• 제목/요약/키워드: Efficiency of Surgery

검색결과 240건 처리시간 0.02초

온라인 커뮤니케이션이 성형외과 의사-환자 관계에 미치는 영향 (The Impact of Online Communication on Doctor-Patient Relationship: Plastic Surgeon's Perspectives)

  • 김석화;김정은;이선영
    • Archives of Plastic Surgery
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    • 제34권6호
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    • pp.697-704
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    • 2007
  • Purpose: The objective of the study is to identify plastic surgeons' views on the effects of online communication between doctors and patients.Methods: Cross-sectional online survey of members of the Korean Society of Plastic and Reconstructive Surgeons was made to identify their evaluation on the accuracy and the relevance of the internet health information and their perceptions of the effects of discussing the information with the patients on time-efficiency, requests for specific interventions, health outcomes, and the doctor-patient relationship. A questionnaire with 25 items was sent to the surgeons' e-mails, and 111 replied. SPSS Win version 12.0 was used to analyze the statistical differences and meanings among data.Results: The percentage of the plastic surgeons who were experiencing the online communication was 65.8%, and the most frequent medium used was homepage of the clinic/hospital. Even though the percentage of the plastic surgeons who were using the online communication for their everyday practice was high, the percentage of patients who visited the clinic/hospital after using the website of the clinic/hospital was relatively low. The effects of online communication on doctor-patient relationship were neutral in 40(36.0%) and positive in 39(35.1%). The effects on the efficiency of the practice was positive in 45(40.5%), and the effects on the quality of care and the patients' outcome were positive in 46(41.4%) respectively.Conclusion: The ratio of surgeons who are experiencing the online communication is relatively high, whereas the ratio of patients who are using online communication is low. Most of plastic surgeons are positive on the effects of the online communication on doctor-patient relationship, quality of care, and patients' outcome.

실시간 광유도 성대주입술의 개발과 임상적 적용 (Development and Clinical Application of Real-Time Light-Guided Vocal Fold Injection)

  • 허진;차원재
    • 대한후두음성언어의학회지
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    • 제33권1호
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    • pp.1-6
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    • 2022
  • Vocal fold injection (VFI) is widely accepted as a first line treatment in treating unilateral vocal fold paralysis and other vocal fold diseases. Although VFI is advantageous for its minimal invasiveness and efficiency, the invisibility of the needle tip remains an essential handicap in precise localization. Real-time light-guided vocal fold injection (RL-VFI) is a novel technique that was developed under the concept of performing simultaneous injection with precise placement of the needle tip under light guidance. RL-VFI has confirmed its possibility of technical implementation and the feasibility in injecting the needle from various directions through ex vivo animal studies. Further in vivo animal study has approved the safety and feasibility of the procedure when various transcutaneous approaches were applied. Currently, RL-VFI device is authorized for clinical use by the Ministry of Food and Drug Safety in South Korea and is clinically applied to patients with safe and favorable outcome. Several clinical studies are currently under process to approve the safety and the efficiency of RL-VFI. RL-VFI is expected to improve the complication rate and the functional outcome of voice. Furthermore, it will support laryngologists in overcoming the steep learning curve by its intuitive guidance.

하악골 신장술에서 압축자극을 통한 골재생시 TGF-${\beta}1$, Osteonectin 및 BMP-4의 발현 (EXPRESSION OF TGF-${\beta}1$, OSTEONECTIN AND BMP-4 ON BONE REGENERATION IN MANDIBULAR DISTRACTION OSTEOGENESIS COMBINATION WITH A COMPRESSION STIMULATION)

