• Archives of Plastic Surgery
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• v.51 no.2
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• pp.169-181
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• 2024

Background With the advent of cranial orthoses as therapeutic medical devices for the treatment of severe positional head deformities in Japan, an increasing number of patients are being treated with them. However, assessing the effectiveness of a treatment is often difficult due to the use of different metrics. This study aimed to evaluate the effectiveness of cranial orthoses for deformational plagiocephaly using two- (2D) and three-dimensional (3D) evaluation metrics. Methods We conducted a retrospective study of infant patients with deformational plagiocephaly who underwent cranial orthosis treatment. We evaluated the severity of deformational plagiocephaly using cranial asymmetry (CA) and the cranial vault asymmetry index (CVAI) as 2D metrics, and anterior and posterior symmetry ratios as 3D metrics. The patients were divided into 24 subgroups based on the initial severity of each outcome and their age at the start of treatment. We analyzed the changes in outcomes and correlations within improvements across the age and severity categories. Results Overall, 1,038 infants were included in this study. The mean CA, CVAI, and anterior and posterior symmetry ratios improved significantly after cranial orthosis treatment. The improvement in each score was greater in patients with more severe initial deformities and in those who underwent treatment at a younger age. Conclusion Cranial orthosis treatment was effective in correcting deformational plagiocephaly in infants, as demonstrated by improvements in both 2D and 3D metrics. Patients with more severe initial deformities and those who underwent treatment at a younger age showed greater improvement.

• Biomedical Science Letters
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• v.30 no.1
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• pp.1-9
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• 2024

Although there have been several attempts to use virtual reality (VR) in the treatment of depression, the results have been inconsistent and existing studies have mostly relied on subjective measures to assess the effectiveness of VR in improving depression. The aim of this study was to investigate the effect of nature experience-based VR intervention on depressive symptoms in a young population using both subjective and objective measurements. The study population included 15 participants who had more than 14 identifiers of the Korean Beck Depression Inventory (K-BDI)-II. Participants received three weeks (four times per week) of VR intervention. The effectiveness of VR was assessed through changes in K-BDI-II scores and depression-related blood biomarkers. Nature experience-based VR intervention led to an approximately 50% reduction of K-BDI-II score (before 25.7±7.7 vs. after 12.5±8.3 (P<0.001)). Of these, loss of pleasure and fatigue showed the largest amount of improvement. However, levels of cortisol, brain-derived neurotrophic factor, and interleukin-6 did not differ from those at baseline. The findings of our pilot study suggest that nature experience-based VR can be a useful adjunctive treatment method for improving depressive symptoms in individuals who have difficulty accessing the real outside natural environment.

• Journal of Korean society of Dental Hygiene
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• v.24 no.4
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• pp.281-289
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• 2024

Objectives: This study aimed to evaluate the effectiveness of the CAMBRA-students application by assessing the changes in dental caries risk factors and management effectiveness in elementary and middle school students. Methods: This study was conducted between July 2023 and May 2024 and included 113 participants (55 experimental and 58 control participants). Participants used the CAMBRA-students application to enter the protective and risk factors. Clinicians recorded the disease indicators and classified the participants into risk groups. Only the experimental group received the tailored dental caries management program, with feedback provided via the applicationat each intervention stage. Results: The pre- and post-intervention assessments revealed an increase in the high-risk group and a decrease in the extremehigh-risk group. Conversely, the control group exhibited a decrease in the high-risk group and an increase in the extreme high-risk group. The DMFT index and rateand salivary flow rate increased in both groups. The Simple Hygiene Score and ΔR decreased and increased in the experimental and control groups, respectively, with no statistically significant differences. Conclusions: The CAMBRA-students application effectively prevented dental caries in children and adolescents. The future development of personalized oral care programs tailored to different life stages is recommended.

• The Journal of Internal Korean Medicine
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• v.45 no.4
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• pp.646-662
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• 2024

Objectives: This study aimed to confirm the effectiveness and safety of electroacupuncture (EA) with transcranial direct current electrical stimulation (tDCS) on motor function improvement in stroke patients. Methods: This study was conducted on patients diagnosed with stroke more than 2 weeks but within 12 months of onset. A total of 22 patients were randomly assigned to the experimental and control groups. The experimental group received EA and tDCS treatment, while the control group received sham EA and sham tDCS treatment. Assessments were conducted using the Korean version of the Fugl-Meyer Assessment (K-FMA) scores, grip and pinch strength tests, Box and Block test (BBT), Nine-hole peg test (9HPT), Berg balance scale (BBS), and the Korean version the Modified Barthel Index (K-MBI) scores. Adverse events were recorded at each intervention. Results: No statistically significant differences were observed in general characteristics between the two groups. The K-FMA, BBS, and K-MBI scores of both groups increased significantly after the intervention, but there was no significant difference between the two groups. Although hand strength and dexterity improved after intervention in both groups, the changes were not statistically significant. In the experimental group, the lateral pinch score increased significantly after the intervention, but this increase was not significant compared to the control group. There was no significant difference in the incidence of adverse events between the two groups. All nine reported adverse reactions were minor, with no moderate or severe adverse reactions reported. Conclusion: This study confirmed the potential effectiveness and safety of EA with tDCS in improving motor function in stroke patients.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.7
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• pp.3349-3357
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• 2013

