• Title/Summary/Keyword: Patients Value

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Differences in Symptoms According to the Concordance Value Between Self-Reported Pain Sites and Standardized Palpation Pain Sites in Temporomandibular Disorder Patients: Pilot Study

  • Jee-Won Jang;Seo-Young Choi;Yong-Woo Ahn;Sung-Hee Jeong;Soo-Min Ok;Hye-Mi Jeon;Hye-Min Ju
    • Journal of Oral Medicine and Pain
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    • v.49 no.3
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    • pp.49-56
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    • 2024
  • Purpose: The aims were to investigate potential differences in clinical assessments among acute pain-related temporomandibular disorder (TMD) with different concordance value (CV) between number of self-reported painful site (NSP) and number of painful sites on palpation (NPP), and if it makes sense to treat them differently. Methods: A total of 61 patients were divided into three groups according to CV: 10 patients (concordance poor [CP]), 19 patients (concordance moderate [CM]), and 32 patients (concordance high [CH]). Clinical assessments were conducted using a standardized method in diagnostic criteria for temporomandibular disorders (DC/TMD). We compared collected information including sex, diagnosis, numerical rating scale (NRS), NPP, NSP, sleep duration, DC/TMD Axis II questionnaire, and perceived stress scale among three groups. Results: Among the clinical assessment, NRS, sleep duration, NPP, NSP, total scores of Oral Behaviors Checklist, Patient Health Questionnaire (PHQ)-15, PHQ-9 showed significant differences among 3 groups. NRS, NPP, NSP, PHQ-15, and PHQ-9 were higher in the CP group than in the CM and CH groups. Sleep duration was positively and NPP, NRS were negatively correlated with CV. Conclusions: While previous studies suggested differences between chronic and acute TMD in DC/TMD items, our findings propose the CV might be a key factor that could predict the severity and susceptibility of acute-TMD patients. However, Additional studies are required to determine whether their long-term prognosis was similar to that of chronic pain patients and what the response to treatment was among the three groups.

The effects of the quality of dental care service by factors on the patient satisfaction and service value (요인별 치과 의료서비스 질이 환자만족과 서비스 가치에 미치는 영향)

  • Kim, Jung-Sook
    • Journal of Korean society of Dental Hygiene
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    • v.6 no.1
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    • pp.25-35
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    • 2006
  • The purpose of this study is to forecast patient satisfaction and service value through the staged regression analysis of the relation between each factor and its satisfaction and service value, following the measurement of the quality of dental care service that patients recognize. And a self-administered survey was used for this study. The subjects of this survey were 394 outpatients of dental clinics located in K city in the period from Dec. 5, 2004 to Feb. 19, 2005, the questionnaire was composed of a total of 31 questions to measure the quality of overall dental care service(22 questions), the patient satisfaction(6 questions) and the service value(3 questions). The 7 points Likert scale ranging from "very poor"(1-point) to "very high"(7-point) was used for these questions The results of study could be summarized as follows: 1. The most useful index to predict patient satisfaction turned out to be "internal environment", followed by "treatment process and waiting time", "dentist", "external environment", and "dental hygienist". 2. The service value had a significant effect on the "internal environment", "dentist", "treatment process and waiting time". 3. The most useful index to predict the service value turned out to be "treatment process and waiting time", followed by "internal environment" and "dentist". Today, the quality of dental care service is becoming a prime concern since it is directly connected to a matter of survival of medical service organizations. Dental clinics desperately need patient-oriented marketing strategies in order to actively cope with changing medical environment. They also need to thoroughly examine possible measures to maximize the service value by establishing a variety of service strategies which can promote service quality that patients recognize.

