• Title/Summary/Keyword: 개선된 방법

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Outcome of Conservative Treatment for Patients with Disc Displacement of Temporomandibular Joint (측두하악관절 원판변위 환자의 보존적 치료결과)

  • Kim, Kyung-Hee;Kim, Ik-Hwan;Ko, Myung-Yun;Ahn, Yong-Woo
    • Journal of Oral Medicine and Pain
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    • v.32 no.3
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    • pp.305-318
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    • 2007
  • To evaluate the treatment outcome after conservative treatment in patients with TMJ disc displacement which is the most common temporomandibular joint arthropathy, the subjects were chosen among the patients who presented to the Department of Oral Medicine of Pusan National University Hospital, diagnosed as TMDs and treated with conservative methods from 1994 to 2006 for 13 years. 88 patients with diagnosis of DD/cR and 60 patients with diagnosis of DD/sR were selected as the experimental group and 74 patients with diagnosis of masticatory muscle disorder (MMD) were selected as the control group. Subjective symptoms and clinical findings were investigated to evaluate and compare the subjects' status at the first visit and the last visit. The results were as follows; 1. Pain, noise, LOM and MCO measurements of DD/cR, DD/sR and MMD groups were markedly improved after conservative treatments including behavior therapy, physical therapy, medication and splint therapy. 2. At the first visit, high score of pain in MMD group, high score of noise and large MCO measurement in DD/cR group and high LOM score in DD/sR group were observed. At the last visit, high score of noise and increased MCO measurement in DD/cR group and high score of pain and LOM in DD/sR group were observed. 3. Among the patients who complained joint sound at their first visit, about 60% showed complete loss of joint sound after conservative treatment 4. DD/cR and DD/sR groups showed satisfactory outcomes after conservative treatments such as behavior therapy, physical therapy, medication and splint therapy while MMD group showed similar treatment outcome irrespective of the treatment modality used. 5. There was no difference in treatment outcomes after conservative treatments when the subjects were classified and compared according to gender, age group and chronicity. 6. MMD showed satisfactory prognosis in 10 treatments in less than 6 months while DD showed favorable prognosis in 10-20 treatments for 6 months to 2 years.

Clinical effect of smoking on the healing response following scaling and root planing (흡연이 비외과적 치주치료 후 치유반응에 미치는 임상적 영향)