  • 박성진;김욱규;정인교;황대석;김용덕;신상훈;김철훈;변준호
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제33권4호
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    • pp.288-296
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    • 2007
  • Distraction osteogenesis(DO) is a technique of lengthning bone including soft tissue by gradual separation of surgically divided bone surfaces. Distraction osteogenesis combination with a compression stimulation(DO-CO) was a new technique by authors to enhance new bone quality and to shorten the consolidation period. The purpose of this study was to compare DO with DO combined with compression force in efficiency by evaluating the expression of TGF-${\beta}1$, osteonectin and BMP-4 on bone regenerate in rabbit mandible. Fourty two rabbits were used for this experiment. On the control group, the distraction was carried out at the rate of 1 mm per day to obtain the amount of 8 mm distraction for 8 days. On the experimental group, the distraction was carried out at the rate of 1 mm per day for 10 days, 3 days-latency period, and then the compression was carried out as counter direction 1 mm per day for 2 days. After 0 day, 5 days, 13 days, 20 days, 27 days, 34 days and 41 days, three rabbits on each group were sacrificed and the distracted portion of mandible were cut and treated for RT-PCR observation. The level of expression of TGF-${\beta}1$ and osteonectin were shown more and longer expression in the experimental group than in the control group. The expression of BMP-4 was maintained with high level during the entire experimental period in both groups. These findings suggested that DO with compression stimulation could be a favorable technique for obtaining a good new bone quality.

폐쇄성 수면무호흡증 환자의 주간 졸림증 및 불면증에 대한 임상 분석 (Clinical Analysis of Daytime Sleepiness and Insomnia in Patients with Obstructive Sleep Apnea)

  • 김인식;엄지훈;윤형준;김동환;김경래;조석현
    • Journal of Rhinology
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    • 제25권2호
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    • pp.69-74
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    • 2018
  • Background and Objectives: Sleep disturbances and excessive daytime sleepiness (EDS) are the major symptoms of obstructive sleep apnea (OSA). This study aimed to investigate clinical implications of insomnia and EDS in patients with OSA using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Materials and Method: We evaluated 131 subjects with suspected OSA who were undergoing polysomnography (PSG) and performing the PSQI and ESS surveys. OSA was diagnosed when the apnea-hypopnea index was five or more. EDS was defined when ESS score was 11 points or higher. Detailed history and questionnaire were used to categorize insomnia. We compared clinical variables and PSG results in subgroups with or without insomnia and EDS. Results: There were no significant differences of PSQI and ESS score between controls and OSA. OSA with insomnia had significantly increased total score (p<0.001) and decreased total sleep time (p=0.001) and sleep efficiency (p=0.001) on the PSQI compared to those without insomnia. OSA with EDS showed significantly increased PSQI score (p=0.022) and decreased total sleep time (p=0.018) on PSG compared to those without EDS. Neither PSQI nor ESS score had a correlation with respiratory variables such as AHI and oxygen saturation. Total sleep time had a significant effect on both insomnia and EDS in patients with OSA. Conclusion: Decreased total sleep time had important effects on subjective symptoms of OSA and comorbid insomnia. Therefore, restoration of decreased sleep time is important in the management of OSA.

슬관절 전치환술 후 발생한 감염에 시행한 관절경적 치료의 임상 결과 (Clinical Results of Arthroscopic Treatment for Infection after Total Knee Arthroplasty)

  • 김경태;이송;김지형;김대근;신원식
    • 대한관절경학회지
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    • 제17권1호
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    • pp.38-43
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    • 2013
  • 목적: 슬관절 전치환술 후 발생한 감염에 대해서 시행한 관절경적 치료의 효용성과 치료 결과에 영향을 미치는 인자들에 대하여 알아보고자 하였다. 대상 및 방법: 슬관절 전치환술 후 발생한 감염에 대하여 관절경적 치료를 시행한 17예를 연구 대상으로 하였다. 혈액검사와 관절액 천자를 통해 감염을 확인한 후 관절경을 이용하여 변연 절제술과 활액막 제거술을 시행하고 항생제를 혼합한 생리 식염수를 사용하여 세척술을 시행하였다. 수술 후 정기적인 검사를 통해 치료의 실패 또는 재발 여부를 확인하고 수술 후 2년까지 감염의 재발이 없는 경우를 치료의 성공이라 판단하였다. 결과: 슬관절 전치환술 후 발생한 감염에 대하여 관절경적 수술로 치료받은 17예 중 13예에서는 1회의 관절경적 치료만으로 감염이 치료되었으나 4예는 감염이 지속 또는 재발되어 재수술을 시행하였다. 치료 결과에 영향을 미치는 인자들에 대해 분석해 본 결과 재수술을 시행한 군에서 관절경적 수술만으로 치료된 군보다 감염 증상 발현 후 수술까지의 기간이 더 길었다(p<0.05). 결론: 관절경적 수술을 이용한 슬관절 전치환술 후 발생한 감염의 치료는 적절한 환자의 선택, 철저한 변연 절제술과 세척술 및 적합한 항생제의 사용 등을 통해서 성공적인 결과를 기대할 수 있으나 감염이 의심된다면 가능한 빨리 수술을 시행해야 할 것으로 사료된다.

