• 재활복지
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• v.21 no.4
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• pp.195-208
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• 2017

This study aimed to investigate the effect of the participation in rehabilitation horseback riding program on the sleep, and to provide the basic data by analyzing the sleep of individuals with autism spectrum disorders. This study subjects consisted of 10 individuals with autism spectrum disorders residing in a residential care facility for the people with intellectual disabilities. They participated in the 12 weeks rehabilitation horseback riding program regularly. To investigate the effects of participating this program on sleep, subjects' sleep time, wake-up time, total sleep time and wake-up frequency during sleep were measured. Descriptive statistics and Friedman test were conducted to analyze the change the sleep. As a reulst of anlysis, it was found that the sleep time came earlier, the total sleep time increased, and the wake-up frequency during sleep reduced. Therefore, the rehabilitation horseback riding program participation was shown to have a positive effect on the subjects' sleep. Since the application of this program can act as a positive factor in the sleep of the participations, it is expected to be used as an in-facility program for the residents with autism spectrum disorders.

• Korean Journal of Clinical Pharmacy
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• v.29 no.3
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• pp.166-172
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• 2019

Background: Hypercalcemia is an important metabolic emergency condition in cancer patients. Bisphosphonate is the treatment of choice for hypercalcemia, whereas calcitonin and hydration with furosemide are recommended for acute supportive therapy. However, data regarding real-world treatment patterns and outcomes of pharmacological treatments are limited. Therefore, we aimed to investigate the treatment patterns and clinical outcomes of hypercalcemia treatment in solid tumor patients. Methods: Electronic medical records of 123 adults with solid cancers and albumin-corrected calcium levels >10.5 mg/dL or ionized calcium levels >1.35 mmol/L were reviewed. We retrospectively analyzed the pharmacological treatment and recovery rate according to the severity of hypercalcemia. Results: A total of 177 cases were identified, of which 49 were not treated and 30 were treated with hydration only. In moderate-to-severe cases, 86.5% received pharmacological treatment. Thirty-four cases (19.2%) were treated with bisphosphonate alone and 58 cases (32.8%) were treated with bisphosphonate and calcitonin. In mild hypercalcemia cases, the recovery rate was higher for those receiving hydration only or pharmacological treatment (79.7%) than for those receiving no treatment (61.4%, p = 0.041). Most moderate-to-severe cases were treated with medication and of those treated, 56.3% recovered. The recovery rate was lower in those treated with bisphosphonate alone (38.2%) than in those who underwent calcitonin combination treatment (73.7%, p = 0.001). Conclusions: Bisphosphonate combined with calcitonin was found to be more effective than bisphosphonate alone for the treatment of moderate-to-severe hypercalcemia. Considering the current shortage of calcitonin, further efforts are required to ensure its stable supply.

• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.4
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• pp.255-266
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• 2022

Background: A previous study reported the effectiveness and patient satisfaction in the dental emergency unit (DEU) of the Pitie Salpetrière Hospital in Paris before coronavirus disease 2019 (COVID-19). The same methodology was used during the COVID-19 pandemic to compare pain, anxiety, and patient satisfaction during the two periods. Methods: This prospective study was conducted in 2020 (NCT04354272) on adult patients. Data were collected on day zero (D0) on site and then by phone during the daytime on day one (D1), day three (D3), and day seven (D7). The primary objective was to assess the pain intensity at D1. Secondary objectives were to assess pain intensity at D3 and D7, anxiety intensity at D1, D3, and D7, and patient satisfaction. Patients were evaluated on a 0-10 numeric scale on D1, D3, and D7; mean scores were compared with non-parametric statistics (ANOVA, Dunn's). Results: A total of 445 patients were given the opportunity to participate in the study, and 370 patients consented. Seventy-one were lost during follow-up. Ultimately, 299 patients completed all the questionnaires and were included in the analysis. In the final sample (60% men, 40% women, aged 39 ± 14 years), 94% had health insurance. The mean pain scores were: D0, 6.1 ± 0.14; D1, 3.29 ± 0.16; D3, 2.08 ± 0.16; and D7, 1.07 ± 0.35. This indicates a significant decrease of 46%, 67%, and 82% at D1, D3, and D7, respectively, when compared to D0 (P < 0.0001). The mean anxiety scores were D0, 4.7 ± 0.19; D1, 2.6 ± 0.16; D3, 1.9 ± 0.61; and D7, 1.4 ± 0.15. This decrease was significant between D0 and D7 (ANOVA, P < 0.001). Perception of general health improved between D1 and D7. The overall satisfaction was 9.3 ± 0.06. Conclusion: DEU enabled a significant reduction in pain and anxiety with high overall satisfaction during COVID-19, which was very similar to levels observed pre-COVID-19 pandemic.

