• Title/Summary/Keyword: treatment satisfaction

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The Effect of Second Toe Valgus on Correction Loss of Hallux Valgus Angle in Surgical Treatment (무지외반증 수술에서 제 2족지의 외반 정도가 무지 외반각 교정소실에 미치는 영향)

  • Kang, Suk Woong;Song, Moo Ho;Kim, Yeong Joon;Oh, Young Kwang;Yoo, Seong Ho
    • Journal of Korean Foot and Ankle Society
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    • v.21 no.4
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    • pp.135-138
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    • 2017
  • Purpose: The purpose of this study is to determine the correlation between the correction loss of hallux valgus angle and the severity of valgus angle of the second toe. Materials and Methods: We selected 312 cases from 268 surgical patients with hallux valgus deformity receiving distal chevron osteotomy. For a radiological evaluation, we analyzed the changes in the hallux valgus angles, first to second intermetatarsal angles, and valgus angle of the second toe post index operations. All patients were women; the mean age was 46 years. The mean follow-up period was 17 months. Results: The mean hallux valgus angle was $33.6^{\circ}$ preoperatively (range, $25.7^{\circ}{\sim}44.8^{\circ}$), $13.1^{\circ}$ (range, $8.4^{\circ}{\sim}16.4^{\circ}$) after 4 weeks of postoperative period, and $17.1^{\circ}$ (range, $9.4^{\circ}{\sim}28.5^{\circ}$) at their final follow-up. The mean valgus angle of the second toe was $8.4^{\circ}$ preoperatively (range, $2.0^{\circ}{\sim}25.8^{\circ}$) and $8.3^{\circ}$ (range, $1.7^{\circ}{\sim}24.9^{\circ}$) at the final follow-up. Preoperatively, there was a positive correlation between the valgus angle of the second toe and hallux valgus angle (r=0.747, p=0.001). The correction loss of hallux valgus angle had a significant correlation with the severity of valgus angle of the second toe (r=0.802, p=0.001). Conclusion: The existence of the second toe valgus deformity may present itself as a cause of correction loss of hallux valgus angle. The preoperative measurement of the second toe valgus angle may be a good predictor of correction loss; therefore, thorough preoperative warning on the possibility of correction loss should be conducted to maximize patient satisfaction after the procedure.

Implant stability installed with CAD-CAM assisted flapless surgery : A pilot study (CAD-CAM assisted flapless 수술법으로 식립된 임플란트의 안정성 : 기초연구)

  • Park, Chan-Jin;Kim, Dae-Gon;Cho, Lee-Ra;Kashiwagi, Kosuke;Kawazoe, Takayoshi;Tanaka, Masahiro
    • Journal of Dental Rehabilitation and Applied Science
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    • v.27 no.4
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    • pp.405-413
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    • 2011
  • It was proposed that technologies derived from CAD-CAM and computed tomography may be useful for flapless implant treatment procedures. The aims of this study were to validate the reliability of this concept in a prospective 12-month clinical study. Twelve patients with fully edentulous areas in their mandibles were included in this study. A total of 71 implants were inserted in interforaminal regions by use of a CAD/CAM drill template($NobelGuide^{TM}$), specially designed for flapless implant surgery. To assess the degree of pain and discomfort, the patients were examined at 2 days and 1 week after surgery. Patient satisfaction and implant functionality were further evaluated at follow-up intervals of 1, 3, 6, and 12 months postoperatively. One implant failed early in 1 patient. All of the other implants were in a good functional state throughout the study. The mean marginal bone loss after 1 year of follow-up was 0.3 mm (SD, 0.1) at center, 0.5 mm (SD, 0.1) at canine and 0.7 mm (SD, 0.2) at distal fixtures, respectively. Statistically, there was not significant differences among each sites(P>.05)The mean ISQ change after 1 year of follow-up was -1.05 (SD, 2.76) at center, -0.85 (SD, 2.59) at canine and -1.27 (SD, 2.18) at distal fixtures, respectively. This prospective pilot study showed that the use of CAD/CAM technology and flapless implant surgery may be considered reliable for fully edentulous mandible of patients.

