• 제목/요약/키워드: conservative conditions

검색결과 395건 처리시간 0.028초

노인 환자에게 투석이 필요한가? (Do Elderly Patients Need Dialysis?)

  • 선인오
    • The Korean Journal of Medicine
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    • 제99권4호
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    • pp.165-168
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    • 2024
  • Initiating dialysis at an advanced age is both a clinical challenge and an ethical dilemma, because the benefits in older adults with advanced chronic kidney disease may be offset by high rates of dialysis-related morbidity. Geriatric conditions, such as aging, frailty, functional impairment, and cognitive impairment, significantly influence the prognosis of elderly patients. Therefore, it becomes important to provide patients and families with prognostic information regarding timing of initiation, which is further complicated by the competing mortality risk. Shared decision-making by clinicians and patients can yield better clinical outcomes and quality of life. Through this approach, patients can opt for the most appropriate treatment based on their personal values, which often entails conservative management.

요통으로 한방병원에 입원한 환자의 병력기간별 호전도에 관한 연구 (The Study on History Period and Treatment Outcomes of Patients Admitted to a Korean Medicine Hospital for Low Back Pain)

  • 조창영;김원우;성익현;이갑수;정재훈;박상원;이진호;하인혁
    • 한방재활의학과학회지
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    • 제24권4호
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    • pp.137-143
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    • 2014
  • Objectives Low back pain causes disability and incurs large socioeconomic burden. Many cases of acute low back pain progress into chronic conditions. As the treatment period extends, burden of socioeconomic expenses also rises. Thus this study is to investigate whether history period influences improvement rate of pain and disability in the patients who receive conservative Korean medicine treatment. Methods 447 inpatients who received conservative Korean Medicine treatment for the management of low back pain have been grouped into acute, sub-acute and chronic according to the length of history period. NRS, ODI and improvement rate of each group were investigated. Treatment every patient has received as follow; acupuncture, herbal medicine, Chuna manipulation, bee venom, and physical treatment. Results Acute patients showed improvement with NRS of $3.98{\pm}2.50$ and ODI of $28.04{\pm}21.54$. The NRS of sub-acute patients showed improvement with NRS of $2.81{\pm}2.07$, ODI also showed improvement with $11.64{\pm}13.94$. Statistically significant difference was observed in NRS, ODI and improvement for acute patients. Improvement in pain and disability was observed to be larger. Conclusions It demonstrated that receiving valid conservative Korean medicine treatment is beneficial for low back pain patients in improvement of their pain and disability.

근단부 성형 크기에 따른 다양한 전동 니켈티타늄 파일의 중심 변위율 및 만곡도 감소 비교 (Comparison of the centering ratio and canal curvature reduction according to the apical preparation size using various NiTi rotary instruments)

  • 곽상원;박정길;허복;김현철
    • 대한치과의사협회지
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    • 제47권7호
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    • pp.435-443
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    • 2009
  • The purpose of this study was to compare the centering ratio and reduction of canal curvature according to the preparation sizes of #30, #40 and #50 using three rotary NiTi instruments which have different shaft tapers. Seventy-two simulated root canals in clear resin blocks (Endo Training Bloc; Dentsply Maillefer, Ballaigues, Switzerland) were divided as following 3 groups according to the file system; the 24 canal blocks prepared with each of ProTaper Universal system (Group P), LightSpeed eXtra system (Group L), and K3 (Group K). The pre- and post-instrumented root canals were scanned and superimposed to evaluate and calculate the centering ratio and reduction of canal curvature. Mean scores of each group were statistically analyzed using one-way ANOV A and Duncan's multiple range test for post-hoc comparison. The results were as followings: 1. Group L showed better centering ratio, followed by K and P. And all experimental groups generally showed increasing tendency of centering ratio as the apical size was increasing from #30 to #50, except at 1 mm level of group P where showed reducing tendency of centering ratio. The smaller the ratio, the better the instrument remained centered in the canal. 2. Group P showed more decrease of canal curvature at all apical shaping size (p < 0.05). Under the conditions of this study, the shaft design could affect the quality of canal shaping and the smooth taperless flexible (LightSpeed) shaft design was capable of preparing canals with good morphological characteristics in curved canals.

