• 제목/요약/키워드: Long-term outcome

검색결과 635건 처리시간 0.021초

Long-Term Incidence and Predicting Factors of Cranioplasty Infection after Decompressive Craniectomy

  • Im, Sang-Hyuk;Jang, Dong-Kyu;Han, Young-Min;Kim, Jong-Tae;Chung, Dong Sup;Park, Young Sup
    • Journal of Korean Neurosurgical Society
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    • 제52권4호
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    • pp.396-403
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    • 2012
  • Objective : The predictors of cranioplasty infection after decompressive craniectomy have not yet been fully characterized. The objective of the current study was to compare the long-term incidences of surgical site infection according to the graft material and cranioplasty timing after craniectomy, and to determine the associated factors of cranioplasty infection. Methods : A retrospective cohort study was conducted to assess graft infection in patients who underwent cranioplasty after decompressive craniectomy between 2001 and 2011 at a single-center. From a total of 197 eligible patients, 131 patients undergoing 134 cranioplasties were assessed for event-free survival according to graft material and cranioplasty timing after craniectomy. Kaplan-Meier survival analysis and Cox regression methods were employed, with cranioplasty infection identified as the primary outcome. Secondary outcomes were also evaluated, including autogenous bone resorption, epidural hematoma, subdural hematoma and brain contusion. Results : The median follow-up duration was 454 days (range 10 to 3900 days), during which 14 (10.7%) patients suffered cranioplasty infection. There was no significant difference between the two groups for event-free survival rate for cranioplasty infection with either a cryopreserved or artificial bone graft (p=0.074). Intergroup differences according to cranioplasty time after craniectomy were also not observed (p=0.083). Poor neurologic outcome at cranioplasty significantly affected the development of cranioplasty infection (hazard ratio 5.203, 95% CI 1.075 to 25.193, p=0.04). Conclusion : Neurologic status may influence cranioplasty infection after decompressive craniectomy. A further prospective study about predictors of cranioplasty infection including graft material and cranioplasty timing is necessary.

척상완 성형술을 이용한 주관절 일차성 골관절염 치료의 장기 추시 결과 (A Long-term Results of Ulnohumeral Arthroplasy in Primary Osteoarthritis of the Elbow)

  • 신성룡;김형년;박용욱;이상수;정운섭;김도영
    • Clinics in Shoulder and Elbow
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    • 제8권2호
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    • pp.122-126
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    • 2005
  • Purpose: To assess the long-term effect of ulnohumeral arthroplasty and the relationship between radiological recurrence and clinical outcome. Materials and Methods: Eleven elbows with primary osteoarthritis were analyzed at an average of eighty months after ulnohumeral arthroplasty. All patients were male with a mean age of fifty years. The outcomes were assessed using the Mayo Elbow Performance Score(MEPS) and the clinical and radiological results were compared. Results: Four elbows were not painful and six were mildly painful but one was not changed. The mean gain in extension was $15^{\circ}$, in flexion $10^{\circ}$. There were satisfactory results in 8 elbows(73%) and the mean MEPS was 81 points. All of eleven elbows had some degree of recurrent osteoarthritis and there was no correlation between radiological recurrence and clinical endpoints in nine elbows. But in two elbows, it appeared that recurrence of osteophyte at coronoid process was severe and caused fair outcome. Conclusion: Ulnohumeral arthroplasy is one of the effective treatment options for primary osteoarthritis of the elbow. The radiological recurrence did not correlated with the clinical outcome in most cases.

요양병원 간호인력 확보수준에 따른 입원환자의 간호결과 (Nursing outcomes of inpatient on level of nursing staffing in long term care hospitals)

  • 김은희;이은주
    • Journal of the Korean Data and Information Science Society
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    • 제26권3호
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    • pp.715-727
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    • 2015
  • 본 연구는 우리나라 요양병원의 간호인력 확보수준과 간호결과의 관련성을 파악하고 간호에 민감한 환자 결과를 알아봄으로써 요양병원의 적정 간호인력 확보에 대한 근거를 제공하기 위해 시행되었다. 자료는 건강보험심사평가원의 2012년 '요양병원 병원평가정보'를 바탕으로 분석하였다. 연구결과, 간호사 1인당 환자 수가 평균보다 많은 그룹에서 유치도뇨관 비율 (고위험군/저위험군)이 통계적으로 유의하게 높았다. 간호인력 1인당 환자 수가 평균보다 많은 그룹에서 일상생활수행능력이 감퇴한 환자비율 (치매환자군/비치매환자군), 요실금, 욕창이 새로 발생한 환자 (고위험군)비율이 통계적으로 유의하게 더 높았다. 그리고 요양병원의 등급이 향상될수록 입원환자의 간호결과가 더 좋아지는 것으로 나타났다. 이는 간호인력 확보수준이 높을수록 그리고 요양등급이 높을수록 환자의 간호결과에 긍정적인 영향이 나타난다는 결과이다. 따라서 요양병원에서 간호인력 수를 적정화시킬 수 있는 보다 강력한 정책적 접근이 필요하다는 것을 제안하는 바이다.

