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The Rehabilitation Services Utilization of People with Disabilities in a Rural Area (농촌지역 재가장애인의 재활서비스 이용실태)

  • Choi, Gyeong-Jin;Kim, Keon-Yeop;Lee, Duck-Hee;Han, Chang-Hyun;Choi, Se-Mook
    • Journal of agricultural medicine and community health
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    • v.36 no.4
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    • pp.227-237
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    • 2011
  • Objectives: This study was conducted to investigate the utilization and its determinants of rehabilitation services of people with disabilities in a rural area. Methods: From March 2 to April 1, 2011, we interviewed 101 disabled people with either physical disabilities or brain lesions. The subjects completed questionnaires about the utilization of rehabilitation services, general characteristics (age, sex, marital status, education level, economic status, health insurance, housing, and employment) and disability characteristics (type, level, comorbidity, reason for the occurrence of the disability, self-rated degree of disability, and daily life care giver). Frequency, Pearson's chi-square test, and a multiple logistic regression were used for statistical analysis. Results: This study showed that 70.3% of the people in this rural area with disabilities were using rehabilitation services. The two most common reasons for not using the services were "doubt about the effectiveness of the service" and "no facilities nearby." The facilities that the disabled people were currently using, in the order of most used to least, were general hospitals or clinics, rehabilitation centers, oriental medicine clinics, and public health centers. Only 19.7% of those who received rehabilitation responded that they were satisfied with the service. Significant factors in the utilization of rehabilitation services were sex, employment, self-rated economic status, and the reason for the occurrence of the disability. Women, people who were currently working, people who were of middle or higher economic status, or people who had acquired a disability were significantly more likely to use the services. Conclusions: A large number of people with disabilities in a rural area use rehabilitation services at present, but accessibility and satisfaction were low. Quantitatively and qualitatively, rehabilitation services for disabled people in a rural area should be centered around Community-based Rehabilitation (CBR). Effective strategies, for example reaching those who have not used the rehabilitation services, will be needed to improve services in rural areas.

Mucociliary Clearance in the Children with Bronchial Asthma (기관지 천식 환아에서의 점액섬모 청소율(Mucociliary Clearance))

  • Lee, Myung-Hyun;Sun, Yong-Han;Nam, Seung-Gon;Koh, Young-Yull;Chung, June-Key
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.2
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    • pp.173-181
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    • 1996
  • Background : Several studies have suggested that impaired mucociliary clearance plays a role in the pathophysiology of bronchial asthma. Cough productive of mucoid sputum is common, and mucous plugs in the airways are frequently observed. These clinical features are in keeping with the histologic lesions of asthma, which involve primarily the epithelial and mucous-producing structures of the conducting airways. Some studies have shown that the mucociliary clearance is impaired in adult asthma, but it has not been studied in childhood asthma. The objectives of this study were to examine whether the mucociliary clearance is impaired in childhood asthma and to estimate the degree of impairment in comparison with that of immotile cilia syndrome. Method : Thirteen children with mild stable asthma and eight patients with immotile cilia syndrome completed this study. Ten healthy children were recruited as a normal control group. The whole-lung mucociliary clearance was measured by the radioaerosol technique. Aerosols, tin colloid particles tagged with the radionuclide technetium-99m($^{99m}Tc$), were generated by means of nebulizer, and inhaled via a mouthpiece. The retention of radioactivity was measured at 30, 60, 90 and 120 minutes by gamma camera, and mucociliary clearance was calculated as percent retention at each time. Results: 1) In each subject, the percent retention decreased variably with the lapse of time. 2) The percent retention of radionuclide decreased at each time in order of normal control, bronchial asthma and immotile cilia syndrome and the percent retention of immotile cilia syndrome was significantly higher than that of normal control at each time(p<0.05). 3) At two hours, the percent retention of bronchial asthma($65.0{\pm}1.8$(SE)%) was significantly higher than that of the normal control($54.4{\pm}3.5%$, p<0.05), and significantly lower than that of immotile cilia syndrome($73.3{\pm}1.4%$, p<0.01). 4) When the percent retention was analyzed according to $PC_{20}$ in the children with bronchial asthma, they had no relationship with each other. Conclusion: Mucociliary clearance in the children with bronchial asthma was significantly lower than normal control. This finding indicates that impaired mucociliary clearance operates in childhood asthma as well, and suggests that it may be one contributing factor in the pathogenesis of asthma. The degree of impairment, however, was not so severe as immotile cilia syndrome.

