• Clinics in Shoulder and Elbow
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• 제19권2호
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• pp.110-116
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• 2016

Background: Arthroscopic surgical repair is a better intervention than non-operative (conservative) treatment for patients with shoulder dislocations. This systematic review determined the numbers-needed-to-treat (NNT) and relative risk reduction (RRR) associated with arthroscopic surgical repair versus non-operative treatment in reducing recurrence rates among patients with first-time traumatic anterior shoulder dislocations. Methods: We searched Google Scholar, MEDLINE, SPORTDiscus, and CINAHL from inception in 2015. All articles had to compare arthroscopic surgical repair and non-operative treatment and be written in English. We used the total number of subjects and the number of recurrent dislocations within each treatment to calculate the NNT and RRR for each study and the pooled data. Results: Six articles were selected and all clearly demonstrated that the arthroscopic surgical repair was more effective than non-operative treatment in reducing the recurrence episodes. The pooled NNT was 1.76 (95% confidence interval [CI]=NNT to benefit 1.50-2.13) and the pooled RRR was 86.0% (95% CI=77.0%-92.0%) among individuals who underwent arthroscopic repair. The average follow-up time was 56 months. Conclusions: A Strength of Recommendation Taxonomy level of evidence of 1 with a grade A recommendation supports the use of arthroscopic surgical repair over non-operative treatment in prevention of first-time traumatic anterior shoulder dislocations. We suggest that sports medicine practitioners consider the patients' age, occupation, and physical activity level when making a clinical decision.

• Annals of Clinical Neurophysiology
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• 제13권2호
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• pp.87-92
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• 2011

Background: Tarsal tunnel syndrome (TTS) is an entrapment neuropathy that occurs in the ankle. Previous studies reported that this disease was due to physiologic factors and structural lesions in the ankle or foot. The authors investigated the causative factors of TTS and their frequency via operative findings. The diagnostic value of MRI was also evaluated based on the concordance between the operative findings and the MRI findings. Methods: This study was performed in retrospective by using medical record of the patients who underwent operations with TTS from August 2003 to May 2010. Physical examination, nerve conduction study, and MRI were conducted on patients who visited department of neurology or orthopedic surgery due to pain and sensory abnormality of their ankle and foot. Results: 34 patients underwent the operation. Ganglion accounted for the largest portion of the operative findings. In addition, varicose veins, intrinsic foot muscle hypertrophy, tenosynovitis, and fascia thickening were mainly observed. Of the 34 patients, 33 patients underwent pre-operative MRI, of whom 18 patients showed MRI findings consistent with the operative findings. Conclusions: Space-occupying lesions accounted for the majority of the causative factors in TTS patients who underwent the surgical treatment. In this study, the MRI appeared useful for identifying causes of TTS.

• 한국병원경영학회지
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• 제3권1호
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• pp.134-164
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• 1998

The purpose of this study is to provide the data for the co-operative treatment of western and oriental hospital. The studies were made a questionnaire to analyze inpatients' awareness on the systems of co-operative treatment and to observe the differences in medical service satisfaction between inpatients who had experienced the co-operative treatment of western and oriental hospital(Group 1) and those who did not (Group 2). The survey was conducted in February 1998, on 250 inpatients who were in a hospital which provided co-operative treatment of western and oriental medicine in Pusan. Korea. The results of this study were disclosed as follows: 54.2% of western hospital inpatients and 90.5% of oriental hospital inpatients suffered from diseases of the nervous system 88.9% of Group 1 and 72.2% of Group 2 believed that the co-operative treatment of western and oriental hospital was more effective in curing diseases of the nervous system. 33.5% or inpatiens in the western hospital and 87.4% of inpatients in the oriental hospital had received the co-operative treatment. In the case of the oriental hospital inpatients who had experienced western treatment, 36.8% received an examination radiologic, 30.7% received a laboratory test, 17.8% received physical therapy, and 14.1% received medication. Whereas, in case of the western hospital inpatients who had experienced oriental treatment, 71.8% received acupuncture, 23.9% received herbal medicine, and 2.8% received oriental medical tests. As to the opinion on the systems of co-operative treatment, 49.6% of Group 1 agreed that 'New medical institutions that adopt the merits of both western and oriental medicine are absolutely necessary.', and 48.9% of Group 1 agreed that 'Since there are strong points and weak points in both western and oriental medicine, partial and gradual introduction of the two systems would be better.' Whereas, 49.6% of Group 2 agreed that the partial and gradual introduction, and 35.7% of Group 2 agreed that the necessity of the new medical institutions. As to the motives for visiting the hospital, the most popular reason for all the inpatients was "others' advice". In the case of Group 1, however, the most popular reason was "the possibility of co-operative treatment". In regards to medical cost, the oriental hospital inpatients felt that their medical cost was too expensive. On the other hand, a smaller percentage of the western hospital inpatients felt that western hospital medical cost were too expensive. And between Group 1 and Group 2, a higher percentage of Group 1 felt that their medical cost was too expensive.