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Comparison of Radiography Findings and Magnetic Resonance Image Findings of Lumbar Spine Instability Patients (요추 불안정 환자에서 단순방사선 소견과 자기공명영상 소견의 비교)

  • Lee, In-Hee;Park, Hee-Joon;Jin, Jong-Sik;Lee, Jyung-Hyun;Kim, Yoon-Nyun
    • The Journal of Korean Physical Therapy
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    • v.19 no.3
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    • pp.41-46
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    • 2007
  • Purpose: This study was to investigate how dose the radiography findings are to magnetic resonance (MR) image findings in the L5-S1 instability patients. The subjects of this study were comprised of eleven males and fifteen females, who had Lumbago and agreed with this research. Methods: Radiography and MR images of Lumbar spine were acquired respectively from subjects in conditions of maximum flexion and extension. The horizontal and angular displacements in lumabosacral spine radiography were used to assess the instability of lumbar spine. MR images were also used to evaluate the intervertebral disc abnormalities and change of bone marrow. Results: The results are as follows. 1. In the case of flexion transitional displacement proposed by Dupuis et al, the specificity and negative predictive value were good accuracy ($0.7{\sim}0.8$), and the negative predictive value was in average. In the case of extension displacement, the negative predictive value was about average ($0.6{\sim}0.7$), but the sensitivity, specificity and positive predictive value were below the poor (<0.6). On the other side, the specificity was about average but other things were below in the case of angular displacement. 2. In the case of flexion transitional displacement proposed by Dupuis et al., compared with the intervertebral disc abnormalities, the negative prediction value was excellent, the sensitivity good, and the specificity about average. In the case of extension, the negative prediction value was about average, but the other things were poor. On the other side the specificity and negative predictive value had good accuracy and the sensitivity and positive prediction value were below average in the case of angular displacement. Conclusion: The above results show that the radiography finding is sufficiently helpful to find the lumbar spine instability as an economic point of view.

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Clinical Study for Objectification of Abdominal Examination with Functional Dyspepsia - Epigastric Diagnosis using Algometer (기능성 소화불량 환자의 복진진단 객관화를 위한 임상연구 - 알고미터를 이용한 심하비경 진단 -)

  • Choi, Gyu-Ho;Rho, Gi-Hwan;Choi, Seo-Hyung
    • The Journal of Korean Medicine
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    • v.43 no.1
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    • pp.1-5
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    • 2022
  • Objectives: Using algometer, measure the pressure pain threshold (PPT) of the epigastric pain(心下痞硬) and calculate the cut-off value, and this can serve as the basis for prognostic diagnosis of functional dyspepsia so we would like to evaluate its diagnostic value. Methods: We investigated 353 patients with functional dyspepsia symptoms who admitted Gangnam Weedahm Oriental Hospital from February 1, 2021 to February 27, 2021. At the time of the patient's visit, an oriental medical doctor measured the pressure at the first pain point on the Algometer of (CV14), twice each, at 1minute intervals. The ROC (receiver operating characteristic) curve and the optimal cut-off value derived through the diagnosis of the (CV14) PPT value for epigastric pain(心下痞硬) and the gold standard of oriental medical doctor, it was evaluated through. Results: In 353 patients, the area under the ROC curve (AUC) was 0.909 (p=0). In addition, the optimal cutting value was 10.05 (kg/cm2), which was statistically significant. Additionally, the sensitivity of the Algometer's PPT measurement was 0.704 and the specificity was 0.884. As a result, if the PPT value of the Algometer exceeds 10.05 (kg/cm2) in terms of the optimal cutting value, it can be seen that epigastric pain(心下痞硬) is lost. Conclusion: Algometer's PPT value measurement can be a reliable test method for quantification of epigastric pain(心下痞硬) diagnosis and can be useful as an objective indicator.