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Ser326Cys Polymorphism of hOGG1 Gene and Risk of Primary Lung Cancer in Koreans (한국인에서 hOGG1 유전자의 Ser326Cys 다형성과 원발성 폐암의 위험도)

  • Chae, Sang-Chul;Kim, Kyung-Rock;Joo, So-Young;Lee, Su-Yean;Kang, Kyung-Hee;Jeon, Kyung-Neoyh;Cha, Seung-Ick;Kim, Chang-Ho;Jung, Tae-Hoon;Park, Jae-Yang
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.1
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    • pp.5-13
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    • 2002
  • Background: DNA repair plays a crucial role in protecting the genome from cancer-causing agents. Therefore, a reduced DNA repair capacity can increase the susceptibility to cancer. The human OGG1 (hOGG1) gene encodes DNA glycosylase/apurinic lyase and excise 8-hydroxyguanine, one of the major premutagenic DNA lesions, which is produced by oxygen radical forming agents including smoking. Recently several polymorphisms in the hOGG1 gene were identified, and it is possible that these polymorphism') may affect the DNA repair capacity and thus modulate cancer susceptibility. The relationship between the codon 326 polymorphism (Ser to Cys) in the hOGG1 gene and lung cancer risk was investigated. Materials and Method: The Ser326Cys genotypes were determined using PCR-RFLP analysis in 299 primary lung cancer patients and 186 healthy controls who were frequency (case:control=3:2) matched according to age and sex. Result: The frequencies of the Ser326Cys genotypes (Ser/Ser, Ser/Cys and Cys/Cys) among cases (23.4%, 51.8%, and 24.7%, respectively) were not significantly different from those among the controls (22.6%,52.1% and 25.3%, respectively). When the analyses were stratified according to age, sex, smoking status and packyears of smoking, no significant association between this polymorphism and lung cancer risk was found. Moreover, the Ser326Cys genotype showed no apparent relationship with any of the histological types of lung cancer. Conclusion: These result suggest that the hOGG1 Ser326Cys polymorphism is not a major contributor to individual lung cancer susceptibility in Koreans.

Comparison of Thinprep (Liquid-Based Cytology) and Conventional Cytology : Abnormal Lesion on Bronchoscopy (기관기내시경상 이상병변을 보이는 환자에게 있어 Thinprep검사법과 기존세포검사법의 효율성 및 유용성에 대한 비교)

  • Lee, Jung Ho;Yang, Jung Kyung;Jung, In Bum;Lee, Jung Hea;Sul, Hae Jung;Kim, Yoon Mi;Kim, Bum Kyeng;Choi, Yue Jin;Na, Moon Joon;Son, Ji Woong
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.6
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    • pp.547-553
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    • 2006
  • Background: Liquid-based cytology is currently known as an effective method, and cervical cytology has been shown to be especially effective from of malignancy detection. In our study, the cytological detection rates of the Thinprep (Liquid-based cytology) and conventional cytology (bronchial washing & brushing) for endobronchial lesions were compared. Methods: Between July 2005 and September 2005, the data from 30 patients with respiration symptom, who had shown abnormal lesion on bronchoscopy, were collected. Results: The bronchoscopic biopsy group was consisted of 30 cytodiagnosis specimens, 24 of which were confirmed to be malignant. The others were tuberculosis (4), bronchiectasis and bronchopulmonary fistula (1 each). Of the 24 malignant case, cancer or atypical cells were detected in 19, 17 and 12 of the Thinprep, brushing cytology and washing cytology cases, respectively. None one of the methods detected cancer cells in the non-malignant specimens. Washing cytology has shown sensitivity, specificity, and positive and negative predictive values of 50, 100, 100 and 33.3% respectively. Brushing cytology has shown sensitivity, specificity, and positive and negative predictive values of 70.8, 100, 100 and 46.2%, respectively. Thinprep has shown sensitivity, specificity, and positive and negative predictive values of 79.2, 100, 100 and 54%, respectively. Conclusions: Thinprep (liquid-based cytology) showed better sensitivity and negative predictive values for the evaluation of lung cancer than conventional cytology. However a large-scale study will be needed in the future.

