The mandibular advancement device(MAD) has been used to help manage snoring and obstructive sleep apnea. The aims of this study were to specify the demographic and clinical characteristics of the patients receiving long-term treatment with MAD and to quantify the compliance with and side effects of the use of the device. Of 103 patients who were treated with MAD for at least one full year after delivery date, 49 were able to be contacted with telephone and complete follow-up questionnaires were obtainable. They were telephoned to determine whether they were still using the device. If not, they were asked when and why they stopped using it. Patients were also asked how much effectiveness of the MAD in decreasing snoring and how much they and their bed-partners were satisfied with the MAD therapy. The initial respiratory disturbance indices and pre-treatment snoring frequency and intensity were obtained from the medical records of initial visit. All the data were compared between users and nonusers. The results were as follows: 1. Of 49 patients 25 are still using the device, but 24 stopped using it. Among nonusers nobody stopped wearing the device within first 1 month, but 37.5% of nonusers stopped wearing it in the following 6 months, and another 4.2% before the end of the first year. 2. The one-year compliance of the MAD therapy was 79.59%. 3. There were no significant differences in mean age, mean body mass index, and gender distribution between users group and nonusers group. 4. There was no significant difference in mean respiratory disturbance index at initial visit between users group and nonusers group. 5. There was no significant difference in pre-treatment snoring frequency and intensity between users group and nonusers group. 6. The degree of decrease in snoring with use of MAD was significantly higher in the users when compared to nonusers. 7. Patient's overall satisfaction with treatment outcome was significantly higher in the users when compared to nonusers. 8. Bed partner's satisfaction with treatment outcome tended to be higher in the users when compared to nonusers. 9. The most frequent reasons why patients discontinued wearing the MAD were: jaw pain(25%), dental pain(20.83%), broken appliance(20.83%), hassle using(16.67%), lost weight(8.3%), dental work(8.3%), no or little effect(4.17%), sleep disturbance(4.27).
Kim Jeong-Hwa;Heo Min-Suk;Lee Sam-Sun;Choi Soon-Chul
Journal of Korean Academy of Oral and Maxillofacial Radiology
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v.29
no.1
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pp.87-103
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1999
Purpose: This study was undertaken to quantitatively estimate the degree of the damage and recovery of the irradiated rat condylar cartilage using the Image Analyzer. Materials and Methods: Experimental animals were 16 male rats of the Sprague-Dawley strain at the age of 20 day irradiated with the dose of 10 Gy in their head and neck region. Four rats were sacrificed at the each of the following time intervals - 1, 4, 7 and 14 days, respectively. The same number of control group animals were sacrificed at the each age of 21. 24, 27 and 34 days, respectively. The specimens were stained with 0.5% toluidine blue and examined with light microscope. The condylar cartilage was divided into 4 zones; fibrous zone, proliferating zone, upper hypertrophic zone, and lower hypertrophic zone. And then, the proliferating zone was subdivided into 2 layers - upper and lower layer, and upper and lower hypertrophic zone were subdivided into three layers, respectively - upper, middle and lower layer. With the aid of Image Analyzer, morphometric analysis was performed. The thickness, the numerical density of cells, the cell area density, the extracellular matrix area density, the mean area of single cell, the mean area of extracellular matrix per single cell were measured and analysed. Results: In the experimental group, the thickness of the fibrous zone was slightly increased and that of the proliferating zone and the upper and the lower hypertrophic zone was markedly decreased. With time, the thickness of the fibrous zone was gradually increased and that of the proliferating zone and the upper and the lower hypertrophic zone was steadily in the decreased state. The numerical density of cells of the proliferating zone was increased on post-irradiated 1 day, but decreased after post-irradiated 4 day, and that of the upper hypertrophic zone was decreased. The numerical density of cells of the lower hypertrophic zone was decreased in the early stage and then was decreased or not significantly different from that of the control group with time. In the experimental group, the cell area density of the fibrous zone and the proliferating zone was decreased in the early stage and then gradually increased or not significantly different from that of the control group with time. The cell area density of the upper and the lower hypertrophic zone was varied with time. The extracellular matrix area density value were totally opposite to the cell area density values: The mean area of single cell of the fibrous zone and the proliferating zone was .decreased on post-irradiated 1 day, and increased after post-irradiated 4 day. The mean area of single cell of the upper hypertrophic zone was varied with each layer and time. In the experimental group, the mean area of extracellular matrix per single cell of the fibrous zone was not significantly different with control group, and that of the proliferating zone was decreased on post-irradiated 1 day, and increased after post-irradiated 4 day. The mean area of extracellular matrix per single cell of the lower hypertrophic zone was increased in the early stage. and that of upper hypertrophic zone was varied with each layer and time. Conclusion: The condylar cartilages of rats were affected by irradiation, but the changes were vaned with each layer and time. By morphometric analysis. the changes of the cells of the condylar cartilage of irradiated rat could be calculated quantitatively.