  • Shim, Ji-Yeon;Kim, Tae-Il;Seol, Yang-Jo;Lee, Yong-Moo;Ku, Young;Rhyu, In-Chul;Chung, Chong-Pyoung;Han, Soo-Boo
    • Journal of Periodontal and Implant Science
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    • v.36 no.1
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    • pp.125-137
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    • 2006
  • 1. 목적 흡연은 치주질환의 주요한 위험 인자 중의 하나이다. 일반적으로 흡연자는 비흡연자보다 비외과적 및 외과적 치주치료에 대한 반응이 덜 효과적인 것으로 알려져 있다. 이 연구에서는 중등도의 만성 치주염이 존재하는 한국인 흡연자와 비흡연자를 대상으로 하여, 비외과적 치주치료인 치석 제거술과 치근 활택술을 시행한 후 6개윌 동안의 임상적 치유 반응을 비교해 보고자 하였다. 2. 방법 20명의 중등도 만성 치주염 환자(흡연자 10명, 비흡연자 10명)를 대상으로 치주낭 깊이(Probing Pocket Depth, PPD), 치은퇴축(GR), 치주탐침시 출혈유무(BOP), #16, 12, 24, 32, 36, 44의 치태지수(Plaque Index, Silness & $L{\"{o}}e$ 1964)를 임상변수로 측정하였다. 치주낭 깊이 (PD)와 치은퇴축(GR)은 전자 탐침(Florida $Probe^{(R)}$ Co. Gainesville, FL)을 이용하여 각 치아당 6군데를 측정하였다. 임상적 부착 수준(CAL)은 치주낭 깊이(PD)와 치은퇴축(GR)의 합으로 계산하였다. 초진시에 전악 임상 검사를 시행하였고, 초진시의 치주낭 깊이에 따라 조사 대상이 되는 치아 부위를 선정하였다. 치주적으로 건강한 부위 $(PD{\leq}3mm)$를 대조군인 1군으로 하고 치주낭 깊이가 4 mm를 초과하고 5 mm 미만인 부위를 2군, 5 mm 이상의 치주낭 깊이를 가지는 부위를 3군으로 설정하였다. 비외과적 치주치료인 치석 제거술, 치근 활택술과 구강위생 교육을 시행하였고 2개월(T1), 4개윌(T2), 6개윌(T3)에 선정된 해당 치아 부위에 대해 임상 재검사를 시행하였다. 3. 결과 BOP와 Plaque Index는 초진, 2, 4, 6개월에 흡연자와 비흡연자 간에 유의할 만한 차이가 없었으나 전반적으로 감소하는 경향이 나타났다. 대조군인 l군에 서는 흡연자와 비흡연자 간에 모든 시기에서 PD, GR, CAL에 유의할 만한 차이가 없었다. 치주낭 깊이가 4 mm를 초과하고 5 mm 미만인 2군에서는 비흡연자에서 6개월에 유의할 만한 치주낭 깊이 감소가 나타났으며, 4개월과 6개윌에 유의할 만한 부착수준의 증가가 관찰되었다(p<0.05). 치주낭 깊이가 5 mm이상인 3군에서는 비흡연자에서 치주낭 깊이 감소가 일관되게 더 많이 나타났으나 통계학적으로 유의할 만한 차이는 6개월째에서만 관찰되었다. 2군과 유사하게 치주낭 갚이 감소는 흡연자보다 비흡연자에서 0.6 mm 더 크게 나타났다. 부착수준의 획득은 2군에서는 4, 6개월째에, 3군에서는 6개월째에 비흡연자에서 유의하게 더 많이 일어났다. 초진시의 치주낭 깊이와 각 시기별 ${\Delta}PD$ 간의 상관관계에서는 치주낭 갚이가 5mm 이상인 3군에서 비흡연자의 경우 6개월째에 가장 강한 상관성이 나타났다($r_s=0.43$, p<0.05). 흡연자에서는 3군에서 어떠한 유의한 상관관계도 나타나지 않았다. 결론적으로 중등도 만성 치주염 환자를 대상으로 한 6개윌의 단기간 연구에서 비외과적 치주치료 후 흡연자에서 비흡연자보다 치주낭 깊이 감소의 개선과 부착수준의 획득이 더 적게 나타나 임상적 치유반응이 좋지 않음을 확인하였다. 이는 흡연이 숙주의 치유반응 부정적인 영향을 주기 때문으로 생각된다.

High VPP Combination Chemotherapy for Advanced Non-Small Cell Lung Cancer (진행된 비소세포 폐암에 대한 High-VPP 복합화학요법의 효과)

  • Hong, Seok-Cheol;Han, Pyo-Seong;Lee, Jong-Jin;Cho, Hai-Jeong;Kim, Ju-Ock;Kim, Sun-Young
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.4
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    • pp.367-377
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    • 1993
  • Background: The benefits of combination chemotherapy in unresectable non-small cell lung cancer remain uncertain. But, according to the recent reports, the response rates of cisplatin-based polychemotherapy regimens are higher than those of single agent. Also, the response rates of high-dose cisplatin group are higher than those of low-dose cisplatin group. In attemp to answer the question whether treatments, combination chemotherapy (high VPP) and combination chemotherapy with radiation therapy, improve survival in advanced non-small cell lung cancer, we begin to study. Method: Thirty-five patients above stage III, diagnosed histologically as non-small cell lung cancer, were enrolled. Among them, nineteen received a combination chemotherapy consisting of VP-16 & high-dose cisplatin (100 $mg/m^2$) and/or radiation therapy. The other group (16 subjects) received no therapy. To investigate the differences of survival and response rates between two groups and the side effects related to therapy, we reviewed patients' records. Results: 1) The overall objective response rate was 47%(9/19) with one complete remission. 2) In patients who received polychemotherapy and radiation therapy, the response rate was 60%(6/10) with one complete remission and survival rates of 3 months, 6 months and 12 months were 100%, 70% and 40%. 3) In patients who received polychemotherapy, the response rate was 33% (3/9) with no complete remission and survival rates of 3 months, 6 months and 12 months were 78%, 67% and 33%. 4) Overall, treated patients survived significantly longer (p<0.05) than non-treated patients (median survival 307 days versus 95 days). 5) Analysis of the various prognostic factors disclosed that good performance status, stage III and squamous cell type showed the good response rates. 6) The toxicities were nausea and/or vomiting (100%), alopecia (90%), anemia (79%), leukopenia (69%), thrombocytopenia (2%), increased creatinine (16%) and neurotoxicity (5%). Conclusion: According to above results, there are relatively good results that high VPP combination chemotherapy in advanced non-small cell lung cancer improves survival in the treated group than in the non-treated group. Thus, it is considerd that we select the patients with proper indications and treat them with effective chemotherpy and radiation therapy. But, because improvement related to high VPP ploychemotherapy is not marked in this study, it is necessary that we should investigate follow-up studies in many cases.

