• Physical Therapy Rehabilitation Science
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• v.10 no.1
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• pp.1-9
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• 2021

Objective: Joint mobilization for arthrokinematics altered by the positional fault of chronic ankle instability (CAI) is an effective intervention for stabilization. In this study, we compared the effects of ankle dorsi flexion range of motion (DFROM) and dynamic balance ability (DBA) in CAI patients via passive joint mobilization (PJM), a method traditionally performed in previous studies, and active joint mobilization (AJM), a method that can have a greater effect on cortical excitability with spontaneous movements. Design: Single-blind two-arm randomized controlled trial Methods: A total of 30 participants were registered: 15 each to the PJM and AJM groups. Each participant received a total of 10 intervention sessions, 10 minutes per session, 5 times a week for 2 weeks. PJM used Maitland's mobilization method to apply joint mobilization with talus in the posterior direction and AJM used an angular joint motion to induce patient's voluntary motion of medial malleolus anterior gliding and lateral malleolus posterior gliding, respectively. DFROM of the ankle was measured by using tape and DBA was evaluated by using the balance system. Results: Significant improvement was observed after intervention in both the PJM and AJM groups except for the DBA-anterior and DBA-right variables of the PJM group. There were statistically significant differences between the AJM and PJM groups in the DFROM, DBA-anterior, DBA-posterior, and DBA-right variables. Conclusions: The overall improvement of DFROM and DBA was found to be more effective in joint mobilization including voluntary movement. When it is accompanied by voluntary movement, it further affects the neuromuscular system of the ankle.

• Tuberculosis and Respiratory Diseases
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• v.85 no.1
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• pp.25-36
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• 2022

Background: Only a few studies directly compared the therapeutic efficacy and safety of two pressurized metered-dose inhalers (pMDIs) in asthma. We analyzed the asthma treatment outcomes, safety, and patient preferences using formoterol/beclomethasone (FORM/BDP), a pMDI with extra-fine particles, compared with formoterol/budesonide (FORM/BUD), another pMDI with non-extra-fine particles. Methods: In this randomized, double-blind, double-dummy parallel group study, 40 adult asthmatics were randomized to FORM/BDP group (n=18; active FORM/BDP and placebo FORM/BUD) or FORM/BUD group (n=22; active FORM/BUD and placebo FORM/BDP). During the two visits (baseline and end of 8-week treatment), subjects were asked to answer questionnaires including asthma control test (ACT), asthma control questionnaires (ACQ), and Quality of Life Questionnaire for Adult Korean Asthmatics (QLQAKA). Lung function, compliance with inhaler, and inhaler-handling skills were also assessed. Results: Ten subjects in the FORM/BDP group and 14 in the FORM/BUD group completed follow-up visits. ACT, ACQ, QLQAKA (a primary outcome), and adverse events did not differ between two groups. We found that the increase in forced expiratory volume in 1 second/forced vital capacity and forced expiratory flow at 25% to 75% of the pulmonary volume in the FORM/BDP group was higher than in the FORM/BUD group. Regarding preference, subjects responded that the flume velocity of FORM/BDP was higher, but more adequate than that of FORM/BUD. They also answered that FORM/BDP reached the trachea and bronchus and irritated them significantly more than FORM/BUD. Conclusion: The use of pMDI with extra-fine particles may relieve small airway obstruction more than the one with non-extra-fine particles despite no significant differences in overall treatment outcomes. Some asthmatics have a misconception about the adequacy of high flume velocity of pMDIs.

• Journal of radiological science and technology
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• v.47 no.3
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• pp.175-182
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• 2024

Advanced modeled iterative reconstruction (ADMIRE) represents a repetitive reconstruction method that can adjust strength and kernel, each of which are known to affect computed tomography (CT) image quality. The aim of this study was to quantitatively analyze the noise and spatial resolution of CT images according to ADMIRE control factors. Patient images were obtained by applying ADMIRE strength 2 and 3, and kernel B40 and B59. For quantitative evaluations, the noise level, spatial resolution, and overall image quality were measured using coefficient of variation (COV), edge rise distance (ERD), and natural image quality evaluation (NIQE). The superior values for the average COV, ERD, and NIQE results were obtained for the ADMIRE reconstruction conditions of ADMIRE 2 + B40, ADMIRE 3 + B59, and ADMIRE3 + B59. NIQE, which represents the overall image quality based on no-reference, was about 6.04 when using ADMIRE 3 + B59, showing the best result among the reconstructed image acquisition conditions. The results of this study indicate that the ADMIRE strength and kernel chosen for use in ADMIRE reconstruction have a significant impact on CT image quality. This highlights the importance of adjusting to the control factors in consideration of the clinical environment.