Park, Dong-Bum;Seo, Jeong-Taeg;Sohn, Heung-Kyu;Lee, Jong-Gap
Journal of the korean academy of Pediatric Dentistry
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v.25
no.2
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pp.352-367
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1998
Intracellular pH (pHi) plays an important role in the regulation of cellular processes by influencing the acitivity of various enzymes in cells. Therefore, almost every type of mammalian cell possesses an ability to regulate its pHi. One of the most prominent mechanisms in the regulation of pHi is $Na^+/H^+$ exchanger. This exchanger has been known to be activated when cells are stimulated by the binding of agonist to the muscarinic receptors. Therefore, the aims of this study were to compare the rates of $H^+$ extrusion through $Na^+/H^+$ exchanger before and during muscarinic stimulation and to investigate the possible existence of $HCO_3^-$ transporter which is responsible for the continuous supply of $HCO_3^-$ ion to saliva. Acinar cells were isolated from the rat mandibular salivary glands and loaded with pH-sensitive fluoroprobe, 2', 7'-bis(2-carboxyethyl)-5(6)-carboxyfluorescein(BCECF), for 30min at room temperature. Cells were attached onto the coverglass in the perfusion chamber and the changes in pHi were measured on the iverted microscope using spectrofluorometer. 1. By switching the perfusate from $HCO_3^-$-free to $HCO_3^-$-buffered solution, pHi decreased by $0.39{\pm}0.02$ pH units followed by a slow increase at an initial rate of $0.04{\pm}0.007$ pH units/min. The rate of pHi increase was reduced to $0.01{\pm}0.002$ pH units/min by the simultaneous addition of 1 mM amiloride and $100{\mu}M$ DIDS. 2. An addition and removal of $NH_4^+$ caused a decrease in pHi which was followed by an increase in pHi. The increase of pHi was almost completely blocked by 1mM amiloride in $HCO_3^-$-free perfusate which implied that the pHi increase was entired dependent on the activation of $Na^+/H^+$ exchanger in $HCO_3^-$-free condition. 3. An addition of $10{\mu}M$ carbachol increased the initial rate of pHi recovery from $0.16{\pm}0.01$ pH units/min to $0.28{\pm}0.03pH$ units/min. 4. The initial rate of pHi decrease induced by 1mM amiloride was also increased by the exposure of the acinar cells to $10{\mu}M$ carbachol ($0.06{\pm}0.008pH$ unit/min) compared with that obtained before carbachol stimulation ($0.03{\pm}0.004pH$ unit/min). 5. The intracellular buffering capacity ${\beta}1$ was $14.31{\pm}1.82$ at pHi 7.2-7.4 and ${\beta}1$ increased as pHi decreased. 6. The rate of $H^+$ extrusion through $Na^+/H^+$ exchanger was greatly enhanced by the stimulation of the cells with $10{\mu}M$ carbachol and there was an alkaline shift in the activity of the exchanger. 7. An intrusion mechanism of $HCO_3^-$ was identified in rat mandibular salivary acinar cells. Taken all together, I observed 3-fold increase in $Na^+/H^+$ exchanger by the stimulation of the acinar cells with $10{\mu}M$ carbachol at pH 7.25. In addition, I have found an additional mechanism for the regulation of pHi which transported $HCO_3^-$ into the cells.
