• Title/Summary/Keyword: 환자 만족

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Outcome of Arthroscopic Suture Bridge Technique for Rotator Cuff Tear: Short Term Clinical Outcome In Full-thickness Tear With Fatty Degeneration Less Than Moderate Degree (회전근 개 파열에 대한 관절경적 교량형 봉합술의 결과: 지방 변성이 중등도 이하인 전층 파열에 대한 단기 추시 임상적 결과)

  • Cheon, Sang-Jin;Hur, Joon-Oh;Suh, Jeung-Tak;Yoo, Chong-Il
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.180-188
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    • 2009
  • Purpose: We evaluate the short-term clinical outcome of arthroscopic rotator cuff tendon repair with suture-bridge technique in patients with full thickness rotator cuff tear. Materials and Methods: 29 (male:17, female:12) consecutive shoulders treated with this index procedure and early rehabilitation were enrolled. Mean age was 56.4 years (range, 34~73 years) and mean follow-up period was 13 months (range, 12-15 months). Clinical outcomes were evaluated by using the University of California Los Angeles (UCLA) score, the Korean Shoulder Scoring System (KSS) and Visual Analogue Scale (VAS). Postoperative cuff integrity was evaluated through magnetic resonance imaging (MRI) and categorized by Sugaya classification. Results: Postoperative UCLA scores improved from 16.4 to 31.6 (p< 0.05) and KSS scores showed 88 at 6 months and 92 at last follow up. Preoperative VAS score was 8.6, which was decreased to 2.1 at 3 months and 1.4 at 6 months postoperatively. 28 patients (96.5%) had increase in range of motion. The follow up MRI was taken in 15 shoulders and the cuff integrity was type I in 6 cases, type II in 7, type III in 1 and type V in 1 by Sugaya classification. Conclusion: Arthroscopic suture-bridge technique resulted in good or excellent clinical outcome in 96.5% of the cases, so we think this technique is one of the reliable procedure for full-thicknes rotator cuff tear.

Comparison of Volumetric Modulated Arc Therapy and Non-coplanar Fixed-field Intensity Modulated Radiation Therapy for Irregular Target adjacent to Organ At Risk (손상위험장기에 인접한 불규칙한 모양의 타겟 치료 시, 용적변조회전 방사선치료와 비동일평면상의 빔을 이용한 세기변조 방사선치료의 유용성 평가 및 비교)

  • Kim, Kyung Ah;Na, Kyung Soo;Seo, Seok Jin;Lee, Je Hee
    • The Journal of Korean Society for Radiation Therapy
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    • v.29 no.1
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    • pp.57-68
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    • 2017
  • Purpose: The purpose of this study was to compare volumetric modulated arc therapy(VMAT) with fixed-field intensity modulated radiation therapy(IMRT) using non-coplanar beam when the shape of target is irregular and the location is adjacent to organ at risk(OAR). Materials and Methods: The subjects of this study were a total of 6 patients who had radiation therapy for whole scalp(2 patients), partial scalp(2 patients), and whole ventricle(2 patients) by True Beam STX(Varian Medical Systems, USA). VMAT plans consisted of coplanar or non-coplanar arcs which can minimize the volume of OAR included in beamlets. All fixed-field IMRT plans consisted of non-coplanar beams using more than 2 angles of Couch. Results: The VMAT and IMRT plans were compared with regard to the maximum dose of both lens, both optic nerves, optic chiasm, and brain stem and the mean dose of both eyeballs and hippocampus. VMAT plans showed higher dose than ncIMRT plans at more than 6 of all OARs in every patient, and the ratio was from 1.1 times to 8.2 times. In case of total scalp and partial scalp, the volume of brain which received more than 20 Gy in the VMAT plans was 2 times larger than the volume in the ncIMRT plans. In case of whole ventricle, there was no significant difference. Target coverage was satisfied in both plans($PTV_{100%}=95%$). The maximum dose in target volume and required monitor unit(MU) of ncIMRT were higher than them of VMAT plans. Conclusion: Even though ncIMRT is less efficient than VMAT with regard to required MU and treatment time, the dose to OARs is much lower than VMAT and PTV Coverage is similar with VMAT. If the shape of target is irregular and location is adjacent to OAR, comparison VMAT plan with ncIMRT plan deserves to be considered.

