• Tuberculosis and Respiratory Diseases
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• v.67 no.3
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• pp.212-220
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• 2009

Background: Ventilator-associated pneumonia caused by multi-drug resistant Acinetobacter baumannii has been increasing and growing as a threat in intensive care units. Limited therapeutic options have forced clinicians to choose colistin with or without combination of other antibiotics. We tried to compare the effectiveness between colistin monotherapy and combination therapy based on in vitro synergistic tests. Methods: From January 2006 to December 2007 in medical ICU of a tertiary care hospital in Korea, We reviewed the medical records of patients treated with intravenous colistin due to ventilator-associated pneumonia caused by multi-drug resistant Acinetobacter baumannii. Results: A total of 41 patients were analyzed. 22 patients had been treated with colistin monotherapy and 19 patients with colistin and combination antibiotics that were found to have in vitro synergistic effects. Baseline characteristics were similar in both groups but the mean duration of colistin administration was significantly longer in the combination group (19.1${\pm}$11.2 days vs. 12.3${\pm}$6.8 days, p=0.042). There were no significant differences in outcome variables between the two groups. Conclusion: Combination treatment based on the in vitro antimicrobial synergy test did not show better outcomes compared with colistin monotherapy in VAP caused by multi-drug resistant A. baumannii.

• Tuberculosis and Respiratory Diseases
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• v.62 no.2
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• pp.105-112
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• 2007

Background: Oxidative stress may play an important role in the pathogenesis of endotoxin-induced acute lung injury (ALI). This study evaluated the therapeutic effect of ${\alpha}$-lipoic acid, a nonenzymatic antioxidant, in a rat model of lipopolysaccharide (LPS) induced ALI. Materials and Methods: ALI was induced in Sprague-Dawley rats by instilling LPS (E.coli, 3mg/Kg) into the trachea. The rats were classified into the control, control+${\alpha}$-lipoic acid, LPS, and LPS+${\alpha}$-lipoic acid groups.The lung lavage neutrophil count, cytokine-induced neutrophil chemoattractant (CINC), lung myeloperoxidase (MPO), and cytokine concentrations (TNF-${\alpha}$, IL-$1{\beta}$, IL-6 and IL-10) were measured at 2 h and 6 h after LPS administration. Results: The total cell and neutrophil counts of the LPS+${\alpha}$-lipoic acid groups were significantly lower than the LPS groups. The protein concentration in the BAL fluid was similar in the LPS groups and LPS+${\alpha}$-lipoic acid groups. The TNF-${\alpha}$, IL-$1{\beta}$, and IL-6 concentrations in the BAL fluid were not decreased by the ${\alpha}$-lipoic acid treatment in the LPS treated rats. Conclusions: Although ${\alpha}$-lipoic acid decreased the level of LPS-induced neutrophil infiltration into the lung, it could not attenuate the LPS-induced ALI at the dose administered in this study.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.1
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• pp.92-97
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• 2000

Osteosarcoma is a primary malignant tumor arising most often in the long bone, but rare in jaw bone. Especially osteogenic sarcoma of the mandible is a rare tumor, comprising less than 0.5% of all head and neck tumors. Osteosarcoma occurs chiefly in young persons, and presenting very survival rates. Histopathologically this tumor can be classified three types, osteoblastic, fibroblastic, chondroblastic and classified from low grade to high grade by anaplasia or mitosis of the tumor cells. Sometimes, the exact diagnosis of osteosarcoma is difficult especially in low grade osteosarcoma, even if clinical or radiographical findings suggest to osteosarcoma. So suspcious to malignant bone tumor in clinical or radiological findings, biopsy should be taked from deep portion and multiple area, and sharing the patient history and radiographs with pathologist will assist in the development of the diagnosis. We report a case of low grade osteosarcoma on the mandible initially difficulty in accurate diagnosis. The patient visited our hospital for routine dental treatment but radiographic findings displayed ill-defined radiolucency with osteoid formation on the mandible. Final diagnosis was difficulty in initial biopsy but subsequent biopsy taked from deep portion presented infiltrative growth and mitosis of the tumor cell in some area with small osteoid bone formation, so we could reach final diagnosis as low grade sarcoma. We treated this patient with bloc resection of the mandible and immediate reconstruction with iliac corticocancellous block.