Kim, Seong-Oh;Choi, Byung-Jai;Lee, Jae-Ho;Sohn, Heung-Kyu
Journal of the korean academy of Pediatric Dentistry
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v.25
no.2
/
pp.400-420
/
1998
We already know that it is very difficult to obtain an "isolated field" for direct bonding during the surgical exposure of unerupted teeth. The aim of this in-vitro study is to simulate the clinical situation of forced eruption and to evaluate the tensile strengths of preligatured button with several types of contamination which can happen during the surgical exposure of unerupted teeth. Four orthodontic direct bonding systems were used. ($Ortho-One^{TM}$, $Rely-a-Bond^{(R)}$, $Ortho-Two^{TM}$, Phase $II^{(R)}$) Each material was divided into four groups(n=20) : Group 1. (Control, no contamination), Group 2. (Rinse etching agent with saline instead of water), Group 3. (Blood contamination of etched surface for 30 seconds), Group 4. (Blood contamination of primed surface for 30 seconds) 320 bovine anterior permanent teeth were divided into the above mentioned 16 groups. Enamel surface was flattened and ground under water coolant. Pre-ligatured buttons were prepared to the same form. (Cut 0.25 ligature wire 10 cm in length. Twist the ligature wire 30 times clockwise. Mark the wire 15mm and 35mm points from button. Make a loop sticking two points together and twist the loop 6 times counterclockwise.) The bonded specimens were stored at $37^{\circ}C$ saline solution for 3 days. Then the tensile strength of each sample was measured with Instron universal testing machine, crosshead speed of 0.5mm/min. The following results were obtained: 1. As compared to control groups (Group 1) of each material, Rely-a-Bond had a significantly lower mean tensile strengths than other material. (p<0.01) 2. In Group 2. of Ortho-One and Rely-a-Bond, the mean tensile strengths decreased about 7.7% and 11.1%, respectively with statistical significances. (p<0.05) 3. In Group 2. of Ortho-Two and Phase II, the mean tensile strengths did not decrease. 4. In Group 3. of Ortho-One, Rely-a-Bond, Ortho-Two, and Phase II, the mean tensile strengths decreased about 60.8%, 56.1%, 60.2%, and 46.0%, respectively with statistical significances. (p<0.01) 5. In Group 4. of Ortho-One and Rely-a-Bond, the mean tensile strengths did not decrease. 6. In Group 4. of Ortho-Two and Phase II, the mean tensile strengths were decreased about 20.95% and 22.28%, respectively with statistical significances. (p<0.01) There were formations of a hump shaped mass from bonding resin under blood contamination which disturbed direct bonding procedure. According to Reynolds, the proper bond strength for clinical manipulation should be at least 45N or about 4.5Kg.F. According to these results, it can be concluded that Ortho-One could be used during surgical exposure of unerupted teeth. In any case, blood contamination of the etched surface should be avoided, but the blood contamination of primed surface of Ortho-One may not decrease bond strength. Just 'blowing-out' is enough to remove blood from primed surface of Ortho-One. You can verify the clean surface of the primer of Ortho-One after blowing out the blood contamination.
