• Title/Summary/Keyword: 환자 만족

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Analysis of relationship between cracked tooth syndrome and occlusion using Q-ray and T-scan (큐레이(Q-ray)와 티스캔(T-scan)을 사용한 치아균열증후군(cracked tooth syndrome)과 교합 사이의 상관관계에 대한 분석)

  • Ahn, Do-Gwan;Choi, Jin-Woo;Kim, Yuseong;Pyo, Se-Wook;Kim, Hee-Kyung
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.3
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    • pp.271-280
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    • 2021
  • Purpose. The aim of this study was to evaluate the relationship between the patient's occlusion and a cracked tooth by using T-scan occlusal analysis and a quantitative light-induced fluorescence (QLF) technology. Materials and methods. This study was carried out on 51 patients having cracked teeth between January, 2019 and December, 2020. The tooth crack was determined with a Q-ray pen and QLF parameters (ΔFmax and ΔRmax) were obtained by a Q-ray software. T-scan tests were conducted to all subjects and then, the occlusal force and disclosing time were analyzed. Mann-Whitney U test was performed to compare the occlusal force and disclosing time between cracked teeth groups and contra-lateral normal teeth groups (α = .05). Mann-Whitney U test was performed to compare ΔFmax and ΔRmax according to the results of cold/bite tests (α = .05). A Spearman correlation analysis was run to determine the relationship between ΔFmax or ΔRmax and occlusal force or disclosing time (α=.05). Results. The mean occlusal force and disclosing time were significantly higher on cracked teeth than on normal teeth (P < .05). The ΔFmax or ΔRmax were not significantly different according to the results of cold/bite tests (P > .05). There was no correlation between ΔFmax or ΔRmax and occlusal force or disclosing time (P > .05). Conclusion. There was a significant relationship between occlusion and cracked tooth syndrome. QLF has the potential to be a valuable tool for the diagnosis of tooth crack in clinical practice.

Clinical Results of Lateral-Posterior Internal Fixation for the Treatment of Scapular Body Fractures (견갑골 체부 골절에서 외측 후방 금속판 고정술의 치료 결과)

  • Lee, Yoon-Min;Yeo, Joo-Dong;Song, Seok-Whan
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.1
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    • pp.46-53
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    • 2020
  • Purpose: Scapular body fractures have generally been treated with non-surgical methods. This study reports the clinical and radiological outcomes after lateral-posterior internal fixation for treating displaced scapular body fractures. Materials and Methods: From March 2007 to May 2017, out of 40 patients who underwent internal fixation for scapular fractures, 13 cases of lateral plate fixation of a scapular body fracture were reviewed retrospectively. Preoperative and postoperative displacement, angulation and glenopolar angle (GPA) were measured. The range of shoulder motion, visual analogue scale (VAS), and disabilities of the arm, shoulder, and hand (DASH), and Constant score were assessed at the last follow-up. Results: The mean follow-up period was 17.7 months (range, 6-45 months). The mean preoperative GPA was 23.3°±3.96° (range, 17.8°-28.1°) and the postoperative GPA was 31.1°±4.75° (range, 22.5°-40.1°). Injury to the suprascapular nerve, nonunion, fracture redisplacement, metallic failure, or infection did not occur. At the last follow-up, the mean range of motion was 150.5°±19.3° in forward flexion, 146.6°±2.34° in lateral abduction, 66.6°±19.1° in external rotation, and 61.6°±18.9° in internal rotation. The VAS, DASH, and Constant scores were 1.7±1.3, 6.2±2.4, and 86±7.9 points, respectively. Conclusion: A scapular body fracture with severe displacement, angulation and marked decreased GPA can be stabilized by lateralposterior plate fixation using the appropriate surgical technique with good functional and radiological results.