The purpose of this study was to verify the effectiveness of an integrated nursing curriculum based on simulation with problem-based learning (PBL) by comparing the clinical competence and the self-confidence of newly graduated nurses. A non-equivalent control group post-test design was employed to compare the clinical competence and the self-confidence in the clinical performance examination using standardized patients between 39 newly graduated nurses with the traditional nursing curriculum and 35 with the integrated nursing curriculum. Data analysis involved Fisher's exact test, t-test, Pearson's correlation coefficient, and ANCOVA with the SPSS 19.0 program. The total clinical competence mean score graded by the standardized patients was not different between the two groups. However, the total clinical competence mean score graded by faculty was significantly higher in the integrated curriculum group than the traditional curriculum group. The mean self-confidence score was significantly higher in the integrated curriculum group than the traditional curriculum group. Active teaching-learning strategies including simulation or PBL in the nursing curriculum could benefit for nursing students by inducing favorable clinical competence and self-confidence. Longitudinal follow-up studies based on observation are needed to explore the patient outcomes in addition to the learner outcomes in clinical settings.

• Korean Journal of Community Nutrition
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• v.25 no.1
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• pp.1-12
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• 2020

Objectives: This study investigates the current state of consuming breakfast among elementary school students residing in Malang, East Java, Indonesia, and to identify factors that influence breakfast behavior. Methods: The research model was set up as per the health belief model, and slightly modified by adding the subjective normative factors of the theory of planned behavior. The survey was conducted from July 17 to August 15, 2017 using a questionnaire, after receiving the permission PNU IRB (2017_60_HR). Results: The subjects were 77 boys (49.4%) and 79 girls (50.6%) suffering from malnutrition with anemia (21.2%) and stunting ratio of Height for Age Z Score (HAZ) (11.5%). Furthermore, moderate weakness (14.8%) and overweight and obesity (12.3%) by Body Mass Index for Age Z Score (BMIZ) were coexistent. According to the results obtained for breakfast, 21.8% did not eat breakfast before school, with 18.8% of the reasons for skipping breakfast being attributed to lack of food. Even for subjects partaking breakfast, only about 10% had a good balanced diet. The average score of behavioral intention on eating breakfast was 2.60 ± 0.58. The perceived sensitivity, perceived severity, perceived benefits, and self-efficacy of the health belief model correlated with breakfast behavior. Of these, self-efficacy (β=0.447, R²=0.200) and perceived sensitivity (β=0.373, R²=0.139) had the greatest effect on breakfast behavior. Mother was the largest impact person among children. Conclusions: In order to increase the level of breakfast behavior intention among children surveyed in Indonesia, we determined the effectiveness by focus on education which helps the children recognize to be more likely to get sick when they don't have breakfast, and increase their confidence in ability to have breakfast on their own. We believe there is a necessity to seek ways to provide indirect intervention through mothers, as well as impart direct nutrition education to children.

• Clinics in Shoulder and Elbow
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• v.17 no.4
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• pp.152-158
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• 2014

Background: To investigate the effectiveness of reverse total shoulder arthroplasty (RTSA) in treating irreparable massive rotator cuff tears (RCTs). Methods: Twenty-nine patients who underwent RTSA for the treatment of irreparable massive RCTs and completed follow-up for at least 1 year were selected. Their mean age was 69.7 years (range, 59-80 years). The mean follow-up was 17.7 months (range, 12-42 months). The shoulder range of motion was measured preoperatively and at final follow-up. The functional result was evaluated using visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeon (ASES) score, and Korean Shoulder Society (KSS) score. Additionally, the shoulders were categorized into two groups depending on prior history of surgery and the clinical outcomes were analyzed between two groups. Results: Mean pain VAS improved, from $6.6{\pm}1.2$ to $2.7{\pm}0.9$ (p=0.001), and the mean functional VAS from $35.7{\pm}4.2$ to $73.3{\pm}5.4$ (p=0.006). The mean ASES score improved from $37.2{\pm}2.8$ to $75.0{\pm}3.8$ (p=0.012). The mean KSS improved from $36.5{\pm}7.2$ to $75.6{\pm}5.4$ (p=0.009), the mean forward elevation from $66.3{\pm}4.7$ to $135.6{\pm}8.4$ (p=0.0001), and the mean abduction from $45.2{\pm}4.2$ to $119.0{\pm}6.5o$ (p=0.0001). Internal rotation differed significantly from the first sacral to the third lumbar vertebrae (p=0.036). External rotation did not change significantly (p=0.076). There was also no statistically significant difference between groups (no previous operation versus none). Four complications occurred: one superficial infection, one with anterior dislocation, one acromial fracture, and one clavicle fracture. Conclusions: RTSA provides reliable pain relief and recovery of shoulder function in patients with massive irreparable RCTs in short-term follow-up.