• Korean Circulation Journal
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• v.52 no.5
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• pp.354-364
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• 2022

Background and objectives: To compare the safety and efficacy of a new everolimus-eluting stent with an abluminal-coated biodegradable polymer (Osstem Cardiotec Centum) with those of the Xience Alpine stent (Xience). Methods: This randomized, prospective, multicenter, parallel-designed, single-blind trial was conducted among patients with myocardial ischemia undergoing percutaneous coronary intervention (PCI) from 21st September 2018 until 3rd July 2020. The primary efficacy endpoint was in-segment late lumen loss (LLL) at 270 days after the procedure and the primary safety endpoints were major adverse cardiac events (MACE), composite of cardiac death, myocardial infarction, and target lesion revascularization. Results: We enrolled 121 patients and analyzed 113 patients who finished 270 days of follow-up for the primary efficacy endpoint. The mean age of the participants was 66.8 years. As for the primary efficacy endpoint, LLL of the Osstem Cardiotec Centum group was 0.09±0.13 mm and that of the Xience group was 0.12±0.14 mm (upper limit of 1-sided 95% confidence interval, 0.02; p for non-inferiority, 0.0084). This result demonstrates the non-inferiority of the Osstem Cardiotec Centum. As for the primary safety endpoint, MACE occurred in one patient (1.59% of the Xience group). Meanwhile, no MACE occurred in the Osstem Cardiotec Centum group. Conclusions: The Osstem Cardiotec Centum is non-inferior to the Xience Alpine^® stent and is confirmed to be safe. It could be safely and effectively applied to patients with coronary artery disease undergoing PCI.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.4
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• pp.213-221
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• 2020

Background: Complications following impacted third molar surgery significantly affect patients' quality of life during the immediate postoperative period. This study aimed to achieve the proper anesthesia method by comparing the effect of the application of lidocaine alone with the application of lidocaine and articaine simultaneously in reducing the complications during and following impacted mandibular third molar surgery. Methods: The study design was a split-mouth double-blind randomized clinical trial. The study was conducted on 13 patients (26 samples) referred for elective surgical removal of bilateral impacted mandibular third molar with similar difficulty on both sides. Each patient underwent similar surgical procedures on two separate appointments. Each patient randomly received 2% lidocaine for conventional inferior alveolar nerve block and 4% articaine for local infiltration before the surgery on one side (group A) and 2% lidocaine alone (for both block anesthesia and infiltration) before the surgery on the other side (group B). Intraoperative and postoperative variables for both groups were established and statistically analyzed. Results: The findings showed that pain on the first day after surgery in group A was significantly lower than that in group B. The patients in group A mentioned experiencing less discomfort following the surgery. The increased horizontal swelling on the first and third days following surgery and oblique swelling on the seventh day in patients in group B were statistically significant. Conclusion: Choosing an appropriate anesthetic drug for oral surgery, specifically impacted third molar surgery, is dependent on the clinician's opinion, however; it seems that the combination of lidocaine and articaine may control the patient's pain significantly better than lidocaine alone.

• Journal of Chest Surgery
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• v.6 no.1
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• pp.89-94
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• 1973

Esophagel atresia and tracheoesophageal fistula may occur as separate entities but usually occur in combination. First described by Durston in 1670, esophageal atresia was not successfully treated until 1939 when Ladd in Boston and Leven in St. Paul obtained the first survivors utilizing the methods of gastrostomy, esophagostomy and extrapleural ligation of the tracheoesophageal fistula as multiple operations which required months of hospitalization. Two years later Cameron Haight performed the first successful primary repair and afterward about 2000 cases of esophageal atresia with distal tracheoesophageal fistula reported in the world. In Korea, there appeared about 27 cases in the literature and 8 successful repaired cases noted in these year. Anther report two cases of esophageal atresia, of which one case was successfully treated with Haight`s method. Case 1.: Normal full term delivered boy with chief complaints of respiratory difficulty and persistent drooling with chocking, 3. lkg, was admitted with emergency 5 hours after delivery. Physical findings revealed no specific abnormal signs except distended abdomen and grunting respiration. Esophagograrn and bronchogram revealed proximal esophageal atresia and distal tracheoesophageal fistula proximal to the carina. Parent refused operative therapy and patient died 24 hours after discharge. Case 2. :3. lkg. normal full term delivered girl was admitted 4 days after delivery with chief complaints of regurgitation after feeding, chocking, cyanotic spell and fever since the day after delivery. Physical examination revealed persistent drooling, grunting respiration, and fever with moderate dehydration. Tracheoesophageal suction and fluid therapy with antibiotics improved her condition and subsided ]pneumonic condition. Esophagogram revealed markedly dilated proximal esophagus as blind loop and stomach distended with gas, and repairing operation as Haight`s method was performed on the 7th day after delivery. Patient tolerated all the operative procedure well and recovered uneventfully. Esophagogram on the 7th postoperative day showed passage of the lipiodol through the anastomotic side with moderate stricture,and feeding permitted. Patient tolerated all the feeding amount well and discharged on the 11th postoperative day. Followup revealed intermittent regurgitation after feeding and corrected with bougination.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.1
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• pp.49-59
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• 2021