Efficacy of Unilateral Biportal Endoscopic Decompression in Lumbar Foraminal Stenosis (요추 추간공 협착증에서 일측성 양방향 내시경적 측부 추간공 감압술의 효과)

  • Lee, Ji-Min;Woo, Young-Ha;Yoo, Seong-Ho;Kim, Young-Jun;Seo, Jin-Hyuk;Bae, Hyuk
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.5
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    • pp.411-417
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    • 2020
  • Purpose: This paper reports the short-term clinical and radiological results of unilateral biportal endoscopic decompression (UBE) to prove its efficacy. Materials and Methods: Twenty patients who received unilateral biportal endoscopic far-lateral decompression (UBEFLD) were analyzed statistically using the visual analogue scale (VAS), modified Macnab criteria and Oswestry Disability Index (ODI) clinically. Radiologically, their intervertebral angle (IVA), percentage slip, disc height index (DHI) and foraminal height index (FHI) were analyzed pre- and postoperatively. Results: The VAS scores were 6.20 preoperatively, which improved to 2.05, 1.75 and 1.45 at postoperative one month, three months and one year, respectively (p<0.001). The modified macnab criteria in both the good or excellent category was 70.0%, 80.0% and 85.0% at postoperative one month, three months and one year, respectively (p=0.034). The ODI improved from 59.8% preoperatively to 35.8%, 33.2%, and 17.1% at postoperative one month, three months, and one year, respectively (p<0.001). The IVA was increased 0.40±0.88 after a surgery (p=0.057). Percentage slip was increased 0.19% after surgery (p=0.134). The DHI changed from 0.49 preoperatively to 0.62 postoperatively (p=0.359), and the FHI changed from 0.71 preoperatively to 0.79 postoperatively (p<0.001). Conclusion: UBEFLD displayed satisfactory results. Such a result highlights the potential of UBEFLD as an excellent alternative to spinal fusion or microscopic surgery.

Treatment of Enchondroma in the Hands and Feet (수족부의 단관골에 발생한 내연골종의 치료)

  • Kim, Jeung Il;Choi, Kyung Un;Lee, In Sook;Song, You Seon;Jeong, Jae Yoon
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.2
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    • pp.162-168
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    • 2020
  • Purpose: The purpose of this study was to suggest an appropriate treatment method by comparing nonsurgical treatment and surgical treatment for enchondroma in the hands and feet. Materials and Methods: Seventy four cases with enchondroma of the hands and feet from January 1996 to March 2017 were selected to evaluate the functional outcomes. Thirty cases were treated with nonsurgical treatment, and 44 cases were treated with surgical treatment, such as curettage only or curettage with a bone graft. The mean follow-up period was 18.1 months. The functional results were analyzed using the Wilhelm and Feldmeier formula. Results: The mean age was 38 years, and the age range was between eight and 69 years. According to the Wilhelm and Feldmeier formula, the mean score of hand enchondroma was 3.09±0.85 and 3.20±0.91 in the non-operative and operative group, respectively. The mean scores of the foot except for the grip strength were 2.57±0.79 and 2.75±0.50, respectively. No significant difference was observed according to the functional results. Among the 18 cases of enchondroma with pathological fractures, nine cases were treated non-surgically and nine cases were treated by surgically. In all 18 cases, complete bone healing was observed at the final follow-up. Conclusion: Relatively satisfactory results were obtained in both surgical and nonsurgical treatment and there was no significant difference in functional outcomes. In cases of enchondroma in the hands and feet, nonsurgical treatment can also be a good treatment option.

Treatment of Pyogenic Arthritis of the Knee Using Drainage Tube Insertion in the Posterior Compartment through the Posterior Transeptal Portal after an Arthroscopic Synovectomy (관절경적 활액막 절제술 후 후격막 삽입구를 통한 배액관의 후방 거치를 이용한 무릎의 화농성 관절염 치료)

