• Journal of Periodontal and Implant Science
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• 제53권3호
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• pp.173-183
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• 2023

Purpose: Treatment for periodontitis has evolved over the years as new technologies have become available. Currently, lasers seem attractive as a treatment modality, but their effectiveness needs to be verified. The purpose of this project was to evaluate Laser Assisted New Attachment Procedure^® (LANAP^®) surgery as a single treatment modality. Methods: As part of a mandatory training program for periodontists and other dentists, 22 consecutive patients diagnosed with moderate to severe periodontitis (probing depth [PD] up to 11 mm) were treated with the LANAP^® surgical approach using a 1064-nm Nd:YAG laser as part of a multi-step protocol. Following single-session active therapy, they were entered into a maintenance program. Their clinical status was re-evaluated at 12-18 months following surgery. Results: All 22 patients completed the 12- to 18-month follow-up. PD, clinical attachment level, and furcation (FURC) showed substantial improvement. Recession was minimal (mean, 0.1 mm), while 93.5% of PD measurements were 3 mm or less at re-evaluation. Furthermore, 40% of grade 2 FURC closed clinically. Conclusions: Within the limits of this case series, LANAP^® was found to be an effective, minimally invasive, laser surgical therapy for moderate to advanced periodontitis.

• Journal of Yeungnam Medical Science
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• 제41권2호
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• pp.120-127
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• 2024

Background: Physiatrists are facing with survivors from disasters in both the acute and chronic phases of muscle and nerve injuries. Similar to many other clinical conditions, neuromusculoskeletal ultrasound can play a key role in the management of such cases (with various muscle/nerve injuries) as well. Accordingly, in this article, a recent single-center experience after the Turkey-Syria earthquake will be rendered. Methods: Ultrasound examinations were performed for various nerve/muscle lesions in 52 earthquake victims referred from different cities. Demographic features, type of injuries, and applied treatment procedures as well as detailed ultrasonographic findings are illustrated. Results: Of the 52 patients, 19 had incomplete peripheral nerve lesions of the brachial plexus (n=4), lumbosacral plexus (n=1), and upper and lower limbs (n=14). Conclusion: The ultrasonographic approach during disaster relief is paramount as regards subacute and chronic phases of rehabilitation. Considering technological advances (e.g., portable machines), the use of on-site ultrasound examination in the (very) early phases of disaster response also needs to be on the agenda of medical personnel.

• International Journal of Computer Science & Network Security
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• 제24권7호
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• pp.11-23
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• 2024

Triage is a practice of accurately prioritizing patients in emergency department (ED) based on their medical condition to provide them with proper treatment service. The variation in triage assessment among medical staff can cause mis-triage which affect the patients negatively. Developing ED triage system based on machine learning (ML) techniques can lead to accurate and efficient triage outcomes. This study aspires to develop a triage system using machine learning techniques to predict ED triage levels using patients' information. We conducted a retrospective study using Security Forces Hospital ED data, from 2021 through 2023 during Hajj period in Saudia Arabi. Using demographics, vital signs, and chief complaints as predictors, two machine learning models were investigated, naming gradient boosted decision tree (XGB) and deep neural network (DNN). The models were trained to predict ED triage levels and their predictive performance was evaluated using area under the receiver operating characteristic curve (AUC) and confusion matrix. A total of 11,584 ED visits were collected and used in this study. XGB and DNN models exhibit high abilities in the predicting performance with AUC-ROC scores 0.85 and 0.82, respectively. Compared to the traditional approach, our proposed system demonstrated better performance and can be implemented in real-world clinical settings. Utilizing ML applications can power the triage decision-making, clinical care, and resource utilization.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제38권
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• pp.50.1-50.6
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• 2016

