• Journal of agricultural medicine and community health
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• v.27 no.2
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• pp.107-126
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• 2002

Health sub-centers(HSCs) have played an important role in primary health care in rural area in Korea. The unification of neighboring HSCs was a strategy to improve the role of HSCs. This study was conducted to reveal the efficacy of the unified HSC established in Yangbuk-myeon, Gyeongju-si in1997. The utilization patterns of HSC and its related factors, and satisfaction of consumer on HSC were compared before and after unification of two HSCs in Gampo-eup, Yangnam-myeon using questionnaire survey, and also the statistics of medical care services and public health services were compared. Four hundred forty nine subjects were questioned in survey, 156 from Gampo-eup, 147 from Yangbuk-myeon, and 146 from Yangnam-myeon. Following unification, the utilization rates and the frequency of visits in Gampo-eup declined. In all three areas, chronic illness was the common factor influencing the utilization and change in frequency of visits to the unified HSC. Following unification, aspects of consumer satisfaction, for example; accessibility and affordability decreased in Gampo-eup, but increased in both Yangbuk-myeon and Yangnam-myeon. The statistics relating to medical care, X-ray examination, home visiting service, vaccination, and health education showed an increase for the unified HSC when compared to the sum of the statistics for the previous two. The execution rates for other public health services were the same, or a little decreased. Clinical laboratory examinations and the issuing of civil affair documents were new services offered by the unified HSC. It is concluded, the overall consumer satisfaction with the unified HSC was improved. In Gampo-eup, where after unification there was no HSC, it seemed to be a barrier to accessing the unified HSC. The effect of the unified HSC, in the respect of medical care and public health services, was not as significant as expected at the time of being established. Therefore, the strategies to reenforce the unified HSC should be developed to provide all residents with comprehensive primary health care services.

• Journal of Dental Rehabilitation and Applied Science
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• v.19 no.2
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• pp.87-96
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• 2003

The purposes of this study were to find out the optimum intensity of magnetic field where magnetism could promote the activity of osteoblast, and to discover the possibility of clinical application in the areas of dental implants and bone grafts by confirming the effect of clinically increasing bone formation. In this experiment, we used the Neodymium magnet, which had magnetic power six times as strong as the current ones and enabled the resistances against the demagnetization up to 20 to 50 times to be minimized with the size of 1mm in sight. In order to culture cells, a specially designed device was used. It was made to adjust the distance and accordingly to control the intensity of the magnetic field, by placing the cell culture plate in the center with a magnet of 1mm long and thick installed on the both ends. Using MC3T3-E1 cell, a kind of osteoblast-like cell, we cultured, for 24 hours, not only the test group which had been cultured under the magnetic fields with different intensity of 5, 10, 50, 100, 500, and 1000 Gauss, but also the control group excluding the influences of the magnetic field. After observing the cell's form and the density of the culture medium through an inverted microscope, we made a series of proceedings needed for the immunofluoroscence staining, such as fixation, normal serum reaction, primary antibody reaction, and secondary antibody reaction. And with a fluorescence microscope, we observed those-above and compared the frequency of expression of IFG-1 receptor. To make a Western immunoblotting analysis, the cells cultured under the same condition as the above had the procedure of the lysis buffer and the acrylamide gel electrophoresis was carried out. Protein transferred into the nitrocellulose membrane and tested on the primary and the secondary antibody reactions was observed and compared. The results were as follows: When observed through an inverted microscope, the nuclear divisions of the cells under the magnetic field of 10 Gauss were the most active, and the density of the cells could be observed the most enormously. As the result of an immunofluoroscence staining of IGF-1 receptor, the expression of IFG-1 was the most frequently observed under the magnetic field of 10 Gauss. On the other hand, few differences of consideration were made between the test group cultured under the magnetic fields of 5, 500, and 1000 Gauss and the control group. In respect of the expression of IFG-1 receptor, the test group cultured under the magnetic fields of 50 and 100 Gauss were higher than the control group, and lower than that cultured under the magnetic field of 10 Gauss.(p<0.05) According to the Western immunoblotting analysis, the band of IFG-1 receptor which had 85KDa of molecular weight was the darkest. Judging from the above-mentioned results, the growth factor receptor of an osteoblast cell which was an important criterion for the bone formation was increased in maximum under the magnetic field of 10 Gauss. Moreover it was observed that the optimum intensity of magnetic field in which magnetism made the activity of the osteoblast cell increase was about 10 Gauss.