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Clinical Experiences of Congenital Aortic Stenosis (선천성 대동맥 판막협착증의 임상 경험)

  • Jeong, Dong-Seop;Ra, Yong-Joon;Lee, Jeong-Ryul;Kim, Yong-Jin;Lee, Chang-Ha;Lee, Cheul;Lim, Hong-Gook;Hwang, Seong-Wook;Kim, Woong-Han
    • Journal of Chest Surgery
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    • v.40 no.1 s.270
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    • pp.17-24
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    • 2007
  • Background: The aim of this study is to assess the clinical results of various procedures in congenital aortic stenosis. Material and Method: From August 1987 to June 2004, 53 patients of congenital aortic stenosis underwent procedures such as percutaneous balloon valvuloplasty, aortic valvuloplasty, Ross procedure, and aortic valve replacement. The mean age of initial procedures was $8.2{\pm}6.0$ years. Percutaneous balloon valvuloplasty was peformed in sixteen patients, aortic valvulopiasty in thirty two patients, Ross procedure in nineteen patients, and aortic valve replacement in fourteen patients. The mean follow duration was $80.6{\pm}60\;(0{\sim}207)$ months. Result: There was 15.1% (8/53) of early mortality and no late mortality. The six patients with critical aortic stenosis were died of left ventricular dysfunction in early series (before 1 year; 4 cases) and two patients died after the Ross procedure and aortic valve replacement respectively. After percutaneous balloon valvuloplasty, most patients needed reoperations (14/16). Thirteen patients needed reoperation, after aortic valvuloplasty. After Ross procedure, two patients needed reoperation due to aortic regurgitation caused by progressive aortic root dilatation. The actuarial survival rate after Ross procedure at 7 years was 90.5%. Conclusion: In young children before the age of one, percutaneous balloon valvuloplasty was considered as :he safe initial palliative procedure. But children over one year-old, aortic valvuloplasty were the effective procedure. Ross procedure can be preformed safely with good results.

Effects of Glue Sniffing on Weight Increase or Central Nervous System of Young Rat (반복된 본드 흡입이 백서의 정상발육에 의한 체중증가와 중추신경계에 미치는 영향)

  • Kim, Heon;Kim, Sun-Min;Cho, Soo-Hun
    • Journal of Preventive Medicine and Public Health
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    • v.26 no.2 s.42
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    • pp.222-230
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    • 1993
  • Industrial glues, known as 'Bonds' in Korea, contain many kinds of organic solvents, and glue sniffing of youths became one of the social problems in Korea. Mixed exposures to solvents by glue sniffing may induce chronic toxicities different from those by exposures to solvents of single component. To test effects of the glue sniffing on weight gain or central nervous system, two groups of 20 male Sprague-Dawley rats were exposed to air(control group) or vapors of the glues to narcotic status(exposed group), and weight check, tail flick test, hot plate test, rotarod treadmill test were done on the 14th,24th, 36th, 45th, 53rd, 86th, 102nd, 117th, 134th and 151st days after the first exposure. On the 188th day, their brains were excised and examined by a pathologist. Weight gain, controlled against time change, showed significant difference between the groups, but response times in tail flick test, hot plate tests, and rotarod treadmill test didn't. In pathological examination with blind method, no macroscopic or microscopic differences were found between the two groups. These results suggests that organic lesion in central nervous system may not ensue glue sniffing, but, before firm conclusion, more studies in various exposure conditions should be followed.