Background: The aim of this study was to evaluate the clinical outcomes of implants that were placed within the maxillary sinus that has a perforated sinus membrane by the lateral window approach. Methods: We examined the medical records of the patients who had implants placed within the maxillary sinus that has a perforated sinus membrane by the lateral approach at the Department of Oral and Maxillofacial Surgery of Chonnam National University Dental Hospital from January 2009 to December 2015. There were 41 patients (male:female = 28:13). The mean age of patients was $57.2{\pm}7.2years$ at the time of operation (range, 20-76 years). The mean follow-up duration was 2.1 years (range, 0.5-5 years) after implant placement. Regarding the method of sinus elevation, only the lateral approach was included in this study. Results: Ninety-nine implants were placed in 41 patients whose sinus membranes were perforated during lateral approach. The perforated sinus membranes were repaired with a resorbable collagen membrane. Simultaneous implant placements with sinus bone grafting were performed in 37 patients, whereas delayed placements were done in four patients. The average residual bone height was $3.4{\pm}2.0mm$ in cases of simultaneous implant placement and $0.6{\pm}0.9mm$ in cases of delayed placement. Maxillary bone graft with implant placement, performed on the patients with a perforated maxillary sinus membrane did not fail, and the cumulative implant survival rate was 100%. Conclusions: In patients with perforations of the sinus mucosa, sinus elevation and implant placement are possible regardless of the location and size of membrane perforation. Repair using resorbable collagen membrane is a predictable and reliable technique.

• Journal of Periodontal and Implant Science
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• 제37권4호
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• pp.691-704
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• 2007

Between 1997 May and 2007 May, One hundred and seventeen patients were treated. There were 129 cases of sinus elevation using a lateral window opening procedure and 258 implants placed simultaneously or delayed. The cumulative survival rate of the implants calculated. The implants were evaluated according to surgical site, quality and quantity of bone, graft material, membrane used, the length and diameter of the implant and complications. 1. The 10-year cumulative survival rate of the implants by sinus augmentation using lateral window approach was 96.90%. 2. There was no difference in the survival rate between the implant placed simultaneously with sinus elevation (one stage) and the procedure performed in the delayed procedure (two stage). 3. There was no difference in the survival rate according to the type and amount of graft materials. 4. There was no difference in the survival rate according to the implant site, bone quality and quantity. 5. There was no difference in the survival rate when the $CollaTape^{(R)}$ or Gore-Tex was placed in the window of the lateral wall. 6. There was no difference in the survival rate of the implant length and diameter. 7. The survival rate was as low as 75.00% when there were more than two complications. Implant placement with sinus augmentation using the lateral window approach is a predictable treatment method. Although the vertical height of residual ridge is insufficient and the quality of bone is poor, the normal survival rate of the implants would be expected if an appropriate graft material and membrane is used with greater effort to prevent complications.

• 대한족부족관절학회지
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• 제27권4호
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• pp.123-130
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• 2023

Purpose: "Hallux valgus" is a common disease encountered in clinical practice and is accompanied by foot deformities. Conservative treatment is commonly used in the early stages of hallux valgus. On the other hand, surgical treatment often becomes necessary as the deformity progresses. Surgical treatments involve various osteotomy methods or joint fusion procedures combined with soft tissue release, and outcomes from these surgical treatments are generally favorable. This study compared two soft tissue release techniques in the hallux region. Materials and Methods: This study conducted a retrospective cohort study on 48 participants who underwent surgical treatment for hallux valgus at a single institution from March 1, 2018, to March 31, 2023. A scarf osteotomy was performed in all cases, and the "Modified Mcbride procedure" or "Trans-articular approach" was done for soft tissue release. Hallux valgus angle (HVA), intermetatarsal angle (IMA), and the degree of subluxation of the lateral sesamoid were measured through simple foot radiographs taken before surgery and one year after surgery. Results: In the Modified Mcbride procedure group, HVA, IMA, and the sesamoid position grade decreased from 34.94° to 9.98°, 15.64° to 5.44°, and 2.47 to 0.44, respectively. In the trans-articular approach group, HVA, IMA, and the sesamoid position grade decreased from 33.42° to 7.34°, 15.06° to 6.03°, and 2.17 to 0.58, respectively. There was no significant difference in these changes between the preoperative and one-year postoperative measurements for both techniques (p-value>0.05). Conclusion: A radiological assessment of soft tissue release through the Modified Mcbride procedure and trans-articular approach in hallux valgus did not show significant differences. Therefore, both surgical techniques can be considered in the distal soft tissue release for a hallux valgus correction.