  • Kim, Tae Ho;Yu, Chang Eon;Shin, Chung Shik
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.3
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    • pp.269-275
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    • 2019
  • Purpose: This study analyzed the treatment effects of drain insertion in the posteromedial portal after an arthroscopic synovectomy and posterior septum resection for pyogenic arthritis. Materials and Methods: From June 2005 to December 2016, 56 cases (55 patients, 1 case of bilateral knee) were diagnosed with pyogenic arthritis and arthroscopic treatment was performed. Fourteen patients (25.0%) were identified with causative organisms. The average follow-up period was 12.3 months, and the mean age was 67.8 years old. Twenty-four cases were males and 31 cases were females. Kellgrene-Lawrence grade (K-L grade) I was 6 patients, II was 20 patients, III was 11 patients, and IV was 18 patients. Surgery was performed through six portal. The posterior septum was removed and a drainage tube was inserted from the posterior medial side to the posterior side of the joint. The Lysholm score was used after surgery for a functional evaluation. The K-L grade at the time of admission and at the last follow-up were compared for a radiological evaluation. Results: The mean normalization period of the C-reactive protein was 59.8 days (6-164 days). Intravenous antibiotics were used for an average of 37.1 days. The results of the functional evaluation revealed a mean Lysholm score of 64.5 (30-98) in a total of 56 cases. Two reoperations was performed, but the treatment was completed with same method in all patients. The K-L grade was similar at the time of surgery and at the last follow-up (p>0.05). Conclusion: The method of drain insertion in the posteromedial portal after arthroscopic synovectomy and posterior septum resection for pyogenic arthritis is an effective technique that can obtain satisfactory results by inducing proper exudate discharge.

Long-Term Survival Analysis of Unicompartmental Knee Arthroplasty (슬관절 부분 치환술의 장기 생존 분석)

  • Park, Cheol Hee;Lee, Ho Jin;Son, Hyuck Sung;Bae, Dae Kyung;Song, Sang Jun
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.5
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    • pp.427-434
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    • 2019
  • Purpose: This study evaluated the long term clinical and radiographic results and the survival rates of unicompartmental knee arthroplasty (UKA). In addition, the factors affecting the survival of the procedure were analyzed and the survival curve was compared according to the affecting factors. Materials and Methods: Ninety-nine cases of UKA performed between December 1982 and January 1996 were involved: 10 cases with Modular II, 44 cases with Microloc, and 45 cases with Allegretto prostheses. The mean follow-up period was 16.5 years. Clinically, the hospital for special surgery (HSS) scoring system and the range of motion (ROM) were evaluated. Radiographically, the femorotibial angle (FTA) was measured. The survival rate was analyzed using the Kaplan-Meier method. Cox regression analysis was used to identify the factors affecting the survival according to age, sex, body mass index, preoperative diagnosis, and type of implant. The Kaplan-Meier survival curves were compared according to the factors affecting the survival of UKA. Results: The overall average HSS score and ROM was 57.7 and 134.3° preoperatively, 92.7 and 138.4° at 1 year postoperatively, and 79.1 and 138.4° at the last follow-up (p<0.001, respectively). The overall average FTA was varus 0.8° preoperatively, valgus 4.1° at postoperative 2 weeks, and valgus 3.0° at the last follow-up. The overall 5-, 10-, 15- and 20-year survival rates were 91.8%, 82.9%, 71.0%, and 67.0%, respectively. The factors affecting the survival were the age and type of implant. The risk of the failure decreased with age (hazard ratio=0.933). The Microloc group was more hazardous than the other prostheses (hazard ratio=0.202, 0.430, respectively). The survival curve in the patients below 60 years of age was significantly lower than those of the patients over 60 years of age (p=0.003); the survival curve of the Microloc group was lower compared to the Modular II and Allegretto groups (p=0.025). Conclusion: The long-term clinical and radiographic results and survival of UKA using old fixed bearing prostheses were satisfactory. The selection of appropriate patient and prosthesis will be important for the long term survival of the UKA procedure.

