• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.40 no.1
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• pp.43-47
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• 2014

Eagle's syndrome is a disease caused by an elongated styloid process or calcified stylohyoid ligament. Eagle defined the disorder in 1937 by describing clinical findings related to an elongated styloid process, which is one of the numerous causes of pain in the craniofacial and cervical region. The prevalence of individuals with this anatomic abnormality in the adult population is estimated to be 4% with 0.16% of these individuals reported to be symptomatic. Eagle's syndrome is usually characterized by neck, throat, or ear pain; pharyngeal foreign body sensation; dysphagia; pain upon head movement; and headache. The diagnosis of Eagle's syndrome must be made in association with data from the clinical history, physical examination, and imaging studies. Patients with increased symptom severity require surgical excision of the styloid process, which can be performed through an intraoral or an extraoral approach. Here, we report a rare case of stylohyoid ligament bilaterally elongated to more than 60 mm in a 51-year-old female. We did a surgery by extraoral approach and patient's symptom was improved.

• Quality Improvement in Health Care
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• v.9 no.2
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• pp.148-163
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• 2002

Background : The personnel of emergency department have been under tremendous pressure to manage unexpected emergency situations and excited patients. And interpersonal conflict has existed always, because emergency department was consisted of various personnel of their own specialty. The patient's satisfaction has to come from the personnel's satisfaction. The purpose of this study was to evaluate emergency department personnel's job satisfaction and its related factors and to improve quality of emergency medical service Methods : A self-administered questionnaire survey to the emergency department personnel was conducted between September 1 and October 31, 2001. The response rate was 90.2%. Using SAS program (Version 6.12), the collected data was analyzed by frequency, ANOVA, multiple comparison, Pearson correlation procedure, and stepwise multiple regression analysis. Result : The analysis of related factors of job satisfaction showed high score of interpersonal interaction (3.246), professional prestige (3.095), autonomy (2.916), task requirements (2.701), organizational requirements (2.444), and pay (1.953) in order of item mean. Professional prestige (0.498), task requirements (0.464), and organizational requirements (0.408) were highly positive correlated with overall level of job satisfaction. The factors influencing the job satisfaction were professional prestige and task requirements which explaining efficacy were 37.6% and 32.2% respectively. The total explaining efficacy was 33.6%. Conclusion : It was found out that emergency department personnel's job satisfaction can be raised by promoting professional prestige and task requirements. The personnel of emergency department have to be satisfied through their job, and the administration of the hospital has to pay more attention to their employees' job satisfaction and it related factors.

• Journal of Gastric Cancer
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• v.12 no.2
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• pp.126-131
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• 2012

Purpose: We developed a standardized critical pathway for gastric cancer surgery and then determined the increase of application, which resulted in an improvement in terms of measurable indices, such as hospital stay and cost. Materials and Methods: A critical pathway was revised and used widely from the 2nd quarter of 2009. We collected clinical data, such as length of stay and complication rate, as clinical indices of quality prospectively. The total cost paid at the patient's discharge, as well as the daily hospital income, were calculated and compared by each quarter from January 2008 to December 2009. Results: The application rate of critical pathway was 11.8% and 87.8% in 2008 and 2009, respectively. There were no perioperative deaths. There was no difference in the complication rates between 2008 and 2009 (P=0.45). However, the mean length of stay was significantly different between the 2 years (P<0.05). Although the total cost was not different, the daily hospital income was significantly higher in the latter year (P<0.05). Conclusions: An increase in the application of critical pathway for gastrectomy resulted in significant decreases in length of stay and increases in the daily hospital income without a compromise on the clinical indices.

• Neonatal Medicine
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• v.28 no.3
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• pp.124-132
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• 2021

Purpose: Neonatal near miss (NNM) allows for the detection of risk factors associated with serious newborn complications and death, the prevention of which could reduce neonatal mortality. This study was conducted with the objective of identifying predictors for NNM in a tertiary hospital in Bangalore city. Methods: This was an unmatched case-control study involving 120 NNM cases and 120 controls. NNM was determined using Pileggi-Castro's pragmatic and management criteria. Data was collected from in-patient hospital records and interviews of postpartum mothers. Multiple logistic regression of exposure variables was performed to calculate adjusted odds ratio (AOR) with 95% confidence interval (CI). Results: Significant predictors were maternal age ≥30 years (AOR, 5.32; 95% CI, 1.12 to 9.29; P=0.041), inadequate antenatal care (ANC) (AOR, 8.35; 95% CI, 1.98 to 51.12; P=0.032), <3 ultrasound scans during pregnancy (AOR, 12.5; 95% CI, 1.60 to 97.27; P=0.016), maternal anaemia (AOR, 18.96; 95% CI, 3.10 to 116.02; P=0.001), and any one obstetric complication (hypertensive disorder in pregnancy, diabetes in pregnancy, preterm premature rupture of membranes, prolonged labour, obstructed labour, malpresentation) (AOR, 4.34; 95% CI, 1.26 to 14.95; P=0.02). Conclusion: The predictors of NNM identified has important implications for public health policy and practice whose modifications can improve NNM. These include expanding essential ANC package to include ultrasound scans, ensuring World Health Organization recommendations of eight ANC visits, capacity building at all levels of health care to strengthen routine ANC and obstetric care for effective screening, referral and management of obstetric complications.

