• Title/Summary/Keyword: Following-Up Characteristics

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Clinical Outcome after Treatment with the First-line Drugs in Patients with Persistent Positive Sputum Smear and Negative Sputum Culture Results (지속적인 객담 도말양성 및 배양음성인 폐결핵환자에서 일차항결핵제로 치료종결한 후의 임상성적)

  • Kwon, Eun-Su;Lee, Jong-Youk
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.4
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    • pp.325-333
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    • 2001
  • Background : This study aimed to estimate the clinical outcome and identify the characteristics of a group of patients with pulmonary tuberculosis who completed anti-tuberculosis therapy with the First-line drugs in spite of having positive smear results with negative sputum culture results over the previous six months. Method : A retrospective chart review of 21 patients who fulfilled the above criteria between 1995 and 1999 was performed. The laboratory data as well as the clinical data of the patients with positive smear results and negative culture results over a six months period were reviewed. Results : The negative conversion of sputum culture results was achieved within $1.3{\pm}1.2$ months and the negative conversion of the sputum smear results was accomplished during $9.5{\pm}3.3$ months. Chest X-rays at 5 months following the institution of anti-tuberculosis therapy from all patients revealed improvements. Four out of 21 patients(19%) relapsed during the follow up, $15.2{\pm}13.4$ months after administering anti-tuberculosis therapy for $13.3{\pm}3.1$ months. Relapses were confirmed from between 3 months and 4 months after the treatment completion. Only one of the four relapses had no past history of anti-tuberculosis therapy and the others had prior treatment twice (p<0.01). The period of anti-tuberculosis treatment was extended to a mean of $4.6{\pm}2.6$ months in 12 patients. However, prolongation of anti-tuberculosis therapy had no affect on the relapse rate (odds ratio, 95% CI 0.18, 2.15). Conclusion : Prolongation of therapy with the First-line drugs is not necessary for patients with persistently positive smear results over 6 months and negative culture results. A patient who has had prior anti-tuberculosis therapy more than twice should be paid the closest attention.

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The Clinical Considerations of Serous Otitis Media and Ventilation Tube (삼출성중이염과 중이내 통기관 유치술의 임상적 고찰)

  • 김영명;박인용;장태영;심형보
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1982.05a
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    • pp.14.2-15
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    • 1982
  • Serous otitis media (SOM) is one of the most common otologic diseases which was first discribed by Politzer in 1869. Currentely, among many methods introduced to treat SOM, ventilation tube insertion is considered to be the most popular and standard method being used. However due to complication of it, there remains many disputable various problems. In order to review the clinical aspect of SOM and search for the effects and safety of ventilation tube, we studied 97 SOM patients, who had performed V-tube from Jan. 1981 to Feb. 1982 at ENT dept. of Severance Hospital. Analizing the clinical symptoms, age distribution, associated disease, otoscopic findings of ear drum, degree of hearing loss, hearing gain after insertion of V-tube and complications, following results were obtained. 1) As a subjective symptom, among 29 cases all patients had hearing loss, 19 cases (65.6%) had tinnitus, 12 cases (44.4%) had autophony and 10 cases (34.5%) of the patients had sensation of ear fullness. 2) In age distribution, 6 to 10 year old group was most numerous up to 42 cases (43.3%) and 20 years and over was 23 cases (23.5%) 3) In adult group SOM tend to be involved unilaterally whereas young child group had tendency involving bilaterally. 4) 49 cases (50.05%) were associated with tonsillitis and adenoid vegetation, 15 cases (15.5%) were associated with sinusitis, 4 cases (4.1%) had nasal allergy. 5) In preoperative otoscopic findings, 62 ears (47.7%) had retraction, 37 ears (23.6%) had bulging, 34 ears (21.7%) had color change, and 29 ears (19.7%) had no significant findings. 6) In characteristics of middle ear fluid, child group was tend to have mucinous content (84.2%) while adult group had serous content (62.5%). 7) Average preoperative air-bone gap of pure tone was 25.3 dB. 8) 24 ears (72.7%) had over 10 dB of postoperative hearing gain and average hearing gain was 17.2 dB. 9) There were 44 ears (28.1%) of complications. Among them 37 ears (23.6%) had infection, 3 ears had atelectasis, 2 ears had granulation tissue, 2 ears had permanent perforations. 10) Among 37 ears suffered from post-op. infection, 19 ears (51.4%) had initial infection just after insertion of ventilation tube, 18 ears (48.6%) were infected during the course of post-ventilation tube. Of 37 infected ears, 26 ears (70.3%) responded to conservative care, while 11 ears (29.7%) was cured after removal of ventilation tube.