Arthroscopically-Assisted Reduction and Internal Fixation of Intra-Articular Fractures of the Lateral Tibial Plateau (관절면을 침범한 경골 외측 고평부 골절에 대한 관절경을 이용한 정복 및 내고정술)

  • Kim, Juhan;Kim, Dong Hwi;Lim, Jae-Hwan;Jang, Hyunwoong;Kim, Young Wook
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.3
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    • pp.227-236
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    • 2019
  • Purpose: To evaluate the results of tibial lateral plateau fractures using arthroscopic-assisted reduction and internal fixation without cortical window or bone grafts. Materials and Methods: From March 2009 to March 2017, 27 patients with Schatzker type II tibial plateau fractures with articular depression and displacement over 5 mm on a computed tomography (CT) scan, who were treated with arthroscopic reduction and internal fixation and followed-up for at least 18 months, were enrolled in this study. Under arthroscopic guidance, the depressed fracture fragment was reduced using a freer and fixed with 5.0 or 6.5 mm cannulated screws through the inframeniscal portal without a cortical window or bone graft. The clinical and radiological results were evaluated using a Rasmussen system. Second look arthroscopy was performed in thirteen patients during the implant removal operation. Results: All fractures healed completely with a mean union time of 8.7 weeks (range from 8 to 12 weeks). Twenty four patients had good to excellent clinical results and 25 patients had good to excellent radiological results according to the Rasmussen classification. A well-healed articular surface with fibrocartilage was also found in 13 cases with second look arthroscopy. The 8 cases on CT scan at outpatient department follow-up showed bone union without bone grafting. Conclusion: Arthroscopic-assisted fixation of tibial lateral plateau fractures is a useful method without a cortical window or bone graft that produces good clinical results.

Optimization and Stabilization of Automated Synthesis Systems for Reduced 68Ga-PSMA-11 Synthesis Time (68Ga-PSMA-11 합성 시간 단축을 위한 자동합성장치의 최적화 및 안정성 연구)

  • Ji hoon KANG;Sang Min SHIN;Young Si PARK;Hea Ji KIM;Hwa Youn JANG
    • Korean Journal of Clinical Laboratory Science
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    • v.56 no.2
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    • pp.147-155
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    • 2024
  • Gallium-68-prostate-specific membrane antigen-11 (68Ga-PSMA-11) is a positron emission tomography radiopharmaceutical that labels a Glu-urea-Lys-based ligand with 68Ga, binding specifically to the PSMA. It is used widely for imaging recurrent prostate cancer and metastases. On the other hand, the preparation and quality control testing of 68Ga-PSMA-11 in medical institutions takes over 60 minutes, limiting the daily capacity of 68Ge/68Ga generators. While the generator provides 1,110 MBq (30 mCi) nominally, its activity decreases over time, and the labeling yield declines irregularly. Consequently, additional preparations are needed, increasing radiation exposure for medical technicians, prolonging patient wait times, and necessitating production schedule adjustments. This study aimed to reduce the 68Ga-PSMA-11 preparation time and optimize the automated synthesis system. By shortening the reaction time between 68Ga and the PSMA-11 precursor and adjusting the number of purification steps, a faster and more cost-effective method was tested while maintaining quality. The final synthesis time was reduced from 30 to 20 minutes, meeting the standards for the HEPES content, residual solvent EtOH content, and radiochemical purity. This optimized procedure minimizes radiation exposure for medical technicians, reduces patient wait times, and maintains consistent production schedules, making it suitable for clinical application.

Investigation on the Perception of Mandatory Clinical Practice in the Department of Radiology Following the Amendment of the Medical Technologists Act (의료기사 등에 관한 법률 개정으로 방사선(학)과 현장실습 의무화에 따른 인식 조사)

