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DENTAL TREATMENT UNDER GENERAL ANESTHESIA IN A PATIENT WITH LOWE SYNDROME : A CASE REPORT (로웨 증후군 환아의 치아우식 치료 증례 보고)

  • Ryu, Jiyeon;Shin, Teo Jeon;Hyun, Hong-Keun;Kim, Young Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Kim, Chong-Chul;Lee, Sang-Hoon
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.12 no.2
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    • pp.82-86
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    • 2016
  • Lowe syndrome is X-linked gene disorder, characterized by cataracts, renal dysfunction and brain abnormalities. Oral healthcare of young patients with Lowe syndrome could be easily neglected due to the uncooperative behavior or other systemic condition of the child. We are presenting a case of successful treatment under general anesthesia with uncooperative child with Lowe syndrome. A 3-year old boy with Lowe syndrome visited Seoul National University Dental Hospital for multiple caries. He had been suffering from congenital cataract, medullary nephrocalcinosis and hypotonia. Multiple caries were observed from clinical and radiographic examination. Concerning behavior management problem and possibility of aspiration due to hypotonia, dental treatment under general anesthesia was planned. Left upper primary first molar was extracted to prevent further infection. Other teeth were treated with Stainless steel crown or composite resin restoration based upon the extent and the severity of dental caries. Under general anesthesia, dental procedure was carried out successfully and safely. Considering uncooperative behavior and other medical conditions of the patient, general anesthesia could be effective. Home oral care and periodic visit to dental clinic should be emphasized to the caregiver of patient with Lowe syndrome, considering the susceptibility of dental caries and other oral manifestation.

Changes of the Cellularities in the Bronchoalveolar Lavage Fluid of the Experimental Silicosis (흰쥐규폐증에서 기관지 폐포 세척액내 세포변화)

  • Lim, Young;Yun, Im-Goung;Oh, Min-Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.38 no.2
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    • pp.143-154
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    • 1991
  • Pneumconiosis is a sort of pulmonary fibrosis consequent to the inhalation of the respirable dusts. Thus, the pathogenesis of silicosis have concentrated largely on the early response of alveolar macrophage and the later fibroblastic stimulation. But the role of the other cells and continuing cell injury in the pathogenesis has not been fully studied. And the chemical factors such as prostaglandin, fibroblast stimulating factor and inhibiting factor and chemotaxin are also participated in the mechanism of pulmonary fibrosis in silicosis. In order to clarify the role of alveolar cells and prostaglandin, we investigated the changes of the cellularities in bronchoalveolar lavage fluid and tissue pathology in the experimental silicosis with the time sequence. The experimental animals were divided into 3 groups; control group received only intratracheal injection of 0.5 ml saline, silica group received the intratracheal instillation of 40 mg silica with the same amount saline, and aspirin group received 450 mg/kg of aspirin after silica instillation. The results were as follows: 1) The total cells of bronchoalveolar lavage fluid in the silica group markedly increased in comparison with the control group, but there was no significant difference between the silica and aspirin groups. 2) The percentages of alveolar macrophages to the total number of cells in the silica group tended to be lower than those in the control group and also lower than those in the aspirin group at the 1st week after silica instillation. 3) The percentages of neutrophils to the total number of cells in the silica group were significantly higher than those in the control group during the entire period and also higher than those in the aspirin group at the 3rd day after silica instillation. 4) In the silica group, the percentages of lymphocytes to the total number of cells were increased 143 progressively with the time course and those were significantly higher than those in the control group from the 3rd week after silica administration. There were marked differences of lymphocyte percentages between the silica and aspirin groups at the 1st week after silica instillation. 5) The inflammatory change was observed in the rat lung at the 1st day after silica instillation. Also the silicotic nodule appeared in the silica group at the 1st week but we could not find out that nodule in the aspirin group at that time. The fibrotic changes in the rat lung tended to be increased progressively with the time course, therefore, the diffuse fibrotic pattern appeared in the whole field at the 20th week after silica instillation. 6) By the electron microscopy, there were gradual increases of phagosomes and vacuoles in the alveolar macrophage in the silica group as compared with the control group. These results suggest that the neutrophils and the lymphocytes have also participated in the pulmonary fibrosis even though the alveolar macrophage has a major role, and prostaglandin mediate the inflammation and pulmanary fibrosis in the experimental silicosis.

