• Title/Summary/Keyword: Trauma center

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A Systematic Review on Prevention and Treatment of Nipple Pain and Fissure: Are They Curable?

  • Niazi, Azin;Rahimi, Vafa Baradaran;Soheili-Far, Sina;Askari, Nafiseh;Rahmanian-Devin, Pouria;Sanei-Far, Zahra;Sahebkar, Amirhossein;Rakhshandeh, Hassan;Askari, Vahid Reza
    • Journal of Pharmacopuncture
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    • v.21 no.3
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    • pp.139-150
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    • 2018
  • Averagely 80% to 90% of breastfeeding women experience the nipple pain and fissures. The important factor for successful breastfeeding is to treat this problem. This study has done as a review with the aim of analysis of the clinical trials in the field of the prevention and treatment of the nipple fissures and pain due to the importance of breastfeeding. For this purpose, the key words of sore, nipples, fissure, trauma, wound, prevention, treatment, therapeutics, therapy, clinical trial, breastfeeding and their Persian synonyms and all of their possible combinations were searched in the national databases: SID and Iran Medex and Magiran, and in the international databases: PubMed, Scopus, Medline, Science direct by May 2017. The Jadad criterion was used to assess the quality of the articles and the articles with a score of 3 or more were included in this study. Finally, 48 clinical trials were reviewed that 17 of them (sample size 1801) scored 3 or more based on the Jadad criterion. Seven articles were also in the non- drug treatment group (sample size 491) and 2 articles in the drug treatment group (sample size 337) and 8 articles in the herbal treatment group (sample size 973).The results show that menthol and warm water compress as well as teaching the correct breastfeeding methods are effective treatments to prevent and treat the nipple pain and fissures. Moreover, applying the herbal medicine for prevention and treatment of the issues raised from breastfeeding may have beneficial such as Aloe vera, Portulaca olearacea. However, more studies with a great methodology are necessary to obtain more accurate evidence.

Effect of embossed new dental pick on periodontitis (Embossed new dental pick이 치주염에 미치는 영향)

  • Suk, Hun-Joo;Kim, Chong-Kwan
    • Journal of Periodontal and Implant Science
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    • v.34 no.3
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    • pp.563-572
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    • 2004
  • Since bacterial plaque is known as the major cause of every oral disease, it is necessary to control plaque to maintain periodontal health. Although tooth brushing has been the typical method of plaque control, additional use of plaque control devices are necessary for cleansing interdental areas. Dental floss has been used for a long time as the additional plaque control device and proved to be effective. The newly developed embossed new dental pick is composed of elastic plastic material in form with its tip longer than other toothpick. In addition, as thickness of the tip gradually increases, it can be adapted easily with minimal trauma to interdental gingiva. The embossed tip can remove dental plaque easily, and the opposite end can approach lingual and palatal areas through triple angulation. Therefore, the authors studied the effect of embossed new dental pick and dental floss on periodontally involved 15 patient. The following results were obtained. 1. For embossed new dental pick, probing depth at baseline, 1 week, 4 weeks were $3.6{\pm}0.6mm$, $3.4{\pm}0.5mm$, $3.2{\pm}0.5mm$, respectively, and $4.2{\pm}0.9mm$, $4.1{\pm}0.9mm$, $4.0{\pm}0.9mm$, respectivly for clinical attachment level. 2. In case of embossed new dental pick, bleeding on probing at baseline, 1 week, 4 weeks were $43.0{\pm}4.4%$, $28.5{\pm}5.1%$, $22.2{\pm}5.6%$, respectively, and, at 1 week and 4 weeks, they were significantly different from that of dental floss. 3. Gingival index of toαhpick at baseline, 1 week, 4 weeks were $1.7{\pm}0.5$, $1.0{\pm}0.3$, $0.9{\pm}0.2$, respectively, and, $1.7{\pm}0.5$, $1.1{\pm}0.4$, $1.0{\pm}0.4$, respectively for plaque index, and $3.0{\pm}0.5$, $1.7{\pm}0.5$, $1.4{\pm}0.4$, respectively for proximal plaque index. proximal plaque index at 4 weeks was significantly different from that of dental floss. 4. The result of questionnaire showed that the two types of device were both satisfactory, however, embossed new dental pick had higher preference as well as satisfaction. As a result, embossed new dental pick is thought to be clinically effective for its simplicity and good accessibility.