• Journal of Korean society of Dental Hygiene
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• v.19 no.3
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• pp.375-385
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• 2019

Objectives: The purpose of this study was to provide basic data for gingivitis management programs by dental hygienists by evaluating the effect of oral health education, oil pulling, and professional toothbrushing on gingivitis. Methods: A total of 38 subjects were divided into three groups: control group (12 subjects), experimental group 1 (13 subjects), and experimental group 2 (13 subjects). The control and experimental groups were instructed to brush using the rotating method. Distilled water was provided to the control group after training. Coconut oil was provided every morning for about 10 minutes. In the experimental group 2, a professional brushing method was used at each visit. Results: There were no significant differences in oral health among the three groups, and there was homology between patient hygiene performance (PHP) index (p=0.144) and bleeding rate (p=0.213). The PHP index showed a significant interaction between the group and measurement time. The control and experimental groups showed changes in the PHP index with time (F=3.711; p=0.013). The bleeding rate showed a significant interaction between the group and measurement period. The control and experimental groups showed changes in the bleeding rate with time (F=6.707; p<0.001). Conclusions: Oral health education, professional toothbrushing, and oil pulling specialists in oral care of gingivitis were effective in managing gingivitis. It is necessary to educate people on self-management methods for oral health promotion using gingivitis management programs by dental hygienists.

• Journal of Trauma and Injury
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• v.31 no.3
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• pp.151-158
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• 2018

Purpose: The regional emergency medical centers manage the patients with major blunt trauma according to the process appropriate to each hospital rather than standardized protocol of the major trauma centers. The primary purpose of this study is to evaluate the effectiveness and influence on prognosis of additional cervical-thoracic-lumbar-spine computed tomography (CTL-spine CT) scan in diagnosis of spinal injury from the victim of major blunt trauma with impaired consciousness. Methods: The study included patients visited the urban emergency medical center with major blunt trauma who were over 18 years of age from January 2013 to December 2016. Data were collected from retrospective review of medical records. Sensitivity, specificity, positive predictive value, and negative predictive value were measured for evaluation of the performance of diagnostic methods. Results: One hundred patients with Glasgow coma scale ${\leq}13$ underwent additional CTL-spine CT scan. Mechanism of injury was in the following order: driver, pedestrian traffic accident, fall and passenger accident. Thirty-one patients were diagnosed of spinal injury, six of them underwent surgical management. The sensitivity of chest, abdomen and pelvis CT (CAP CT) was 72%, specificity 97%, false positive rate 3%, false negative rate 28% and diagnostic accuracy 87%. Eleven patients were not diagnosed of spinal injury with CAP CT and C-spine lateral view, but all of them were diagnosed of stable fractures. Conclusions: C-spine CT scan be actively considered in the initial examination process. When CAP CT scan is performed in major blunt trauma patients with impaired consciousness, CTL-spine CT scan or simple spinal radiography has no significant effect on the prognosis of the patient and can be performed if necessary.

• The Korea Journal of Herbology
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• v.28 no.6
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• pp.25-29
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• 2013

Objectives : The dried root of Sophora flavescens Aiton have been used to treat patient with skin diseases such as eczema in Eastern countries. S. flavescens can clear away heat and dry dampness and purge sthenic-fire from the liver and gallbladder. Recently, anti-allergic effect of S. flavescens has been reported. However, the effect on skin condition of contact dermatitis still remains unknown. Thus, the purpose of this study is to evaluate the efficacy of S. flavescens on contact dermatitis. Methods : In order to investigate the effects of S. flavescens (methanol extract of S. flavescens, MESR) on skin condition, the contact dermatitis was induced in mice skin by using 1-fluoro-2,4-dinitrofluorobenzene (DNFB). As the effective endpoints, skin thickness, skin weight, histopathological change were checked. In addition, effects on skin lesion, body weight and spleen/body weight ratio were also investigated. Results : Topical application of MESR ($500{\mu}g/day$) lowered skin thickness (P < 0.05) and skin weight (P < 0.05), respectively. MESR-treated group showed diminished spongiosis and immune cell infiltration in skin tissues compared to those of non-treated control group. The inhibition of skin lesions was also observed in MESR-treated group. In addition, MESR did not affect body weight gain and spleen/body weight ratio in contrast with those in dexamethasone-treated group. Conclusion : These data suggest that Sophorae Radix could improve skin lesion of contact dermatitis. This indicates the possibility for Sophorae Radix to be used to patients with skin diseases such as contact dermatitis.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.25 no.6
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• pp.473-480
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• 2022

