and effectiveness to Soeum type, more in men than women, and increasingly to ages; The category of 'impatient and disarmed quickly' to Soyang type in both women and men, especially with ages 21 or more; The category of 'impatient' to Soyang type women or with ages 21 or more. Other categories have low discriminating power or low effectiveness. Concernig expression type of one's thought, the question category of 'straightly' has high discriminating power and effectiveness to Soyang type, more in wemen than men, and especially to ages 21 or more; The category of 'tender' to Soeum type, in women or with ages 40 or less; The category of 'indirectly' to Taeum type in men or with ages 41 or more; The category of 'straightly and stuborn' to Soyang type with ages 41 or more; The category of 'indirectly and tender' to Soeum with with ages 20 or less; The category of 'not express and tender' to Soeum type with ages 41 or more; Conclusions : Question categories concerning total characteristics of mind, response type in anger and expression type of one's thought, are partially discriminating and effective to specific constitution according to sex and ages, and some categories are more discriminating and effective when they are composited. But generally, the discriminating power of Taeum constitution group and group with ages 20 or less was too low, so it is necessary to develope question categories for those groups.

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Analysis of Factors Affecting Nontherapeutic INRs in Korean Outpatients with Mechanical Heart Valves (인공심장판막 치환환자의 치료범위를 벗어난 INR 원인분석)

  • Lee Ju Yeun;Jeong Young Mi;Lee Myung Koo;Kim Ki-bong;Ahn Hyuk;Lee Byung Koo
    • Journal of Chest Surgery
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    • v.38 no.11 s.256
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    • pp.746-760
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    • 2005
  • Background: Following the implantation of heart valve prostheses, it is important to maintain therapeutic INR to reduce the risk of thromboembolism. The objectives of this study were to determine the causes of nontherapeutic INRs, and to identify the factors associated with nonadherences to warfarin therapy in Korean outpatients with prosthetic heart valves managed by a pharmacist-run anticoagulation service (ACS). Material and Method: A retrospective chart review was completed for all patients enrolled in the ACS at Seoul National University Hospital from March, 1997b to September, 2000. The data on 868 patients (5,304 visits) who were at least 6 months post-valve replacement were included. All possible causes of nontherapeutic INRs were documented for each patient visit. The association of covariates to noncompliance was investigated by univariate analysis. Result: The reasons for nontherapeutic INRs were identified as follows: inadequate dosage adjustment $(21\%)$, nonadherences to dosing regimen $(13\%)$, drug/herbal interactions $(12\%)$, changes in diet $(7\%)$, and indeterminate cause $(42\%)$. Younger age, shorter duration of ACS and longer duration of warfarin therapy were associated with nonadherence. Conclusion: In this study, nonadherence and interactions between diet and medications were found to be important factors influencing nontherapeutic INRs. Longer duration of enrollment in the ACS affected the adherence to warfarin therapy Positively whereas younger age and longer duration of warfarin therapy affected negatively.

Implementation of a Remote Patient Monitoring System using Mobile Phones (모바일 폰을 이용한 원격 환자 관리 시스템의 구현)

  • Park, Hung-Bog;Seo, Jung-Hee
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.13 no.6
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    • pp.1167-1174
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    • 2009
  • In the monitoring of a patient in a sickroom, not only the physiologic and environmental data of the patient, which is automatically measured, but also the clinical data(clinical chart)of the patient, which is drew up by a doctor or nurse, are recognized as important data. However, since in the current environment of a sickroom, clinical data is collected being divided from the data that is automatically measured, the two data are used without an effective integration. This is because the integration of the two data is difficult due to their different collection times, which leads the reconstruction of clinical data to be remarkably uncertain. In order to solve these problems, a method to synchronize the continuous environmental data of a sickroom and clinical data is appearing as an important measure. In addition, the increase of use of small machines and the development of solutions based on wireless communications provide a communication platform to the developers of health care. Thus, this paper realizes a remote system for taking care of patients based on a web that uses mobile phones. That is, clinical data made by a nurse or doctor and the environmental data of a sick room comes to be collected by a collection module through a wireless sensor network. An observer can see clinical data and the environmental data of a sickroom through his/her mobile phone, integrating and storing his/her data into the database. Families of a patient can see clinical data made by hospital and the environment of the sick room of the patent through their computers or mobile phones outside the hospital. Through the system,hospital can provide better medical services to patients and their families.

Measuring Agreement of Modified MP3 and CVMS according to BMI Percentile (중지 중절골과 경추를 이용한 골령 평가의 체질량 지수에 따른 일치도)

  • Yi, Seoksoon;Lee, Daewoo;Yang, Yeonmi;Kim, Jaegon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.46 no.1
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    • pp.48-56
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    • 2019
  • The objective of this study was to examine measuring agreement between middle phalanx of the third finger and cervical vertebrae analysis for assessing skeletal maturity according to body mass index percentile. A retrospective chart view was used to select patients with body mass index data, hand - wrist radiographs and lateral cephalograms of same day. The patients were divided into 4 groups by body mass index percentile. The hand - wrist radiographs were analyzed using modified middle phalanx of the third finger method and the lateral cephalograms were categorized according to cervical vertebral maturation stage. The degree of agreement between the 2 methods of analyzing skeletal maturation was measured by calculating weighted kappa statistic according to body mass index percentile group. There was a good agreement between the 2 methods in the entire body mass index percentile group. According to the body mass index percentile group, the agreement was found to be different, and the pattern was different between boys and girls. Pediatric dentist should consider sex and weight status when evaluating growing children and adolescents because it can affect the agreement of 2 method of analyzing skeletal maturation.