Background: To evaluate changes in the effectiveness of phentolamine mesylate in combination with different local anesthetics (LAs) and vasoconstrictors. A prospective randomized double-blind study was conducted with 90 patients divided into three groups, with each group being administered one of three different LAs: lidocaine 2% 1/80,000, articaine 4% 1/200,000, and bupivacaine 0.5% 1/200,000. Methods: We compared treatments administered to the mandible involving a LA blockade of the inferior alveolar nerve. Results were assessed by evaluating reduction in total duration of anesthesia, self-reported patient comfort using the visual analog pain scale, incidence rates of the most common adverse effects, overall patient satisfaction, and patient feedback. Results: The differences among the three groups were highly significant (P < 0.001); time under anesthesia was especially reduced for both the lip and tongue with bupivacaine. The following adverse effects were reported: pain at the site of the anesthetic injection (11.1%), headaches (6.7%), tachycardia (1.1%), and heavy bleeding after treatment (3.3%). The patients' feedback and satisfaction ratings were 100% and 98.9%, respectively. Conclusions: Efficient reversal of LAs is useful in dentistry as it allows patients to return to normal life more readily and avoid common self-injuries sometimes caused by anesthesia. Phentolamine mesylate reduced the duration of anesthesia in the three studied groups, with the highest reduction reported in the bupivacaine group (from 460 min to 230 min for the lip and 270 min for the tongue [P < 0.001]).

• Journal of Korean Academy of Fundamentals of Nursing
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• v.23 no.2
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• pp.184-193
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• 2016

Purpose: The aims of the current study were to evaluate the effects of superficial cold and heat after spine surgery on pain, satisfaction with pain control and comfort level, and to identify subjective responses and adverse effects. Methods: A prospective, single-blind, randomized controlled trial was utilized. The intervention group (n=36) received superficial cooling until the wound drain was removed and thereafter followed by superficial heating until discharge, while the control group (n=34) received only superficial cooling until wound drain was removed. Data were collected from August 4 to November 11 2014. Results: There was significant difference in pain according to time within groups (F=71.87, p<.001). However, we found no difference in pain between groups. The intervention group reported higher patient satisfaction with pain control (4 vs 3, z=-2.83, p=.005) and higher comfort level (5 vs 4, z=-4.12, p<.001) than the control group. Conclusion: Results indicate that sequential application of superficial cold and heat is a useful method in clinical practice for management of pain after spine surgery.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.6 no.2
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• pp.84-93
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• 2010

The developmental disorder(intellectual disorder(ID) and autism spectrum disorder(ASD)) can severely impair a patient's ability to communicate and socialize. So they require physical management techniques, pharmacologic agents, and general anesthesia more than the normal at the dental clinic. The behavior therapy is a kind of the psychotherapy and is applied to the patient with behavioral problems. Seoul Dental Hospital for Disabled(SDHD) set up the Dental Behavior Clinic for the patients with developmental disorder and treated 32 patients with ID or ASD, blind. 18 patients were treated according to the ordinary plans, 14 patients stopped the treatment by different reasons. The various results of the treatment were produced by the kind or severity of the diseases, age and cooperation of the patients and the caregivers. Especially, the behavior therapist helped to figure out the characteristics of the patients and to make individualized treatment plans. In the future, it will be necessary to treat more patients and to make the dental behavior therapy objectify. And through the dental behavior therapy, it will be expected that the patients will become more cooperative to the dental clinic and can receive regular check-up peacefully, reducing the frequency of the general anesthesia.

• The Korean Journal of Pain
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• v.13 no.1
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• pp.93-96
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• 2000

Background: Psoas compartment block with local anesthetics and corticosteroids is one of the treatments which provides long term analgesia of the lower back and anterior thigh unilaterally, and its technical easiness and safety allows blind application without C-arm guidance in the out-patient clinic. This study aimed to evaluate the mean of the depth from the skin to the psoas compartment, and its correlation to the following attributes: age, weight, height and PI (Ponderal Index). Methods: We investigated 28 patients who underwent psoas compartment block. All blocks were performed using Chayen's method (punctured at the point of 3 cm caudally and 5 cm laterally from the 4th lumbar vertebral spinous process) with a 22 G, 8 cm Tuohy needle under C-arm guidance. We recorded the depth from skin to the psoas compartment, height, weight and PI (weight (kg)/height (cm)$\times100$ (%)). Data were analyzed using the Pearson product-moment correlation coefficients. The correlations between the depth and other attributes identified by p-value of less than 0.05 were considered statistically significant. Results: The mean depths from skin to the psoas compartment were $6.02{\pm}0.28$ cm in men, $5.44{\pm}0.22$ cm in women. There is no significant correlation between the depth and other patient's attributes. Conclusions: The mean depths from skin to the psoas compartment may be one of the guide for psoas compartment block in outpatient clinics without C-arm guidance.