• Clinical and Experimental Reproductive Medicine
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• v.30 no.1
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• pp.85-93
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• 2003

Objective : To evaluate the safety and efficacy of selective fetal reduction (SFR) and compare the outcome of twin pregnancy after SFR in multiple pregnancy induced by assisted reproductive technology (ART) with that of natural twin pregnancy. Methods : From September 1995 to March 2002 in Ajou University Hospital, SFR was performed in 79 patients whose gestational sacs were more than 3. Of these 79 patients, 47 patents resulted in twin pregnancy after SFR. SFR was performed using transvaginal intracardiac KCl injection at gestational age of $6{\sim}9$ weeks. Control group was composed of 264 patients with natural twin pregnancy, who delivered after intrauterine pregnancy at 24 weeks, from June 1994 through December 2002. We compared Obstetric and perinatal outcomes between SFR group and natural twin group. Results: Among 47 patients with twin pregnancy after SFR, 2 spontaneous abortion were occurred at intrauterine pregnancy at 8 and 19 weeks. Obstetrical and perinatal outcomes were available in 43 patients. Single intrauterine fetal death was occurred in 1 of 43 (2.3%) patients in SFR group. Incidence of preterm labor, premature rupture of membrane, preeclampsia and placenta previa were similar, but gestational diabetes mellitus (GDM) was occurred more frequently in SFR group (3 (7.0%) vs 4 (1.5%), p=0.02). Mean gestational age, mean birth weight, incidence of discordancy, use of intubation and ventilation, incidence of fetal anomaly, low (<7) Apgar score and intrauterine growth restriction were similar in both groups. Conclusion: Twin pregnancy after SFR has the increased incidence for GDM but other obstetric and perinatal outcome was similar compared with natural twin pregnancy. So SFR is a safe and effective procedure, so we suggest SFR is needed in multifetal pregnancy more than triplet.

• The Journal of Korean Medicine
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• v.30 no.2
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• pp.56-62
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• 2009

Objectives: We tried to clarify the relationship between lifestyle and plasma homocysteine concentration. We analyzed the data of patients with acute ischemic stroke from the Hanbang stroke registry supported by the Ministry of Science and Technology of Korea. Methods: 458 subjects were recruited from the patients admitted to the Internal Medical Department of Kyunghee University oriental medical center, Dongguk University Ilsan oriental medical center, Kyungwon University Songpa oriental medical center and Kyungwon University Incheon oriental medical center from April 2007 to August 2008. We divided the subjects into four groups by quartiles of plasma homocysteine concentrations and compared the first and last quartile groups. Results: 1. In univariate analysis, the high homocysteine concentration group showed higher rate of older age, male gender, smoking, drinking and lower values in vitamin B12, folic acid, creatinine than the control group with statistical significance. 2. In multivariate analysis, older age, male gender smoking and folic acid showed a close relationship with statistical significance (each OR=3.620, OR=4.218, OR=3.558, OR=0.789). Conclusions: According to the analysis, the relationship between high homocysteine concentration and smoking in patients with acute ischemic stroke were clarified. We hope to standardize and establish criteria on homocysteine in Korea by large epidemiological survey. These study results could be utilized in the future as a basis material.

• Women's Health Nursing
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• v.13 no.4
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• pp.245-253
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• 2007

Purpose: The purpose of this study was to measure the effects of a breastfeeding management program for promotion of breastfeeding. Method: The study design was a non-equivalent control group pre-post test. The study subjects were pregnant women receiving a breastfeeding education class in one hospital in Ilsan. The total number of study subjects was 153 pregnant women, namely 75 mothers in the experimental group and 78 in the control group. Data was collected between June and November, 2006. A breastfeeding management program was provided to the experimental group while admitted for delivery, and in weeks 2, 4, 8, 12, 16, 20, and 24 of the postpartum period. The rates of breastfeeding were measured in weeks 2, 4, 8, 12, 16, 20, and 24 of the postpartum period. Result: There were significant differences in the scores of rate of breastfeeding between the two groups(all cases), which were 93.1 in the experimental group and 85.8 in the control group at week 4; 88.1 vs 71.8 at week 8; 83.4 vs 56.7 at week 12; 71.4 vs 53.9 at week 16; and 65.7 vs 48.4 at week 20 respectively. However, there were not significant differences in the scores of rate of breast-feeding between the two groups, which were 97.7 in the experimental group and 96.0 in the control group in the early postpartum period at week 2, and 59.6 vs 45.3 at week 24. Add to this, the study analyzed only people who had jobs. As a result, the scores of rate of breastfeeding were 94.8 in the experimental group which were significantly higher than 88.5 in the control group at week 4; 93.2 vs 73.3 at week 8; 89.6 vs 57.2 at week 12; and 75.0 vs 46.0 at week 20 respectively. However, there were not significant differences at week 2, week 16 and week 24. Conclusion: The results of this study suggest that a breastfeeding management program during the last trimester of the perinatal period and postpartum period may increase the duration of breastfeeding in postpartum clients who intend to breastfeed. This study supports the literature which found that prenatal education and postpartum support are important to the outcome of breastfeeding.