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Characteristics of Percutaneous Absorption of Glycol ethers (Glycol ethers에 대한 피부 투과 특성)

  • Lee, Han-Seob;Choi, Sung-Boo;Kim, Nac-Joo;Keun, Jang-Hyoun;Hwang, Hyun-Suk;Baek, Jung-Hun;Choi, Jin-Ho;Lee, Ho-Joon
    • Journal of the Korean Applied Science and Technology
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    • v.30 no.1
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    • pp.116-126
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    • 2013
  • Glycol ethers are a group of solvents based on alkyl ethers of ethylene glycol commonly used in paints. These solvents typically have a higher boiling point, together with the favorable solvent properties of lower-molecular weight ethers and alcohols. The word "Glycol ethers" was registered as a United States trademark by Union Carbide Corp. Typically, glycol ethers are found in pharmaceuticals, sunscreens, cosmetics, inks, dyes and water based paints. On the other hand, glycol ethers are used in degreasers, cleaners, aerosol paints and adhesives. Most glycol ethers are relatively water soluble, biodegradable and only a few are considered toxic. Therefore, they are unlikely to pose an adverse risk to the environment. Recent study suggests that occupational exposure to glycol ethers is related to low motile sperm count in men, but the finding has been disputed by others. In this study, skin permeation of 3 types glycol ethers were studied in vitro using matrix such as solvent and detergent. The absorption of glycol ethers[methyl glycol ethers(MC), ethyl glycol ethers(EC) and butyl glycol ethers(BC)] has been measured in vitro through rat skin. Epidermal membranes were set up in Franz diffusion cells and their permeability to PBS measured to establish the integrity of the skin before the glycol ethers were applied to the epidermal surface. Absorption rates for each glycol ethers were determined and permeability assessment made to quantify any irreversible alterations in barrier function due to contact with the esters. Types of glycol ethers in vitro experimental results on MC> EC> BC quickly appeared in the following order: skin permeation was beneficial to the skin permeation small molecular weight, the difference in chemical structure, such as hydrophilic, because with the partition coefficient and solubility mechanisms and passive diffusion to increase the speed at which transmission is considered.

A Development of Kolb's Learning Style Based Team Organization Support System (Kolb의 학습양식에 기반 한 팀 조직 지원 시스템 개발)

  • Park, Su-Hong;Jung, Ju-Young;Hong, Jin-Yong;Kim, Seong-Ok;Ryu, Young-Ho;Kang, Eun-Kyeong
    • Journal of The Korean Association of Information Education
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    • v.12 no.1
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    • pp.9-22
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    • 2008
  • The purpose of this research is to develop a prototype of the support system in order for team building associated with web-based project learning having applied Kolb's learning style. To accomplish this purpose, the following research tasks were performed. First, core idea in order to embody the system's value, key activities, tools that will support pertinent activities and the strategy so as to develop guidelines, etc. were devised and prepared. Second, a system was designed on the basis of structural model of teaching design, then after, interface was developed. The core factors in this system are inspection of learning style, organizing a team and team building. Above all, it is required to make learners know about learning environments, of which they are in favor, and also its distinctive features through inspection of learning style, and then focusing on learning style, a team should be organized insomuch as to accommodate a variety of learning styles as much as possible. For the purpose of team building, after learning style of each constituent member of the team has been made known, then the roles will be divided among the constituent members of the team so as to suit their individual characteristics referring to each of their learning styles that have been exposed. To verify the value of this system developed and efficiency thereof, a focus group interview was conducted. The focus group consisted of professionals, all from related fields. After the interview, the points required to make further improvements were elicited and taken care of by follow-up actions as needed. And having reflected such improvements made, the final system was developed. With this newly developed system, learners can get the results of inspection of learning style so quickly by performing inspection any time any where, and based on the results from such inspection, a team comprising dissimilar constituents who exhibit a variety of different propensities will be automatically organized. Thus, this system may be used not only for web-based project learning having unspecified persons elected as constituents, but in the offline space also.