Assessment of Damages for Non-pecuniary Loss and Compensation for Damages in Medical Accidents - Overview for Cases of Medical Injury Relief in Korea Comsumer Agency - (의료사고의 손해배상과 위자료 산정 -한국소비자원 의료피해구제 사례들의 일별-)

  • Kim, Kyoung Reay;Ahn, Bup-Young
    • The Korean Society of Law and Medicine
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    • v.13 no.2
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    • pp.179-214
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    • 2012
  • There are two opinions on the legal characteristics of damages for non-pecuniary loss, a private sanctions theory and complementary function of damages for non-pecuniary loss, briefly. There is a close connection between the legal characteristics and the function of damages for non-pecuniary loss. The functions of damages for non-pecuniary loss are consist of satisfaction, prevention( sanctions) and complementation. Several cases of medical injury relief reported to Korea Comsumer Agency are categorized as follows, 1) cases of death after having an operation, 2) diagnosed with disability after a medical accident, 3) extended damages happening related to delayed diagnosis, 4) et cetera(a plastic surgery, a treatment with oriental medicine), and the damages for non-pecuniary loss in respect to each cases are examined. In the case of occurring death or disability, Korea Comsumer Agency has set up guidelines for assessment of damages for non-pecuniary loss by classifying into major and collateral violation for a duty of care. Furthermore, the damages for non-pecuniary loss in the case of all sorts of cancers, are assessed in accordance with the degree of responsibility subsequent to dividing cancer into good and poor prognosis. When it comes to a complementary function of damages for non-pecuniary loss in the actual work, it is hard to assess the damages as it is difficult to objectify non-pecuniary loss, such as emotional distress. Though compensation for damages is major legal characteristics of consolation money, preventing a damage(private sanctions) through consolation for a victim or sanctions against an assailant also has great significance. Therefore, it is necessary to approach flexibly for mutual agreement by considering specialty( concrete facts) of individual issue thoroughly. If considering this aging society that limits the possible age for work to 60 years old, it is needed to have a complementary function of consolation money in mind not to make it less meaningful for victims due to small sum of consolation money.

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PDA Transmission of Medical Images by CDMA (CDMA에 의한 의료영상의 PDA전송)

  • Lee, Myong-Ho;Lim, Jae-Dong;Ahn, Bung-Ju;Lee, Hwun-Jae;Lee, Sang-Bock
    • Journal of the Korean Society of Radiology
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    • v.1 no.2
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    • pp.13-22
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    • 2007
  • The purpose of this study was to survey a development of the wireless transmission system of medical images for ubiquitous medicine. There have been many changes in medical equipments and medical record medical treatment and medical record within hospital and PACS(Picture Archiving Communication System) which is picture management system for patients can be typical cases. It is difficult to use these automated medical systems unless they are within hospital and in case of rapid image reading in the emergency cases or in absence of doctor, it is difficult to perform it immediately. The present study implemented an image transmission system using CDMA connection so that images in the server can be viewed at any time and in any place. Remote wireless diagnosis based on medical images using PDA is applicable to medical areas that require mobility, and the use of PDA can be an ideal alternative for point of care. The use of PDA enables prompt and accurate access to digital medical images, which in turn reduces medical accidents and improves the quality of medical services through high productivity and efficiency of medical practitioners' works. It also enables quick response to patients' demands and high-quality medical services and, consequently, patients' high satisfaction.

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A Study on 'Health' concept of Sasang Constitutional Medicine (건강개염(健康槪念)의 사상의학적(四象醫學的) 고찰(考察))