Purpose: Low bone mineral density (BMD) is a complication in children with inflammatory bowel disease (IBD). There are limited data evaluating dual-energy x-ray absorptiometry (DXA) as a screening tool for low BMD in children with IBD. We performed a single site retrospective analysis of DXA use. Methods: Children aged 5-18 years with IBD diagnosed between 2013 to 2017 at the Royal Children's Hospital, Australia, were included. Patient demographics, measures of disease activity, DXA scores, and factors related to BMD were collected. Results: Over a median follow up of 5.1 (4-6.4) years, 72/239 (30.1%) children underwent DXA, and 28/239 (11.7%) children had a second DXA. Our DXA practice differed to consensus guidelines regarding initial screening based on height and/or body mass index (BMI) z-score (8/17 [47.1%]), and repeat surveillance (13/42 [31.0%]). Children had a median lumbar spine (LS) z-score -0.80 (-1.65-0.075). Children with LS z-score≤-2.0 (n=14) had lower weight (6.57 [1.78-23.7] vs. 51.1 [26.5-68.7], p=0.0002) and height centiles (3.62 [1.17-17.1] vs. 42 [16.9-67.1], p=0.0001), and higher faecal calprotectin (FCP) (3041 [1182-4192] vs. 585 [139-2419], p=0.009) compared to children with LS z-score>-2.0. No fractures were reported. Of 28 children who underwent a second DXA 1.6 (1.1-2.2) years following initial DXA, no significant change in z-scores occurred. Conclusion: Children with IBD had low BMD. In addition to height centile and weight centile, FCP was associated with lower BMD, and should be considered in DXA screening guidelines. Greater clinician awareness of DXA consensus guidelines is required. Future prospective studies are required.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.26 no.1
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• pp.47-57
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• 2022

Backgrounds/Aims: It is challenging to assess the efficacy of partial hepatectomy (PH) as a treatment option for patients with hepatocellular carcinoma (HCC) accompanied by cirrhosis. This study aimed to determine the cure fraction of PH for HCC accompanied by cirrhosis compared to that for HCC without cirrhosis. Methods: A systematic review was performed on outcomes of previous studies that compared recurrence-free survival (RFS) after PH in patients with HCC with or without cirrhosis. A meta-analysis was conducted to obtain the cumulative hazard ratio for two patient groups: cirrhosis and non-cirrhosis. Cure fractions after PH in both groups were determined using a cure model analysis. Results: A total of 18 studies were eligible for meta-analysis and 13 studies were selected for the cure model analysis. The cumulative hazard ratio for RFS of the cirrhosis group compared to that of the non-cirrhosis group was 1.66 (95% confidence interval [CI], 1.43-1.93). Survival data of 3,512 patients in both groups were reconstructed from survival curves of original articles for cure model analysis. The probability of being statistically cured after PH for HCC was 14.1% (95% CI, 10.6%-18.1%) in the cirrhosis group lower than that (32.5%) in the non-cirrhosis group (95% CI, 28.6%-36.4%). Conclusions: The prognosis after PH for HCC accompanied by cirrhosis is inferior to that for HCC without cirrhosis. However, a cure can be expected for one-seventh of patients with HCC accompanied by cirrhosis after PH.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.26 no.3
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• pp.293-297
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• 2024

Objective: As the prevalence of neuroendovascular interventions increases, it is critical to mitigate unnecessary radiation for patients, providers, and health care staff. Our group previously demonstrated reduced radiation dose and exposure during diagnostic angiography by reducing the default pulse and frame rates. We applied the same technique for basic neuroendovascular interventions. Methods: We performed a retrospective review of prospectively acquired data after implementing a quality improvement protocol in which pulse rate and frame rate were reduced from 15 p/s to 7.5 p/s and 7.5 f/s to 4.0 f/s respectively. We studied consecutive, unilateral middle meningeal artery embolizations treated with particles. Total radiation dose, radiation per angiographic run, total radiation exposure, and exposure per run were calculated. Multivariable log-linear regression was performed to account for patient body mass index (BMI), number of angiographic runs, and number of vessels catheterized. Results: A total of 20 consecutive, unilateral middle meningeal artery embolizations were retrospectively analyzed. The radiation reduction protocol was associated with a 39.2% decrease in the total radiation dose and a 37.1% decrease in radiation dose per run. The protocol was associated with a 41.6% decrease in the total radiation exposure and a 39.5% decrease in exposure per run. Conclusions: Radiation reduction protocols can be readily applied to neuroendovascular interventions without increasing overall fluoroscopy time and reduce radiation dose and exposure by 39.2% and 41.6% respectively. We strongly encourage all interventionalists to be cognizant of pulse rate and frame rate when performing routine interventions.