• Title/Summary/Keyword: Clinical adaptation

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Early complications and performance of 327 heat-pressed lithium disilicate crowns up to five years

  • Huettig, Fabian;Gehrke, Ulf Peter
    • The Journal of Advanced Prosthodontics
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    • v.8 no.3
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    • pp.194-200
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    • 2016
  • PURPOSE. The prospective follow-up aimed to assess the performance of lithium disilicate crowns and clinical reasons of adverse events compromising survival and quality. MATERIALS AND METHODS. 58 patients were treated with 375 heat-pressed monolithic crowns, which were bonded with resin cement. Annual recalls up to five years included a complete dental examination as well as quality assessment using CDA-criteria. Any need for clinical intervention led to higher complication rate and any failure compromised the survival rate. Kaplan-Meier-method was applied to all crowns and a dataset containing one randomly selected crown from each patient. RESULTS. Due to drop-outs, 45 patients (31 females, 14 males) with the average age of 43 years (range = 17-73) who had 327 crowns (176 anterior, 151 posterior; 203 upper jaw, 124 lower jaw) were observed and evaluated for between 4 and 51 months (median = 28). Observation revealed 4 chippings, 3 losses of retention, 3 fractures, 3 secondary caries, 1 endodontic problem, and 1 tooth fracture. Four crowns had to be removed. Survival and complication rate was estimated 98.2% and 5.4% at 24 months, and 96.8% and 7.1% at 48 months. The complication rate was significantly higher for root canal treated teeth (12%, P<.01) at 24 months. At the last observation, over 90% of all crowns showed excellent ratings (CDA-rating Alfa) for color, marginal fit, and caries. CONCLUSION. Heat pressed lithium disilicate crowns showed an excellent performance. Besides a careful luting, dentists should be aware of patients' biological prerequisites (grade of caries, oral hygiene) to reach full success with these crowns.

The Treatment of Tibial Shaft Fractures by Interlocking Nailing (Interlocking Nail을 사용한 경골간부 골절의 치료)

  • Lee, Jae-Chang;Lee, Jae-Sung;Ahn, Myun-Whan;Kim, Sae-Dong;Ihn, Joo-Chul
    • Journal of Yeungnam Medical Science
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    • v.5 no.1
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    • pp.61-67
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    • 1988
  • The treatment of tibial shaft fracture has become one of the most controversial subjects in orthopedic surgery. Comminuted, segmental and rotationally unstable fractures or bone defect at fracture site have problems of the fixation. The interlocking nail solve these problems. We have experienced 8 cases of the tibial shaft fractures treated with interlocking nail from 1986 to 1988. Authors analysed these cases and our own clinical study. The results were as follows. 1. The average bone union rate was about 15 weeks. 2. The interval between operation and crutch walking was 4:3 weeks. 3. The merits of this operation were the short hospitalization and early adaptation of social activity. 4. The advantage is be able to do early ambulation without following muscular atrophy or joint stiffness. 5. The results were assessed on clinical examination and radiographic appearance by Hamza et al. An excellent results were 7 cases and good result was 1 case.

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THE STUDY ON THE MICROLEAKAGE OF THE RESTORATION WITH SELF-ETCHING PRIMING/BONDING AGENT (Self-etching priming/bonding agent를 이용한 수복에서 microleakage에 관한 연구)

  • Yoo, Seung-Hoon;Kim, Jong-Soo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.1
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    • pp.26-33
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    • 2004
  • Self-etching priming bonding system was recently developed in order to simplify the clinical skills & save chair time after continuous improvements on dentin bonding agents. To test the magnitude of microleakage of a new "self-etching priming bonding agent" using sound premolar 4th, 5th, 6th generation dentin bonding agent was applied. Measure the magnitude of infiltration to the gap of enamel-restoration interface and dentin-restoration interface. After bonding of composite resin to sample surfaces according to the manufactures direction and 500 times thermocycling on dwell time 30 second, and microleakage was measured by the ratio of the depth to the axial wall and the magnitude of infiltration. Afterward analyzed by ANOVA test. The result were as follows ; 1. Enamel groups showed lesser microleakage (Group I, II, III, IV) than dentin groups(Group V, VI, VII, VIII). (p<0.05) 2. There are no statical differences among the dentin groups, in enamel groups, group IV showed more microleakage than group I, II, III. (p<0.05). For a clinical acceptance, better enamel marginal adaptation is required.