  • Hwang, Min-Woo;Lim, Jin-Ny;Jung, Yong-Jae;Kim, Sang-Bok;Lee, Soo-Kyung;Koh, Byung-Hee;Song, Il-Byung;Lee, Tae-Gyu
    • Journal of Sasang Constitutional Medicine
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    • v.15 no.3
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    • pp.88-99
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    • 2003
  • Background and Objective : The status of development of instruments to assess the 'health status' reflecting the concept of Sasang Constitutional Medicine is still far from satisfaction, despite their importance in building basic data for health promotion, evaluation of effectiveness of treatment, health policy and so on. for these reasons the health scale of Sasang Constitutional Medicine shod be developed. Therefore as from of preliminary research, this study is to review the concept of health and symptoms in health status in Sasang Constitutional Medicine. Methods : It was researched as bibliologically with Dong-mu's chief medical writings such as ${\ulcorner}Dongyi$ Soose $Bowon{\lrcorner}$(東醫壽世保元)${\ulcorner}Dongyi$ Soose Bowon Sasang Chobongyun(東醫壽世保元四象草本卷)${\lrcorner}$ - Results and conclusion : 1. In Sasang Constitutional Medicine, it is suggested that Inherent vitality(命脈實數) has relations to health and Knowledge-Acting(知行) is a primary factor which affects health. And it is thought that Healthy condition(完實無病) is that human being has enough Healthy energy(保命之主) of Small viscera. 2. In Sasang Constitutional Medicine, it is thought that stool, urine, sweating and digestion become important indexes to measure the physical health state. 3. In Sasang Constitutional Medicine, it is thought that the mental health is in control of inclination of mind by golden mean(中庸) and in tranquillity of constant mind according to constitution. 4. In Sasang Constitutional Medicine, it is thought that the social health is state thar can do social acting harmoniously by keeping away from alcohol, sexual appetite, property and power.

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Delayed Lacrimal Stent Implantation Using Mini Monoka$^{(R)}$ in Canalicular Laceration (누소관 열상환자에서 Mini Monoka$^{(R)}$를 이용한 지연된 스텐트 삽입술)

  • Hwang, Jae-Ha;Kim, Hong-Min;Kim, Ji-Hoon;Kim, Kwang-Seog;Lee, Sam-Yong
    • Archives of Reconstructive Microsurgery
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    • v.20 no.1
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    • pp.32-37
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    • 2011
  • Purpose: Canalicular laceration is relatively common due to its exposed, vulnerable location in case of facial trauma. Conjunctivodacryocystorhinostomy has been the standard treatment for canalicular obstruction secondary to unrepaired canalicular laceration. In spite of a high rate of relieving tear-duct obstruction, this method is noted to be associated with low rate of patient satisfaction and a number of complications. The goal of this study is to report the good results of delayed lacrimal stent implantation with Mini Monoka$^{(R)}$ for patients whose canaliculi were not repaired by initial surgery. Methods: From May of 2005 to February of 2007, four patients who underwent delayed lacrimal stent implantation using Mini Monoka$^{(R)}$ in canalicular laceration were retrospectively reviewed. First, the previous scar incision was made over the lower lid and we identified the cut end of proximal lacerated canaliculus. The Mini Monoka$^{(R)}$ was passed through the punctum to the cut end of the proximal lacerated canaliculus. We identified the cut end of the distal lacerated canaliculus, whose cut end has rolled white edges after careful excision of the scarred lid tissue. We then passed Mini Monoka$^{(R)}$ through the lacerated inferior canaliculus. Using an operating microscope, we placed three interrupted sutures of 8-0 Ethilon to join the canalicular ends. Silicone stent was left in place for 6 months. The mean age of the patients was 48.5 years (range, 35 to 59 years). The time interval from initial trauma to delayed lacrimal stent implantation was between 3 and 31 days. Follow-up periods ranged from 12 and 20 months. Results: The results of reconstruction were classified into normal, fair and poor. Patent lacrimal drainage systems were achieved in three of the four cases. In one case, epiphora was encountered. No cases of stent displacement, conjunctivitis or granuloma formation were encountered. Conclusion: Even though canalicular reconstruction was delayed for a long time, attempting canalicular reconstruction would be acceptable before considering secondary operations like dacryocystorhinostomy and conjunctivodacryocystorhinostomy.