A Study on the Usefulness of an Ankle Joint Examination Assistive Device using a 3D Printing (3D 프린터를 이용한 발목관절 검사 보조기구의 유용성연구)

  • Dong-Hee Hong;Eun-hye Kim;Young-Cheol Joo
    • Journal of the Korean Society of Radiology
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    • v.17 no.7
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    • pp.1099-1108
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    • 2023
  • The mortise view radiography procedure is an ankle joint examination and observes the presence of trauma, sprain, or dislocation suspected in the ankle joint. The auxiliary equipment used during the mortise view radiography procedure can generate artifacts in the radiograph images and is not diverse enough to be custom-made for each patient; not cost-efficient. The purpose of this study is to create a custom assistive device to support mortise view radiography procedure. This study utilized 3D printing technology to create the mortise view radiography procedure assistive device (ShinHan Device; SHD). The lengths of the tibiotalar joint (TTJ), talar calcaneal joint (TCJ), and medial joint (MJ) were measured and evaluated by five researchers using both SHD and the prototype Hologic tool. The mean ranges were found to be 39.42-39.47 mm for TTJ, 31.41-31.57 mm for TCJ, and 21.21-21.23 mm for MJ while using SHD device. On the other hand, the measurements showed mean ranges of 39.73-39.79 mm for TTJ, 31.46-31.50 mm for TCJ, and 21.31-21.35 mm for MJ while using the Hologic tool. Based on this study results, the error ranges at all positions decreased by 24% for TTJ, 17% for TCJ, and 36% for MJ when using SHD device compared to the Hologic tool. Moreover, when SHD was used, it allowed for a highly reproducible examination posture (ICC = 0.99), and it enabled the acquisition of radiograph images without artifacts, which were present in the Hologic tool.

Performance of ChatGPT 3.5 and 4 on U.S. dental examinations: the INBDE, ADAT, and DAT

  • Mahmood Dashti;Shohreh Ghasemi;Niloofar Ghadimi;Delband Hefzi;Azizeh Karimian;Niusha Zare;Amir Fahimipour;Zohaib Khurshid;Maryam Mohammadalizadeh Chafjiri;Sahar Ghaedsharaf
    • Imaging Science in Dentistry
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    • v.54 no.3
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    • pp.271-275
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    • 2024
  • Purpose: Recent advancements in artificial intelligence (AI), particularly tools such as ChatGPT developed by OpenAI, a U.S.-based AI research organization, have transformed the healthcare and education sectors. This study investigated the effectiveness of ChatGPT in answering dentistry exam questions, demonstrating its potential to enhance professional practice and patient care. Materials and Methods: This study assessed the performance of ChatGPT 3.5 and 4 on U.S. dental exams - specifically, the Integrated National Board Dental Examination (INBDE), Dental Admission Test (DAT), and Advanced Dental Admission Test (ADAT) - excluding image-based questions. Using customized prompts, ChatGPT's answers were evaluated against official answer sheets. Results: ChatGPT 3.5 and 4 were tested with 253 questions from the INBDE, ADAT, and DAT exams. For the INBDE, both versions achieved 80% accuracy in knowledge-based questions and 66-69% in case history questions. In ADAT, they scored 66-83% in knowledge-based and 76% in case history questions. ChatGPT 4 excelled on the DAT, with 94% accuracy in knowledge-based questions, 57% in mathematical analysis items, and 100% in comprehension questions, surpassing ChatGPT 3.5's rates of 83%, 31%, and 82%, respectively. The difference was significant for knowledge-based questions(P=0.009). Both versions showed similar patterns in incorrect responses. Conclusion: Both ChatGPT 3.5 and 4 effectively handled knowledge-based, case history, and comprehension questions, with ChatGPT 4 being more reliable and surpassing the performance of 3.5. ChatGPT 4's perfect score in comprehension questions underscores its trainability in specific subjects. However, both versions exhibited weaker performance in mathematical analysis, suggesting this as an area for improvement.