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Detection of rpoB Gene Mutation in Rifampin-Resistant M. Tuberculosis by Oligonucleotide Chip (Oligonucleotide chip을 이용한 Rifampin 내성 결핵균의 rpoB 유전자 돌연변이 검출)

  • Park, Soon-Kew;Lee, Min-Ki;Chung, Byung-Seon;Kim, Cheol-Min;Chang, Chul-Hun L.;Park, Hee-Kyung;Jang, Hyun-Jung;Park, Seung-Kyu;Song, Sun-Dae
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.5
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    • pp.546-557
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    • 2000
  • Background : Oligonucleotide chip technology has proven to be a very useful tool in the rapid diagnosis of infectious disease. Rifampin resistance is considered as a useful marker of multidrug-resistance in tuberculosis. Mutations in the rpoB gene coding $\beta$ subunit of RNA polymerase represent the main mechanism of rifampin resistance. The purpose of this study was to develop a diagnosis kit using oligonucleotide chip for the rapid and accurate detection of rifampin-resistance in Mycobacterium tuberculosis. Method : The sequence specific probes for mutations in the rpoB gene were designed and spotted onto the glass slide, oligonucleotide chip. 38 clinical isolates of Mycobacterium were tested. A part of rpoB was amplified, labelled, and hybridized on the oligonucleotide chip with probes. Results were analyzed with a laser scanner. Direct sequencing was done to verify the results. Result : The low-density oligonucleotide chip design어 to determine the specific mutations in the rpoB gene of M. tuberculosis accurately detected rifampin resistance associated with mutations in 28 clinical isolates. Mutations at codons 531, 526, and 513 were confirmed by direct sequencing analysis. Conclusion : Mutant detection using oligonucleotide chip technology is a reliable and useful diagnostic tool for the detection of multidrug-resistance in M. tuberculosis.

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The Differences of Anthropometric and Polysomnographic Characteristics Between the Positional and Non-positional Obstructive Sleep Apnea Syndrome (체위 의존성 및 체위 비의존성 폐쇄성 수면 무호흡증후군의 신체계측인자 및 수면구조의 차이)

  • Park, Hye-Jung;Shin, Kyeong-Cheol;Lee, Choong-Kee;Chung, Jin-Hong;Lee, Kwan-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.6
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    • pp.956-963
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    • 2000
  • Backgrounds : Obstructive sleep apnea syndrome(OSA) can divided into two groups, positional(PP) and non-positional(NPP) obstructive sleep apnea syndrome, according to the body position while sleeping. In this study, we evaluated the differences of anthropometric data and polysomnographic recordings between the two types of sleep apnea syndrome. Materials : Fifty patients with OSA were divided two groups by Cartwright's criteria. The supine respiratory disturbance index (RDI) was at least two times higher than the lateral RDI in the PP group, and the supine RDI was less than twice the lateral RDI in the NPP group. This patients underwent standardized polysomnographic recordings. The anthropometric data and polysomnographic data were analyzed, statistically. Results : Of all 50 patients, 30% were found to be positional OSA. BMI was significantly higher in the PP group(p<0.05). Total sleep time was significantly longer in the PP group (350.6$\pm$28.2min, 333.3$\pm$46.0min, (p<0.05). Sleep efficiency was high in the PP group(89.6$\pm$6.4%, 85.6$\pm$9.9%, p<0.05). Deep sleep was significantly higher and light sleep was lower in the PP group than in the NPP group but no difference was observed in REM sleep between the two groups. Apnea index(AI) and RDI were significantly lower( 17.0$\pm$10.6, 28.5$\pm$13.3, p<0.05) and mean arterial oxygen saturation was higher in the PP group(92.7$\pm$1.8%. p<0.05) than in the NPP group. Conclusion : Body position during sleep has a profound effect on the frequency and severity of breathing abnormalities in OSA patients. A polysomnographic evaluation for suspected OSA patients must include monitoring of the body position. Breathing function in OSA patients can be improved by controlling their obesity and through postural therapy.