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Cutting efficiency of apical preparation using ultrasonic tips with microprojections: confocal laser scanning microscopy study

  • Kwak, Sang-Won;Moon, Young-Mi;Yoo, Yeon-Jee;Baek, Seung-Ho;Lee, WooCheol;Kim, Hyeon-Cheol
    • Restorative Dentistry and Endodontics
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    • 제39권4호
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    • pp.276-281
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    • 2014
  • Objectives: The purpose of this study was to compare the cutting efficiency of a newly developed microprojection tip and a diamond-coated tip under two different engine powers. Materials and Methods: The apical 3 mm of each root was resected, and root-end preparation was performed with upward and downward pressure using one of the ultrasonic tips, KIS-1D (Obtura Spartan) or JT-5B (B&L Biotech Ltd.). The ultrasonic engine was set to power-1 or -4. Forty teeth were randomly divided into four groups: K1 (KIS-1D / Power-1), J1 (JT-5B / Power-1), K4 (KIS-1D / Power-4), and J4 (JT-5B / Power-4). The total time required for root-end preparation was recorded. All teeth were resected and the apical parts were evaluated for the number and length of cracks using a confocal scanning micrscope. The size of the root-end cavity and the width of the remaining dentin were recorded. The data were statistically analyzed using two-way analysis of variance and a Mann-Whitney test. Results: There was no significant difference in the time required between the instrument groups, but the power-4 groups showed reduced preparation time for both instrument groups (p < 0.05). The K4 and J4 groups with a power-4 showed a significantly higher crack formation and a longer crack irrespective of the instruments. There was no significant difference in the remaining dentin thickness or any of the parameters after preparation. Conclusions: Ultrasonic tips with microprojections would be an option to substitute for the conventional ultrasonic tips with a diamond coating with the same clinical efficiency.

치과 의료의 질 향상(Quality improvement) 경진대회 경향 분석 (Analysis of trends in the dental care quality improvement contests)

  • 황수정;신호성;김진;김명희;안은숙
    • 대한치과의료관리학회지
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    • 제9권1호
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    • pp.38-43
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    • 2021
  • Based on data from the Korean Academy for Dental Administration, which has been conducting the Dental Quality Improvement (QI) Contest since 2010, we aimed to provide basic data for the development of dental quality improvement indicators by analyzing the trends of dental quality improvement activities. A total of 54 articles in the dental QI contest from 2015 to 2021 were used to search for frequently used words and to classify the quality of dental care. The criteria for the quality dimension of dental care were first classified into structure, process, and outcome, and secondary classification was performed into patient safety, timeliness, patient-centeredness, equity, efficiency, effectiveness, and accessibility. The frequently used key terms were satisfaction (five times), efficiency (four times), system (three times), and implant (three times). The activities for process evaluation were high at 62.26%, structural evaluation activities at 35.85%, and outcome evaluation activities at 1.89%. According to the components of dental care quality improvement, the activity performed under efficiency was the highest (33.96%), followed by patient-centeredness (18.87%), effectiveness (16.98%), patient safety (15.09%), accessibility (5.66%), timeliness (1.89%), and the equity (1.89%). QI activities in dental hospitals were mainly activities on improvement in structure and process, as well as activities on efficiency, patient-centeredness, effectiveness, and patient safety.