• Journal of Korean Neurosurgical Society
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• v.30 no.8
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• pp.976-980
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• 2001

Objectives : For Parkinsonian patients who had not reacted favorably on drug therapy are good candidate for ventroposterolateral pallidotomy, although not curative. We studied these patients after unilateral pallidotomy, to confirm the effectiveness and safety of this procedure. Methods : We evaluated the 17 patients with idiopathic Parkinson's diesease who had undergone unilateral posteroventral pallidotomy. All patients responded to levodopa initially. Mean age was 55 years(38-75years), and mean duration of disease was 9.8 years(3-20years). Pre-and postoperative evaluation at 3 month intervals included Unified Parkinson's Disease Rating scale(UPDRS) scoring, Hoehn and Yahr(H & Y) staging, and neuropsychological examinations. Results : Pallidotomy significantly improved parkinsonian symptom(tremor, rigidity, bradykinesia, dyskinesia, sensory symptom). Nine of 10 patients who showed dyskinesia preoperatively significant improvement. The mean dose of levodopa in 9 patients was lowered. The mean H & Y score and UPDRS score were improved in on and/or off time in 15 patients. Among patients who were not improved, one patient worsened, and the others showed no change. The mean overall UPDRS off score changed from 76 preoperatively to 44(33%) at 6 months and from 70 to 52(25%) at 1 year. Transient surgical morbidity was showen in four patients and included dysarthria, hypotonia and confusion. Conclusion : We conclude that pallidotomy is safe and effective in patients who have levodopa-reponsive parkinsonism with severe symptom fluctuation. Unilateral pallidotomy also considered helpful to ipsilateral symptom. Unilateral pallidotomy can improve all of parkinsonian's symptom and allow to reduce the levodopa medication. Most of patients show satisfactory results.

• Clinics in Shoulder and Elbow
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• v.15 no.2
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• pp.117-122
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• 2012

Purpose: To assess the effectiveness of internal fixation using a precontoured locking compression plate for the treatment of the displaced clavicle fracture by analyzing both radiological and clinical outcomes. Materials and Methods: We reviewed 34 cases of displaced clavicle shaft fracture treated by internal fixation using precontoured locking compression plates between May 2009 and February 2010. Radiological outcomes were analized on the basis of bone union and the differences between the time for bone union depending on sex and age. Clinical outcomes were analyzed on the basis of quick DASH Scores and the differences in the range of motion of the affected shoulder compared to the contralateral shoulder. Results: In the radiological evaluation, all fractures showed bone union, and the average time for bone union was 12.3 weeks, without delayed unions. Time for bone union did not differ significantly with respect to sex and age (p=0.87). In the clinical evaluation, the average final quick DASH Score was 23.5 (range, 12~42). At final follow up, the range of motion after bone union in the affected shoulder was not significantly different from that of the contralateral shoulder (p=0.69). Conclusion: The internal fixation achieved using precontoured locking compression plate in displaced clavicle shaft fracture showed effective bone union and can be considered as a reliable method with fine clinical results showing early range of motion at the shoulder joint.

• Clinics in Shoulder and Elbow
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• v.13 no.2
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• pp.202-208
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• 2010

Purpose: In this study we introduced minimal invasive plate osteosynthesis (MIPO) and analyzed clinical outcomes to determine the effectiveness of this intervention in proximal humerus fractures. Materials and Methods: We studied 27 patients including 16 cases with a 2-part fracture, 10 cases with a 3-part fracture, and 1 case with a 4-part fracture. Clinical outcomes were evaluated using UCLA score, KSS score and recovery of range of motion. Time to union and humerus neck-shaft angle change were estimated by radiologic assessment. The average follow up period was 19 months. Results: UCLA scores were "excellent" for 15 patients, "good" for 12 patients. The mean KSS score was 91.4 at final follow-up. The average shoulder range of motion was $167.2^{\circ}$ in forward elevation. Bone union occurred by 14.1 weeks postoperatively. Humerus neck-shaft angle recovery was "excellent" in 24 patients and "moderate" in 3 patients. There were no complications such as axillary nerve paralysis, deep infection, or subacromial impingement of the plate. Conclusion: MIPO for proximal humerus fractures is an effective procedure if performed with sufficient understanding of the anatomical structures. MIPO leads to minimized dissection of soft tissue, low complication rates and early recovery of range of motion.