• Journal of Radiation Protection and Research
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• v.48 no.2
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• pp.59-67
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• 2023

Background: This study aims to reevaluate natural radiation exposure, following up on our previous study conducted in 2019, and to assess the associated risk of lung cancer to the public residing in the gold mining areas of Betare-Oya, east Cameroon, and its vicinity. Materials and Methods: Gamma-ray spectra collected using a 7.62 cm×7.62 cm in NaI(Tl) scintillation spectrometer during a car-borne survey, in situ measurements and laboratory measurements performed in previous studies were used to determine the outdoor absorbed dose rate in air to evaluate the annual external dose inhaled by the public. For determining internal exposure, radon gas concentrations were measured and used to estimate the inhalation dose while considering the inhalation of radon and its decay products. Results and Discussion: The mean value of the laboratory-measured outdoor gamma dose rate was 47 nGy/hr, which agrees with our previous results (44 nGy/hr) recorded through direct measurements (in situ and car-borne survey). The resulting annual external dose (0.29±0.09 mSv/yr) obtained is similar to that of the previous study (0.33±0.03 mSv/yr). The total inhalation dose resulting from radon isotopes and their decay products ranged between 1.96 and 9.63 mSv/yr with an arithmetic mean of 3.95±1.65 mSv/yr. The resulting excess lung cancer risk was estimated; it ranged from 62 to 216 excess deaths per million persons per year (MPY), 81 to 243 excess deaths per MPY, or 135 excess deaths per MPY, based on whether risk factors reported by the U.S. Environmental Protection Agency, United Nations Scientific Committee on the effects of Atomic Radiation, or International Commission on Radiological Protection were used, respectively. These values are more than double the world average values reported by the same agencies. Conclusion: There is an elevated level of risk of lung cancer from indoor radon in locations close to the Betare-Oya gold mining region in east Cameroon. Therefore, educating the public on the harmful effects of radon exposure and considering some remedial actions for protection against radon and its progenies is necessary.

• Journal of the Korean Society of Radiology
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• v.17 no.7
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• pp.1091-1097
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• 2023

Bolus is used in radiation therapy to prescribe an even dose to the tumor when the skin surface is inclined or has irregularities. At this time, the dose to the skin surface increases. Due to the patient's unique body structure and irregular skin, voids may occur between the bolus and the skin, which may reduce the accuracy of treatment. Therefore, in this study, the existing bolus and the self-produced bolus through 3D printing were applied to the nasal area, and the difference between the surface dose after treatment plan and the dose directly measured with an Optically Stimulated luminescence(OSL) dosimeter was compared to the existing bolus. The bolus rate was 97%, PLA 100.33%, ePETELA 75A 100.53%, and ePETELA 85A 100.36%. It was confirmed that there was little error in the measurement values and treatment plan values for each material. In addition, compared to when applying a conventional bolus, a difference of -3% to +0.5% for a 3D printed bolus can be confirmed, so a customized bolus produced through 3D printing can complement the shortcomings of the existing bolus. It is believed that there will be.

• Journal of Oral Medicine and Pain
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• v.32 no.1
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• pp.9-33
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• 2007