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전동식 니켈 티타늄 파일의 표면 결함 및 단면 형태가 반복응력 하에서 피로 파절에 미치는 영향 (EFFECT OF SURFACE DEFECTS AND CROSS-SECTIONAL CONFIGURATION ON THE FATIGUE FRACTURE OF NITI ROTARY FILES UNDER CYCLIC LOADING)

  • 신유미;김의성;김광만;금기연
    • Restorative Dentistry and Endodontics
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    • 제29권3호
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    • pp.267-272
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    • 2004
  • The purpose of this in vitro study was to evaluate the effect of surface defects and cross-sectional configuration of NiTi rotary files on the fatigue life under cyclic loading. Three NiTi rotary files ($K3^{TM},{\;}ProFile^{\circledR},{\;}and{\;}HERO{\;}642^{\circledR}$) with #30/.04 taper were evaluated. Each rotary file was divided into 2 subgroups : control (no surface defects) and experimental group (artificial surface defects), A total of six groups of each 10 were tested. The NiTi rotary files were rotated at 300rpm using the apparatus which simulated curved canal (40 degree of curvature) until they fracture. The number of cycles to fracture was calculated and the fractured surfaces were observed with a scanning electron microscope. The data were analyzed statistically. The results showed that experimental groups with surface defects had lower number of cycles to fracture than control group but there was only a statistical significance between control and experimental group in the $K3^{TM}$ (p<0.05), There was no strong correlation between the cross-sectional configuration area and fracture resistance under experimental conditions. Several of fractured files demonstrated characteristic patterns of brittle fracture consistent with the propagation of pre-existing cracks. This data indicate that surface defects of NiTi rotary files may significantly decrease fatigue life and it may be one possible factor for early fracture of NiTi rotary files in clinical practice.

산도변화와 침지시간이 광중합 복합레진의 잔류단량체 유출에 미치는 영향 (EFFECT OF PH AND STORAGE TIME ON THE ELUTION OF RESIDUAL MONOMERS FROM POLYMERIZED COMPOSITE RESINS)

  • 전철민;유현미;권혁춘
    • Restorative Dentistry and Endodontics
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    • 제29권3호
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    • pp.249-266
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    • 2004
  • The purpose of this study was to determine whether pH and time has any influence on the degradation behavior of composite restoration by analyzing the leached monomers of dental composites qualitatively and quantitatively after storage in acetate buffer solution as a function of time using high performance liquid chromatography (HPLC) / mass spectrometer. Materials and Methods:Three commercial composite restorative resin materials (Z-250, Heliomolar and Aeliteflo) with different matrix structure and filler composition were studied. Thirty specimens (7mm $diameter{\times}2mm$ thick) of each material were prepared. The cured materials were stored in acetate buffer solution at different pH (4, 7) for 1, 7 and 45days. As a reference, samples of unpolymerized composite materials of each product were treated with methanol (10mg/ml). Identification of the various compounds was achieved by comparison of their mass spectra with those of reference compound, with literature data. and by their fragmentation patterns. Data were analysed statistically using ANOVA and Duncan's test. Results:1. Amounts of leached TEGDMA in Aeliteflo were significantly larger than those of UDMA in Z-250 and Heliomolar at experimental conditions of different storage time and pH variation (p<0.001). 2. As to comparison of the amounts of leached monomers per sorage time, amounts of leached TEGDMA in Aeliteflo and UDMA in Z-250 and Heliomolar were increased in the pH 4 solution more significantly than in the pH 7 solution after 1day, 7days and 45days, respectively (p<0.001). 3. In total amounts of all the leached monomers with storage times, the overall amounts of pH 4 extracts were larger than those of pH 7 extracts for all resin groups, but there was no significant difference (p>0.05).

주근단공의 조건에 따른 Root ZX의 정확성 평가 (An evaluation of the accuracy of Root ZX according to the conditions of major apical foramen)