• The Journal of the Korean dental association
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• v.53 no.10
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• pp.688-695
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• 2015

Purpose: The institutionalized elderly have placed the most vulnerable state, and the report about the oral health status of the institutionalized elderly was scarce. The aims of the current study were to investigate the oral health status of institutionalized elderly. Materials and methods: The survey of the oral health status was carried out on 487 institutionalized elderly from 4 longterm care facilities of Seoul metropolitan city, Gyunggi province, and Gangwon province in Korea. Results: The prevalence of dental caries, root caries, and dental calculus of the institutionalized elderly was 19.2%, 15.3%, and 23.7%, respectively. The percentage of edentulism among the institutionalized elderly was 26.2%. Those who had poor oral hygiene and tongue coating were 43.9% and 90.5%, respectively. The percentages wearing complete and removable partial denture on maxilla were 12.8% and 3.3%, respectively. The percentages wearing complete and removable partial denture on mandible were 7.8% and 5.6%, respectively. The percentages of institutionalized elderly needing complete and removable partial denture on maxilla were 29.7% and 27.2%, respectively. The percentages of institutionalized elderly needing complete and removable partial denture on mandible were 24.5% and 30.9%, respectively. Conclusion: The oral health stuatus of institutionalized elderly was poor. For the oral health promotion of elderly in longterm care facilities, it is essential to educate nurses and caregivers about the importance of the oral health and oral hygiene method.

• Imaging Science in Dentistry
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• v.41 no.2
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• pp.63-69
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• 2011

Purpose : The purpose of this study was to evaluate a new technique for localizing impacted mesiodens using its horizontal magnification ratio on panoramic radiographs. Materials and Methods : Location-magnification equation of a panoramic equipment was obtained from horizontal magnification ratio of a metal ball which was located variable positions from the center of image layer at interval of 2 mm. Panoramic radiographs were obtained from a skull phantom with a metal ball which was a substitute for impacted mesiodens and was embedded 10mm(Group 1), 15mm(Group 2), and 20mm(Group 3) posterior to the central incisor. Each group obtained 7 panoramic radiographs at variable positions and one periapical radiograph. Three methods were used to estimate the actual width of the incisors and the balls which were used to calculate the magnification ratio. The methods included using the actual incisor width and the calculated ball width (Method 1), using the actual incisor width and the ball widths measured on periapical radiograph (Method 2), and using the incisor and the ball widths measured on periapical radiograph (Method 3). The location of the metal ball was calculated by using the location-magnification equation. Results : The smallest difference between the calculated and the actual distance was $0.1{\pm}0.7 \;mm$ in Group 1/ Method 3. The largest difference was $-4.2{\pm}1.6 \;mm$ in Group 3/Method 2. In all groups, method 3 was the most accurate. Conclusion : Quantitative localization of impacted mesiodens is possible by using panoramic radiograph.

• Journal of Periodontal and Implant Science
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• v.47 no.5
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• pp.264-272
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• 2017

Purpose: This study evaluated trends in tooth extraction due to acute and chronic periodontal disease (PD) using data from the National Health Insurance Service-National Sample Cohort for 2002-2013. Methods: A random sample of 1,025,340 individuals was selected as a representative sample of the population, and a database (DB) of diagnostic and prescription codes was followed up for 12 years. We used multivariate logistic regression analysis to assess the incidence of total extraction (TE), extraction due to periodontal disease (EPD), and immediate extraction due to periodontal disease (IEPD) according to sociodemographic factors (sex, age, household income, health status, and area of residence). Results: The incidence of tooth extraction was found to be increasing, and at a higher rate for TE in PD patients. In 2002, 50.6% of cases of TE were caused by PD, and this increased to 70.8% in 2013, while the number of cases of IEPD increased from 42.8% to 54.9% over the same period. The incidence rates of extraction due to acute and chronic PD increased monotonically. We found that the incidence rates of TE, EPD, and IEPD were all 2-fold higher among patients with high income levels and those who were not beneficiaries of health insurance. Conclusions: The rates of TE, EPD, and IEPD have been steadily increasing despite dental healthcare policies to expand public health insurance coverage, increasing the accessibility of dental clinics. Moreover, the effects of these policies were found to vary with both income and education levels. Consistent patient follow-up is required to observe changes in trends regarding tooth extraction according to changes in dental healthcare policies, and meticulous studies of such changes will ensure optimal policy reviews and revisions.