Steroid를 첨가한 Cardioplegic solution의 심근보호효과에 관한 실험적 연구 (An experimental study on the myocardial protection effect of the steroid mixed cardioplegic solution)

  • 유시원
    • Journal of Chest Surgery
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    • 제17권4호
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    • pp.565-573
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    • 1984
  • The increasing use of cardioplegic solution for the reduction of ischemic tissue injury requires that all cardioplegic solution be carefully assessed for any protective or damaging properties. This study describes functional assessment of the efficiency of steroid in cardioplegic solution by using a Langendorffs perfusion model. Isolated rat heart were subject to a 2 minute period of coronary infusion with the steroid mixed cold cardioplegic solution immediately before and also at the midpoint of a 60 minutes period of hypothermic [10\ulcorner\ulcorner] ischemic arrest. The result of this study were as follows: 1.Spontaneous heart beat after ischemic arrest occurred 14 second later Langendorffs reperfusion in the steroid mixed Young & GIK group and 16 second later in the control group. [Young & GIK without steroid] A good recovery state of spontaneous heart beat was shown in both groups. 2.The percentage of recoveries of heart rate during the 30 minute after postischemic Langendorffs reperfusion was; at first 5 minute 106.3\ulcorner.7% [P<0.05] in the steroid mixed Young & GIK group. This percentage of recovery of steroid mixed Young & GIK group was significantly greater than the control group during the first 5 minute course. 3.The percentage of recovery of coronary flow during the 30 minute after postischemic Langendorffs reperfusion was; at first 5 minute 101\ulcorner.2% in the steroid mixed Young & GI K group. This percentage of recovery of the steroid mixed Young & GIK group was not significantly than the control group during the first 5 minute.

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체외 배양된 SNU-1 세포주에서 transglutaminase C antisense inhibition이 일으키는 세포핵질 변화 (NUCLEAR MATRIX CHANGES BY THE ANTISENSE INHIBITION OF TRANSGLUTAMINASE C IN IN VITRO CULTURE OF SNU-1 CELLS)

  • 장재현;이석근;박영욱
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제29권2호
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    • pp.86-94
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    • 2003
  • It has been known that transglutaminase C (TGase C, TGase II) is directly participated in the DNA organization of chromosome, and affects the cellular processes such as proliferation, differentiation, and apoptosis of cells, but still not known what mechanism is working on. In this study, the cytogenetic and the immunohistochemical methods were used to observe the TGase C expression in the nuclear chromosome of the proliferating cells, especially in mitotic stage. The human gastric adenocarcinoma (SNU-1) cell line was used for immunohistochemistry and antisense inhibition study in vitro. The present study was also aimed to disclose the efficiency of antisense inhibition by using antisense oligonucleotide DNA labeled with fluorescence, and found that anti-TGase C probe was diffusely infiltrated into the cytoplasm and the nucleus of the cell. By the antisense inhibition the nuclei of SNU-1 cells became rough nuclear shape, as they were greatly reduced in TGase C immunoreactivity both for the normal and apoptotic SNU-1 cells. However, it is clearly presumed that the TGase C directly interacts with the chromosome of SNU-1 cells and it may play an important role in the division and organization of the chromosome during the mitotic stage.

Orthodontic tooth movement after periodontal regeneration of intrabony defects

  • Conchita Martin;Mariano Sanz
    • 대한치과교정학회지
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    • 제54권1호
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    • pp.3-15
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    • 2024
  • The prevalence of intrabony defects in patients with advanced periodontitis stages III and IV is high. These patients usually need both periodontal treatment and orthodontic therapy, including tooth movement through bone defects, to improve masticatory function, aesthetics, and overall quality of life. Clinical practice guidelines recommend periodontal regenerative surgical interventions to resolve these defects and propose initiating orthodontic tooth movement (OTM) once periodontal therapy goals have been met. Surgical interventions using various regenerative technologies like barrier membranes and enamel matrix proteins, combined or not with bone replacement grafts, have proven effective in regenerating lost periodontal tissues. However, the combination of periodontal and orthodontic treatments requires consideration of how periodontal regenerative therapies influence OTM. Studies suggest that regenerated bone may differ in density, composition, vascularity, and cellular activity, potentially affecting the speed and efficiency of OTM, and potential root resorption of moved teeth. Understanding the sequence and timing of implementing OTM after regenerative periodontal interventions is crucial due to their interlinked processes of bone resorption and formation. This narrative review aims to uncover scientific evidence regarding these combined treatments, examining the impacts of different regenerative technologies on OTM and delineating their advantages, limitations, and best practices.