• Journal of the korean academy of Pediatric Dentistry
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• v.24 no.4
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• pp.763-770
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• 1997

The air abrasive technique is a non-mechanical method by which teeth are treated before restoration and stains and calculi are removed from tooth surfaces using the kinetic energy of small particles. The air abrasive technique in dentistry was first introduced in the 1950's with as instrument called 'Airdent'. But, as the main restorative materials of the period were amalgam and gold, and the instrument's inability to control the flow of particles caused the particles to be spread throughout the clinics, widespread use was not possible. In the 1990's, as these techincal problems were solved and more interest in new restorative materials rose in an effort to preserve sound tooth structure, new developements took place in instruments related to the air abrasive technique. The air abrasive technique produces less pressure, vibration and heat that might cause patient discomfort and facilitates the preservation of sound tooth structure. It also reduces the need for anesthesia and is less harmful to the pulp. Other advantages include increase in dentin bonding strength of composite resin, lower possibility of saliva contamination and maintenance of a dry field. But there is not direct contact between the nozzle and the tooth, the operator cannot use his or her tactile sense and must rely solely upon visual input. Other disadvantages are: the tooth preparation depends on the operator's ability; alpha-alumina particles, after bouncing off the tooth surface, cause damage to dental mirrors; the equipment is expensive and takes up a certain amount of space in the clinic. The author conducted case report using the air abrasive technique on patient visiting the Department of Pediatric Dentistry at Seoul National University Dental Hospital and arrived at the following conclusions. 1. The tooth preparation capability of different air abrasive devices varied widely among manufacturers. 2. It was more effective in treating early caries lesions and stains compared to lesions where caries had already progressed to produce soft dentin. 3. The cold stream and noise caused by the evacuation system was a major cause of discomfort to pediatric patients. 4. As there is no direct contact with tooth surface when using the air abrasive technique for tooth preparation, considerable experience and skill is required for proper tooth preparation.

• Korean Journal of Health Education and Promotion
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• v.17 no.2
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• pp.183-205
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• 2000

This research was designed to compare the health condition and the quality of life of the elderly inpatients with those of the normal elderly people. The subjects of study were 482 elderly inpatients and 304 normal elderly people. The research was conducted in July and August using the instrument WHOQOL. The results of the research are as follows: For the level of health, it was recognized that male was healthier than female, having higher the education, living in the city rather than in the rural, keeping the normal life than being in the hospital. There were little difference in the past medical histories of the elderly inpatients and the normal elderly people. As to the diseases currently under the treatment, there were some difference between the elderly inpatients and the normal elderly people but the tendency was similar in the kinds and the frequencies. As to the recognition for the quality of life between the elderly inpatients and the normal elderly people based on the records reflected on each of the domains of WHOQOL, the normal elderly people more positively recognized in the overall quality of life and the following domains: physical, psychological, level of independence, and spirituality/religion/personal beliefs. The normal elderly people more positively recognized especially in the level of independence domain (mobility, activities of daily living, dependence on medication or treatments, working capacity). In the social relationships domain only the sexual activity was significant and the normal elderly people more positively recognized. The elderly inpatients showed the correlation of over 0.5 in the overall quality of life and the following domains: environment, social relationships, physical, psychological, level of independence. It was over 0.6 in the physical domain and the domains of psychological and level of independence. and the psychological domains of level of independence and social relationships. For the points of overall quality of life, it had no correlation with hospitalization but the health condition, residential district, occupation, and taste exerted a significant effect. As a result of separate analyses of the elderly inpatients and the normal elderly people, the health condition and the age only were the common variable which would exercise a significant effect. Besides, the primary factors which would exercise the quality of life were the occupation and taste for the elderly inpatients, and the residential district and source of income for the normal elderly people. In conclusion, it is first and foremost important to improve the standard of health for the overall quality of life for the elderly people, regardless of hospitalization. Therefore, a plan must be urgently drawn up for revitalization of the health promoting projects for the elderly people and the public health projects for the elderly people, and the investment must be increased for settlement of health problems of the elderly people.