• Sleep Medicine and Psychophysiology
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• v.16 no.2
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• pp.65-73
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• 2009

Objectives: The purpose of this study was to assess the clinical and polysomnographic characteristics of Korean patients with obstructive sleep apnea syndrome (OSAS), especially in relation to differences due to age and gender. Methods: All subjects were consecutive patients who were proven to have OSAS with nocturnal polysomnography. They were interviewed with a structured interview format including sociodemographic information, past medical history, medication, and sleep-related history. Simultaneously, they were also given Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) to answer in order to check subjective sleep quality and subjective sleepiness. Results: Mean age of the 308 subjects was $49.5{\pm}$13.3 years, with 77.6% of the subjects being males and 22.4% of the subjects being females. The aging effects on the sleep architecture in Korean OSAS corresponded with normal aging, but with the effect of OSAS itself superimposed, the extent of aging effects was more marked than that of normal aging. The severity of Korean patients of OSAS was not correlated with age. When divided into age subgroups, significant correlation was found between RDI and BMI in patients of each subgroup of those in the 4th to 7th decades. The oldest subgroup (>70 years) described their subjective sleep quality as poorer than any other age subgroups, despite of less subjective drowsiness. The severity of OSAS and the change of sleep architecture of male subjects turned out to be severer than those of female ones. The female/male ratio of the subjects tended to increase with aging. Conclusions: The aging effect on the sleep architecture in Korean OSAS seems to be a mixture of the changes by normal aging and sleep disorder per se. The severity of OSAS was not correlated with age, but highly correlated with BMI. The severity of OSAS and the change of sleep architecture of male patients were severer than those of female ones.

• Sleep Medicine and Psychophysiology
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• v.14 no.2
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• pp.92-98
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• 2007

Objectives: Obstructive sleep apnea syndrome (OSAS) is the most common form of sleep-disordered breathing and often presents with comorbid depressive symptoms. In this study, we evaluated the relationship between depressive symptoms and sleep parameters as measured by nocturnal polysomnography (NPSG) and simultaneous wrist actigraphy. Methods: Two hundred sixty-four subjects with clinically suspected cases of OSAS underwent one-night polysomnography, while simultaneously wearing a wrist actigraphy device. They also completed two questionnaires；the Epworth Sleepiness Scale-Korean version (ESS-K) and the Beck Depression Inventory (BDI). Of the cases studied, 105 subjects were proven by NSPG to have OSAS without other sleep disorders. NPSG and wrist actigraphy data from the subjects were analyzed. Pearson correlation and paired t-test were used in order to evaluate the relationship between depressive symptoms and sleep-parameters. Results: Mean age of the subjects was $46.1{\pm}13.1$ years. Means of the ESS-K score and BDI scores were $10.9{\pm}4.7$ and $12.8{\pm}8.1$, respectively. NPSG sleep parameters significantly differed from those of wrist actigraphy. There was no correlation found between subjects' respiratory disturbance index (RDI) and BDI scores. When directly comparing sleep parameters between subjects who were more depressed versus subjects who were less depressed, both total sleep time and sleep efficiency were decreased in the more depressed. A correlation between RDI and ESS-K scores was also found in the more depressed group. Conclusions: Although our findings suggest that there is no relationship between RDI and depressive symptoms, there are other significant differences in the sleep parameters between subjects who are more depressed versus those without depression. We recommend that patients with depression should also be evaluated for clinical symptoms of OSAS.