Analysis of factors affecting crestal bone loss around the implants

  • Park, Ji-Hoon;Kim, Young-Kyun;Yun, Pil-Young;Yi, Yang-Jin;Yeo, In-Sung;Lee, Hyo-Jung;Park, Jin-Young
    • Journal of Korean Dental Science
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    • v.2 no.2
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    • pp.12-17
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    • 2009
  • Purpose : To determine whether peri-implant crestal bone loss could be affected by systemic disease, primary ISQ value, implantation method (submerged vs. non-submerged), surface treatment, and bone density Materials and methods : Patients who underwent fixture installation from June 24, 2005 to October 23, 2008 at Seoul National University Bundang Hospital were evaluated. A total of 157 patients (male: 52, female: 85) had 346 fixtures installed. Among them, 49 patients had periapical radiographs taken 1 year after prostheses were first set. A total of 97 fixtures were implanted. In particular, 30 fixtures were installed in patients with systemic diseases such as diabetes mellitus, cardiovascular disease, hypertension, and liver disease. The immediate stability of implants was measured with $Osstell^{tm}$. Implant surface treatment was classified into two groups (RBM, Cellnest (Anodized)), and bone density, into four groups (D1~D4). The bone resorption on the mesial and distal areas of fixtures was measured with periapical radiographs using the paralleling technique, and the mean value was calculated. The length determination program in IMPAX (AGFA, Belgium) was used. Results : At least 332 out of 346 (96%) installed GS II implants were successfully osseointegrated 1 year after prostheses were first set. The mean value of the bone resorption of the installed GS II implants was 0.44mm. The minimum value was 0mm, and the maximum value, 2.85mm. There was a statistically significant difference between the implantation methods (submerged, non-submerged) with regard to the amount of alveolar bone loss 1 year after prostheses were first set (p<0.05). Non-submerged implants showed less crestal bone loss. Note, however, that other variables had no correlation with crestal bone loss (p>0.05). Conclusion : There was a statistically significant difference between the 1-stage method and 2-stage method with regard to the amount of alveolar bone loss 1 year after prostheses were first set. Systemic disease, primary ISQ value, surface treatment, and bone density were not associated with alveolar bone loss. Other variables were assumed to have a correlation with alveolar bone loss.

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Utility Analysis for Pegfilgrastim in DLBCL Patients on R-CHOP Regimen (항암치료를 받는 미만성거대비세포 림프종 환자에서 페그필그라스팀에 대한 효용성 평가)

  • Jung, Hee Won;Kim, Jeong Mee;Min, Myung Sook;Lee, Young Mee;Bang, Joon Seok
    • Korean Journal of Clinical Pharmacy
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    • v.25 no.3
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    • pp.151-158
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    • 2015
  • Objective: This study was designed to compare pegfilgrastim and filgrastim in diffuse large B-cell lymphoma (DLBCL) patients treated with a rituximab with cyclophosphamide, hydroxydaunorubicin, oncovin, and prednisone (R-CHOP) regimen in terms of clinical efficacy and cost-effectiveness. Method: Clinical efficacy was measured by trough level of absolute neutrophil count (ANC), days of ANC under 50% of baseline value, days of ANC under 90% of baseline value, duration of ANC recovery to baseline value, days of ANC less than $0.5{\times}10^9cells/L$, and difference of peak and trough level of ANC during 1 cycle of R-CHOP regimen. To evaluate cost-effectiveness, total prices of used filgrastim and pegfilgrastim within 1 cycle of R-CHOP were analyzed. Results: In terms of clinical efficacy, trough level of ANC and days to ANC recovery showed statistical significance. The median trough levels of ANC with administration of filgrastim and pegfilgrastim were 0.18 and 1.94 (p = 0.021), respectively, and the median durations of ANC recovery to baseline value were 5.5 days and 2 days (p = 0.023), respectively. For the median days of ANC under 50% of baseline value, days of ANC under 90% of baseline value, days of ANC less than $0.5{\times}10^9cells/L$, and difference of peak and trough level of ANC during 1 cycle of R-CHOP, the pegfilgrastim group performed better than the filgrastim group. However the difference was not statistically significant. In terms of overall expense during 1 cycle of R-CHOP, pegfilgrastim is about 3.43 times more expensive than filgrastim. Conclusion: Pegfilgrastim is more efficient than filgrastim in terms of clinical efficacy. In terms of prices, pegfilgrastim is more expensive than filgrastim for patients, but it is more convenient in clinical use. Therefore, pegfilgrastim should be the preferred choice of G-CSF for neutropenic patients. Further comparative study of pegfilgrastim and filgrastim is needed.