Journal of the korean academy of Pediatric Dentistry
/
v.38
no.1
/
pp.33-41
/
2011
The objective of this study was to compare the shear bond strengths of five dentin adhesive systems cured with three different light curing sources. Seventy five noncarious permanent teeth were collected and stored in an 0.1% thymol solution at room temperature after extraction. The tested adhesives were: Adper Scotchbond Multi-purpose Plus Adhesive (SM) Adper Single bond 2 (SB), Clearfil SE Bond (SE), Adper Prompt L-Pop (PL), G-Bond (GB). And three light curing unit systems were used: Elipar Free light 2(LED), OptiLux 501 (Halogen), Flipo (PAC). For the shear bonding test, the labial and lingual surfaces of permanent teeth were used. To obtain a flat dentin surface, the labial and lingual surfaces of the teeth were sanded on SiO2 with number 600 grit and then divided into 15 groups of 10 surfaces each. All samples were theromocycled in water $5^{\circ}C$ and $55^{\circ}C$ for 1000 cycles. The results were as follows: 1. When cured with Freelight 2, the shear bond strength of SM was significantly higher than that of PL, GB (p<0.05), whereas no significant difference was found among those of any other bonding agents. 2. When cured with Optilux 501, the shear bond strength of SM was significantly higher than those of any other bonding agents (p<0.05), whereas no singnificant difference was found among those of andy other bonding agents. 3. When cured with Flipo, the shear bond strength of SM was significantly higher than those of SB, SE, GB (p<0.05), whereas no significant differences was found among those of any other bonding agents. 4. For comparison according to three different light cure unit system, except SB and GB, each three dentin bonding agents showed no significant difference. For SB, only Freelight 2 was significantly higher than the others, with no significant difference between Optilux 501 and Flip. For GB, Statistically significant difference was found only between Freelight and Flipo.
Journal of The Korean Association For Science Education
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v.33
no.7
/
pp.1367-1384
/
2013
The purpose of this study was to develop a Science Academic Emotion Scale for Elementary Students. To make a scale, authors extract a core of 14 emotions related to science learning situations from Kim & Kim (2013) and literature review. Items on the scale consisted of 14 emotions and science learning situations. The first preliminary scale had 174 items on it. The number of 174 items was reduced and elaborated on by three science educators. Authors verified the scale using exploratory factor analysis, confirmatory factor analysis, inter-item consistency and concurrent validity. The second preliminary scale consisted of 141 items. The preliminary scale was reduced to seven factors and 56 items by applying exploratory factor analysis twice. The seven factors include: enjoyment contentment interest, boredom, shame, discontent, anger, anxiety, and laziness. The 56 items were elaborated on by five science educators. The scale with 56 items was fixed with seven factors and 35 items to get the final scale by applying confirmatory factor analysis twice. Except for Chi-square and GFI (Goodness of Fit Index), other various goodness of fit characteristics of the seven factors and 35 items model showed good estimated figures. The Cronbach of the scale was 0.85. The Cronbach of seven factors are 0.95 in enjoyment contentment interest, 0.81 in boredom, 0.87 in shame, 0.82 in discontent, 0.87 in anger, 0.77 in anxiety, 0.81 in laziness. The correlation coefficient was 0.59 in enjoyment contentment interest, 0.54 in anxiety, 0.42 in shame, and 0.28 in boredom, which were estimated using the Science Academic Emotion Scale and National Assessment System of Science-Related Affective Domain (Kim et al., 1998). Based on the results, authors judged that the Science Academic Emotion Scale for Elementary Students achieved an acceptable validity and reliability.
Kim, Byoung-Hak;Min, Byeong-Hee;Choi, Nak-Joong;Oh, Bong-Se;Park, Ki-Yeol;Min, Kwang-Sik
Journal of Aquaculture
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v.21
no.3
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pp.157-166
/
2008
Species composition and standing crop of phytoplankton were investigated in the ark shell Scapharca broughtonii farming areas from March, 2006 to February, 2007 in Jinhae Bay. Water temperature ranged from 7.56 to $25.90^{\circ}C$, salinity from 13.74 to 34.78 psu, dissolved oxygen from 4.13 to 13.20 mg/L, chlorophyll $\alpha$ from 2.77 to 104.98 $mg/m^2$ and pH from 7.83 to 8.65. Dominant species was Nitzschia and Rhizosolenia from March to May, Skeletonama costatum and Prorocentrum from June to August, Skeletonama costatum, Thalassiosira, Chaetoceros from September to November and Thalassiosira, Chaetoceros from December to February. Colonial diatoms were more dominant than the single cell diatoms. Standing crop was the highest in July at three stations. Standing crop of Skeletonama costatum was the highest as 1,760.0 cells/mL at St. 1, 1,075.2 cells/mL at St. 2 and 698.4 cells/mL at St. 3 in July.