A STUDY ON THE ENAMEL EROSION BY FERMENTED MILKS (수종 유산균 발효유의 법랑질 침식효과에 대한 연구)

  • Sim, Jeung-Ho;Jeong, Tae-Sung;Kim, Shin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.4
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    • pp.555-563
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    • 2004
  • The pH of beverages is known to be low and have, therefore, been implicated in the increasing incidence of erosion. Erosion is believed to be the predominant cause of teeth wear in children and young adults, although there will always be a contribution from attrition and abrasion. The aim of the present study was to evaluate the effect of yogurt on the progression of erosive demineralization in human enamel using demineralization model in vitro. In 4 yogurts, available on the market, pH, buffering capacity and the concentrations of calcium, phosphate and fluoride were determined. The buffering effect was determined by titration with NaOH. 50 milliliters of each drink was then titrated with 1M sodium hydroxide, added in 0.5 milliliters increments, until the pH reached about 7. Human deciduous enamel(n=40) samples were divided into four groups and exposed to 80ml of the yogurt for 30,60, 90 and 120min. Enamel surface microhardness(VHN) was examined before and after each exposure. 1. The average PH of fermented milk was 3.77 and this pH value was acidic enough to cause tooth erosion. 2. All of the fermented milks were found to be erosive(p<0.05) 3. The teeth exposed to the fermented milk all showed erosion like lesions and microhardness measurements showed that enamel surface hardness decreased proportionately with increased time of immersion in all tooth specimen groups. 4. After immersion for 30 and 60 minutes, reduction rate of microhardness values was not significantly different between the groups(p>0.05). However, after 90 and 120 minutes, reduction rate of each group was significantly different(p<0.05).

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Antibiotic Susceptibility of Bacteria Isolated from Infected Root Canals (감염근관에서 분리 배양한 세균의 수종 항생제에 대한 감수성 조사)

  • Lim, Sang-Soo;Kim, Mi-Kwang;Min, Jeong-Beom;Kim, Min-Jung;Park, Soon-Nang;Hwang, Ho-Keel;Kook, Joong-Ki
    • Korean Journal of Microbiology
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    • v.42 no.3
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    • pp.185-194
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    • 2006
  • The aim of this study was to identify the bacteria isolated from endodontic lesions by cell culture and to determine the antimicrobial susceptibility of them against 8 antibiotics. The necrotic pulpal tissues were collected from 27 infected root canals, which were diagnosed as endodontic infection. Samples were collected aseptically from the infected pulpal tissue of the infected root canals using a barbed broach and a paper point. The cut barbed broaches and paper points were transferred to an eppendorf tube containing $500{\mu}l\;of\;1{\times}PBS$. The sample solution was briefly mixed and plated onto a BHI-agar plate containing 5% sheep blood. The agar plates were incubated in a $37^{\circ}C$ anaerobic chamber for 2 to 5 days. The bacteria grown on the agar plates were identified by comparison of 16S rRNA gene (rDNA) sequencing method at the species level. To test the sensitivity of the bacteria isolated from the infected root canals against 8 antibiotics, minimum inhibitory concentrations (MIC) were determined using broth dilution assay. The data showed that 101 bacterial strains were isolated and were identified. Streptococcus spp. (29.7%) and Actinomyces spp. (21.8%) were predominantly isolated. The 9 strains were excluded in antimicrobial susceptibility test because they were lost during the experiment or were not grown in broth culture. The percentage of bacteria susceptible for each antibiotic in this study was clindamycin, 87.0% (80 of 92); tetracycline, 75.0% (69 of 92); cefuroxime axetil, 75.0% (69 of 92); amoxicillin + clavulanic acid (5:1), 71.7% (66 of 92); penicillin G, 66.3% (61 of 92); erythromycin, 66.3% (61 of 92); amoxicillin, 44.6% (41 of 92); and ciprofloxacin, 31.5% (29 of 92). The susceptibility pattern of 8 antibiotics was dependent on the host of the bacteria strains rather than the kinds of bacterial species. These results indicate that antibiotic susceptibility test should be performed when antibiotics are needed for the treatment of infected root canals.