Effect of Therapeutic Excercises on Shoulder Dysfunction in VDT-related Female Office Workers (VDT 취급 여성 사무직 근로자들의 견관절 기능장애에 대한 운동요법의 효과)

  • Choi, Soon-Seok;Jeong, Kui-Won;Urm, Sang-Hwa;Jeong, Soo-Jin;Lee, Jong-Tae;Chun, Jin-Ho;Lee, Chae-Un;Pae, Ki-Taek
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.2 s.61
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    • pp.228-239
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    • 1998
  • Visual display terminal(VDT) is popular in majority of office in modern countries. Musculoskeletal pain due to repetitive work with VDT is a serious industrial accident at present. In recent studies, shoulder pain in VDT users is the most common problem in Korea. The purpose of this study was to evaluate and compare the effect of excercises on shoulder dysfunction in VDT-related female office workers. Of the 119 patients with shoulder dysfunction, 32 patients entered into the study. 16 patients(Group I) were not prescribed excercises, other 16 patients (Group II) performed throughout the specific shoulder excercises such as pendular excercises(for-ward, backward and circumduction) and sidelying external rotation excercises with weights. After 3 months of excercises, the two groups were compared in term of the pain rating scale, disability questionnaire score and range of motion score. The results were summarized as follows ; 1. The pain rating scale in Group I before and after 3 months were not differenced significantly(p value=0.784) and in Group II, the scale before and after excercises were differenced significantly(p value=0.0005). 2. The disability questionnaire scores in Group I before and after 3 months were not differenced significantly(p value=0.437) and in Group II, the scores before and after excercises were differenced significantly(p value=0.0002). 3. The ROM scores of the affected shoulder in Group I before and after 3 months were not differenced significantly(p value=0.876) and in Group II, the scores before and after excercises were differenced significantly(p value=0.0017). In conclusion, that the specific shoulder excercises on shoulder dysfunction in VDT-related female office workers are encouraged.

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Overall Survival of Filipino Patients with Squamous Cell Carcinoma of the Head and Neck: A Single-Institution Experience

  • Albano, Pia Marie;Lumang-Salvador, Christianne;Orosa, Jose;Racelis, Sheryl;Leano, Modesty;Angeles, Lara Mae;Ramos, John Donnie
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.8
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    • pp.4769-4774
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    • 2013
  • This paper is the first to present the incidence and overall survival of patients with squamous cell carcinoma of the head and neck (SCCHN) from the extreme northern part of the Philippines. We retrospectively retrieved the records of patients with histologically-confirmed squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx and larynx at the Mariano Marcos Memorial Hospital and Medical Center, Ilocos Norte, Philippines, from 2003 to 2012 and analysed prognostic factors associated with survival. Of the 150 cases, only 80 (53.3%) were still living when the study was terminated. Median age at initial diagnosis was 61.5 years and the male to female ratio was 7:3. The majority of the cases had tumours in the oral cavity (50.7%), followed by the larynx (36.7%). Sex (log rank=1.94, p value/${\alpha}$=0.16), tumor site (log rank=0.02, p value/${\alpha}$=0.90), tumor grade (log rank=1.74, p value/${\alpha}$=0.42), and node stage (log rank=0.07, p value/${\alpha}$=0.80) were not shown to be associated with the survival of our cases. Only 45 (30.0%) had no regional lymph node involvement (N0) at presentation and 12 (8.0%) had already developed distant metastases. Among the 150 patients, 71 (47.3%) were not able to receive treatment of any kind. Oddly, treatment (log rank=1.65, p value/${\alpha}$=0.20) was also shown to be not associated with survival. The survival rate of those who underwent surgery, radiotherapy, or both was not statistically different from those who did not receive any treatment. Only the tumor stage (log rank=4.51, p value/${\alpha}$=0.03) was associated with patient survival. The overall mean survival was 49.3 months, with survival rate diminishing from 88.3% during the 1st year to 1.80% by end of the study. This relatively low survival rate of our cases only reflects their poor access to quality diagnostic and treatment facilities.