• Journal of East-West Nursing Research
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• v.8 no.1
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• pp.41-49
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• 2003

Introduction: The purpose of this study was to compare the different concepts of oriental nursing as perceived by nurses, doctors, and patients in oriental hospitals. Method: A descriptive survey design was used for this study. Fifty-eight nurses, 26 doctors and 28 inpatients in 3 oriental hospitals were recruited from October to December 2002. The data were collected through a semi-structured open questionnaire. The data were analyzed by content analysis. Result: 1. The perceived concept of oriental nursing varied among the subjects. The nurses regard it as "a traditional nursing activity based on oriental philosophy" (60.3%), while the doctors viewed it as "a supplement to western nursing activity"(38.5%). For patients, the oriental nursing activity was considered as "a cordial form of nursing like that from a family member" (50.0%) and "an activity that doesn't differ so much from western nursing" (42.8%). 2. As for oriental nursing activities actually practiced, both the nurses and the doctors agreed that they carry out traditional oriental nursing activities such as explaining the treatment (taking oriental medicines, administering acupuncture etc.; nurses 96.6%, doctors 57.7%) and direct care like removing acupuncture needles (nurses 43.1%, doctors 34.6%). Patients replied that a western nursing activity is performed rather than an oriental nursing activity. 3. As for the required oriental nursing activity, nurses stated they apply traditional oriental methods such as CHUNA exercise therapy, moxibustion, cupping method etc. in their nursing practice. Doctors remarked that they try to understand the patients' state by approaching patients through an oriental way of thinking. Patients wish to get kindly care. 4. As a whole, 34.5% of nurses and 25.0% of patients have experienced little satisfaction from oriental nursing activity. Nurses found it valuable to carry out western nursing (39.3%), while patients found satisfaction in the use of a cordial attitude (39.9%). 5. Both nurses and doctors defined the first reason that oriental nursing activity cannot be performed more often was the lack of education in oriental nursing, and the absence of interest in oriental nursing. Conclusion: Nurses and doctors appreciate an oriental way of nursing, and think that this type of nursing activity has been carried out even though it may be infrequent. However this oriental nursing activity has won recognition from patients who view western nursing activity as being more important.

• Journal of Yeungnam Medical Science
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• v.7 no.2
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• pp.151-158
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• 1990

We reviewed 30 cases of superior vena cava syndrome in adult patients who were seen at the Yeungnam University Hospital from January 1985 to June 1990. The results were as follows : 1. The male-to-female ratio was 6.5:1, and the most patients were in the age group between the sixth and seventh decades. 2. The most common symptoms were dyspnea (87%) and followed by cough (63%), facial swelling (63%) and chest pain (44%) and the physical signs were dilated neck vein (97%), facial edema (93%) and facial flushing (45%) in order of frequency. 3. The simple chest x-ray findings were superior mediastinal widening (90%), right hilar mass (77%) and pleural effusion (31%). 4. Diagnosis was made by history and physical examination (100%), chest C-T scan (100%), simple chest x-ray (97%), bronchoscopy with biopsy (40%) and so on. 5. 21 cases of patients were confirmed by histology : 14 cases (46%) of bronchogenic ca. 4 cases (14%) of lymphoma, 3 cases (10%) of metastic lung ca. Of bronchogenic ca. small cell ca was 7 cases (23%), squamous cell ca, 5 cases (17%), and unclassified ca was 2 cases (6%). 6. In response of treatment, the clinical improvement was achieved in 18 cases with radiotherapy alone. 1 case with chemotherapy only, and 6 cases with radio-chemotherapy.