• Journal of Oral Medicine and Pain
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• v.33 no.3
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• pp.257-267
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• 2008

The mentophysical disease causes diseases in digestive, respiratory, circulating systems, including chronic pain, through combined reactions from different individual characteristics, mental stress and temperamental factors. The most common symptom related to orofacial area is pain and the contributive factors include biological, behavioral, environmental, social, emotional, recognitive factors. These factors affect the course of the symptom according to individual's character and human nature. In pain, sleep acts as a contributive factor, and pain could bring about sleep disturbance and vice versa. Deterioration of sleep quality would act as a factor that aggravates mental stress. Therefore, relatively accurate and simple mental examinations and sleep quality test should be carried out for the patients with symptoms related to orofacial area. This study evaluated the mental state in relation to the sleep quality which could affect orofacial pain. The number of poor sleeper was 18 in male subjects, and 1 in female subjects and PSQI global index was higher in male($6.11{\pm}2.38$) than female($4.67{\pm}2.18$). SCL-90-R index showed no sex difference. Poor sleeper showed significantly high value in SOM, O-C, I-S, ANX, PHOB, PSY, GSI, PST. When SCL-90-R T scores were compared according to sleep quality, higher the subjective sleep quality score, O-C and I-S showed significant increase. As sleep disturbances score increased, PAR, PSY, PST showed statistically significant increase. In comparison of SCL-90-R T score according to daytime dysfunction, statistically significant increase in DEP, ANX, HOS, PHOB, PAR, GSI was observed. Therefore, the quality of sleep and psychological status have a high correlation. This is likely to influence chronic pain in the orofacial field. As a result, clinicians treating orofacial pain should evaluate the sleep quality and psychological status of the patient. Further studies of larger sample sizes including various age, occupation, and pain groups are necessary in order to apply the results to clinical practice.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.1
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• pp.1-11
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• 2009

Statement of problem: There are two methods of color choice for the esthetic restoration. One is visual shade matching which draws a comparison between shade guide and teeth in dentist's own eye and the other is using a digital shade analysis system recently introduced. Although the visual shade matching has a lot of problems, decision of color by this visual shade matching and the ways of expression for the decided color are still applicable to clinical dentistry. Purpose: This study is designed to investigate shade guides used in the dental clinics and laboratories have the same value using ShadeEye-$NCC^{(R)}$ dental chroma meter (Shofu Inc., Kyoto, Japan) using shade guide are evaluated. Material and methods: At the first experiment, eight Vita Lumin Vacuum shade guides (Vident Inc., California, USA) were collected from the dental clinics. A1 and B1 shade tabs are chosen and the colors are analyzed five times each in both tooth and porcelain modes by digital shade analysis system, ShadeEye-$NCC^{(R)}$. In the second experiment, twelve Vita shade guides using practically in the dental clinics and laboratories were collected and also A1 and B1 shade tabs are chosen and the colors of A1 and B1 are analyzed one time each in both tooth and porcelain modes by ShadeEye-$NCC^{(R)}$. Results and conclusion: There were significant differences among eight shade guides in terms of shade (chroma), value and hue in both of A1 and B1 (P<.05). Shade guides using in present both dental clinics and laboratories did not show significant differences, except A1 in the porcelain mode, it showed significant differences (P<.05) in the shade even though the shade tab has the same name.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.1
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• pp.29-38
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• 2009

Statement of problem: A casting connection technique is widely used for repair, correction and addition to base metal framework. However, a casting connection technique may increase the risk of failure in clinical situations when high stresses exist. Purpose: The purpose of this study was to investigate the mechanical retentive groove design comparatively to increase the joint strength by using the three-dimensional finite element analysis model of a 3-unit fixed partial denture. Material and methods: Ten finite element models were constructed. (Model A: One retentive groove, Model B: Two retentive grooves, Model C: Three retentive grooves, Model D: Four retentive grooves, Model E: One horizontal groove and two vertical grooves, Model F: Two horizontal grooves and one vertical groove, Model G: One groove with the enlarged dimension, Model H: Two grooves with the enlarged dimension, Model I: One groove with the increased height, Model J: One groove with the increased width of base). The vertical force was applied to the mesial and the distal fossa to the casting connection of mandibular first molar. Results: The main factors, affecting joint strength of casting connection were both the retention between the primary cast and the secondary cast and the thickness of the primary cast remaining after preparing retentive groove. The increase of retentive force, according to the numbers and the dimension of retentive groove had an effect on distributing stress. However, in some cases, the increase of retentive force resulted in the increase of stress by reducing thickness of the primary cast in the connection area. Conclusion: The design of retentive groove that limits number of retentive groove for metal thickness and increases the depth of retentive groove for retention is highly recommended.

• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.1
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• pp.32-44
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• 2001

The purpose of this study was to investigate the effects of Er : YAG laser on cutting efficacy and temperature changes of dentin. We used the dentin specimens of human premolars and molars which contain the physiologic saline and maintain the pulpal pressure in dentinal tubules. Each specimen was exposed to Er : YAG laser with non-contact handpiece type delivery system under different treatment condition of irradiation energy, pulse repetition rate, and exposure time. Two procedures were conducted by the presence of water flow during lasing. The specimens were grouped by thickness of dentin. We investigated the cavity pattern, volume, and temperature change of dentin specimen to determine the cutting efficacy and temperature rise of Er : YAG laser, and obtained following results. 1. Cutting volume of dentin was increased by increasing the irradiation energy, pulse repetition rate, and exposure time(P<0.05). 2. Margins of abulated cavities were sharp and clean and floors of cavities were conical in shape and showing smooth surfaces. Upper diameter of abulated cavities were increasing as laser parameter of irradiation energy, pulse repetition rate, and exposure time were increased. A few cracks were observed on abulated surfaces under treatment condition of laser parameter with 150mJ, 5Hz, and 5sec. 3. Temperature was increased as laser parameter of irradiation energy, pulse repetition rate, and exposure time were increased, and temperature rise was decreased as dentin thickness was increased(P<0.05). 4. Temperature rise was decreased under water flow compared with no water flow during laser exposure(P<0.05). From these results, we think that the method of using a Er:YAG laser would be effective and safe in cutting dentin for clinical application.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.3
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• pp.527-533
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• 2004

One clinical technique recommended for improving marginal integrity is "rebonding" or application of unfilled resins to the surface of composite restoration. But continuously the restorations are affected with occlusal load. There is room for doubt that the rebonding agent has the positive effect on microleakage in spite of the stress generated by the occlusal load. This study determined the effect of rebonding on microleakage of Class V resin composite restorations under load cycling. Class V cavities were prepared on the buccal surface of 40 sound extracted premolars and restored with a hybrid light-cured resin composite according to manufacturers' directions. They were randomly divided into two groups consisting of 20 samples: a control(group I), without surface sealing, and the other group(group II) in which margins were etched and rebonded. After thermocycling, each of groups was divided into subgroups(group A, B), and load cycling(total 100,000 cycles with 4-100N load at a rate of 1 Hz) were applied on the group B. Assessment of microleakage utilized methylene blue dye penetration. The following results were obtained: 1. In the occlusal region, no significant difference was noted in the scores regardless of whether or not the rebonding agent was used(group TA-IIA, IB-IIB)(p>0.05). 2. In the cervical region, the control group with rebonding(group IIA) showed the better result than the group without rebonding(group IA)(p<0.05). 3. In the cervical region, the rebonded group with load cycling(group IIB) showed similar results to the group without rebonding(group IB) and no significant difference was noted(p>0.05).

• Advances in pediatric surgery
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• v.12 no.1
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• pp.70-85
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• 2006

A nationwide survey on necrotizing enterocolitis (NEC) was undertaken among members of the Korean Association of Pediatric Surgeons. The members were required to complete a questionnaire and the case registration form for each patient during the three-year period from July 2001 to June 2004. Eighty one patients were included in the questionnaire, but only 71 patients were registered from 22 members in 16 hospitals. At the same time survey on focal intestinal perforation (FIP) was undertaken and 17 patients were registered from 11 members in 10 hospitals. Total 19,041 newborns were admitted to neonatal intensive care unit during the study period. Eighty one patients (17.27 %) were underwent surgery among 469 babies who were managed under the impression of NEC. The male to female ratio was 2.1:1. The premature were 60.6 %. The most common site of involvement was ileum. Overall and operation survival of NEC were 72 % and 79 %, respectively. The survival was lower in smaller babies, multiple segments involvement and involvement of both the small and large intestine. But there was no difference in survival according to sex or prematurity. The FIP showed very similarity with NEC in terms of incidence, and the age of diagnosis and operation. But the survival was much better and 100 %. The results showed the clinical characteristics of NEC and the trend of management in NEC in Korea. In the future we hope we can discuss about this topic in prospective manner.