• Tuberculosis and Respiratory Diseases
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• v.72 no.3
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• pp.284-292
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• 2012

Background: The aim of this study was to investigate therapeutic outcomes and assess factors associated with therapeutic outcomes in hematologic patients with invasive pulmonary aspergillosis (IPA). Methods: We analyzed all consecutive cases of IPA in adults with hematologic diseases from January 2008 to January 2009 at a Catholic Hematopoietic Stem Cell Transplantation (HSCT) Center in Seoul, Korea. Results: A total of 54 patients were identified. Underlying diseases were acute myelogenous leukemia (n=25), acute lymphoblastic leukemia (n=10), myelodysplastic syndrome (n=7), chronic myelogenous leukemia (n=3), multiple myeloma (n=3), severe aplastic anemia (n=2) and other hematologic diseases (n=4). Twenty six patients (48.2%) were assessed as having a favorable response, of which 16 patients (29.6%) showed complete response. Overall 12-week mortality and IPA attributable mortality were 38.9% (n=21) and 33.3% (n=18), respectively. In multivariate analysis, uncontrolled underlying disease (odds ratio [OR], 7.31; 95% confidence interval [CI], 1.49~35.94; p=0.014) was associated with an unfavorable response, and for 12-week mortality, uncontrolled underlying disease (OR, 11.79; 95% CI, 1.49~93.46; p=0.020) and hypoalbuminemia (OR, 9.89; 95% CI, 1.42~68.99; p=0.021) were significantly poor prognostic factors. Conclusion: IPA still remains as a poor therapeutic outcome, especially in patients with refractory hematologic diseases.

• Tuberculosis and Respiratory Diseases
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• v.83 no.1
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• pp.42-50
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• 2020

Background: Fractional exhaled nitric oxide (FeNO) is regarded as a potential biomarker for identifying eosinophilic inflammation. We aimed to evaluate the clinical implication of FeNO and its influence on inhaled corticosteroids (ICS) prescription rate in Korean chronic obstructive pulmonary disease (COPD) patients. Methods: FeNO level and its association with clinical features were analyzed. Changes in the prescription rate of ICS before and after FeNO measurement were identified. Results: A total of 160 COPD patients were divided into increased (≥25 parts per billion [ppb], n=74) and normal (<25 ppb, n=86) FeNO groups according to the recommendations from the American Thoracic Society. Compared with the normal FeNO group, the adjusted odds ratio for having history of asthma without wheezing and with wheezing in the increased FeNO group were 2.96 (95% confidence interval [CI], 1.40-6.29) and 4.24 (95% CI, 1.37-13.08), respectively. Only 21 out of 74 patients (28.4%) with increased FeNO prescribed ICS-containing inhaler and 18 of 86 patients (20.9%) with normal FeNO were given ICS-containing inhaler. Previous exacerbation, asthma, and wheezing were the major factors to maintain ICS at normal FeNO level and not to initiate ICS at increased FeNO level. Conclusion: Increased FeNO was associated with the history of asthma irrespective of wheezing. However, FeNO seemed to play a subsidiary role in the use of ICS-containing inhalers in real-world clinics, which was determined with prior exacerbation and clinical features suggesting Th2 inflammation.

• Korean Journal of Health Education and Promotion
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• v.28 no.2
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• pp.51-62
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• 2011

Objectives: The aim of the study was to identify the effects of a community-level metabolic syndrome self-care management program. Methods: Data included baseline demographics, abdominal circumference, blood pressure, blood sugar, triglyceride, and HDL-cholesterol collected at 15 public health centers in Seoul from January to March, 2010. A data obtained(584 men and 410 women) from Metabolic Syndrome Management Program in Seoul was analyzed using Paired t-test and Linear mixed model. Results: The group with 6-month intervention resulted in significant decrease in abdominal circumference, systolic and diastolic blood pressure, blood sugar, and triglyceride. In moderate intervention group with 3-month follow-up showed tendency that abdominal circumference(-1.27(${\beta}$)) and diastolic blood pressure(-1.66(${\beta}$)) are significantly reduced. In the group with aggressive intervention, the more counseling led to significant reduction in abdominal circumference(-0.22(${\beta}$)). Conclusions: These results indicate that a self-care for metabolic syndrome management can improve metabolic syndrome status over a short-term period. Further structured research is needed to develop a systematic program on health behaviors focusing on exercise, diet, and intervention.

• Journal of Hospice and Palliative Care
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• v.20 no.3
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• pp.188-193
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• 2017

Purpose: There has been very little study on the associations between patient's symptoms themselves and family caregiver (FC)'s depression in the palliative phase. This cross-sectional study was to investigate the relationship between symptom features of terminally ill cancer patients and their FC's depression. Methods: We performed a multicenter survey using the MD Anderson symptom inventory and the Hospital Anxiety and Depression Scale. A total of 293 patient-FC pairs were recruited from seven tertiary medical centers. A multivariate regression analysis was applied for identifying the relevant factors associated with FC depression and for estimating adjusted depression score of FCs. Results: Among various psychosocial factors, low FC quality of life, low social support, spouse, and more caregiving time were significantly associated with FCs' depression. According to the presence of FCs' depression, there were significant differences in some symptom characteristics of patients. Even after adjusting for the relevant confounders, depression scores were lower in FCs caring for patients who had negative symptoms (loss of appetite, P=0.005; drowsiness, P=0.024; and dry mouth, P=0.043) than in FCs caring for patients who had not. FCs caring for patients with severe appetite loss had lower depression scores than those with not severe one (P=0.039). Conclusion: Our result suggests that patient's symptom characteristics might be helpful when evaluating a FC's depression.