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Multiplex PCR of Endotracheal Aspirate for the Detection of Pathogens in Ventilator Associated Pneumonia (기계환기폐렴의 원인균 진단에서 인공기도 흡인액을 이용한 Multiplex PCR과 세균배양 결과의 비교)

  • Song, Ju Han;Myung, Soon Chul;Choi, Song Ho;Jeon, Eun Ju;Kang, Hyung Gu;Lee, Hye Min;Cho, Sung Keun;Choi, Jae Chol;Shin, Jong Wook;Park, In Won;Choi, Byoung Whui;Kim, Jae Yeol
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.3
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    • pp.194-199
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    • 2008
  • Background: Early identification of pathogens can improve the prognosis of patients with ventilator associated pneumonia (VAP). In the present study, we evaluated the feasibility of performing multiplex PCR for endotracheal aspirates to detect three important pathogens (P. aeruginosa, K. pneumoniae and MRSA) in patients with VAP. Methods: The endotracheal aspirates of 24 patients were collected within 24 hours of the diagnosis of VAP for performing multiplex PCR. Forward and reverse primers were designed to target the specific site of each pathogen (the oprL gene for P. aeruginosa, 16S rRNA for K. pneumoniae and the mec gene for MRSA). We analyzed the clinical data of the VAP patients, including the culture reports for the endotracheal aspirates. Results: Twenty-four patients (M:F=18:6, mean age=$70{\pm}11$) with VAP were enrolled. Pathogens were isolated from 11 patients (P. aeruginosa in 2, K. pneumoniae in 1, MRSA in 2, other enteric Gram negative bacilli in 3, S. pneumoniae in 2 and mixed infection in 1). Multiplex PCR detected three cases of P.aeruginosa (2 cases coincided with the culture reports) and four cases of K. pneumoniae (1 matched with the culture report). PCR detected two MRSA cases, which did not coincide with the culture reports. Conclusion: Multiplex PCR of the endotracheal aspirate showed some ability to detect Gram negative bacilli, although caution is required when interpreting the results.

A Study on the Nutritional Assessment and the Effects of Enteral Nutritional Supports of Tube Feeding In-patients (경관급식 중인 입원환자의 영양상태 평가와 영양 보충제 투여의 영향에 관한 연구)

  • 윤숙영;김성미
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.25 no.5
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    • pp.855-864
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    • 1996
  • The purpose of this study is to evaluate nutritional status of tube feeding patients, and to investigate the effects of giving enteral nutritional support to them. 83 in-patients have been examined for their nutritional status. The mean caloric density was 0.77kca1/m1. 36.1% to 75.9% of them were malnourished in terms of biochemical assessment. The energy intake showed the significant and positive correlation in all biochemical parameters. And the protein intake showed the significant and positive correlation in total protein, serum albumin, serum iron, hemoglobin, hematocrit and TLC. But age was correlated negatively to serum albumin and transferrin. The amount of energy and protein intake has been significantly increased as the tube feeding duration became longer. Also the effect of enteral nutritional support for 6 weeks has been investigated. Case group(n=8) was administered 250kca1 of polymeric formula in addition to their usual diet, while control group(n=8) kept the amount of their original intake. When comparing the biochemical changes of the case group and those of control group at week 0 and week 6 respectively, it showed significant differences in total protein, serum transferrin and TLC. This study suggests that the malnourished status of tube feeding patients can be improved and even prevented if nutritional support is properly administered.

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Improvement of Lacquer Collection Method by CEPA Application in Lactree(Rhus verniciflua Stokes) (CEPA 처리(處理)에 의한 옻나무 칠액(漆液) 채취법(採取法) 개량(改良)에 관(關)한 연구(硏究))