In the field of dentistry, there existed relatively few emergency patients or patients who need intensive care and thus had low medical dispute rates. However, these days, there is a general tendency of increased medical disputes. Although many medical disputes are caused by medical accidents of the dentists, because dental assistants are also lawfully involved in practicing dentistry, there is a possibility of medical disputes or medical accidents caused by dental assistants. Therefore, the role of the dental assistants cannot be ignored. This study consists of a survey given to dental hygienists currently working in general hospitals, dental hospitals and private dental clinics. Following is the results of the analysis of 275 respondents' backgrounds, medical disputes rates including patients' complaints, their understanding of medical regulations and their general understanding of overall dental practice and medical disputes. 1. 251 of 274(91.6%) respondents doubted the risk of medical accident and dispute. 2. 81(29.5%) dental hygienist experienced complaint from patients. They have been working in the private dental clinic, the rate of this experience was high. 3. 349 case of 1805(19.3%) the complaints by patients, highest percentage among its category, were those regarding dental fees and poor service. 4. 129 case of 1805(7.1%) patients' complaints, highest percentage among it's subcategory, were those regarding the absence of explanations of precautions or request of agreements before dental treatment. 5. 252 of 267 (94.4%) dental hygienists chart after a scaling treatment. However, only 55(20.7%) dental hygienists chart the fact of explaining the precautions. 6. 6(2.2%) dental hygienists do not inspect patients' medical history, if patients don't mention it. 7. 104 of 274(38.0%) dental hygienists responded to be capable of administering first aid treatment. 8. 115(41.8%) dental hygienists have a first aid kit and equipment. 9. In case of medical dispute, 268(97.8%) dental hygienists respond that, charting plays a big role in resolving the dispute. 10. In case of medical dispute, 272(93.3%) dental hygienists respond that, explanation and agreement before treatment have an important role in settlement of dispute 11. Only 160(58.4%) dental hygienists responded correct answer that the duration of keeping medical records is 10 years. 12. 124(45.3%) respondents thought that it is legal for a dental hygienist to take a panoramic dental X-ray, 71(25.9%) respondents thought that it is legal practice cervical resin treatment by dental hygienist, and 37(13.5%) respondents thought that it is legal extract primary teeth by dental hygienist. 13. 24(18.76%) respondents thought that it doesn't matter to tell patient's state to others 14. 272(99.27%) responded that receiving education for the prevention of medical disputes was needed and of them, 61.0% thought it was urgent. 15. 186(64.2%) has never had classes regarding the prevention of medical disputes while in school and 212(77.4%) has not had the same type of classes after graduating from school. 16. 256(93.4%) responded that there will be even more of an increased number of medical disputes. Among them, 83.3% of respondents though that due to the increased opportunity of acquiring information through the internet and mass media. The study shows that 29.5 percentage of dental hygienists have experienced the medical disputes and complaints and they are lack of recognition of medical regulations and dental hygienist's official duty. So, there is a big potential of the percentage to increase. Therefore, the correct understanding of explaining precautions and requesting agreement before dental treatments and performing them are mandatory. Moreover, classes regarding the prevention and counterplans of medical disputes need to be widely offered.

• Journal of radiological science and technology
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• v.31 no.4
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• pp.337-346
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• 2008

A questionaire survey was conducted for patients who had been examined at the Department of Radiology to investigate the items that need to be improved. Brainstorming was also conducted by team members to suggest the tactics that can efficiently perform the QI activity by selecting the most frequently answered topics for the reduction of waiting time of x-ray examination. From September 2006 to November 2007, number of patients before and after conducting QI was compared for 3 months by each category differentiated by types of detailed causes. A patient case was set as one shooting for one patient. After conducting QI, the waiting cases before conducting QI were evaluated for the method of improvement for 3 month through the QI team discussion and conducted by following the improvement method for the next 1 month and the waiting cases were measured and the difference before and after the QI activity was compared in percentage. 1. When patient waiting cases were compared before and after conducting QI activity against the causes of repetition, it resulted in 3.9% of reduction effect. 2. When patient waiting cases were compared before and after conducting QI activity against the causes for the lack of guiding, it resulted in 1.1% of reduction effect. 3. When patient waiting cases were compared before and after conducting QI activity against the causes of miss-inputting prescription, it resulted in 1.1% of reduction effect. 4. When patient waiting cases were compared before and after conducting QI activity against the causes for emergency patients, patients with acute pain and discomfort patients, it resulted in 12.0% of reduction effect. 5. When patient waiting cases were compared before and after conducting QI activity against the causes for shooting overlapping of outpatients and hospitalized patients, it resulted in 4.7% of reduction effect. There are many factors to reduce the patient waiting cases in radiography. The first step is for radiology department to find these factors through QI, to improve them, which is the reason why the QI team is organized to perform the QI activities.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.9 no.2
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• pp.138-147
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• 1998