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Arthroscopic Repair of Traumatic Subscapularis Tendon Tear (외상성 견갑하건 파열의 관절경하 봉합술)

  • Cho, Su-Hyun;Cho, Hyung-Lae;Ku, Jung-Hoei;Hwang, Tae-Hyok;Park, Man-Jun;Choi, Jae-Hyuk
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.3
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    • pp.180-187
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    • 2010
  • Purpose: Rotator cuff tears involving the subscapularis are less common than those involving the superior and posterior rotator cuff. The purpose of the present study was to report the clinical results of repair of isolated traumatic tears of the subscapularis tendon. Materials and Methods: Fifteen patients (13 males, 2 females; mean age 46.2 years; range 35 to 52) with unilateral ruptures of the subscapularis tendon after trauma who underwent arthroscopic repair between February 2003 and October 2008 were reviewed retrospectively. All the cases were isolated tears of the subscapularis without the involvement of any other rotator cuff tendon and were followed for at least two years (mean 28 months). The entire subscapularis was involved in 9 cases and the tear was localized to the upper two thirds in 6 cases. The preoperative and postoperative status of patients with isolated subscapularis tears were analyzed using the Constant Score, American Shoulder and Elbow Society Index (ASES Index) and postoperative integrity was determined through magnetic resonance imaging. Results: The average clinical outcome scores and strength were all improved significantly at the time of the final follow-up. The constant shoulder score improved from 41.5 to 81.3 points (P<0.05) compared to before surgery and ASES index improved from 46.4 to 89.6 points (P<0.05) postoperatively. Thirteen patients (87%) were satisfied with the result of the treatment. The total tears were significantly more improved by surgery than the partial tears. In 12 of 15 patients (80%) were judged to reveal healed tendon on magnetic resonance imaging at a mean of 13 months postoperatively. The postoperative score was significantly lower for the patients with a failed repair than it was for those with an intact repair (P<0.05). Conclusion: Repair of traumatic isolated subscapularis tears through arthroscopic techniques effectively restores patient function with regard to pain, mobility, strength and postoperative tendon integrity. The postoperative integrity of the repair correlates with the functional results and the total tears were more improved by surgery than the partial tears, but future studies may be needed.

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Efficacy and Safety of Topical Application of Epidermal Growth Factor (EGF) for Korean Acne Patient (한국인 여드름 환자에서 표피성장인자가 함유된 외용제의 피부 적용에 대한 유효성 및 안전성 평가)

  • Suh, Joon Hyuk;Hyun, Moo Yeol;Jang, Seong Eum;Choi, Sun Young;Kim, Myeung Nam;Kim, Beom Joon
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.42 no.2
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    • pp.111-118
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    • 2016
  • Acne vulgaris is a chronic inflammatory condition characterized by comedo, papule, cyst, nodule and postinflammatory hyperpigmentation. Meanwhile, it is also induced by adverse event of drugs. Among them, acneiform folliculitis is a side effect of epidermal growth factor receptor (EGFR) inhibitor, which is an anticancer agent, and its incidence may occur in upward of 75 ~ 100% of cases. The main method of acne vulgaris treatment is oral antibiotics, retinoids, topical medication and so on. However, it is limitation that teratogenicity caused by retinoids and antibiotic resistance increased by using antibiotics. In this study, we aimed to evaluate the clinical efficacy and safety of topical recombinant human (rh) EGF in treating facial acne vulgaris. Twenty three Koreans (age: 10 ~ 29 years) with mild to moderate acne vulgar participated in the study and applied topical rhEGF cream (trouble control EGF) with 3 products (trouble control clarifying cleansing foam, trouble control all-clear filling toner, redroll calming moisture) on their face twice daily for four weeks. Several assessment methods were applied: Acne lesion counts score by investigator's global assessment, efficacy and satisfaction score by subjects. Skin sebum output level, hydration level and redness level were also measured at each visit. At the final visit, skin sebum level, transepidermal water loss, skin redness statistically decreased and acne lesions (comedone, papule) were statistically reduced. No severe side effects were observed during the study. In conclusion, topical rhEGF seems to be an effective and safe adjuvant treatment option for mild acne vulgaris.