Use of mini-implants to avoid maxillary surgery for Class III mandibular prognathic patient: a long-term post-retention case

  • Suh, Hee-Yeon;Lee, Shin-Jae;Park, Heung Sik
    • 대한치과교정학회지
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    • 제44권6호
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    • pp.342-349
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    • 2014
  • Because of the potential morbidity and complications associated with surgical procedures, limiting the extent of orthognathic surgery is a desire for many orthodontic patients. An eighteen-year-old woman had a severe Class III malocclusion and required bi-maxillary surgery. By changing the patient's maxillary occlusal plane using orthodontic mini-implants, she was able to avoid the maxillary surgery; requiring only a mandibular setback surgery. To accurately predict the post-surgery outcome, we applied a new soft tissue prediction method. We were able to follow and report the long-term result of her combined orthodontic and orthognathic treatment. The changes to her occlusal plane continue to appear stable over 6 years later.

Common Errors in Endodontic treatment

  • Kim, Jin-Woo
    • 대한치과보존학회:학술대회논문집
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    • 대한치과보존학회 2001년도 춘계학술대회
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    • pp.257-257
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    • 2001
  • Failures occur in dentistry as a result of manny factors some of which can be controlled by the operator whilst others are unavoidable. The long-term success rate of endodontic treatment has often been thought to be very high although studies reported in the literature do not support this perception. The number of failure can be reduced by adhereing to accepted treatment procedures and by avoiding 'short cut'. Endodontic disaters are usually related to operator errors and they mat have detrimental effects on the outcome of treatment in the long term, eventually becoming catastrophes. Endodontic disasters will require special techniques to salvage them whereas catastrophes usually result in loss of the tooth and every effort should be made to prevent such problems from occurring. This presentation will cover common errors in endodontic procedures especially access opening, canal negotiation, canal irrigation, canal preparation, canal filling, post preparation.ration.

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The Long-Term Safety and Efficacy of Intrathecal Therapy Using Sufentanil in Chronic Intractable Non-Malignant Pain

  • Monsivais, Jose Jesus;Monsivais, Diane Burn
    • The Korean Journal of Pain
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    • 제27권3호
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    • pp.297-300
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    • 2014
  • This report describes the long term safety and efficacy of intrathecal therapy using Sufentanil for the management of chronic intractable neuropathic pain in 12 chronic pain patients. Standardized psychological screening was used to determine treatment suitability. Evaluation data included the Visual Analog Scale (VAS), Wong-Baker Faces Scale, Brief Pain Inventory (BPI), Disability of Arm, Shoulder, and Hand (DASH), McGill Quality of Life Questionnaire, and complications (granulomas, toxicity, withdrawal, or deaths). SPSS version 18 was used for data analysis. Pre- and post- treatment BPI measures and pain scale scores showed a statistically significant difference. There were no complications directly related to drug toxicity, nor drug withdrawals, granulomas, or deaths. Intrathecal therapy with Sufentanil therapy offers a good treatment alternative for those cases that have failed both surgery and standard pain treatment. Strict patient selection based on psychological screening, control of co-morbidities, a proper pain management may contribute to successful outcome.

옥외 폭로 10년의 결과에 기초한 마감 재료의 중성화 및 염분 억제 효과 검토 (10 years of outdoor Exposure based on the results of the Carbonation and Salinity Inhibition Finishing Materials Review)

  • 박재홍;하세가와 타쿠야;오사무 센부;오상균;박동천
    • 한국건축시공학회:학술대회논문집
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    • 한국건축시공학회 2011년도 춘계 학술논문 발표대회 1부
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    • pp.45-47
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    • 2011
  • Finishing materials used during the construction of reinforced concrete structures aid in providing resistance to carbonation and help ensure the durability of a structure. However, detailed examinations of this phenomena using data gained from long-term outdoor exposure are not only lacking, but also are not taken into account as factors affected by the local environment. In this research, the velocity coefficient in terms of carbonation is compared as a difference according to the local region and the averaged annual temperature, and the carbonation-preventive effects of finishing materials are analyzed. As an outcome of this study, the results of long-term carbonation can be evaluated from carbonation resistance R induced by an acceleration carbonation test.