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Predictors of Meaning in Life in Adolescents with Leukemia (백혈병 경험 청소년의 생의 의미에 영향을 미치는 요인)

  • Hong, Sung-Sil;Park, Ho-Ran
    • Child Health Nursing Research
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    • v.21 no.1
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    • pp.74-81
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    • 2015
  • Purpose: The purpose of this study was to identify predictors of spiritual well-being and meaning in life for adolescents with leukemia. Methods: Participants were 102 adolescents (11-21 years) recruited at C university hospital from June to August in 2014. The eligible participants were diagnosed with leukemia and are on follow-up care at the outpatient clinic. Participants were assessed for spiritual well-being, meaning in life, self-esteem, and social support. Results: Levels of spiritual well-being and meaning in life for these adolescents with leukemia were 3.69 out of 6 and 3.10 out of 4, respectively. Self-esteem and social support from family were factors affecting spiritual well-being. Self-esteem, existential well-being and social support from family and friends were predictive for meaning in life and accounted for 68% of total variance. Conclusion: The results show that there are several factors affecting spiritual well-being and meaning in life in adolescents with leukemia. Therefore, nursing intervention programs for adolescents with leukemia should include strengthening self-esteem and social support as well as considering the spiritual aspect of life in order to find meaning in life beyond leukemia.

Preliminary Report of Use-Effectiveness of Ovulation Method in Korea (자연피임법으로서의 배란법의 피임효과)

  • Bae, S.C.;Chung, Y.J.;Rha, J.G.;Oh, W.S.;Kim, S.J.
    • Clinical and Experimental Reproductive Medicine
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    • v.3 no.1
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    • pp.27-32
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    • 1976
  • In recent years, explosive increase in population has been damaging mankind in terms of deprivation of natural resources and more of economical demands. Therefore, we have thought about problems as to counter-balance the increasing population, and reached a resolution of artificial methods of controlling birth. In the past, though now used in some of contraceptive methods, extravaginal ejaculation, condom were commonly used. But recently, pills, IUD and several kinds of operative procedures are quite popular. Though the recent methods are known to be effective compared with the traditional methods, a certain unwanted side effects as well as limited value of usages now must be discussed. On this aspect, we are trying to research for a ideal methods such as symptom free, more of natural way of family planning and try to zero the failure rate. And also it has been suggested that only if those scientific methods of controlling birth can be base on religious concepts of moral being, it will be enlightened. At the Happy Family Planning Clinic of St. Mary's Hospital, we apply Billing's ovulation method to out-patients who want contraception and usually advise them to use it on a self-care basis. For a retrospective study of the presurvey data analysis and use-effectiveness of the ovulation method from April 1, 1975 to Nov., 30, 1975, we have dealt with a total of 1,383 women (urban areas 465, rural areas 918). The results of preliminary survey were as follows; 1) Among 465 women in Seoul areas, the failure rate was 10.3, which signified unplanned pregnancies of 32 women. 27 of the 32 women were pregnant due to the users own failure and the remaing 5 due to the failure of the method. Therefore, the failure of the method accounted for 1.6. 2) Among 918 women in rural areas, the failure rate was 15.2 signifing unplanned pregnancies in 93 women. The cause of the failure in 81 of the 93 women was attributable to the user's own mistake and that in the remaing 12 to the default of the method. Therefore, the failure attributable to the method accounted for 2.0.