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The Inflow of the Creative-Class and Forming of Cultural Landscape on the Kyunglidan-Gil (경리단길 창조계급의 유입과정과 문화경관 형성요인)

  • Yang, Hee eun;Son, Yong-Hoon
    • Journal of the Korean Institute of Landscape Architecture
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    • v.41 no.6
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    • pp.158-170
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    • 2013
  • With the recent 'Creative economy' and 'Cultural prosperity' coming to the fore as a new code to build up a city or a region, it is necessary to focus on strengthening the regional creative capacity as well as developing spontaneous regional culture. In such trend this research aims to explore the Kyunglidan-gil, Seoul, Korea in which creative-class are appearing autogenously in clusters and forming new cultural landscape, to identify the factors of their accumulation and changing aspect of cultural landscape. This study has the following purposes: First, Investigating the historical context of the Kyunglidan-gil's landscape. Second, considering the process of the creative-class being flowed into the Kyunglidan-gil as the subject leading to the modification of the region. Third, their activity was analyzed to consider the unique aspect of forming the cultural landscape at the Kyunglidan-gil. Regarding why the creative-class should flow in, results of the study drew five factors including region in issue compared to inexpensive rents, coexistence with nature, quiet atmosphere seeming isolated from the urban confusion, location possible to test and share individual materials one likes, and a site with synergy effect of activity through the network with acquaintances. Also, five characteristics of cultural landscape forming by the people's activity were drawn - space of communication for increasing creativity, temporary and flexible spatial use, expression of one's identity and taste, distinguishing, and positive use of the existing facilities. Like this, by exposing the 'creative-class', a subject of the leader in changing process of the Kyunglidan-gil, this research identified the aspect of forming cultural landscape.

A Study on Qian Yi(錢乙)'s Medical Though (전을(錢乙)의 의학사상(醫學思想)에 관(關)한 연구(硏究))