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우리나라 의학의 현실과 미래: 교육, 연구, 진료를 중심으로 (The Current and Future State of Academic Medicine in Korea: Education, Research, and Patient Care)

  • 정대철
    • 의학교육논단
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    • 제21권2호
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    • pp.73-79
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    • 2019
  • Academic medicine is built from a foundation of education, research, and patient care. Since good patient care results from the application of medical research and continuous education, these three components cannot be separated for medical development to occur. In Korea, many obstacles hinder the achievement of academic medicine, such as an inefficient medical delivery system, limitations of primary care, low insurance prices, and no long-term health care plan. Medical education has changed to outcome-based education, but presented temporal integration status. Governance of healthcare research is not centralized, and Korea is awarded relatively fewer grants than other countries. Medical professors have reached a burnout state due to patient care responsibilities in addition to research and education duties. Many medical systems, including the medical delivery system and insurance problems, may contribute to distrust between doctors and patients. The government is not involved in a long-term health care policy. The multitude of factors mentioned here are hindering the achievement of academic medicine in Korea.

학습성과의 개념과 작성에 대한 탐구 (A Critical Evaluation of the Concept and Writing of Learning Outcomes)

  • 이동엽;양은배
    • 의학교육논단
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    • 제18권3호
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    • pp.125-131
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    • 2016
  • Recent changes in educational paradigms that emphasize the performance or outcomes of education are redefining how learning objectives are being described as 'learning outcomes' in various academic disciplines. Medical education is not an exception to this trend. However, it has come to our attention that the key concepts and appropriate descriptions of learning outcomes have not been well understood among educators and that this lack of understanding has hindered our efforts to implement the practice in the field. This study aims to provide a direction to establish and describe learning outcomes by examining previous studies that have focused on setting learning objectives as well as learning outcomes. Setting and describing learning outcomes starts from reflection on the approach of behavioral learning objectives, which overemphasizes learner's acquired knowledge, skills, and attitude in each classroom rather than actual performance. On the other hand, the learning outcome approach focuses on what the learner is able to do as a result of a learning experience. This approach is more learner-friendly and encourages students to lead and be responsible for their learning process. Learning outcomes can best be described when the relevance of actual contexts and the hierarchy of learning objectives are considered. In addition, they should be in the form of context, task, performance, and level, as well as be planned with proper assessment and feedback procedures. When these conditions are met, the learning outcome approach is beneficial to students as it presents a curriculum that is more open to learners. Despite these advantages of the learning outcome approach, there is a possible concern that setting the learning outcomes and describing them can restrict evaluation to lower cognitive skills if the concept of learning outcome is narrowly interpreted or is set too low. To avoid such narrow applications, it is important for educators to understand the comprehensiveness of the learning outcome setting and to consider long-term outcomes embedded in an organizational vision rather than only short-term behavioral outcomes.

Relationship between Exports, Economic Growth and Other Economic Activities in India: Evidence from VAR Model

  • SUBHAN, Mohammad;ALHARTHI, Majed;ALAM, Md Shabbir;THOUDAM, Prabha;KHAN, Khaliquzzaman
    • The Journal of Asian Finance, Economics and Business
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    • 제8권12호
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    • pp.271-282
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    • 2021
  • In recent years, a significant number of empirical studies have examined the relationship between export and economic growth in India. However, this study analyses the relationship between exports and economic growth through the time series model. The main aim of this study is to investigate the causal relationship between exports and economic growth in India. The VAR model was used for the period 1961 to 2015 after verifying the stationarity of the variables through using Augmented Dickey-Fuller and Phillip-Perron tests. The Indian export sector has been found to have a significant and positive impact on economic growth and other long-term economic activities. The study also employed the Granger causality test to check the direction of causality and found that RXGS, RGDP, RPFC, and RGFC had a unidirectional relationship and RXGS and RMGS had a bidirectional relationship in long run. Also, the findings of this study suggest that a steady-state between exports and economic growth can be achieved in India over a long period. The overall outcome of this study provides a testimony of the fact that the export sector plays a vital role in economic growth in India and also leads to the long-term growth of other economic activities.