The Current Research Status of Complementary and Integrative Medicine in Practice-Based Research Networks: A Systematic Review (개원의중심연구망에서 수행된 보완통합의학 관련 연구 현황: 체계적 문헌고찰)

  • Won, Jiyoon;Han, Gajin;Kim, Yejin;Park, Jae Rang;Noh, Eunyoung;Ji, Yu-jin;Adams, Jon;Lee, Hyangsook
    • Korean Journal of Acupuncture
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    • v.37 no.4
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    • pp.209-230
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    • 2020
  • Objectives : Practice-Based Research Networks (PBRNs), collaborations of practitioners and academic researchers, have provided platforms for conducting research to address clinical questions generated from daily routine care. This review aimed to critically analyse articles from PBRNs that are related to complementary and integrative medicine (CIM) and to suggest future directions for a PBRN which is appropriate for Korean Medicine (KM). Methods : PubMed, PBRN registries in Agency for Healthcare Research and Quality and relevant PBRN websites were searched up to November 2019 for research articles from PBRNs that focused on CIM regardless of study design. Methodological quality of the included studies was assessed. The included studies were read in full, classified and summarised according to their topics. Results : A total of 51 articles published from 1998 through 2020 were included in this review. They were categorised into three principal themes based on research questions and findings: health services research (embracing researches examining characteristics of patients and CIM practitioners/practices, and communication between patients and practitioners); effectiveness and safety of CIM practices/interventions; and feasibility studies of instruments and interventions in PBRN settings. The study designs varied including surveys (n=30), prospective observational studies (n=6), 2ndary analyses of existing studies (n=7), protocols (n=7), retrospective chart review (n=1) and qualitative study (n=1). Quality of the included studies greatly varied. Conclusions : PBRNs can serve as a feasible platform for conducting practice-relevant research on KM and CIM. Considering growing demands on evidence-base for routine practice of KM amid various stakeholders, a PBRN in KM community and further researches nested within PBRN designs are warranted.

A Comparative Analysis of Clinical Features and Treatment Outcomes of Intussusception according to Age Distribution (연령에 따른 장중첩증의 임상양상 및 치료에 대한 비교분석)

  • Park, Bum Chul;Kim, Seok Young;Jung, Su Jin
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.2
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    • pp.150-156
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    • 2005
  • Purpose: We divided the children diagnosed with intususception into three different age groups and compared the clinical symptoms and treatment outcomes in order to analysis diagnosis and treatment of Intusussception. Methods: A retrospective chart review was established of 159 patients diagnosed with intussuception who had been admitted to Department of Pediatrics and General Surgery, Bundang CHA hospital from January, 2000 to May, 2004. We divided the patients into three groups, according to their age. Those who were under five months of age (group I; 21 patients), those between 5~11 months of age (group II; 61 patients), and those older than 11 months of age (group III; 77 patients). Then we compared the age, sex, seasonal distribution of occurrence, the cause, the clinical features, radiologic review, the type of intusussception, surgical methods, recurrence rate and treatment outcomes, among these three groups. Results: On comparing the clinical symptoms and signs among the three groups, the most common major clinical symptom and sign was irritabiltity in all three groups. Vomiting with irritability was statistically more common in group I (p<0.05) and bloody stool was most frequent in group III. The average time taken until a diagnosis was made after the symptom onset was, 21 hours in group I, 20 hours in group II and 22 hours in group III. Which showed no significant difference. But there was a higher rate of delayed diagnosis in group I, which took over 48 hours until the diagnosis was made (group I; 23.8%, group II; 4.9%, group III; 7.8%). Simple abdominal X-rays showed more frequent instances of intestinal obstruction in group I (p<0.05). The primary treatment done was barium enema which showed a failure rate of 52.4% in group I, 26.2% in group II and 14.3% in group III. Showing the highest failure rate in group I. Conclusion: The youngest group had vague symptoms which lead to delayed diagnosis and more frequent surgical procedures. As so, we advocate the importance of further evaluation and close observation, considering intussusception in children with symptoms of irritability and vomiting, especially in the early infant group.

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The Association between Family Support, Activities of Daily Living and Depression among Hospitalized Older Patients with Chronic Diseases (만성질환 입원노인의 가족지지 및 일상생활 수행능력과 우울과의 관련성)

  • Kim, Jeong Yi;Ryu, So Yeon;Han, Mi Ah;Choi, Seong Woo
    • Journal of agricultural medicine and community health
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    • v.41 no.1
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    • pp.13-26
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    • 2016
  • Purpose: This study was performed to identify the association between family support, activities of daily living (ADL) and depression among hospitalized older patients with chronic diseases. Methods: This study subjects were 100 elderly patients with chronic diseases including chronic respiratory diseases, diabetes mellitus and et al. in a general hospital. The collected data were patient characteristics, family support, ADL, and depression by structured questionnaire and medical chart review. The used statistical analyses were t-test, analysis of variance, Pearson's correlational analysis and multiple regression analysis. Results: The mean scores of family support, ADL and depression were $49.95{\pm}8.68$, $8.65{\pm}2.65$, $6.66{\pm}3.78$, respectively. The prevalence rate of depression was 64.0%. In simple analysis, the statistically significant associated factors with depression were age, spouse, economic status, social activity, subjective health status, and number of pain. Depression had statistically a significant positive correlation with ADL and a negative correlation with family support. The final result of hierarchial multiple regression analysis (Model 3), the factors related to depression were family support (b=-.135, p<.001), subjective health status (b=2.510, p=.001). Conclusions: It is necessary to develop and apply the program for controlling the depression of elderly patients with health education, reinforcement of supportive systems in hospital. And, further multidisciplinary studies should be done.