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Development and Evaluation of an Evidence-Based Nursing Protocol for Fever Management in Adult Patients (성인 발열 환자를 위한 근거기반 간호 지침 개발 및 평가)

  • Shin, Yong Soon;Kim, Sung Reul;Yoo, Sung-Hee;Kim, Sun Hwa;Kim, Jeoung Hee;Kim, Hyun Jung;Na, Ra;Chae, Jee Sun;Lee, Hye Jin;An, Young Hee;Kim, Kyoung-Ok
    • Korean Journal of Adult Nursing
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    • v.25 no.3
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    • pp.250-262
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    • 2013
  • Purpose: This study was designed to develop, to implement and evaluate a fever management nursing protocol for adult patients. Methods: This study was conducted through seven steps following both the guideline development procedures of the Scottish Intercollegiate Guidelines Network and the Model of the Asan Medical Center Evidence-Based Practice, as follows: 1) identifying the clinical needs and composition of the protocol development group; 2) identifying and evaluating the evidence; 3) assessing the level of evidence and grading recommendations; 4) forming a protocol; 5) evaluating the protocol using an expert group validity test and identifying barriers to its implementation; 6) protocol development; and 7) evaluation of practical improvement measures following implementation of the protocol. Results: The evidence-based protocol for fever management in adult patients was completed and includes five domains and 15 items. The protocol had good content validity (CVI=.90) and nursing practice could be improved after implementation of the protocol. Conclusion: This nursing protocol can be used as a guide for nursing in febrile adult patients. We recommend that further guidelines be updated in an interdisciplinary manner in order to foster local adaptation of the best clinical practices.

Perception, Attitudes, Preparedness and Experience of Chemotherapy-Induced Alopecia among Breast Cancer Patients: a Qualitative Study

  • Kim, Im-Ryung;Cho, Ju-Hee;Choi, Eun-Kyung;Kwon, In-Gak;Sung, Young-Hee;Lee, Jeong-Eon;Nam, Seok-Jin;Yang, Jung-Hyun
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1383-1388
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    • 2012
  • Objectives: Regardless of its negative impact on quality of life, little is known about the importance of alopecia from the patients' perspective. This study aimed to explore the whole experience of chemotherapy-induced alopecia among Korean breast cancer patients including perception, attitudes, preparedness, and changes after alopecia. Methods: Patients expected to experience or had experienced alopecia were recruited at a tertiary hospital in Seoul, Korea. Semi-structured in-depth interviews were performed in 21 patients. Recurrent issues were identified and placed into thematic categories. Results: All patients think that appearance is important and they pay attention to how they look like. They had negative perceptions about alopecia. Patients were not well prepared for alopecia, and experienced substantial physical, psychological and social distress. Lack of information and limited social support combined with negative images of cancer made it difficult for patients to overcome the trauma and deterred them from usual daily activities resulting in poor quality of life. Conclusions: Patients were not well prepared for alopecia and negative perceptions, lack of preparedness, and limited social support and resources increased alopecia-related distress. Educational programs for preparing patients to cope with alopecia distress and advocate activities to change people's negative perception about alopecia are needed to reduce the burden imposed by alopecia in cancer patients.