• 한국지역지리학회지
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• 제21권4호
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• pp.639-648
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• 2015

최근 들어 졸업생의 취업 경쟁력 강화, 기업친화형 우수 인재 확보, 대학 내 산학협력 활성화를 위한 수단으로 Co-op 교육(장기현장실습) 중심의 산학협력교육에 대한 중요성이 부각되고 있다. 지금까지 우리나라 대학들은 전공연계성과 취업연계성이 낮은 단기 인턴십 위주의 현장실습 프로그램을 주로 운영해 왔다. 이러한 문제점에 대응하여, 정부는 현재 '현장실습 운영 지침' 제정을 추진하고 있으며, 장기현장실습 시범대학을 선정하는 등 장기현장실습 중심의 산학협력교육 활성화를 위해 노력하고 있다. 산학협력교육의 제도적 활성화를 위해서는 이 제도를 오랫동안 시행해 온 북미와 유럽의 대학들에 대한 다양한 사례 연구가 축적될 필요가 있다. 이를 위해 본 연구에서는 미국의 센트럴워싱턴대학교(CWU)를 사례로 하여 Co-op 교육의 운영 실태를 중심으로 분석하고, 산학협력교육 활성화를 위한 정책적 함의를 제시하였다. 사례 연구의 주요 분석 결과는 다음과 같다. 첫째, CWU 학생들은 주로 좁게는 카운티 내, 넓게는 워싱턴 주 내에서 현장실습을 수행하고 있으며, 실습을 했던 기관으로 취업을 하는 경우가 많아, 현장실습의 지역연계성이 높은 것으로 나타났다. 둘째, CWU의 현장실습 프로그램은 전공연계성이 높고, 특히 인문사회, 예체능, 사범계열의 학생들의 현장실습이 활발한 것으로 나타났다. 셋째, 실습 참여 학생의 자격조건은 엄격한 대신, 전공 특성에 따라 유연하게 현장실습 프로그램을 운영하고 있다. 이러한 분석 결과를 토대로 하였을 때, 우리나라 대학들의 현장실습 프로그램 또한 전공연계성, 취업연계성, 지역연계성을 높이는데 초점을 둘 필요가 있고, 대학 및 전공의 특성에 따라 유연하게 운영할 필요가 있다고 판단된다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제34권6호
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• pp.628-634
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• 2008

The purpose of this study is to examine reproducibility of operation plan and 3-dimentional jaw movement patterns by comparing jaw position of STO with post-operative jaw position. Twenty patients with class III dental and skeletal malocclusion who were treated with Le-Fort I osteotomy and B-SSRO were reviewed. Lateral cephalometric radiographs were taken within two weeks before operation and two days after operation. Cephalometric radiographs were compared and analyzed with orthognathic computer program '$V-Ceph^{TM}$'. Post-operative maxillary advancement was insufficient compared to maxillary advancement through STO. Post-operative setback movement was over compared to mandibular setback movement through STO. But statistically this is not significant. Maxillary vertical location is insignificant on the whole. Especially post-operative maxillary clockwise rotation is significant compared to maxillary rotation through STO. Post-operative maxillary clockwise rotation tendency is generally observed in all patients. So surgeons and staffs must consider this tendency when operation plan is established ans operation is being performed. Using intra or extra oral marking points, face bow, and bite plate will make exact surgery possible.

• Imaging Science in Dentistry
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• 제33권4호
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• pp.223-229
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• 2003

Purpose: To compare the effects of the conservative treatment and operative treatment by observation of osseous changes of the TMJ and mandibular asymmetry in condylar fracture patients. Materials and Methods: 33 condylar fracture patients (17 with conservative and 16 with operative treatment) were included in this study. After a minimum of 6 months after the surgical procedure, patients were given a follow up examination of the osseous changes using a transcranial view. Differences in the osseous changes of both groups were compared and the asymmetry indices were calculated on a postero-anterior skull view. Results: The TMJ of the operative treatment group showed more significant osseous changes than the conservative treatment group. The affected TMJ showed more significant osseous changes than the unaffected TMJ in the both groups. The unaffected TMJ of the conservative group and the affected TMJ of the operative group showed significant osseous changes. The mandibular asymmetry indices in the conservative and operative group were 5.12 and 7.30 respectively at the time of treatment, and 2.39 and 3.41 respectively at the follow-up. But the mandibular asymmetry between the both groups showed no statistical differences. Conclusion: The TMJ of the operative group showed more significant osseous changes than the conservative group, but the mandibular asymmetry between the both groups showed no statistical difference.