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External Fixation of Retaining Ligament in Correction of Facial Disfigurement in Type-1 Neurofibromatosis Patients (유지 인대의 외부 고정을 통한 제1형 신경섬유종증 환자의 안면부 변형 교정)

  • Myung, Yu-Jin;Lee, Yoon-Ho
    • Archives of Plastic Surgery
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    • v.38 no.3
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    • pp.257-262
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    • 2011
  • Purpose: In neurofibromatosis patients, complete surgical excision of the mass is almost impossible and surgical treatment usually consists of multiple serial excisions that only result in a debulking effect. Remnant tumor mass has a gravitational effect on facial soft tissues that leads to sagging of skin and soft tissue, and eventually, facial disfigurement and asymmetry. The purpose of our surgical method is to perform soft tissue lifting with longer lasting effect with less surgical risk of damaging facial nerve and vessels. With external fixation using K-wire or surgical screw, the procedure only called for a short incision length and had additional adhesive properties that enabled anchoring of soft tissue in a lifted position for a longer postoperative period. Methods: A total of 5 neurofibromatosis patients (NF-1) visited our clinic for mass reduction and face lifting. The age of patients ranged from 13 to 42 (mean 28.8 years), and most patients had a long history of multiple excisions in the past. Face lifting was performed in 2 different areas, the periorbital area in 3 patients, and the midface in 2 patients. The materials used in fixation of retaining ligament were K-wire (n=3) and titanium screw (n=2). Results: Follow up period was from 5 month to 3 years and 1 month (mean=2 years and 1 month). All patients conveyed satisfaction with the results and no major complications were reported. The lifting effect lasted for as long as 3 years, and there were no complaints of relapse of soft tissue depression or sagging within the operated area. 1 patient (M/13) needed secondary k-wire insertion and additional mass excision in 1 year and 10 months postoperatively due to tumor growth. In two patients with K-wire fixation, mild dimpling and tenderness were observed in the follow up period, but in about 2 months postoperatively, dimpling was relieved and there was no need for removal of fixating material. Conclusion: Surgical lifting in neurofibromatosis patients can be challenging, for mass excision cannot be done completely and gravitational effect by residual mass can be persistent. External fixation of the retaining ligament in patients with neurofibromatosis can give satisfactory results-for incision length is relatively shorter, and the lifting effect can last longer compared to other various face lifting techniques.

Use of Complementary and Alternative Medicine among Cancer Patients in Korea (우리나라 소화기암 환자들의 대체의료이용에 관한 연구)

  • Jung, Eun-Young;Han, Dong-Woon;Choi, Byung-Hee;Kim, You-Kyum;Park, Yeon-Hee
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.6
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    • pp.1590-1596
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    • 2007
  • Complementary and alternative medicine (CAM) has gained in popularity among cancer patients in recent years. The use of CAM in cancer patients is common with about one third of patients using some form of CAM in Western countries. The purpose of this study was to analyze the use of CAM and determine what factors affect to use CAM among cancer patients to provide CAM therapy information and assist therapy selection among various CAM therapies to cancer patients. The design of the study was descriptive cross-sectional, and data were collected using a 16-item questionnaire. This study was conducted in subjects with confirmed diagnosis of stomach, colon, liver, or pancreas cancer, in both out-patients clinics and inpatients setting in a tertiary hospital in Seoul Korea. As a result, among the participants, past or current CAM use was reported by 75%, which shows a statistically significant difference in income groups(P<0.05), but no difference in age and religion groups. The most common therapies use by cancer patients included traditional Korean medicine (32.1%), folk remedies (26.6%), exercise (14%), dietary supplements (11.6%), physical therapy (9.9%), diet therapy (5%), and meditation (4%). 77.8% of patients show satisfaction and 64.4% shows perceived effectiveness of CAM. Male patients with higher income, and previous treatment were more likely to use CAM. The main benefits from CAM reported by cancer patients were psychological improvement and symptom improvement. Of the cancer patients used CAM, 30.9% were dissatisfied, 25.8% did not have benefits from the use, and 7.6% experience side effects. Cancer patients who prefer CAM (more than 3 kinds) used it to cure cancer, on the contrary, the one who do not prefer CAM used to improve symptoms and psychological stability. The main sources of information about CAM were family and friends(54.4%), and media(24.5%), doctor and nurse(18.3%), and religion group(2.6%). Findings suggest that due to the relatively high use of CAM among cancer patients in Korea, this topic should be taken into account in the development of a holistic approach to cancer patients and efficient cancer patients management system and proactive and consistent management of CAM is necessary in the health care system in Korea.