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Effects of Mobile based-Healthcare Service using Human Coaching to the Self-care of Diabetes (당뇨병 환자의 자가관리를 위한 모바일 기반의 휴먼코칭 헬스케어서비스의 효과)

  • Lee, Mi-Joon;Kang, Hee-Kyung
    • Journal of Convergence for Information Technology
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    • v.7 no.4
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    • pp.83-89
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    • 2017
  • This study aims to investigate the impact of a mobile-based human coaching healthcare service provided for diabetic patients by nurses on their self-management ability. This study collected data from 311 persons who were diagnosed with diabetes from all over the country, and the collected data were analyzed through SPSS Win 23. The results of the study are summarized as follows: First, it was found that the utilization of a glucose meter by the provision of the mobile-based human coaching healthcare service was men group, and there was a statistically significant difference (${\chi}^2=6.059$, p= .048*). Second, there was a positive correlation in the utilization between the glucose meter and an activity tracker band by the provision of the mobile-based human coaching healthcare service, which was statistically significant (r=.660, p< .001). Third, as a result of checking the changes of the utilization of the glucose meter by the provision of the mobile-based human coaching healthcare service, it was maintained between 79% and 41% from Week 1 through 49. In conclusion, this study partially confirmed that the mobile-based human coaching health service was easily accessible and cost-effective in enhancing the participants'self-healthcare ability.

Factors Influencing the Intention of Admission into a Charged Nursing Home for the Elderly (유료노인전문요양원 입주의사 결정요인에 관한 연구)

  • Yoo, Young-Soon;Cho, Eun-Hi;Yu, Byung-Chul;Jeong, Ki-Won;Urm, Sang-Hwa;Kim, Sung-Jun;Chun, Jin-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.34 no.1
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    • pp.1-8
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    • 2001
  • Objectives : To gather information about the factors which influence the interest and intention of admission into charging nursing hones for the elderly(CNH), as these homes represent an important method for resolving the problems related to the rapid population aging occurring in Korea. Methods : A face-to-face interview survey was carried out with 320(men 159, women 165) patients over 60 years old who were admitted at 2 university hospitals and 5 general hospitals in the Busan area between December 1998 and March 1999. Data were analyzed through t-test, ANOVA, correlation and multiple regression analysis. Results : The mean age and years of education of the study population was 67.0 and 7.7 years, and the types of chronic degenerative disease included musculoskeletal disorders(20.1%), cerebrovascular disease(17.1%), and diabetes(14.3%). The major forms of household living arrangement prior to admission were elderly alone(22.6%), and elderly couple(33.5%), while about half of them(55.5%) didn't want to live with their children id the future. Almost half were paying medication fees by themselves(46.6%). The level of actual intention of admission$(3.07{\pm}1.39)$ into a CNH was lower than that of interest$(3.22{\pm}1.33)$(p<0.01). Multiple analysis revealed that the intention of admission increased with decreasing number of future supportive persons$(\beta=-0.107)$, lower level of activity in daily life$(\beta=-0.447)$, and longer years of education$(\beta=-0.447)$ with 32.7% of $R^2$. As for the factors which determined the admission into a CNH, the fee and facilities were considered to be most important, and professional nursing and physician's care were the most desired services. In nomenclature, they preferred 'elderly hospital' or 'elderly health center' to CNH. Conclusions : Interest in CNH is increasing recently, but existing studies about patient experiences in CHN are still limited. This study may form a basis for future examinations of the needs and uses for CNH. Active financial support and public information are considered by the authors to be important factors for the induction of welfare services for the elderly, though CNH.