Comparison of Shear Wave Elastography and Pathologic Results Using BI - RADS Category for Breast Mass (유방종괴에 대한 BI-RADS범주를 이용한 횡탄성 초음파와 병리결과 비교분석)

  • An, Hyun;Im, In-Chul
    • Journal of the Korean Society of Radiology
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    • v.12 no.2
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    • pp.217-223
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    • 2018
  • This study to search the diagnostic performance of shear wave elastography(SWE) in breast mass and to compare the biopsy result and stiffness obtained from shear wave elastography. Diagnostic breast ultrasonography and SWE were targeted for 157 patients who had breast ultrasonography was diagnosed mass from June 2017 to September 2017. Pathology results of 157 patients showed a benign 92 patients(Age, $44.54{\pm}11.84$) and a malignancy 65 patients(Age, $51.55{\pm}10.54$). Final evaluation, biopsy result, and quantitative SWE result were obtained and compared with each other according to Breast Imaging Reporting and Data System(BI-RADS) of diagnostic breast ultrasonography. Quantitative SWE value and pathologic result showed the highest diagnostic specificity of 83.70% in Emean and sensitivity of 89.23% in Emin. Quantitative SWE result and biopsy result is statistically significant.(p=0.000). The optimal cut-off value for malignant lesions was 66.3 kPa and 63.7 kPa, respectively, for the sensitivity, specificity, high maximum mean elasticity value(Emax) and mean elasticity value(Emean) and this showed the highest diagnostic area under the ROC curve(Az) value compared to other SWE measurement(p=0.000). The addition of SWE to conventional US in breast mass make a increase diagnostic specificity and reduce unnecessary biopsy. Therefore, it is expected that it will be helpful to analyze the breast mass using the above analysis and apparatus.

Surgical treatment of patent ductus arteriosus in adult (성인에 있어서 동맥관개존증의 외과적 치료)

  • Mun, Byeong-Tak;Kim, Sang-Hyeong;Lee, Dong-Jun
    • Journal of Chest Surgery
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    • v.17 no.1
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    • pp.32-40
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    • 1984
  • During the past six years from July 1977 to June 1983, fifteen adult patients of patent ductus arteriosus were surgically treated. The results were as follows: 1. Of the 15 patients, their age range was 17 to 34 years with a mean of 24 years, and sexual predominance was women [9. cf. 6 men]. 2. The most common symptom showed exertional dyspnea, and 10 patients were classed in NYHA class II, the rest were all class III. 3. On physical examination, all patients were auscultated continuous murmur, but concomitantly diastolic murmur was noted apical region in 2 patients. 4. On roentgenogram of chest, normal finding was 3 patients, and the other patients were revealed the evidence of pulmonary congestion. 5. The electrocardiogram was normal in 6 patients, but LVH was seen in 5, and 2 patients were LVH+ LAH. 6. Cardiac catheterization was performed in 12, and mean value of SO2[LPA-RV] was 6.3%, Q/Q 2.09, peak systolic pulmonary arterial pressure 45.3 mmHg, and Rp/Rs 0.365. 7. All operations were carried out by posterolateral thoracotomy. In 6 patients, division and suture of ductus were possible, the other patients were treated by division and ligation with heavy silk or Dacron patch. 8. Postoperative complications were hoarseness, persistent murmur, reoperation for bleeding, and atelectasis. Early and late mortality was 20% [3 patients], and cause of death was mainly aneurysmal rupture of previous operative site.

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