Difference of Somatic Symptoms between Anxiety Disorder and Major Depressive Disorder and Their Domainal Association with Suicidal Idealization, Plan and Attempts (불안 장애와 주요우울장애에서 나타나는 신체 증상과 증상군에 따른 자살 사고, 계획, 행동과의 관계 고찰)

  • Ahn, Jun Seok;Kim, Eun young;Cho, Maeng Je;Hong, Jin Pyo;Hahm, Bong-Jin;Chung, In-Won;Ahn, Joon-Ho;Jeon, Hong Jin;Seong, Su Jeong;Lee, Dong-Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.2
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    • pp.174-183
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    • 2016
  • Objectives : The aim of this study is to evaluate difference of somatic symptoms of anxiety disorder and major depressive disorder and domainal association with suicidal idealization, plan, and attempts. Methods : A total of 359 adults diagnosed with major depressive disorder and anxiety disorder of last one year participated. Participants interviewed with certain sections of Korean version of Composite International Diagnostic interview of CIDI. Sections of interests includes questionnaires regarding somatic symptoms and suicidal idea, plan and attempts of last one year. Results : Chest pain shows more prevalence in major depressive disorder. Symptoms of Headache and loose stool are more prevalent in anxiety disorder. Difficulty in equilibrium and fainting spells are more common somatic complaints of co-diagnosis states of anxiety disorder and major depressive disorder. Comparing 3 domains of pain symptoms, gastrointestinal symptoms and pseudo-neurological symptoms, pain symptom domains, gastrointestinal symptoms domain shows significant statistic difference between diagnosis. Average somatic symptom numbers of each symptom domains increase through suicidal idealization, plan and attempt, accordingly. Conclusions : Our finding shows some of somatic symptoms are more prevalent at certain diagnosis. Since increasing numbers of somatic complaints of each symptom domains goes with the suicidal idealization to suicidal attempts, proper psychiatric evaluation and consultations are crucial for patients with numerous somatic complaints in non-psychiatric clinical settings.

Comparison of Thyroid Doses for Shielding Material Changes in Neck Computed Tomography (Neck CT에서 차폐체 재료 변화에 따른 Thyroid 선량 비교 연구)

  • Kang, Eun Bo
    • Journal of the Korean Society of Radiology
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    • v.13 no.1
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    • pp.65-71
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    • 2019
  • With regard to current Neck CT, Bismuth shielding boards are often being used to reduce exposure to superficial organs such as the thyroid. However, beam hardening often occurs near superficial organs with Bismuth shielding boards and variations in CT Number, Noise, and Uniformity values occur severely. This study looked into the usefulness of shielding boards made from aluminum and silicone that can be easily obtained and have good machinability by comparing them to the existing Bismuth shielding board. An Aluminum 7.3mm and a Silicone 21.5mm were made with shielding ratios similar to that of the Bismuth(0.06 mmPb). TLD (TLD-100) was placed on the thyroid area of the Phantom (RS-108T) and 5 doses were measured for each. To compare image quality, CT Number and Noise variations in axial images of the thyroid area in Neck CT images were compared. Also, variations in CT Number, Noise, and Uniformity were measured in the AAPM phantom images and compared. In the results, when thyroid doses for each shielding board were compared, the Bismuth shielding board showed a 14% reduction, the Silicone 21.5mm showed a 15% reduction, and the Aluminum 7.3mm showed a 13% reduction compared to the Non-Shield. Statistically, there were no significant differences in comparison with the Bismuth shielding board. In CT Number variations of thyroid area images, variations were largest for the Bismuth shielding board. With Uniformity evaluations of the AAPM phantom, the Bismuth shielding board was found unsuitable and the Aluminum 7.3mm and Silicone 21.5mm satisfied the acceptance criteria. Research results show that the Aluminum 7.3mm and Silicone 21.5mm have a similar shielding ratio to the high-priced Bismuth shielding board that is currently being used clinically and in comparison tests of CT Number attenuation coefficient variations, Noise, and Uniformity which are phantom image evaluation items, they proved to be better than Bismuth shielding boards. If various shielding boards are made using aluminum and silicone, sized appropriately for superficial organs, it would be useful in decreasing patient doses.