  • 박신영;이동균;황호길
    • Restorative Dentistry and Endodontics
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    • 제37권2호
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    • pp.68-73
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    • 2012
  • Objectives: The purpose of this study was to assess the accuracy of Root ZX (J. Morita Corp.) according to the location of major foramen and open apex. Materials and Methods: 81 mandibular premolars with mature apices were selected. After access preparation, 27 teeth were instrumented to simulate open apices. 54 teeth were classified according to location of major foramen under surgical microscope (${\times}16$). The file was fixed at the location of apical constriction by Root ZX using glass ionomer cement .The apical 4 mm of the apex was exposed and photo was taken and the distance from file tip to the major foramen was measured by calibrating metal ruler on graph paper. The results were statistically analyzed using ANOVA and Scheffe test at p < 0.05 level. Results: Mean distance from file tip to major foramen was 0.308 mm in Tip foramen group (I), 0.519 mm in Lateral foramen group (II) and 0.932 mm in open apex group (III). Root ZX located apical constriction accurately within ${\pm}0.5mm$ in group I of 85.71%, in group II of 59.09%, and in group III of 33.33%. There was a statistically significant difference between group I and III (p < 0.05). Conclusion: Root ZX located apical constriction accurately regardless of location of major foramen. However, Root ZX couldn't find it in open apex. Clinicians have to use a combination of methods to determine an appropriate working length at open apex. It may be more successful than relying on just electronic apex locator.

요통환자의 물리치료에 관한 임상적 연구

  • 이재학;장수경;한동직
    • 대한물리치료사협회지
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    • 통권3호
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    • pp.11-18
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    • 1981
  • A Clinical Study of physical Therapy on the Low Back Conditions J. B. Rhee, S. K. fang, D. J, Han Low back pain usually is due primarily to a faulty mechanics, ,dis'c disease and other contributing factors .Conservative treatment of low back pain is considered to be useful with applicationes physical therapeutic measures including elimination of gravity, but surgical treatment is alternative to conservative .This study 1s conducted to analyse and evaluate efficiency of physical therapy on the low back pain on 452 cases who were treated at the Korea University Hospital, from January 1, 1978 to December 31. 1978.The results obtained in this study are summarized as follows :1. Sex distribution of total rationㄷs surveyed showed that 5l.3% in male and 487% in female.2 . In the age distrbution. the mest Liedominant age group was 25-54 years with7O.8 % .3 . The most proportion of the cases by occupation was housewife 27.7%, clerical and office workers 2l.7% , students 12.8% and labours 12.2 % respectively .4 . The most common causes of low back conditions classified, the Strain or Trau-rla revealed the highest frequency with 58.4% and thc Herniated Nucleus Pulpe-sus with 29.2 % of the total.5 . The modalities of physical therapy suitable to each cases were applied : 94.0%of all cases were treated with deep thermotherapy, 91.4 % hydrocollator steampack, 86.7% strengthening exercise of the weak muscles, pelvic traction 34.1%.6 . In regard to the duration required for the physical therapy. Herniated Nucleus Pulposus were approximately 4 weeks and strain or trauma were 2 weeks.7 . The improvement by physical therapy on lcw back conditions was classified in-to 41grades and showed following reaulits , excellent 42.5%, good 37.8%, fair 13.7% and poor 6.0% respectively.

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다양한 파장폭의 가시광선에 의해 중합된 복합레진의 미세경도와 변연누출도 (MICROHARDNESS AND MICROLEAKAGE OF COMPOSITE RESIN CURED BY VISIBLE LIGHT WITH VARIOUS BAND OF WAVELENGTH)

  • 박수만;이재용;한승렬;하상윤;신동훈
    • Restorative Dentistry and Endodontics
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    • 제27권4호
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    • pp.403-410
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    • 2002
  • Several ways of curing are being tried to improve material's properties and reduce marginal gap. However, all are considering about the pattern of light intensity. It was noted from the preliminary study the change of light wavelength from filter changing may give an impact on material's property and microleakage. The object of this study was to verify the effect of filters with various wavelength width on the microhardness and microleakage of composite resin ; hybrid type of DenFil and submicron hybrid type of Esthet X. Composite resins were cured using 3 kinds of filter; narrow-banded(465-475 nm), mid-banded(430-470 nm), wide-banded(400-500 nm). After the estimation of microhardness. degree of dye penetration and the maximum gap from SEM evaluation were done between 4 groups that showed no difference in microhardness value of the lower surface . The results were as follows : 1 Adequate microhardness could not be gained with a narrow-banded filter irrespective of curing time. At the upper surface, DenFil should be polymerized with middle or wide-banded filter for 20 seconds at least, while Esthet X be col$.$ed with middle or wide-banded filter for 30 seconds at least to get simitar hardness value to control group. 2. There was little dye penetration in enamel margin, but all dentin margins skewed much more dye penetration irrespective of curing conditions. Although there was no statistical difference, groups cured with mid-banded filter for 40 seconds and with wide-width filter for 20 seconds showed relatively less dye penetration. 3. It was revealed from the SEM examination that group cured with wide-banded filter had the smallest gap without statistical significance. Spearman's rho test showed that the correlation between the results of dye penetration and SEM examination was very low. From these results, it could be concluded that curing with wide-width filter would be better than the other techniques, even though the curing technique using mid-width filter seems to have its own unique advantage.