An Influence Stretching Exercise with Ultrasound and Microwave Application Having on Knee Joint Position Sense after Induction to Muscle Fatigue (근피로 유발 후 신장운동시 심부투열치료가 슬관절 위치감각에 미치는 영향)

  • Park, Jang-Sung;Choi, Eun-Young;Jung, Hwa-Su
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.8 no.1
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    • pp.37-42
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    • 2010
  • Purpose : This study will recognize about the influences that stretching exercise with ultrasound and microwave application has on a knee joint position sense after induction to muscle fatigue. Methods : The object by each ten people divided at random thirty physical healthy adult men to constant group 1, group 2, group 3 to the objects. Treadmill exercised for induction to muscle fatigue, and let an exercise intensity decided on 85% of the maximum heart beat number with the goal heart beat number, and you exercise. Goal heart beat number measured as used heat rate monitor, and measured a oneself at the scale in order to recognize own physical state after end treadmill exercise to all objects to criteria to evaluate an ability shown in case of sports. Knee joint position sense used a N-K table, and experimenter did so as adaptation got passively arbitrary three angle done, and to order an original position. The object carried in person out one angle that experimenter designated, and measured repeatedly an error along him to this three times after being so. Rear before induction to muscle fatigue a position sense and measured after stretching exercise application, and played. Stretching exercise after induction applied stretching exercise, stretching exercise with ultrasound, stretching exercise with microwave, and applied to each group 1, group 2 and group 3 to muscle fatigue. Results : The result each group the difference which considers does not come out it was not but, improvement of the position sense is the possibility of knowing was from group 1, group 2 and group 3. Conclusion : These findings stretching exercise and stretching exercise with ultrasound and microwave after induct ion give help to a position sense elevation, and execute stretching exercise, and be effective against damage prevention by physical insecurity to muscle fatigue, and look.

Correlation Between Career Satisfaction and Career Decision Self-Efficacy and Career Maturity of Nursing Students (간호대학생의 전공만족도, 진로결정 자기효능감과 진로성숙도에 관한 상관성 연구)

  • Kim, You-Mi;Kang, Su-Chan;Kwon, Ki-Nam;Seo, Yoo-Jin;Sung, Seong-Hun;Son, Jeong-Lim;Son, Hyeon-Ah;Shin, Yu-Ra;Kim, Eun-Hee
    • Journal of Korean Clinical Health Science
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    • v.6 no.1
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    • pp.1074-1082
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    • 2018
  • Purpose: This study intends to understand the correlation between career satisfaction and career decision self - efficacy and career maturity of nursing students, and to examine whether career satisfaction and career decision-making self-efficacy affect career maturity. Methods: The data analyzed using IBM SPSS Statistics 20 were collected from April 1, 2016 to April 15, 2014 in 184 students at the four-year college of Nursing in J city. Results: The results of the analysis of the correlation between major satisfaction, career decision self-efficacy and career maturity of nursing college students indicate that there was a positive correlation with career maturity (r=.428, p<.001), career decision self-efficacy (R=.442, p<.001) and majors' satisfaction (r=.605, p<.001) either. likewise, career maturity and career maturity were positively correlated with career maturity and career satisfaction. Conclusions: Therefore, it is possible to enhance and improve adaptation to major through conversations in conjunction with counseling and career guidance from the entrance, and maintaining intimate and solid relationship between the students and professors, also, the students and senior of whom, leading to intensify positive implication to future career.

Investigation of a pre-clinical mandibular bone notch defect model in miniature pigs: clinical computed tomography, micro-computed tomography, and histological evaluation

  • Carlisle, Patricia L.;Guda, Teja;Silliman, David T.;Lien, Wen;Hale, Robert G.;Baer, Pamela R. Brown
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.1
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    • pp.20-30
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    • 2016
  • Objectives: To validate a critical-size mandibular bone defect model in miniature pigs. Materials and Methods: Bilateral notch defects were produced in the mandible of dentally mature miniature pigs. The right mandibular defect remained untreated while the left defect received an autograft. Bone healing was evaluated by computed tomography (CT) at 4 and 16 weeks, and by micro-CT and non-decalcified histology at 16 weeks. Results: In both the untreated and autograft treated groups, mineralized tissue volume was reduced significantly at 4 weeks post-surgery, but was comparable to the pre-surgery levels after 16 weeks. After 16 weeks, CT analysis indicated that significantly greater bone was regenerated in the autograft treated defect than in the untreated defect (P=0.013). Regardless of the treatment, the cortical bone was superior to the defect remodeled over 16 weeks to compensate for the notch defect. Conclusion: The presence of considerable bone healing in both treated and untreated groups suggests that this model is inadequate as a critical-size defect. Despite healing and adaptation, the original bone geometry and quality of the pre-injured mandible was not obtained. On the other hand, this model is justified for evaluating accelerated healing and mitigating the bone remodeling response, which are both important considerations for dental implant restorations.