• 대한영상의학회지
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• 제83권3호
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• pp.658-668
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• 2022

목적 혈액투석경로의 기능부전에 대한 인터벤션 치료 시 경요골 동맥 접근법의 유용성을 연구하고자 한다. 대상과 방법 2008년 1월부터 2019년 4월까지 73명의 환자에서(남성 43명, 여성 30명, 평균 연령 67.4세; 범위 42-92세) 경요골 동맥 접근법을 이용한 시술을 시행한 환자들에 대해 후향적 연구를 시행하였다. 환자들의 기본적인 특성과 병변의 특성, 경요골 동맥 접근을 통한 인터벤션 시술의 기술적 및 임상적 성공률, 시술과 연관된 합병증에 대해 조사하였고 장기 개통성에 대해서는 카플란-마이어 방법을 이용하여 분석하였다. 결과 모든 환자에서 요골 동맥을 통한 혈관조영술을 성공적으로 시행하였고, 기술적 성공률은 98.6%(72/73), 임상적 성공률은 91.7%(67/73)였다. 일차적 개통률의 중앙값은 18.8 ± 15.9개월이었고, 3, 6, 12개월 누적 개통률은 각각 82.1%, 68.6%, 그리고 63.9%였다. 모든 환자에서 손의 허혈과 같은 주요한 합병증은 발생하지 않았으며 경요골 동맥 천자와 연관한 즉각적인 합병증 또한 발생하지 않았다. 결론 혈액투석경로 기능 부전 환자에서 경요골 동맥 접근법을 통한 인터벤션 시술은 안전하고 임상적으로 유용한 방법으로 생각된다. 또한 선별된 환자에서 전통적인 경정맥 접근법에 대해 대안으로 기능할 수 있을 것으로 생각된다.

• Journal of Korean Neurosurgical Society
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• 제30권9호
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• pp.1079-1085
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• 2001

Objective : We analysed various surgical approaches and surgical results of 28 middle cranial base tumors for the purpose of selecting optimal surgical approach to the middle cranial base tumor. Methods : In this retrospective review, 28 patients, including 16 meningioma, 6 trigeminal neurinoma, 2 pituitary adenoma, 2 craniopharyngioma, 1 facial neurinoma, and 1 metastatic tumor, underwent surgical treatment using skull base technique. Of theses, 16 tumors were mainly confined to middle cranial fossae, 5 tumors with extension into both anterior and middle fossa, and 7 tumors with extension into both middle and posterior fossa. Tumors that confined to the middle cranial fossa or extended into the anterior cranial fossa were operated with modified pterional, orbitozygomatic or Dolen'c approach, and tumors that extended into the posterior cranial fossa were operated with anterior, posterior or combined transpetrosal approach. Completeness of tumor resection, surgical outcome, postoperative complication, and follow up result were studied. Results : Total tumor removal was achieved in 9 tumors of 10 tumors that did not extended to the cavernous sinus, and was achieved in 7 tumors of 8 tumors that extended to the lateral wall of the cavernous sinus. Of 10 tumors that extended to the venous channel of the cavernous sinus, only 2 were removed totally. Surgical outcome was excellent in 14 patients, good in 10, fair in 2 and poor in 2. There were no death in this series. Dumbell type tumor which extended into both middle and posterior fossae showed tendency of poor prognosis as compared with tumors that confined middle cranial fossa and extended into both anterior and middle cranial fossa. Postoperative dysfunctions were trieminal hypesthesia in 3, oculomotor nerve palsy in 2, abducens nerve palsy in 2, hemiparesis in 2, cerebellar sign in 1, facial palsy in 1 and hearing impairment in 1. Conclusion : Based on our findings and a review of the literature, we conclude that, when selecting the surgical approach to the middle cranial fossa tumors, the most important factors to be considered were exact location of the tumor mass and existence of the cavernous sinus invasion by tumor mass. We recommend modified pterional or orbitozygomatic approach in cases with tumors located anterior and middle cranial base, without cavernous sinus invasion. In cases with tumors invading into cavernous sinus, we recommend Dolen'c or orbitozygomatic approach. And in lateral wall mass and the cavernous sinus, it is preferred to approach the tumor extradurally. For the tumor involing with middle fossa and posterior fossa(dumbell type) a combined petrosal approach is necessary. In cases with cavernous sinus invasion and internal carotid artery encasement, we recommend subtotal resection of the tumor and radiation therapy to prevent permanent postoperative sequele.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제35권4호
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• pp.236-242
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• 2013