Authors surveyed intrafamilial child sexual abuse in the children under 15years old in clinical. We sent the semi-structured child sexual abuse questionnaires to 7055 board certified pediatrics, obstetrics and gynecology, family medicine and emergency medicine. Total respondents were 1205. The results from these respondents were as follows. 1) The numbers of respondents who have had the experience of treating victims of intrafamilial child sexual abuses were 157(13.0% of total respondents). 2) Among the perpetrators, 58(36.9%) were siblings and 32(20.4%) 26(16.6%) were step-fathers, and respectively. The most common age bracket was 10s(39.5%), and the next was 40s and 50s (33.7%) Almost all(98.7%) of the perpetrators were male. 3) The mean age of victims was $12.1{\pm}3.3$ years old, and all of the victims were female, and the number of victims who had previous mental or physical handicaps and behavior problems were 5(3.2%) and 8(5.1%) respectively. 4) The ways by which intrafamilial child sexual abuses were found were abnormal behaviors 45(28.7%), victim's own report 40(25.5%), pregnancy 18(11.5%), pain complaint 13(8.3%), other person's report 13(8.3%), and detection during examination 12(7.6%). 5) Time lags between intrafamilial child sexual abuses and hospital visits were after 1 month 97(61.8%), from 1 day to 1 week 29(18.5%), within 1 day 21(13.4%), and from 1 week to 1 month 10(6.4%). 6) Physical complications were perineal wound 93(59.2%), hymen rupture 90(57.3%), pregnancy 68(43.3%), wound of other part of body 11(7.0%), and sexually transmitted disease 4(4.5%). 7) Treatment for victims were discharge 92(58.6%), admission, operation or transfer to a bigger hospital 25(15.9%), psychiatry consult 19(12.1%), report to police(10.9%) and social work consult 3(1.9%). These results suggest that considerable numbers of physicians have had the experience of treating victims of intrafamilial child sexual abuses, and intrafamilial child sexual abuses are the major medical as well as social issue in children in Korea.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.9 no.2
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• pp.127-137
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• 1998

The authors surveyed extrafamilial sexual abuse in the children under 15years old by the physician's reports. We sent the semi-structured child sexual abuse questionnaires to 7055 board certified pediatrics, obstetrics and gynecology, family medicine and emergency medicine. Total respondents were 1205. The results from these respondents were as followings. 1) The number of respondents who have had the experience of treating victims of extraf/amilial child sexual abuse were 641(53.2% of total respondents). 2) 338(52.7%) of the perpetrators were known persons and 277(43.2%) were strangers, the most common age bracket were 20s, 30s and 10s, and almost all(99.8%) of the perpetrators were male. 3) The mean age of victims was $9.7{\pm}3.5$ years old, and almost all(98.6%) of the victims were female. 4) The ways by which extrafamilial child sexual abuses were found were victim’s own reports：273(62.6%), pain complaint, 156(24.3%) and abnormal behavior 96(15.0%), other person’s report 72(11.2%), detection during examination 19(3.0%), and pregnancy 4(0.6%). 5) Time lags between extrafamilial child sexual abuses and hospital visits were within 24 hours 332 (51.8%) and from 1 day to 1 week 232(36.2%), victims were rather quickly 6) Physical complications were perineal wound 571(89.1%), hymen rupture 349(54.4%), wound of other part of body 124(19.3%), pregnancy 37(5.8%), and sexually transmitted disease 18(2.8%), and other serious complications such as vaginal-rectal lacerations 8, intastinal bleeding 7, death 2, hypotensive shock 1. These results suggest considerable numbers of physicians have had the experience of treating victims of extrafamilial child sexual abuses, and extrafamilial child sexual abuses are the major medical as well as social issue in children in Korea.

• Journal of the Korean Chemical Society
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• v.51 no.3
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• pp.251-257
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• 2007

The Tumor necrosis factor-α, (TNF-α), is involved in the pathogenesis of multiple sclerosis and contributes to the degeneration of oligodendrocytes as well as neurons. Nicotine has been found to have immunosuppressive and inflammation-suppressing effects. Astrocytes, the major glial cells in the CNS, are capable of producing TNF-α at both the mRNA and protein levels in response to interleukin-1 (IL-1) or TNF-α. Nicotine has been shown to influence glial cell functions. To order to explore the role of astrocytes in the production of TNF-α, astrocytes were pretreated with nicotine and are stimulated with IL-1β to determine their effects on TNF-α production. The results are as follows. Cytotoxic effects of nicotine on human fetal astrocytes were noted above 10 μg/ml of nicotine. The effect of IL-1β on TNF-α mRNA expression in primary cultured human fetal astrocytes was maximal at 2 h after IL- 1β(100 pg/ml) treatment. Human fetal astrocytes were pretreated with 0.1, 1, and 10 μg/ml of nicotine and then stimulated with IL-1β (100 pg/ml) for 2 h. The inhibitory effect of nicotine on expressions of TNF-α mRNA in human fetal astrocytes with pretreated 0.1 μg/ml of nicotine is first noted at 8 hr, and the inhibitory effect is maximal at 12 h. The inhibitory effect at 1 μg/ml of nicotine is inhibited maximal at 24 h. Nicotine at 0.1, 1 and 10 μg/ml concentrations significantly inhibits IL-1β-induced NF-κB activation. Collectively, this study indicates that nicotine might inhibit the expression of TNF-α in activated human fetal astrocytes.