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A Study on Service Satisfaction of Users' Family in Charged Recuperation Facilities Specializing in the Old (유료노인전문요양시설 이용자 가족의 서비스 만족도 및 요구조사)

  • Chung, Yeon-Kang;Han, Seung-Eui;Lee, Young-Mi
    • Research in Community and Public Health Nursing
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    • v.14 no.3
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    • pp.397-406
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    • 2003
  • The purpose of this study is to provide the basic data in order to improve the quality of charged recuperation facilities which are specialized in the old. after finding out the satisfaction degree for the services which are provided in the current charged recuperation facilities specialized in the old and surveying the services which are demanded by users. As for the research method. the subjects were 88 family members of the users in the five charged recuperation facilities, which are specialized in the old and located in Seoul and Incheon. The survey research was executed from 27th July to 15th September, 2002. Then the collected data were analyzed by using the SPSS 10.0 for windows program. The research results are as follows. Firstly, in the satisfaction degree of the user's family about the daily service showed the highest satisfaction degree for the kind service of the staff to the users. In the satisfaction degree about the specialized service of the user's family, the satisfaction degree was high in bedsore prevention, periodical health care, proper medical treatment, family counsel, and adequate disease management. In the satisfaction degree about the facility and environmental service, the satisfaction degree about the surrounding environment of the facility or safety facility, and the comfort condition was high. In the satisfaction degree about the services related to the local society, it was high in the hospital and medical-related field. Secondly, in the demanded services, the demanding degree for worship, mental and spiritual nursing, hospice, funeral service, family meeting, and support for the special vehicle were not so high, but it was shown that they were generally demanded. Thirdly, it was shown that the provided services had an overall high satisfaction degree. In the service satisfaction degree according to the general characteristics of the user's family, it was recognized that there was a significant difference between the distinction of sex and local society related services. Also, there was a significant difference in the satisfaction degree between age and specialized service. Through the above research results, detailed rehabilitation programs such as linguistic treatment and working treatment should be more and more compensated in order to supplement the insufficient points of the services provided by the charged recuperation facility specialized in the old. Additionally, the correlation with the local society such as education and training for specialized human labor, close cooperation among the facilities, and positive participation in local society events are thought to be reinforced.

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Study on Aged Men's Utilization Status and Satisfaction of Removable Dentures (일부 노인들의 가철성 틀니 사용 실태 및 만족도 조사)

  • Park, Jong-Hee;Park, Ji-Won
    • Journal of Technologic Dentistry
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    • v.34 no.3
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    • pp.291-302
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    • 2012
  • Purpose: It is to survey old men's utilization status of dental clinic and temporary-binding dentures and then to provide basic data to make a program for manufacturing old men's dentures and their teeth health education. Methods: Random selection was made on old men living in Daejeon and Chungnam, and a survey was conducted from April 15 to May 20, 2011. 500 questionnaires were distributed and 420 questionnaires were collected. Using spss 18.0 program, final analysis was made on 363 questionnaires except for 57 questionnaires which had missing value or showed some doubts about the unreliability. Results: 1. With respect to number of natural teeth as per the age, the upper/lower jaws had meaningful differences (P<.001), which means that the older the person is, the smaller number of natural teeth is. In the meantime, there was no meaningful difference according to sex. 2. With respect to kind of prosthetics installed in a mouth as per the age, there was meaningful difference in the upper jaws (P<.05) but there was no meaningful difference in the lower jaws. It was found out that the older the persons are, the more they use removable dentures while the younger the persons are, the more they use fixed partial dentures. 3. With respect to mouth health condition recognized by oneself, it showed bad (44.4%) and good (10.3%),which means recognition as bad is greater, and the age when prosthetics were first used is dispersed variously from below 40 to over 70. 4. Dental care institutions which they mainly used are hospital and clinics (91.5%), and 66.4% of them visited dental clinics lately. Preferential treatment if they go to dentists is as follows in the order of prosthetics (33.9%), gum treatment (24.2%) and pain treatment (14.9%). 5. 68.4% of them revisited dentists after installation of dentures and the reason for revisit is as follows in the order of poorly fitted dentures (35.1%), painful gum 25.9%, regular check-up 25.4% and difficult chewing 9.6%. Conclusion: As our country enters into an aging society, mouth health problem of old men has come to a serious issue, and therefore, a survey was conducted on some old men with respect to their utilization status of dental clinic and removable dentures in order to provide basic data for improvement of quality of their life, maintenance and enhancement of their mouth health. The study result shows that the older they are, the higher the loss rate of teeth as well as needs for prosthetics are, and thus it is thought the study will help to develop mouth health education program which may improve quality of old men's life by recovery of mouth functions declined due to loss of teeth and by regular check-up, education for mouth health control and following-up control of dentures.