Comparison of Efficacy of Propofol When Used with or without Remifentanil during Conscious Sedation with a Target-Controlled Infuser for Impacted Teeth Extraction

  • Sung, Juhan;Kim, Hyun-Jeong;Choi, Yoon Ji;Lee, Soo Eon;Seo, Kwang-Suk
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.14 no.4
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    • pp.213-219
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    • 2014
  • Background: Clinical use of propofol along with remifentanil for intravenous sedation is increasing in these days, but there are not enough researches to evaluate proper target concentration when these drugs are infused by using target controlled infusion (TCI) pump in dental treatment cases. In this study, we compared efficacy of TCI conscious sedation and target concentration of propofol when it used with or without remifentanil during conscious sedation with the help of a TCI for the surgical extraction of impacted teeth. Methods: After IRB approval, all the charts of patients who had undergone surgical extraction of impacted teeth under propofol TCI sedation for 6 months were selected and reviewed for this study. After reviewal of charts, we could divide patients in two groups. In one group (group 1), only propofol was selected for sedation and initial effect site concentration of propofol was $1{\mu}g/ml$ (n = 33), and in another group (group 2), both propofol and remifentanil was infused and initial effect site concentration of each drug was $0.6{\mu}g/ml$ and 1 ng/ml respectively (n = 25). For each group, average propofol target concentration was measured. In addition, we compared heart rate, respiratory rate, and systolic and diastolic blood pressure as well as oxygen saturation. Besides, BIS, sedation scores (OAAS/S), and subjective satisfaction scores were compared. Results: Between group 1 and 2, there were no significant differences in demographics (age, weight and height), and total sedation time. However, total infused dose and the effect site target concentration of propofol was $163.8{\pm}74.5mg$ and $1.13{\pm}0.21{\mu}g/ml$ in group 1, and $104.3{\pm}46.5mg$ and $0.72{\pm}0.26{\mu}g/ml$ in the group 2 with $1.02{\pm}0.21ng/l$ of the effect site target concentration of remifentanil, respectively. During sedation, there were no differences between overall vital sign, BIS and OAAS/S in 2 groups (P > 0.05). However, we figured out patients in group 2 had decreased pain sensation during sedation. Conclusions: Co-administration of propofol along with remifentanil via a TCI for the surgical extraction of impacted teeth may be safe and effective compared to propofol only administration.

A Study on Market Segmentation of American Family Restaurants Based on Relational Benefits (관계혜택에 따른 미국 패밀리 레스토랑의 시장세분화에 관한 연구)

  • Kim, Hyun-Jung
    • Culinary science and hospitality research
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    • v.20 no.4
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    • pp.266-279
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    • 2014
  • The purposes of the study are to segment the American family restaurant market based on relational benefits and to compare each group's demographics, dining characteristics, relationship quality(consumer identification, switching costs, satisfaction, commitment), and relational outcomes(positive word-of-mouth intentions and share of purchases). 510 responses were collected from American family restaurant customers and analyzed using frequency analysis, EFA, reliability test, cluster analysis, MANOVA, discriminant analysis, chi-square test, and ANOVA. The results of the study found three different types of relational benefits: confidence, special treatment, and social benefits. The results of cluster analysis identified three market segments, namely, high relational benefits consumers, medium relational benefits consumers, and low relational benefits consumers. The three groups were different in terms of age(p<0.05) and level of education(p<0.05). In addition, high relational benefits consumers showed a higher level of relationship frequency(p<0.001), relationship quality(p<0.001), and relational outcomes(p<0.001), followed by medium and low relational benefits consumers. Overall, the results indicated that family restaurants need to deliver excellent relational benefits to customers in order to achieve desired relationship quality and relational outcomes. Managerial implications were provided.