• Progress in Medical Physics
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• v.23 no.4
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• pp.209-218
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• 2012

Recently, an adequate number of qualified medical physicist is needed for achieving effective treatment and securing safety to the patient, staff and the public on the course of radiation therapy, since the equipment and the technique of radiation therapy are being developed fast and becoming complex. The studies on medical physics staffing level in United State and European countries were investigated. These results were applied to the domestic situation in order to anticipate indirectly the adequate number of medical physicist in Korea. The current number of medical physicists of 6 (middle to large sized) hospitals in Korea was less than 50% of number recommended in the study. Further detailed research specified on the domestic situation is needed in order to expect adequate number of medical physicist more accurately, and particle beam therapy has to be also considered in the research since the facility site is increasing gradually.

• IMMUNE NETWORK
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• v.7 no.3
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• pp.124-132
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• 2007

Background: Regulatory T cells (Tregs) have been investigated intensively for some decades. These cells regulate the immune system, prevent overactivated immune responses and can be used therapeutically. For rheumatoid arthritis (RA), understanding the functions and status of Tregs is an important step for understanding immune regulation in this autoimmune disease. Methods: We investigated the percentages, phenotypes and suppressive functions of $CD4^+CD25^+$ Tregs in peripheral blood (PB) of patients with RA. Results: The percentages were higher in the patients (n=12) than in healthy controls (n=10), and the cells expressed the $CD45RB^{low}$, CTLA-4 and CCR7 phenotypes. We also investigated the expression of Foxp3 and secretion of interleukin (IL)-10 induced $CD4^+CD25^+$ Tcells by anti-CD3 antibody treatment. A suppressive function of the patients' cells was shown through coculture with $CD4^+CD25^-$ T cells in vitro. Conclusion: We suggest that, despite their increased numbers and suppressive function, they manage the ongoing inflammation ineffectively. It might be possible to apply IL-10 to induce the proliferation of IL-10-producing Tregs as therapy for RA.

• Journal of Korean Academy of Nursing
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• v.21 no.3
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• pp.323-338
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• 1991

This study investigated the effect of supportive nursing care including modified guided imagery on the discomfort, self- esteem, erythrocyte semdimentation rate(ESR) and quality of life(Q. L.) in persons with rheumatoid arthritis (R. A.). The purpose was to contribute to the development of theoretical nursing care to enhance the Q. L. of persons with chronic illness. From Nov. 22, 1990 to May 2, 1991, 49 patients registered at a rheumatic clinic at one general hospital in Seoul, were accepted according to the research criteria as subjects for this study. Among these, 26 were selected for an experimental group to he treated with an interpersonal interview and modified guided imagery, the other 23 became the control group not treated for the purpose of measuring and comparing the effect of the treatment. Statistical analysis was done by a SAS program for X$^2$-test, unpaired t -test, Pearson correlation coefficients and factor analysis. The results were as follows : 1. The pre-experimental discomfort level of the total subject group averaged 25.42(S. D. ＝8.77), and the difference between the pre /post experimental discomfort levels of the two groups was not statistically significant. 2. The pre - experimental self- esteem scores of the total subject group averaged 27.48(S. D. ＝3.95), and the difference between the pre /post experimental self -esteem scores of the two groups was not statistically significant. 3. The pre - experimental Q. L. scores of the total subject group averaged 28.70(S. D. ＝5.99), and the difference between the pre /post experimental Q. L. score of the two groups was statistically significant (t＝2.1748, df＝47, p＝ .0347), 4. The pre - experimental mean of the ESR of the total subject group was 34.48(S. D. ＝19.50) mm, and the difference between the pre /post expeimental ESR scores of the two groups was not statistically significant. 5. The Family support scores of the total subject group averaged 41.28(S. D. ＝10.27). 6. The total subject group 0.L. score was correlated with self-exteem score (r＝ .3984, p＝ .0046). In this study, supportive nursing care including modified guided imagery increased the quality of life scores for this group of persons with R. A. significantly. So the concept of supportive nursing care of this study may be effective in enhancing the quality of life persons with chronic illness. Further investigations related to the methodology and with other groups of clients was recommended.