Purpose: The objective of this retrospective study is to evaluate the factors affecting the spread of odontogenic infection. Furthermore, this study was performed to apply to future treatments. Methods: A total of 65 patients, who had received treatment for odontogenic infections from 2010 to 2012 for 3 years, were enrolled in this study. The causes of infection, presence of systemic disease, and complications, durations of treatment, treatment methods, and inflammation levels were compared with the data. Results: Patients over 70 years with systemic disease required immediate drainage, systemic antibiotic therapy and hospitalization. We can determine the direction of the early diagnosis and treatment through blood tests (white blood cells, neutrophil, C-reactive protein [CRP]) and computed tomography. Patients over 70 years with systemic disease had the highest percentage. In addition, these patients showed high levels of inflammation index, such as CRP average of 24.8 and needed for a long-term treatment period and a wide range of surgical incision & drainage several times. Systemic diseases, particularly diabetes mellitus and hypertension, accelerate the spread of infection and had a negative effect that delays healing. Eventually, five of the 65 patients showed serious systemic complications. Conclusion: When evaluating cervico-facial infected patients due to odontogenic infection, the most important thing is deciding the appropriate diagnosis and degree of disease. Considering the patient's systemic status and age, we need to decide the treatment plan. Especially, those patients over 70 years with systemic disease should be treated with rapid surgical approach, and the use of a wide range of antibiotics and intensive care. If proper treatment principle does not apply, severe life-threatening complications will result, such as necrotizing fascitis, acute airway obstruction, mediastinitis, and others.

• 대한한의학회지
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• 제41권2호
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• pp.23-33
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• 2020

Objectives: To investigate the prevalence of pain, clinical characteristics of pain, association between clinical features and pain of patients with Parkinson's Disease(PD). Methods: We undertook a retrospective review of the medical records of patients diagnosed with PD between 2012 and 2019 at Kyung Hee University Korean Medicine Hospital at Gangdong in South Korea. Results: A total of 172 PD patients met entry criteria and 147 out of 172 patients(85.5%) reported pain. In comparison with general population, PD patients has high prevalence of pain. Female PD patients more frequently reported pain than male (P=0.03). 102 out of 147patients(69.3) complained of musculoskeletal pain, and musculoskeletal pain show significant difference depending on the PD motor subtypes (P=0.039). Pain was mainly locatedin the leg (57.8%) in all PD motor subtypes. Tremor-dominant PD more frequently felt pain in upper limb than postural instability-gait difficulty dominant(PIGD) PD, but it was not statistically significant. Conclusions: These findings showed high prevalence of pain in PD patients, the correlation between female and pain, and the relationship between PD motor subtype and pain type. Our study can contribute to the clinical approach based on a more in-depth understanding of PD patients with pain.