  • Oh, Jun Hwan;Kim, Ki Wook;Park, Hyun Kook
    • The Journal of Korean Medical History
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    • v.14 no.2
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    • pp.109-152
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    • 2001
  • Throughout this paper, I adjusted the study of 'Qian Yi'(錢乙)'s Medical Thought, and the following is the summary. 1. 'Qian Yi' wrote 'Xiao Er Yao Zheng Zhi Jue'("小兒藥證直訣", edited by 誾季忠), and there were 'Shang Han Lun Zhi Wei'("傷寒論指微"), 'Ying Ru Lun', however those are loss of the record. 2. Qian Yi's 'Zhi Jue'("直訣") was influenced by 'Lu Xin Jing', yet if we compare the quality of 'Sheng Li, Byeng Li, Bang Jae'(生理, 病理, 方劑), 'Lu Xin Jing' cannot be the foundation of 'Zhi Jue'. He took over 'Nei Jing, Shang Han Lun, Jin Gui Yao Lue, Shen Long Ben Cao Jing, Tai Ping Sheng Hui Fang'("內經", "傷寒論", "金?要略", "神膿本草經", "太平聖惠方") and put them together to the direct clinical experiences of pediatrics. 3. There is no reference regarding the difficulties of pediatric diagnosis and diseases in 'Huang Di Nei Jing'("黃帝內經") Before 'Bei Song'(北宋), regardless of the lack of data related to pediatric diseases, 'Qian Yi' established the pediatric system in 'Xiao Er Yao Zheng Zhi Jue' for the first time. 4. In his diagnosis of the pediatric diseases, he 'Si Zhen He Can'(四診合參), also considered in the eye exam seriously. In addition, he closely combined 'Wu Zang Bian Zheng'(五臟辨證), and diagnosis the pediatric diseases. 5. 'Wu Zang Bian Zheng', what Qian established method was based on 'Zheng Ti Guan'(整體觀) in 'Huang Di Nei Jing'. It was based on clinical experiences and established the perspectives of 'Tian Ren Xiang Ying'(天人相應). First of all, he pinpointed 'Zhu Zheng'(主證) clearly. Secondly, he pinpointed the relationships to symptoms and then, he distinguished a generic character of 'Xu, Shi, Han, Re'(虛, 實, 寒, 熱). Finally, he made an induction from genealogical pediatric physiology. 6. 'Qian Yi' took a serious view of 'Ban Zhen'(斑疹), the inadequate field in those days. At that time, he criticized on the habituation of the misuse of medication. He treated separately which 'Ji Jing'(急驚) as 'Liang Xie'(凉瀉) and 'Man Jing'(慢驚) as 'Wen Bu'(溫補). He proposed 'Cong Gan Zhu Feng, Xin Zhu Jing'(從肝主風, 心主驚) theory and formulated 'Jing Feng'(驚風) theory as well. 7. As an opponent of a tendency to misusage of medicine, 'Qian Yi' made out a prescription with pliant medicine. He emphasized on the treatment to 'Gong Bu Shang Zheng, Bu Bu Zhi Xie, Xiao Bu Jian Shi'(攻不傷正, 補不滯邪, 消補兼施) because he had so lucid demonstration to 'Xu Shi Han Re'(虛實寒熱) of the five viscera in the field of 'Bang Yak'(方藥). 8. There were no pediatrics schools at that time, however, the pediatrics was being made up gradually by 'Jin Yuan Si Da Jia'(金元四大家) who was influenced by 'Qian Yi'. He raised an objection to medical treatment using pliant medicine. 'Qian Yi' applied 'Qu Xia'(驅下) treatment using 'Han Liang'(寒凉) medicine. 'Han Liang Pai'(寒凉派) is greatly influenced by Qian. 'Chen Wen Zhong'(陳文中) had a great impact on 'Han Liang Pai' who used a 'Zao Shu Wen Bu'(燥熟溫補) medicine for treatment. Since 'Song Jin'(宋金), he had a tremendous influence on pediatrics treating patients in both 'Han Wen'(寒溫) ways. 9. 'Qian Yi' had an influence on his medical thoughts on future generations, especially to 'Wan Quan'(萬全) of 'Ming Dai', 'Wu Tang'(吳塘) of 'Qing Dai'(淸代) and 'Yun Shu Jie'(?樹珏) of 'Min Guo'(民國). 'Wan Quan' is an advocate of 'You Yu, Bu Zu Zhi Shuo'(有餘, 不足之說)of 'Xiao Er Wu Zang'(小兒五臟) that he revealed Qian's 'Wu Zang Bian Zheng'(五臟辨證). 'Wu Tang' disclosed Qian's 'Xiao Er Ti Zhi Shuo'(小兒體質說) and 'Xiao Er Ke'(小兒科)'s 'Yong Yao Lun'(用藥論), therefore, he uncovered pediatric physiological characteristics through the advocate of Qian's 'Zang Fu Rou Ruo, Ji Gu Nen Qie, Yi Xu Yi Shi, Yi Han Yi Re' (臟腑柔弱, 肌骨嫩怯, 易虛易實, 易寒易熱). 'Yun Shu Jie' developed intrinsic relationships among time, symptom and 'Tian Ren Xiang Ying Guan'(天人相應觀), What 'Qian Yi' stated about them. And also, he developed Qian's 'Di Huang Wan'(地黃丸), 'Xie Qing Wan'(瀉靑丸), 'Yi Huang San'(益黃散) clinical usages as well. 10. Regarding Qian's 'Wu Zang Xu Shi'(五臟虛實), it has an influence on 'Zhang Yuan Su'(張元素)'s 'Zang Fu Bing Ji Bian Zheng'(臟腑病機辨證). 'Di Huang Wan', 'Xie Qing Wan', 'Xie Xin Tang'(瀉心湯), 'Yi Huang San', 'Xie Huang San'(瀉黃散) are the standard prescription of 'Wu Zang Bu Xie'(五臟補瀉). It is under the influence of Qian's treatment. Besides, 'Qian Yi' took a serious view of 'Xiao Er'(小兒)'s 'Pi Wei'(脾胃). 'Qian Yi' had an impact on 'Li Dong Yuan'(李東垣) one of the member of 'Bu Tu Pai'(補土派). 'Di Huang Wan', which placed great importance on 'Bu Yi Shen Yin'(補益腎陰), had a great impact on 'Da Bu Yin Wan'(大補陰丸) and 'Jin Yuan Si Da Jia' as well. 11. In a theory of Qian's 'Wu Zang Bian Zheng', though it had been stated clearly in 'Wu Zang Bian Zheng', but he neglected in 'Liu Fu Bian Zheng'(六腑辨證). In prescription field, The problem with the medicine is that it is either toxic or mineral, therefore, we are not able to use those medicine in a clinical testing at the present time.