  • Jeong-Mu Lee;Yong-Ki Lee;Sung-Min Ahn
    • Journal of the Korean Society of Radiology
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    • v.18 no.3
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    • pp.293-300
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    • 2024
  • On October 31, 2023, the revision of the Medical Technologist Act made it mandatory to complete field training courses in order to obtain a license as a radiologic technologist. Therefore, we would like to survey the actual situation of field training in medical institutions to inform the revised Medical Technologist Act and propose improvement measures to increase the effectiveness of field training. A survey was conducted from March to April, 2023, among radiologic technologists working in medical institutions. The questionnaire was sent through a form on a domestic portal site, Company N, and 120 respondents completed it. Eighty-two respondents, or 68.3 percent, had experience in educating on-the-job training students. 58% of the respondents were aware of the fact that the amendment to the Act on Medical Technologist etc. made field training mandatory to obtain a radiologic technologist license. In accordance with Article 9 of the Medical Technologist Act, which prohibits unlicensed persons from practicing, 50% of the respondents were aware that those who are in training to complete an education course equivalent to the license they are seeking to obtain at a university or other institution are allowed to practice as medical Technologists. When asked what is currently taught during fieldwork, 6% of respondents said that they are required to perform radiation-generating activities in addition to observing, guiding patients, and positioning and moving patients. When asked about the future direction of education as fieldwork becomes mandatory for licensure, 77% of respondents said that they will teach more than they currently do. When asked about the appropriate total length of fieldwork, 35% said 12 weeks and 480 hours, 33% said 8 weeks and 320 hours, and 27% said 16 weeks and 640 hours. It can be seen that the current on-the-job training is inadequate according to various regulations, and students' satisfaction is low. However, with the revision of the Act on Medical Technologists, field training has become mandatory to obtain a license as a radiologist, and it is necessary to improve the educational conditions of field training. Therefore, it is necessary to comply with the Nuclear Safety Act and the Rules on the Safety Management of Diagnostic Radiation Generating Devices, introduce standardized training objectives and evaluation systems, designate training hospitals and radiologists in charge of training, and introduce extended training periods and simulation exercises to internalize field training.

Surgical Treatment for Isolated Aortic Endocarditis: a Comparison with Isolated Mitral Endocarditis (대동맥 판막만을 침범한 감염성 심내막염의 수술적 치료: 승모판막만을 침범한 경우와 비교 연구)

  • Hong, Seong-Beom;Park, Jeong-Min;Lee, Kyo-Seon;Ryu, Sang-Woo;Yun, Ju-Sik;CheKar, Jay-Key;Yun, Chi-Hyeong;Kim, Sang-Hyung;Ahn, Byoung-Hee
    • Journal of Chest Surgery
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    • v.40 no.9
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    • pp.600-606
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    • 2007
  • Background: Infective endocarditis shows high surgical mortality and morbidity rates, especially for aortic endocarditis. This study attempts to investigate the clinical characteristics and operative results of isolated aortic endocarditis. Material and Method: From July 1990 to May 2005, 25 patients with isolated aortic endocarditis (Group I, male female=18 : 7, mean age $43.2{\pm}18.6$ years) and 23 patients with isolated mitral endocarditis (Group II, male female=10 : 13, mean age $43.2{\pm}17.1$ years) underwent surgical treatment in our hospital. All the patients had native endocarditis and 7 patients showed a bicuspid aortic valve in Group I. Two patients had prosthetic valve endocarditis and one patients developed mitral endocarditis after a mitral valvuloplasty in Group II. Positive blood cultures were obtained from 11 (44.0%) patients in Group I, and 10 (43.3%) patients in Group II, The pre-operative left ventricular ejection fraction for each group was $60.8{\pm}8.7%$ and $62.1{\pm}8.1%$ (p=0.945), respectively. There was moderate to severe aortic regurgitation in 18 patients and vegetations were detected in 17 patients in Group I. There was moderate to severe mitral regurgitation in 19 patients and vegetations were found in 18 patients in Group II. One patient had a ventricular septal defect and another patient underwent a Maze operation with microwaves due to atrial fibrillation. We performed echocardiography before discharge and each year during follow-up. The mean follow-up period was $37.2{\pm}23.5$ (range $9{\sim}123$) months. Result: Postoperative complications included three cases of low cardiac output in Group I and one case each of re-surgery because of bleeding and low cardiac output in Group II. One patient died from an intra-cranial hemorrhage on the first day after surgery in Group I, but there were no early deaths in Group II. The 1, 3-, and 5-year valve related event free rates were 92.0%, 88.0%, and 88.0% for Group I patients, and 91.3%, 76.0%, and 76.0% for Group II patients, respectively. The 1, 3-, and 5-year survival rates were 96.0%, 96.0%, and 96.0% for Group I patients, and foo%, 84.9%, and 84.9% for Group II patients, respectively. Conclusion: Acceptable surgical results and mid-term clinical results for aortic endocarditis were seen.