• Journal of Korean Biological Nursing Science
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• 제14권1호
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• pp.25-32
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• 2012

Purpose: influence of benzodiazepine (midazolam)or cholinergic inhibitor (atropine or glycopyrrlate) on intra-operative body temperature remains unclear and controversial. This study compares intra-operative body temperature in 50 abdominal surgical patients under general anesthesia between the administration of midazolam and glycopyrrolate in combination, or glycopyrrolate alone. Methods: Patients who underwent abdominal surgery were recruited from September 2008 through October 2009 at Gachon University Gil hospital in incheon. Core body temperature was measured in the right ear using a tympanic membrane thermometer at induction of general anesthesia and at 1 hr, 2 hr, and 3 hr after induction. Results: There were no differences in core body temperature at any measurement point between either patient group (F=1.08, $p$=.377). Core body temperature decreased throughout the 3 hr after induction in both groups (F=9.22, $p$ <.001). Specially, core temperatures at induction of general anesthesia (p<.001), 1 hr (p<.001), 2 hr ($p$ <.001), and 3 hr ($p$ <.001) after induction were lower than before administration of midazolam and glycopyrrolate, or glycopyrrolate alone. Conclusion: We conclude that a cholinergic inhibitor (glycopyrrolate, 0.1 mg) therefore seems not to affect intra-operative body temperature of patients given a benzodiazepine (midazolam, 0.04 mg $kg^{-1}$), and not to increase body temperature in patients not given a benzodiazepine during the 3 hr after the induction of general anesthesia. Intra-operative warming therefore is needed to prevent hypothermia in surgical patients who receive pre-operative administration of midazolam and/or glycopyrrolate.

• 한국산학기술학회논문지
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• 제11권9호
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• pp.3412-3416
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• 2010

본 연구의 목적은 대장암환자 수술치료가 신체기능에 영향을 미치는 요인을 규명하고자 시도되었다. 서울지역에 소재한 종합병원에 내원한 대장암 환자 110명을 대상으로 2009년 12월 15일부터 2010년 1월 30일까지 설문 및 면접조사를 실시하였다. 연구결과는 첫째, 수술치료 부작용은 복원술 후 보다 복원술 전 환자들에서 유의하게 높았다(t=5.284, p<0.001). 둘째, 성적만족은 수술 전이 수술 후 방사선 치료 환자들보다 유의하게 높은 것으로 나타났다(t=1.946, p<0.05). 셋째, 배뇨문제는 장루가 있는 경우가 장루가 없는 경우보다 유의하게 높은 불편감을 가진 것으로 나타났다(t=1.537, p<0.05). 결론적으로 대장암환자 수술치료의 신체기능을 향상하기 위해서는 기능상태 및 증상 불편감을 개선시킬 수 있는 중재프로그램의 개발이 필요하다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권9호
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• pp.4463-4467
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• 2016

Purpose: To review the impact of using intra-operative ultrasound guided breast conserving surgery with frozen sections on final pathological margin outcome with the current guidelines set forth by the Society of Surgical Oncology (SSO) and the American Society of Surgical Oncology (ASTRO). Materials and Methods: A retrospective review including all cases of intra-operative ultrasound guided breast conserving surgery was performed at the National Cancer Institute Thailand between 2013 and 2016. Patient demographics, tumor variables, intraoperative frozen section and final pathological margin outcomes were collected. Factors for positive or close margins were analyzed. Results: A total of 86 patients aged between 27 and 75 years with intra-operative ultrasound guided breast conserving surgery were included. Three cases (3.5%) of positive margin were detected by intra-operative frozen section and 4 cases (4.7%) by final pathology reports. There were 18 cases (20.9%) with a close margin (<1 mm). Factors affecting this result comprised multi-foci, presence of invasive ductal carcinoma (IDC) combined with ductal carcinoma in situ (DCIS) and invasive lobular carcinoma (ILC). Conclusions: With the current SSO/ASTRO for adequate margin guidelines, using intra-operative ultrasound to locate the boundary for resection with breast conserving surgery provided a high success rate in obtaining final pathology free margin outcomes and minimizing re-operation risks especially when combined with intra-operative frozen section assessment. The chance of finding positive or close margins appears higher in cases of IDC combined with DCIS, ILC and with multi-foci cancers.

• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.2027-2030
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• 2016

Objective: To investigate the effect of peripheral blood CD4 + CD25 + regulatory T cell on postoperative immunotherapy in patients with renal carcinoma. Methods: 38 patients with renal cell carcinoma were recruited, and 20 patients from the operation group purely underwent the radical nephrectomy therapy, 18 patients from the combined group successively underwent the radical nephrectomy therapy and IFN-${\alpha}$ adjuvant immunotherapy. Additionally, 12 healthy subjects were recruited in the same period of time and regarded as the control group. Flow cytometry was used to detect CD4 +, CD8 +, CD4 + CD25+ T lymphocyte subset content and the ratio of all parts in the pre-operative period, in the first post-operative week and in the third post-operative month, compare and analyze its variation trend. Results: The CD4+CD25+ T lymphocyte subset content of individual renal carcinoma patients was significantly higher than that of the control group, also increases with the progression in the tumor stage (P<0.05). The post-operative CD4 + CD25+T lymphocytes of individual operation group and combined group patients showed different degrees of increment, but the increment of the combined group was significantly lower than that of the operation group (P<0.05). For the combined group patients with less pre-operative CD4 + CD25+T lymphocytes, their levels would increase after the immunotherapy, while the pre-operative patients with more CD4 + CD25+ T lymphocytes were the opposite situation. Conclusion: The detection of peripheral blood CD4+CD25+ regulatory T lymphocyte subset can reflect the anti-tumor immune status of renal cell carcinoma patient body. It can contribute to predict the prognosis of immunotherapy and provide reference for the choice of renal carcinoma post-operative adjuvant immunotherapy.