The Design of Mobile Medical Image Communication System based on CDMA 1X-EVDO for Emergency Care (CDMA2000 1X-EVDO망을 이용한 이동형 응급 의료영상 전송시스템의 설계)

  • Kang, Won-Suk;Yong, Kun-Ho;Jang, Bong-Mun;Namkoong, Wook;Jung, Hai-Jo;Yoo, Sun-Kook;Kim, Hee-Joung
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2004.11a
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    • pp.53-55
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    • 2004
  • In emergency cases, such as the severe trauma involving the fracture of skull, spine, or cervical bone, from auto accident or a fall, and/or pneumothorax which can not be diagnosed exactly by the eye examination, it is necessary the radiological examination during transferring to the hospital for emergency care. The aim of this study was to design and evaluate the prototype of mobile medical image communication system based on CDMA 1X EVDO. The system consists of a laptop computer used as a transmit DICOM client, linked with cellular phone which support to the CDMA 1X EVDO communication service, and a receiving DICOM server installed in the hospital. The DR images were stored with DICOM format in the storage of transmit client. Those images were compressed into JPEG2000 format and transmitted from transmit client to the receiving server. All of those images were progressively transmitted to the receiving server and displayed on the server monitor. To evaluate the image quality, PSNR of compressed image was measured. Also, several field tests had been performed using commercial CDMA2000 1X-EVDO reverse link with the TCP/IP data segments. The test had been taken under several velocity of vehicle in seoul areas.

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Analysis of revision anterior cruciate ligament reconstruction (전방 십자인대 재재건술의 분석)

  • Park, Chan-Hee;Song, Eun-Kyoo;Seon, Jong-Keun;Yim, Ji-Heoun;Kang, Kyung-Do;Lee, Tae-Min
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.2
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    • pp.47-53
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    • 2011
  • Purpose: As the number of the anterior cruciate ligament (ACL) reconstruction has increased, the incidence of revision of ACL reconstruction due to reconstruction failure has been also increased. Therefore, authors analyzed the reason of the failure of ACL reconstruction and the clinical result of the ACL revision. Materials and methods: From February 1998 to July 2010, we selected 36 cases which was followed at least 12months after the ACL reconstruction failure. Duration from reconstruction to revision, the average duration was 60 months (5~334) and on first reconstruction, we used allograft on 23 cases (63.9%) and autograft on 13 cases (36.1%). For the main symptom of ACL reconstruction failure, instability was the most common symptom, and 35 cases (97.5%) were undergone only one reconstruction and 1case (2.5%) was undergone two reconstruction. Clinical results were evaluated by Lysholm knee joint score, pivot shift test, and Telos device. Results: Average follow-up duration of the patients was 21 months (12~40), and the reason for the ACL reconstruction failure, trauma was most common by 19 cases (52.8%), malposition of the femoral tunnel was 13 cases (36.1%), malposition of the tibia tunnel was 1case (2.8%), and failure of osteointegration was 3 cases (8.4%). On performing the ACL revision, we used allograft on 34 cases (94%) and autograft on 2 cases (6%), and 21 cases accompanied injury of the meniscus (medial meniscus 14 cases, lateral meniscus 7 cases). Lysholm knee joint score was improved from 66.5 points, preoperatively to 92 points on last follow-up (p<0.01). In most cases, patients were satisfied (92%) with the operation results. Tegner activity score was also improved from 2.0 points preoperatively to 6.2 points on the last follow-up. On Lachman and pivot sift test, 33 cases and 30 cases were improved to grade I respectively, and on stability test using Telos device, the bilateral difference was improved from mean 15.5 mm preoperatively to 4.5 mm on the last follow-up. Conclusion: After 1 year follow-up, Revision of ACL had a little anterior instability but it showed satisfactory result on clinical result and patient's subjective satisfaction.