PROSPECTIVE CLINICAL EVALUATION OF THREE DIFFERENT BONDING SYSTEMS IN CLASS V RESIN RESTORATIONS WITH OR WITHOUT MECHANICAL RETENTION (접착제와 와동형성의 차이에 따른 5급 복합레진 수복의 전향적 임상연구)

  • Lee Kyung-Wook;Choung Sae-Joon;Han Young-Chul;Son Ho-Hyun;Um Chung-Moon;Oh Myoung-Hwan;Cho Byeong-Hoon
    • Restorative Dentistry and Endodontics
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    • v.31 no.4
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    • pp.300-311
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    • 2006
  • The purpose of this study is to evaluate prospectively the effect of different bonding systems and retention grooves on the clinical performance of resin restorations in non-carious cervical lesions (NCCLs). Thirty-nine healthy adults who had at least 2 NCCLs in their premolar areas were included in this study. One hundred and fifty teeth were equally assigned to six groups: (A) Scotchbond Multi-Purpose (SBMP, 3M ESPE, St. Paul, MN, USA, 4th generation bonding system) without retention grooves; (B) SBMP with retention grooves; (C) BC Plus (Vericom Co., Anyang, Gyeonggido, Korea, 5th generation bonding system) without retention grooves; (D) BC Plus with retention grooves; (E) Adper Prompt (3M ESPE, Seefeld, Germany, 6th generation bonding system) without retention grooves; (F) Adper Prompt with retention grooves. All cavities were filled with a hybrid composite resin. Denfil (Vericom Co., Anyang, Gyeonggido, Korea) by one operator. Restorations were evaluated at baseline and at 6-month recall, according to the modified USPHS (United States Public Health Service) criteria. Additionally, clinical photographs were taken and epoxy resin replicas were made for SEM evaluation. At 6-month recall, there were some differences in the number of alpha ratings among the experimental groups. But, despite the differences in the number of alpha ratings, there was no significant difference among the 3 adhesive systems (p < 0.05). There was also no significant difference between the groups with or without mechanical retention (p < 0.05). Follow-ups for longer periods than 6 months are needed to verify the clinical performance of different bonding systems and retention grooves.

The Usefulness of Multidetector CT Arthrography in the Diagnosis of Shoulder Pathology -Comparison with MR Arthrography and Arthroscopic Findings in the Same Patient- (견관절 병변의 진단에서 다중 검출 전산화 단층촬영을 이용한 관절조영술의 유용성 - 동일 환자에서 시행한 자기공명 관절조영술 및 관절경 소견과의 비교 -)

  • Kim, Dong-Soo;Park, Kyoung-Jin;Kim, Yong-Min;Choi, Eui-Sung;Shon, Hyun-Chul;Cho, Byung-Ki;Park, Ji-Kang;Kim, Seok-Won
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.115-125
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    • 2009
  • Purpose: The purpose of the study is to evaluate the usefulness of CT arthrography (CTA) by conducting a comparative study of CTA and MR arthrography (MRA) with the arthroscopic findings in the same patients. Materials and methods: Forty nine patients who suffered from shoulder disease underwent MRA and CTA concurrently. The sensitivity and specificity of CTA was evaluated, as compared to MRA, in the case of four types of shoulder pathological lesions. The accuracy of CTA was evaluated by analyzing the arthroscopic findings of thirty four patients. Results: Compared to MRA, CTA showed a sensitivity of 90% and a specificity of 100% for diagnosing supraspinatus tendon (SST) full thickness tear, and CTA showed a sensitivity of 100% and a specificity of 97.5% for making the diagnosis of superior labrum anterior to posterior (SLAP) lesion. For diagnosing partial articular side supraspinatus avulsion (PASTA) lesion, some studies have shown the usefulness of CTA with a sensitivity of 71.4% and a specificity of 97.7%. However, for diagnosing SST bursal side partial tear, the sensitivity of CTA was as low as 10%. CTA has been shown to be relatively accurate when the diagnoses were verified with the arthroscopic findings; diagnosing SST full thickness tear and SLAP lesion with CTA has shown an accuracy of 100% and87.5% respectively, and CTA showed 71.4% diagnostic accuracy for PASTA lesion. Conclusion: CTA was a useful tool and it was equivalent to MRA for the assessment of SST full thickness tear, SLAP lesion and PASTA lesion, but not bursal side partial tear. Thus, it may be used preferably to diagnose shoulder pathology and for follow up as an inexpensive tool after operation.