Journal of Dental Rehabilitation and Applied Science
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v.16
no.1
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pp.51-60
/
2000
The purpose of this study was to compare the microleakage at the interface of cast post and tooth according to the type of cement. Forty anterior teeth with single root were used. The teeth were cut 2 mm coronal from the cementoeamel junction and chamfer finish line was made on 1 mm coronal from the cementoeamel junction. After the routine endodontic treatment, post space was prepared using #5.5 Parapost drill to a depth of 7 mm. After the pick up impression, core building was made to 3 mm of clinical crown with burnout wax, then post and core was cast with nonprecious metal. The teeth were divided into four groups of ten each. In Group I, post and core were cemented with Fleck's(Zinc phosphate cement) In Group II, post and core were cemented with Fuji I(Glass ionomer cement) In Group III, post and core were cemented with Superbond C & B(Composite resin cement) In Group IV, post and core were cemented with Panavia 21(Composite resin cement) All cemented teeth were stored in normal saline at $37^{\circ}C$ for 7 days and thermocycled from $5^{\circ}C$ to $55^{\circ}C$ for 500 cycles with a dwell time of 30 seconds. After thermocycling, teeth were immersed in 1% Basic fuchsin dye for 48 hours. All 40 teeth were then embedded in the epoxy resin and cut buccolingually with a cutting instrument. The degree of penetration of dye at interface was graded on a scale of 0 to 4 using a stereomicroscope at 25 to 40 times magnification. Through the findings of this study, the following conclusion were obtained. 1. All the groups showed the microleakage at the interface of cast post core and tooth. 2. Group I showed the highest microleakage score among the groups with a significant difference(p<0.05). 3. Group II showed higher microleakage score than Group III and Group IV with a significant difference(p<0.05). 4. Group IV showed the lowest microleakage score but there were no significant difference with Group III(p>0.05).
Obstructive sleep apnea syndrome(OSAS) in childhood is unique and different n-om that in adulthood in several aspects, including pathophysiology, clinical features, diagnostic criteria, complications, management, and prognosis. Characteristic features of childhood OSAS in comparison with the adult form are the variety of severe complications such as developmental delay, more prominent behavioral and cognitive impairments, vivid cardiovascular symptoms, and increased death risk, warranting a special attention to the possible diagnosis of OSAS in children who snore. However, the childhood OSAS is often neglected and unrecognized. We, therefore, report a case of very severe OSAS in a 5-year-old boy who was sucessfully treated with continuous positive airway pressure(CPAP) treatment. Interestingly, the patient was comor-bid with the attention deficit hyperactivity disorder. Prior to the initial visit to us, adenotonsillectomy had been done at the age of 4 with no significant improvement of apneic symptoms and heavy snoring. On the initial diagnostic procedures, marked degree of snoring was audible even in the daytime wake state and the patient was observed to be very hyperactive. Increased pulmonary vascularity with borderline cardiomegaly was noted on chest X-ray. The baseline polysomnography revealed that the patient was very sleep-apneic and snored very heavily, with the respiratory disturbance index(RDI) of 46.9 per hour of sleep, the mean SaO2 of 78.8%, and the lowest SaO2 of 40.0%(the lowest detectable oxygen level by the applied oxymeter). The second night polysomnography was done for CPAP titration and the optimal pressure turned out to be $8.0\;cmH_2O$. The applied CPAP treatment was well tolerated by the patient and was found to be very effective in alleviating heavy snoring and severe repetitive sleep apneas. After 18 months of the CPAP treatment, the patient was followed up with nocturnal polysomnography(baseline and CPAP nights) and clinical examination. Sleep apneas were still present without CPAP on the baseline night. However, the severity of OSAS was significantly decreased(RDI of 15.7, mean SaO2 of 96.2%, and the lowest SaO2 of 83.0%), compared to the initial polysomnographic findings before initiation of long-term CPAP treatment. Wechsler intelligence tests done before and after the CPAP treatment were compared with each other and surprising improvement of intelligence(total 9 points, performance 16 points) was noted. Clinically he was found to be markedly improved in his attention deficit hyperactive behavior after CPAP treatment, but with minimal change of TOVA(test of variables of attention) scores except conversion of reaction time score into normal range. On the chest X-ray taken after 18 months of CPAP application, the initial cardiopulmonary abnormalities were not found at all. We found that the CPAP treatment in a young child is very effective, safe, and well-tolerated and also improves the co-morbid attention deficit hyperactive symptoms. Overall, the growth and development of the child has been facilitated with the long-term use of CPAP. Cardiovascular complications induced by OSAS have been also normalized with CPAP treatment. We suggest that early diagnosis and active treatment intervention of OSAS in children are crucial in preventing and ameliorating possible serious complications caused by repetitive sleep apneas and consequent hypoxic damage during sleep.