The Effects of Communication Competence, Clinical Competence and Experience of Handover on Self-efficacy of Handover Reporting among Nursing Students (간호대학생의 의사소통능력, 임상수행능력, 인수인계 경험이 인수인계 자기효능감에 미치는 영향)

  • Oh, Hyo-Sook
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.4
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    • pp.321-331
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    • 2020
  • This study was conducted to investigate communication competence, clinical competence and experience of handover which influence self-efficacy of handover among nursing students. The study design was a descriptive survey. A total of 255 students were recruited from nursing departments in G-city. Structured questionnaire was self-administrated from June to September, 2019. The collected data were analyzed using t-test, ANOVA, Pearson's coefficient and stepwise multiple regression. As results of the study, communication competence 57.3, clinical competence 69.8 and self-efficacy of handover was 33.8. Self-efficacy of handover had significant differences in gender(F=4.60, p<.001), age(F=16.72, p<.001), grade(t=-6.39, p<.001), satisfaction of clinical practice(F=3.68, p=.027), education experience about handover(t=26.44, p<.001), experience of handover(t=4.84, p<.001), fear of handover(F=16.97, p<.001), and handover importance of patient's safety(F=6.42, p=.002). Self-efficacy of handover had significant positive correlations with communication competence(r=.249, p<.001) and clinical competence(r=.426, p<.001). In multiple regression analysis, fear of handover(β=-.294, p<.001), clinical competence(β=.252, p<.001), grade(β=.191, p=.001), experience of handover(β=.185, p<.001), gender(β=.150, p=.003), and education experience about handover(β=.126, p=.017) were significant factors of self-efficacy of handover explaining 40.0%(F=29.26, p<.001) of the variables. In conclusion, to enhance self-efficacy of handover for nursing students, it is necessary to develop educational program for increasing experiences of handover, education experience about handover, and clinical competence.

Literature review and future tasks necessary to establish of Korean Dietary Reference Intake for choline (콜린의 한국인 영양소 섭취기준 제정 검토를 위한 문헌 고찰 및 향후 과제)

  • Shim, Eugene;Park, Jae-Hee;Lee, Yunjung;Park, Eunju
    • Journal of Nutrition and Health
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    • v.55 no.2
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    • pp.211-226
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    • 2022
  • Choline, an essential nutrient for humans, is required for the structural integrity of the cell membranes, methyl-group metabolism, synthesis of the neurotransmitter acetylcholine, synthesis of the membrane phospholipid components of the cell membranes, and the transport of lipids and cholesterol. Choline can be synthesized in the body, but it is insufficient to meet the daily requirements and hence it must be obtained through the diet. In the United States/Canada, Australia/New Zealand, Europe, China, and Taiwan, the adequate intake (AI) and tolerable upper intake level (UL) of choline have been established, while the establishment of the 2020 Dietary Reference Intakes for Koreans (KDRI) for choline was postponed due to the lack of a choline database for Korean foods and studies on the choline intake of Koreans. However, as part of the preparation work for the 2020 DRI revision and finalization, choline intake and the possibility of disease occurrence were verified through analysis of published data. The groundwork for the subsequent establishment of a choline DRI was laid through a literature search, evaluation, and review of the literature reported from 1949 up to 2019. This can be regarded as the culmination of this project. According to the results of randomized controlled trials (RCTs), cohort studies, case-control studies, and cross-sectional observational studies in humans, approximately 400-500 mg/day of choline intake was effective in preventing liver function damage (fatty liver), neural tube damage, cardiovascular disease, breast cancer, and cognitive function improvement. The same amount of choline intake, however, also correlated with the risk of prostate and colorectal cancer. At present, there is limited information available on choline intake and health outcomes, particularly for the Korean population. More human studies, including clinical trials on the requirements and the physiological benefits associated with dietary intake, are needed to establish the KDRI for choline.