Open Heart Surgery after Pulmonary Artery Banding in Children (소아에서 폐동맥밴딩술후의 개심술 치료)

  • 김근직;천종록;이응배;전상훈;장봉현;이종태;김규태
    • Journal of Chest Surgery
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    • v.32 no.9
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    • pp.781-789
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    • 1999
  • Background: Pulmonary artery banding(PAB) accompanies some risks in the aspect of band complications and mortality in the second-stage operation. To assess these risks of the second-stage operation after PAB, we reviewed the surgical results of the second-stage operation in the pediatric patients who had undergone PAB in infancy. Material and Method: From May 1988 to June 1997, a total of 29 patients with preliminary PAB underwent open heart surgery. Ages ranged from 2 to 45 months(mean 20.6$\pm$9.0 months). Preoperative congestive heart failure conditions were improved after PAB(elective operation group) in 27 patients, but early second-stage procedures were required in the remaining 2 patients due to sustaining congestive heart failure(early operation group). Preoperative surgical indications included 2 double outlet right ventricles(DORV group) and 27 ventricular septal defects as the main cardiac anomaly(VSD group). Result: The mean time interval from PAB to the second-stage operation was 15.5$\pm$8.7 months(range 5 days to 45 months). One patient in the DORV group underwent intraventricular tunnel repair and modified Glenn procedure in the other. In the VSD group, the VSD was closed with a Dacron patch in all patients. Concomitant procedures included a right ventricular infundibulectomy in 4 patients and a valvectomy of the dysplastic pulmonary valve in 1 patient. At the second-stage operations, pulmonary angioplasty was required due to the stenotic banding sites in 18 patients. One patient underwent complete ligation of the main pulmonary artery with the modified Glenn procedure. The mortality at the second-stage operation was 17.2%(5 patients). Causes of death were 4 low cardiac output, and 1 autoimmune hemolytic anemia. Diagnosis with DORV and the early operative group were the risk factors for operative death in this series. There was 1 late death. Conclusion: This study revealed the second-stage operation for pulmonary artery debanding and closure of VSD in children was complicated by the correction of the acquired lesions with a significantly high incidence of morbidity and early postoperative deaths. Primary repair is recommended for isolated VSD, if possible.

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Clinical Analysis of Primary Varicose Vein - review of 209 cases - (원발성 하지정맥류의 임상적 고찰 - 209례 보고 -)

  • Lee, Yuen-Jae;Park, Chul;Kim, Jong-Seok;Kim, Han-Yong;Yoo, Byung-Ha
    • Journal of Chest Surgery
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    • v.34 no.12
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    • pp.909-916
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    • 2001
  • Background : Varicose vein is a very common vascular disease and has recently become a matter of concern for thoracic and cardiovascular surgens. Material and Method : We analyzed 209 cases or 269 feet with varicose vein retrospectively, which had been treated in our hospital from April 1999 to December 2000. Result : Male : Female ratio was 1:3(Male : 52 cases, Female : 157 cases), mean age was 42.2$\pm$9.7 years old, mean duration of varicosities was 12.2$\pm$9.7 years, and mean follow up was 14.8$\pm$6.1 months from July 2001. Most common symptom was leg pain(122 cases, 58.4%). Long standing job(44 cases), pregnancy(37 cases), and family history related to varicose vein came to 79.9% as the major predisposing or precipitating factors. Anatomic classifications of main lesion were GSV (greater saphenous vein,126 cases), LSV(lesser saphenous vein,18 cases), and reticular veins and telangiectasias(65 cases). Main treatments were stripping of GSV, stab avulsion, ligation of saphenofemoral junction, sclerotherapy, and conservative treatment. Comparing A group (stripping of GSV) with B group(sclerotherapy of GSV), A group had more complications than B group; however, A group had less recurrences than B group(p 0.05). Comparing C group(stab avulsion of LSV) with D group(sclerotherapy of LSV), there were 2 cases of recurrence in D group; however, there were no statistical differences between the two groups in complication and recurrence(p>0.05). Comparing B group(sclerotherapy of GSV) with E group(sclerotherapy of reticular vein and telangiectasia), there were no differences in complication; however, B group had more recurrences than E group. Post-stripping complications were ankle numbness and tingling(2 cases), ankle pain(2 cases),ankle swelling(2 cases), and wound pain(1 case). Postsclerotherapy complications were thrombophlebitis(1 case) and skin ulcer(1 case). Conclusion: Sclerotherapy for varicose vein involving GSV had more recurrences than stripping for lesions involving GSV. Sclerotherapy for reticular vein and telangiectasia had less recurrences than sclerotherapy for lesion involving GSV. Sclerotherapy is a very convenient method without operation and admission, thus further research is demanded in case of varicose vein involving GSV.

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