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Clinical Results of Anterolateral Thigh Perforator Flap for Soft Tissue Reconstruction of the Foot and Ankle (족부 및 족관절부 연부조직 재건을 위한 전외측 대퇴 천공지 피판술의 임상결과)

  • Han, Soo-Hong;Hong, In Tae;Lee, Yohan;Jo, Yong-Gil;Kwon, Young Woo
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.40-48
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    • 2017
  • Purpose: Soft tissue reconstruction of a defect around the foot and ankle is a particularly challenging procedure due to the anatomical and functional characteristics of this area. Hence, only a limited number of treatment options are available. Moreover, if patients wish to avoid additional scars on the ipsilateral lower leg for cosmetic reasons, even fewer options are available for treatment. The authors used an anterolateral thigh perforator flap for soft tissue defects in this area, when other surgical options were inadequate. The aim of this study was to report the clinical results and the efficacy of this procedure. Materials and Methods: Sixteen cases of soft tissue defects around the foot and ankle were included. Participants included 12 male and 4 female subjects, and the mean age was 34 years. The most common cause of defect was acute trauma, and the average follow-up period was 33 months. Flap survival time, surgical complications, and ambulation status at the final follow-up stage were evaluated. Results: All 16 flaps successfully survived, except for one case with partial flap necrosis that was thought to be due to weight bearing earlier than scheduled. All patients were able to walk independently without any aid at the final follow-up stage. No patients showed other significant surgical complications. Conclusion: The anterolateral thigh perforator flap is a good alternative for soft tissue defects of the foot and ankle, when other options are not applicable. This study also demonstrated that surgery using an anterolateral thigh perforator flap is safe and highly reliable.

Incidence and Associated Factors of Delirium after Orthopedic Surgery (정형외과 수술 후 발생한 섬망의 발생 빈도와 관련 인자)

  • Lee, Si-Wook;Cho, Chul-Hyun;Bae, Ki-Cheor;Lee, Kyung-Jae;Son, Eun-Seok;Um, Sang-Hyun
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.2
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    • pp.157-163
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    • 2019
  • Purpose: To investigate the incidence and associated factors of delirium after orthopedic surgery. Materials and Methods: A total of 2,122 cases, who were older than 20 years and underwent orthopedic surgery at a single medical center during a one year period were included. Among them, 132 patients who were diagnosed with delirium after surgery under the Diagnostic and Statistical Manual of Mental Disorders-V criteria and medicated under the consultation of a psychiatrist were included in the study The differences in the incidence of delirium and several affecting factors were analyzed. Results: The overall incidence of delirium after surgery was 6.2% (132 in 2,122 cases). The mean age of the delirium group was 77.4 years (range, 54-92 years), which was higher than that of the non-delirium group (58.1 years). The percentage of women in the delirium group was 63.6% (84 in 132 cases), which was higher than that of the women in the non-delirium group (49.0%). The incidence of delirium after surgery was 9.3% (85 in 916 cases) due to trauma and 3.9% (47 in 1206 cases) due to disease. The incidence of postoperative delirium according to the surgical region was 29.2% (7 in 24 cases) in two or more regions, 13.7% (72 in 526 cases) in the hip, and 9.6% (14 in 146 cases) in the spine, 3.5% (20 in 577 cases) in the knee-lower leg, 2.5% (5 in 199 cases) in the foot-ankle, 2.4% (11 in 457 cases) in the shoulder-elbow, and 1.6% (3 in 189 cases) in the forearm-wrist-hand. Delirium occurred more rapidly in women and surgery due to disease, and the duration of delirium was longer in patients with dementia and major depressive disorders. Conclusion: The incidence of postoperative delirium was high in cases of surgery due to trauma and in cases of surgery in two or more sites. The incidence of postoperative delirium according to a single surgical region was higher in the order of the hip, spine, and knee. Active intervention is needed regarding the correctable risk factor.