  • Choi, Tae Bong;Hyun, Jung Oh;Kim, Mahn Jo;Na, Chun Su;Kim, Gab Tae;Lee, Jae Ho
    • Journal of Korean Society of Forest Science
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    • v.89 no.2
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    • pp.208-215
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    • 2000
  • In order to improve 'Salso' method (conventional tapping method) which was very inefficient in the aspects of collection time and labor, this study was carried out to investigate the effect of the application date and the distance from treatment point in the lactree(Rhus verniciflua) treated with 10% CEPA and to decide the possibility of application of the technique in the field. Bark thickness was significantly increased to the part 40cm above and below the treatment point, but urushiol content was increased to the part 20cm above and 10cm below the zone treated with 10% CEPA. The urushiol content of the bark was highest at 5cm above the treated zone and decreased in the order of 10, 20, and 40cm. And the urushiol contents of the bark of the upper part were higher than that of the low part. The effects of CEPA on bark thickness were similar to urushiol contents. Urushiol production of lactree is highly dependent on climatic conditions and particularly on the precipitation, and duration of sunshine. Ten percent of CEPA-lanolin pastes which was treated on June 16 affected bark anatomy and urushiol contents, while the treatment on August 24 did not affect. In the Rhus verniciflua treated with 10% CEPA, the urushiol contents was initially increased from 7 days after treatment, continued for the 4 weeks, and then slight decrease occurred at 5 weeks after the treatment. We measured a total sap yield by Salso method in lactree treated with 10% CEPA. By applying 10% CEPA, the sap yield was increased 3-4 times compared to that of untreated trees in the first tapping. But the relative ratio was gradually decreased from the second tapping to sixth, and after seventh tapping, the untreated trees secreted more sap than the treated trees. We discussed about the causes.

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Effects of Zizyphus jujuba var. boeunesis Extracts on the Growth of Intestinal Microflora and Its Antioxidant Activities (대추 추출물이 장내 미생물의 생육에 미치는 영향 및 항산화 활성)

  • Jeong, Hye-Mi;Kim, Yi-Seul;Ahn, Seung-Joon;Auh, Mi-Sun;Ahn, Jun-Bae;Kim, Kwang-Yup
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.40 no.4
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    • pp.500-508
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    • 2011
  • This study was carried out to investigate the effects of jujube extracts on intestinal microflora, along with their antioxidant activities, according to extraction method. The antimicrobial activities of the extracts were measured using the agar diffusion method with a jujube extract concentration of 50 mg/mL. Neither the first nor second jujube extracts were inhibitory against the tested intestinal bacteria. However, water extracts of jujube significantly enhanced the growth of lactic acid bacteria, especially Bifidobacterium bifidum and Bifidobacterium adolescentis. Total phenol compounds and flavonoid compounds were higher in the 1st than in the 2nd water extracts. The EDA values of both water and ethanol extracts increased in proportion to the extract concentration. The 1st water extract showed the highest value among all the others, which was 85.60% at the concentration of 0.05 mg/mL. Furthermore, the 1st water extract showed stronger antioxidant activity than the other samples with an activity of 679.91 mg AA eq/g. These results support the potential use of jujube water extracts as a functional food component and a valuable resource for the development of nutraceutical foods, to increase the growth of Bifidobacterium spp. in the human intestine.

A Study on Stage of Concern, Level of Use, Innovation Configuration, and Intervention demand of Teachers in Culinary Practice Education (조리실습 교육에 대한 교사의 관심도, 실행 수준, 실행 형태 및 지원 요구도 조사)

  • Park Eun-Sook;Kim Young-Nam
    • Journal of Korean Home Economics Education Association
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    • v.18 no.3 s.41
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    • pp.41-60
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    • 2006
  • The system of teaching culinary practice needs drastic modification to catch up with dietary life and education curriculum changes. To reflect such changes, it is necessary to instill a strong will and interest as well as educational environment improvement in teachers. In this sense, this study researched the teachers' stages of concerns, levels of use, innovation configuration, and intervention demands, based on the CBAM(Concerns Based Adoption Method) developed by Hord et. al. For the survey, 500 questionnaires sent by mail and 187 were analyzed by SPSS/win 10.0 program. The results are summarized as follows. 1) The teachers stages of concerns on culinary practice is assessed to be in the lowest level of perceptual stage, which indicates a state of indifference. 2) In terms of the levels of use, routine use was the highest, followed by refinement use, integrated use, research use, and reinvent use in descending order. Mechanical use posted the lowest level. Even though the stages of concern showed the beginning stage, the Level of use was relatively high. 3) About the innovation configuration, approximately 30% of the teachers were not accomodate the culinary practice referred to the 7th National Education Curriculum. 4) According to the intervention demands on culinary practice education, it was found that teachers generally wanted more interventions in every component. Among the intervention components, the highest demand was on the support for facility. Demand on the financing is the second highest. Teachers in the level of routine use demanded more information and materials supply and individual encouragement, but teachers in the level of preparation needed study opportunity for training on operation skills more.

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