Pain management is a major issue in caring of cancer patients. Patients' concerns for reporting pain and taking analgesics are patient-related barriers to the management of cancer pain. Since such study has not been done at all in Korea, it is clearly needed to study on these problems. The purpose of this study is to attain basic data in order to improve cancer pain management in Korea. This is done by: 1) examining the extent of patients' concerns that might be barriers to the optimal pain management, and the extent of related factors (pain management hesitancy, adequacy of using analgesics, pain severity and pain interference); 2) identifying the relationship between patients' concerns and the related factors. The data has been collected from 180 cancer patients who were hospitalized in medical wards of one university hospital in Seoul, Korea during the period from November 1, 1997 to February 28, 1998. The data has been collected through interviews with (1) Barriers Questionnaire - Korean Version (BQ-K); (2) Hesitancy Experience Questionnaires (HQ); (3) Pain Management Index (PMI); (4) Brief Pain Inventory (BPI); and (5) Demographic Data. The data were analyzed by descriptive statistics and by t-test, One-way ANOVA, Pearson correlation using SPSSWIN program. The Results are as following: 1) The mean scores of Pain Management Concerns (PMC) by BQ-K were toward the moderate with a little high points(2.59). Most of the patients (99.4%) had some extent of concerns (over lout of maximum 5 points). Among the eight subscales of BQ-K, the Pain Management Concerns (PMC) about 'Fear of tolerance' was the highest (3.80) and 'Worry about side effects' was the least (1.40). 2) The extent of Pain Management Hesitancy (PMH) by HQ of wnom had pain on the day of the interview was a little higher than moderate score(5.53 out of maximum 10 points). 6.7% of the patients with experiencing pain used less adequate analgesics for the severity of pain than they were expected. 27.8% of them never used any analgesics at all. The mean score of pain severity by BPI was 16.59 (maximum: 40), and that of the interference with daily life by BPI was 32.03 (maximum: 70). 3) The patients who were older, less educated, and in low socio-economic status were likely to have more concerns. Pain Management Concerns (PMC) was positively correlated with Pain Management Hesitancy (PMH) (r=.75), pain severity (r=.44) and pain interference (r=.50). Those who were not using adequate analgesics had higher Pain Management Concerns (PMC) than did those who were using adequate analgesics (t=-5.42). The patients who had more Pain Management Concerns (PMC) tended to hesitate more to report pain and to use analgesics. They used more inadequate analgesics for the severity of pain and also had experienced more pain severity and interference with daily life. In conclusion, the patients' concerns for reporting pain and for using analgesics are major patient-related barriers to cancer pain management in Korea. The patients' concerns were correlated significantly with the level of the hesitancy experience, inadequate use of analgesics, the pain severity and the interference with daily life. Considering this, an educational program for cancer patients under the treatment with analgesics should be developed in order to solve these problems.
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