Prevotella nigrescens의 용혈특성에 관한 연구 (A STUDY ON THE HEMOLYTIC PROPERTIES OF PREVOTELLA NIGRESCENS)

  • 곽주석;장훈상;장석우;이수종;유용욱;민경산
    • Restorative Dentistry and Endodontics
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    • 제30권4호
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    • pp.335-343
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    • 2005
  • 세균의 용혈활성은 세균이 숙주 내에서 생존하기 위해 필요한 철을 획득하기 위한 특성이며 기능 면에서 볼 때 숙주에 대한 중요한 독력인자로 간주될 수 있다. 본 연구에서는 괴사치수 및 치근단 치주염으로 진단된 환자의 근관에서 분리한 Prevotella nigrescens의 용혈활성을 다양한 조건 하에서 측정하여 그 특성을 규명하는 것을 목적으로 한다. 1. 임상에서 분리한 P. nigrescens와 표준균주인 P. nigrescens ATCC 33563에서 모두 용혈활성이 나타났다. 2. 사람, 면양 및 말 세 가지 종에 대해 용혈활성을 비교한 결과 사람의 적혈구에서 가장 강한 용혈활성을 나타내었다. 3. 용혈소 억제제인 $NaN_3$와 dithiothreitol(DTT)는 농도의존적으로 P. nigrescens의 용혈활성을 감소시켰다 (p<0.05) 4. P. nigrescens가 최대 용혈활성을 나타내는 최적의 pH는 4이었으며, $50^{\circ}C$이하의 온도에서는 용혈활성을 보였으나 $95^{\circ}C$에서 급격히 감소하였다. 5.배양조건에 따른 P. nigrescens의 용혈활성을 비교한 결과 $10\%\;CO_2$배양기에 배양한 경우 혐기성 조건에서 배양한 것보다 더 높은 용혈활성을 보였다.

고농도의 불소를 포함하는 과포화용액이 apatitic crystal growth에 미치는 영향 (THE EFFECT OF THE SUPERSATURATED SOLUTIONS CONTAINING HIGH CONCENTRATIONS OF FLUORIDE ON SEEDED CRYSTAL GROWTH)

  • 권중원;금기연;이승종;정일영;이찬영
    • Restorative Dentistry and Endodontics
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    • 제24권2호
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    • pp.330-336
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    • 1999
  • In biological systems, the mineral that forms hard tissue is of an apatitic nature, and hydroxyapatite($Ca_5OH(PO_4)_3$: HA) is generally considered as the prototype for such a mineral. Thus, the precipitation of HA, having biological implications, has been the subject of several investigations. Crystal growth studies using HA seeds in supersaturated solutions have enhanced our understanding of the process and mechanism involved in seeded crystal growth. From these studies, it has become apparent that the precipitation rate of HA onto the seed crystals depends on the various conditions, especially on the additives. The relation between the supersaturated solution containing fluoride and the process of HA crystal growth enhances the understanding of mechanism of HA crystal growth. Until recently, the studies have been on the crystal growth of enamel minerals and synthetic HA seeds in the supersaturated solution containing 1~2 ppm fluoride. The purpose of the present investigation is to study the effect that fluoride of high concentration has on the crystal growth kinetics of HA. In order to produce the composition found in the secretory enamel fluid, experimental solutions of 1mM Ca, 3mM P, and 100mM Tris as background electrolyte were used. Then this experimental solutions were added to 0, 2, 4, 6, 8, 10 ppm fluoride. The effect of fluoride at high concentrations on the precipitation was examined in a bench-top crystal growth model adopting a miniaturized reaction column. Chemical analysis was employed for characterization of working solutions before and after the experimentation. Remarkable findings were : 1) the amount of crystal growth was gradually accelerated as the fluoride concentration increased until 6 ppm, but decreased in 8 and 10 ppm fluoride; 2) the amount of fluoride ion consumed in crystal formation was constant despite the increase in fluoride concentration.

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