Transection of the posterior horn of the medial meniscus at the posterior tibial attachment - Clinical features and A new repair technique (Pullout suture) - (내측 반월상 연골 후각의 후방 경골 부착부위의 절단 파열 - 임상 양상 및 새로운 봉합 수기(pullout suture) -)

  • Ahn, Jin-Hwan;Ha, Chul-Won;Kim, Ho;Kim, Sung-Min
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.2
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    • pp.109-114
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    • 1999
  • Purpose : The importance of meniscal repair is well recognized. But transeciton of the posterior horn of the medial meniscus at the posterior tibial attachment is rarely documented and known irreparable. We experienced 9 cases of transection, and present clinical features and pull out suture technique. Methods and Materials : There were 9cases of transection of the posterior horn of medial meniscus from September 1998 to July 1999 in our hospital. Age was 59.3 years in average and ranged from 38 to 70years. Clinical features and MRI made diagnosis in all cases. We confirmed the diagnosis with arthroscopy and repaired the transection with pullout suture technique. Clinical features : Transection of the posterior horn of the medial meniscus at the posterior tibia attachment occurred frequently in middle aged people. They complained posterior knee pain, but they have no history of definitive trauma. Characteristically they had difficulty in full flexion of the knee and in having a squatting position. MRI is very important in diagnosis of transection, especially in coronal view, there is separation of the posterior horn of the meniscus from the posterior tibial attachment. Surgical technique : Pullout suture technique includes debridement of fibrous or scar tissue, exposure of the subchondral bone of the posterior tibial attachment site, suture the transected end of the meniscus with PDS suture, bone tunnel formation from the anteromedial aspect of the proximal tibia, insertion of wire loop through the tibia tunnel, pull the PDS suture through the tibia tunnel out of the joint and stabilize the PDS with post-tie technique to the proximal tibia. Conclusion : Transection of the posterior horn of the medial meniscus at the posterior tibial attachment is not common clinically and rarely documented. Clinical features and MRI are very important in diagnosis of this type tear. Arthroscopic pullout sutures is useful for treatment of this type tear of the meniscus.

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ORTHODONTIC TRACTION OF HORIZONTALLY ERUPTED LOWER LATERAL INCISOR ON THE LINGUAL SIDE (설측으로 수평 맹출한 하악 측절치의 교정적 견인)

  • Mah, Yon-Joo;Sohn, Hyung-Kyu;Choi, Byung-Jai;Lee, Jae-Ho;Kim, Seong-Oh
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.1
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    • pp.117-123
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    • 2010
  • Tooth eruption is the movement of the tooth from the developing place in the alveolar bone to the functional position in the oral cavity. The permanent incisors originate from the dental lamina on the lingual side of preceding deciduous tooth and erupt to the level of the occlusion through the well developed gubernacular cord. Ectopic eruption is a developmental disturbance in the eruption pattern of the permanent dentition. Most of the ectopically erupted lower incisor has been found in lingual side. The ectopically erupted tooth could be repositioned by orthodontic force in the early mixed dentition, which could help preventing the problems of loss of space and the lingual tilting of the lower anterior teeth. An eight-year-old girl visited the department of pediatric dentistry, Yonsei Dental University Hospital, for the evaluation and the treatment of the lower right lateral incisor, which was horizontally erupted in the lingual side, parallel to the mouth floor. Her tongue was placed on the labial side of that tooth. There was no previous dental history of dental caries or trauma on the pre-occupied primary incisor. Clinical and radiographic examinations including the computed tomography(CT), showed no evidence of dilacerations on root. Therefore, we decided to start active orthodontic traction of the lower right lateral incisor. We designed the fixed type of buccal arch wire and the lip bumper with hook for the traction. Button was attached to the lingual side of the ectopically positioned tooth. Elastic was used between the appliance and the button on that tooth. After the tooth become upright over the tongue level, appliance was change to the removable type and periodic check-up with occlusal guidance was followed to monitor the position of the tooth. In this case using the fixed appliance with modified form of lip bumper and hook embedded in acrylic part instead of extraction was very efficient up-righting the ectopically erupted tooth toward the occlusal plane.