Pruritus in Burn Survivors (화상환자의 소양증 특성 조사)

  • Kim, Kyung Ja;Won, Mi Hwa
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.1
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    • pp.45-53
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    • 2016
  • This study examined pruritus to provide the data based on burn patient pruritus. A self-report questionnaire survey was conducted among ninety five burn survivors, who were over 18 years of age with admission periods longer than two weeks. The results indicated that the average burn range was $18.95{\pm}17.10%$, severity was $48.83{\pm}23.96$, and distress was $46.42{\pm}25.80$. A significant difference in pruritus consequences was observed according to frequency. The patients consistently experienced pruritus, even if it happened less often, difficulty in falling asleep (F=4.817, p=.004), poor mood (F= 5.955, p=.015)), and loss of concentration (F=6.483, p<.000). A significant difference in the pruritus consequences according to duration was observed, lasting for 30 minutes for all groups, more than the population and less than 30 minutes, difficulty in falling asleep (F=7.452, p<.000), poor mood (F=3.655, p<.015), and loss of concentration (F=12.564, p<.000). The frequency, duration (r=.29, p=.004), severity (r=.45, p<.000), distress (r=.44, p<.000), and consequences of pruritus in burn patients (r=.29, p=.004) showed a positive correlation. The results of this study could be used as a base material for the care of burn patients experiencing pruritus.

Genome-Wide Association Analyses on Blood Pressure Using Three Different Phenotype Definitions

  • Park, Ji-Wan;Uhmm, Saan-Yong;Shin, Chol;Cho, Nam-H.;Cho, Yoon-Shin;Lee, Jong-Young
    • Genomics & Informatics
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    • v.8 no.3
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    • pp.108-115
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    • 2010
  • Hypertension is the most prevalent disease worldwide and is itself a risk factor for cerebral, cardiac, and renal diseases. The inconsistency of candidate genes suggested by previous genomewide association studies (GWASs) may be due to not only differences in study design and genetic or environmental background but also the difference in the power of analysis between continuous traits and discrete traits. We analyzed 352,228 single nucleotide polymorphisms (SNPs) in 8842 unrelated Koreans obtained from Ansan and Ansung cohorts. We performed a series of GWA analyses using three different phenotype models; young hypertensive cases (278 subjects) versus elderly normotensive controls (680 subjects); the upper 25% (2211 hypertensive cases) versus the lower 25% of the SBP distribution (2211 hypotensive controls); and finally SBP and DBP as continuous traits (8842 subjects). The numbers of young hypertensive cases and elderly normotensive controls were not large enough to achieve genomewide significance. The model comparing the upper 25% subjects to the lower 25% of subjects showed a power that was approximate to that of QTL analysis. Two neighboring SNPs of the ATP2B1 gene, rs17249754 (SBP, p=$2.53^{-10}$; DBP, p=$1.28{\times}10^{-8}$) and rs7136259 (SBP, p=$1.30{\times}10^{-9}$; DBP, p=$6.41{\times}10^{-8}$), were associated with both SBP and DBP. Interestingly, a SNP of the RPL6 gene, rs11066280, revealed a significant genomewide association with SBP in men only (p=$3.85{\times}10^{-8}$), and four SNPs located near the MAN2A1 gene showed a strong association with DBP only in elderly men aged 60-70 years (e.g., rs6421827, p=$4.86{\times}10^{-8}$). However, we did not observe any gene variant attaining genomewide significance consistently in the three phenotype models except for the ATP2B1 gene variants. In general, the association signal with blood pressure was stronger in women than in men. Genes identified in GWASs are expected to open the way for prevention, early diagnosis, and personalized treatment of hypertension.