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Growth of the Korean Public Library from the Point View of Acculturation (문화변용이론의 시각에서 본 우리나라 공공도서관의 발전과정)

  • Chun Myung Sook
    • Journal of the Korean Society for Library and Information Science
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    • v.10
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    • pp.39-70
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    • 1983
  • The concept of the public library defined by the Korean Library Association does not describe the current state of the Korean public library but describes the public libraries in the western society. Korean public library was formed after the western public library but it was modified and reconciled with the tradition of Korea. The difference between the concepts occured in the acculturation process of the Korean public library. According to the International Encyclopeadia of the Social Sciences, acculturation comprehends those phenomena which result when groups of individuals having different cultures come into continuous firsthand contact, with subsequent changes in the original cultural patterns of either of both groups. Korea opened its door to western world in 1876, and it began to contact with the western world. As the consequence, the concept of the public library of the West diffused to Lee Dynasty which were characterized by the confucianism and the extended family system. These two characteristics were against the public library concept and it could not function as it was and it had to be modified to fit to Korean society. The American public library was formed by the diffusion of English public library. The concept fitted in the colonial American society which was characterized by the Christianity and nuclear family system. Religion and family life were closely knitted together and they contributed much to the formation of the American public library. Also the society needed various information to form their new nation. The need of the public library grew and the public library repidly developed as the American society was urbanized and industrialized. The changes of Korean public library has passed the following process of acculturation. 1. The Korean culture contacted with Western world. 2. The public library concept diffused to Korea, but the people were illiterate and the need of the public library was for the preservation of the old books. The collection was not for people. 3. The function of the public library in Korea was altered slightly as several intellectuals who formed the first modern public library tried to literate Koreans as a means of liberation :from Japan through the library service. 4. The traditional libraries such as sodandg and hyangyo disorganized and finally disappeared as the traditional elements of the culture disappeared and the new cultural elements prevailed in Korea. 5. When the traditional elements of culture were disorganized, a reinterpretation of the diffused culture appeared. With the appearance of the vouth group which was not existed in the traditional society, cultural facilities for them were needed. They began to use public library as their reading rooms. This pattern has been institutionalized ever since in Korean public library. 6. When the new element of the culture spread, the traditional cultural elements react against this element. As the new public libraries sprung out, there were movements to restore the old Korean tradition of the family libraries and Hyangyo to counteract to the new libraries. This movements were not successful and they all disappeared as they could not keep up the rapid social change occurred in the Korean society. 7. In the process of the cultral change, cultural lag occurred between the public library and the users who could not adopt to the new library. This has been continued to the present time. 8. This diffused concept of the public library was modified and became native to Korean society. However, the acculturation of the public library concept has not changed the traditional ideas of Korean people and their behavior. The Korean society recently has been changing rapidly and the function of the Korean public library is improving accordingly; 1. The extended Korean family system is disorganizing. As the consequence, the public library could substitute the family system offering information and recreation service, etc. 2. The growth of educated population is requiring a variety of library materials. An individual library can not meet the needs of them and cooperative library service will be needed to share resources. The public library will become the center of the cooperative service. 3. The Koreans are watching TV more hours than they read printed materials. For them, the public library needs to collect audiovisual materials. Especially the teaching materials should be all audiovisualized for the effective teaching. 4. Technology is developing rapidly in Korea, especially computer technology is applied in many parts of the society. This will also influence library service. The public library will be developing as the centralized library computer system. When the Korean public library functions as the extended family system and the center of the cooperative library system, the Korean public library will be functioning as the public library defined by the Korean Library Association.

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Effects of Dietary Energy Level and Slaughter Weight on Growth Performance and Grades and Quality Traits of the Carcass in Finishing Pigs (비육돈에서 사료의 에너지 수준과 도살체중이 성장성적과 도체의 등급 및 육질특성에 미치는 영향)