Development of a Korean version of the Bereavement Care Confidence Scale (K-BCCS) (한국형 사별돌봄자신감 척도 개발)

  • Kwon, So-Hi;Kim, Young-Joo
    • The Journal of Korean Academic Society of Nursing Education
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    • v.27 no.2
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    • pp.197-209
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    • 2021
  • Purpose: The purpose of this study is to evaluate the validity and reliability of the Korean Bereavement Care Confidence Scale (K-BCCS). Methods: The Perinatal Bereavement Care Confidence Scale (PBCCS) was translated into Korean according to an algorithm of cultural adaptation process and excluded six items which were specific to perinatal bereavement. A total of 229 clinical nurses participated in the study. Construct validity, convergent validity, discriminant validity, and group comparison validity were evaluated, and Cronbach's α was calculated to estimate the reliability of the K-BCCS. Results: The K-BCCS consisted of 31 items in 7 factors, including knowledge and skills for bereavement care (12 items), organizational support (6 items), awareness of the needs (3 items), interpersonal skills (3 items), workload influence (2 items), continuous education (2 items), and understanding the grief process (3 items). The factor loading of 31 items within the 7 factors ranged from .60 to .86. For the convergent validity, the construct reliability (CR) ranged from .74 to .94, and the average variance extracted (AVE) ranged from .49 to .73, which is considered acceptable. The discriminant validity showed that the AVEs of the subscales were greater than the square of the correlation coefficient r. The nurses who had experience providing bereavement care (t=4.94, p<.001) or had received bereavement education (t=6.64, p<.001) showed higher K-BCCS values those without experience. The Cronbach's α of 31 items was .93 and ranged from .60 to .94 per subscale. Conclusion: The K-BCCS is a valid and reliable tool for evaluating nurses' confidence in bereavement care.

Ultrasound and clinical findings in the metacarpophalangeal joint assessment of show jumping horses in training

  • Yamada, Ana Lucia M.;Pinheiro, Marcelo;Marsiglia, Marilia F.;Hagen, Stefano Carlo F.;Baccarin, Raquel Yvonne A.;da Silva, Luis Claudio L.C.
    • Journal of Veterinary Science
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    • v.21 no.3
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    • pp.21.1-21.14
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    • 2020
  • Background: Physical exercise is known to cause significant joint changes. Thus, monitoring joint behavior of athletic horses is essential in early disorders recognition, allowing the proper management. Objectives: The aims of this study were to determine the morphological patterns, physical examination characteristics and ultrasound findings of show jumping horses in training and to establish a score-based examination model for physical and ultrasound follow-ups of metacarpophalangeal joint changes in these animals. Methods: A total of 52 metacarpophalangeal joints from 26 horses who were initially in the taming stage were evaluated, and the horses' athletic progression was monitored. The horses were evaluated by a physical examination and by B-mode and Doppler-mode ultrasound examinations, starting at time zero (T0), which occurred concomitantly with the beginning of training, and every 3 months thereafter for a follow-up period of 18 months. Results: The standardized examination model revealed an increase in the maximum joint flexion angles and higher scores on the physical and ultrasound examinations after scoring was performed by predefined assessment tools, especially between 3 and 6 months of evaluation, which was immediately after the horses started more intense training. The lameness score and the ultrasound examination score were slightly higher at the end of the study. Conclusions: The observed results were probably caused by the implementation of a training regimen and joint adaptation to physical conditioning. The joints most likely undergo a pre-osteoarthritic period due to work overload, which can manifest in a consistent or adaptive manner, as observed during this study. Thus, continuous monitoring of young athlete horses by physical and ultrasound examinations that can be scored is essential.