  • Park, Man-Jong;Jeong, Jin-Yeun;Ha, Duck-Min;Han, Jeong-Cheol;Sim, Tae-Geon;Park, Byung-Chul;Park, Gu-Boo;Joo, Seon-Tea;Lee, Chul-Young
    • Journal of Animal Science and Technology
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    • v.51 no.2
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    • pp.143-154
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    • 2009
  • (Y $\times$ L) $\times$ D-crossbred gilts and barrows weighing $80.2\pm0.2$ kg were fed a "medium-energy" (ME) or "low-energy" (LE) diet (3.2 vs 3.0 M cal DE/kg) and slaughtered at 110, 125, or 138 kg, after which physicochemical and sensory quality traits of major primal cuts of resulting carcasses were analyzed, under a 2 (sex) $\times$ 2 (diet) $\times$ 3 (slaughter weight; SW) factorial arrangement of treatments. The ADG and ADFI were greater (P<0.01) in barrows than in gilts and also in 125- and 138-kg vs 110-kg SW. Moreover, ADG and gain:feed were greater in ME vs LE (P<0.01), whereas ADFI was greater in LE vs ME (P<0.01). Backfat thickness, which increased with increasing SW (P<0.01), was not affected by sex or diet. Carcass marbling score was greater (P<0.01) in gilts and LE than in barrows and ME, respectively. Carcass quality grade, which was superior in LE vs ME, was not affected by SW, whereas the yield grade decreased abruptly between 125- and 138-kg SW primarily due to the upper limit of carcass weight imposed on the A and B grades. Physicochemical characteristics including pH, drip loss, and variables pertaining to color of belly, ham, and loin were not affected significantly by any of the treatment factors, albeit statistically significant in some cases, in terms of quality criteria. In sensory evaluation, the acceptability of fresh belly was not influenced by any of the treatment factors. Marbling score of fresh ham was greater in LE vs ME (P<0.01) and tended to increase between 110- and 125-kg SW (P=0.10); in loin, the increase of this variable between the two SW was significant (P<0.01). Following cooking, LE was superior to ME in the acceptability in belly and ham, but the effect of SW was insignificant in any of the sensory quality traits evaluated in this study in any of the three major primal cuts. In conclusion, the present results suggest that SW can be increased to up to 138 kg without compromising carcass quality and that LE has some beneficial effects on quality of the whole carcass and the major primal cuts.

Analysis of the medication compliance of hypertensives and its influential factors (고혈압 환자의 투약순응도와 영향 요인 분석)

  • Son, Kyung-Ae;Kim, Yoon-Shin;Hong, Min-Hee;Jeong, Mi-Ae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.5
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    • pp.1897-1904
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    • 2010
  • The administration data of the national health insurance and health insurance bills were utilized in this study. The data of 432,915 patients who were at the age of 30 and up and used the out-patient departments of every medical institution located in some regions involving two southern and northern provinces once or more during a 184-day period from July to December. As a result of analyzing their prescription compliance and factors affecting it, the following findings were given: The average rate of the prescription compliance of the patients stood at 61.5 percent. It denoted that they were prescribed to take medicine for approximately 113 days during the six-month(184 days) period of time, and the rate of the patients who complied with the prescriptions just stood at 13.0 percent. They used out-patient department for 4.3 days on the average due to hypertension and they visited 1.1 medical institutions on the average. 94.9 percent just used a medical institution. The largest group (11.6%) suffered from diabetes as co-morbidity, and 23.3 percent of the hypertensives had co-morbidity. Concerning the relationship between their characteristics and prescription compliance, those who were male, who were beneficiaries of the national health insurance, who mainly used general hospitals and who suffered from co-morbidity complied better with the prescription they got. Their prescription compliance got better at the age of 65 to 74 and got worse afterwards. As for factors affecting their prescription compliance, the patients who were male, who were aged between 55 and 64 and who were beneficiaries of the national health insurance, who mainly used specialized general hospitals, general hospitals and public health centers and who had heart diseases and diabetes as co-morbidity complied better with the prescriptions. The above-mentioned findings of the study suggested that it's needed to make a factor analysis of the poor prescription compliance of patients from diverse angles, and that existing hypertension care plans should carefully be reviewed to improve the prescription compliance of patients and to find a feasible alternative. As hypertensives are easily likely to develop co-morbidity like diabetes, systematic health education should be provided for them to get into the right life habits such as taking low-salt meals or quitting smoking. In addition, the development of health care programs is required.

Variables Affecting Long-Term Compliance of Oral Appliance for Snoring (코골이 치료용 구강장치의 지속적 사용에 영향을 주는 요인의 분석)

  • Lee, Jun-Youp;Hur, Yun-Kyung;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.33 no.4
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    • pp.305-316
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    • 2008
  • 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).