• Tuberculosis and Respiratory Diseases
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• v.58 no.2
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• pp.160-166
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• 2005

Background : Although home oxygen therapy in hypoxemic patients with chronic lung disease has been increasing over the decade in Korea, the present state has not been known well. This study was done to know the situation of home oxygen therapy in a Korean university hospital. Methods : Between January 1, 2000 and August 31, 2003, 86 patients prescribed home oxygen therapy by the pulmonary physicians of Asan Medical Center were investigated using their medical record and questionnaire. Results : Patients (52 men, mean age of 61 years) with home oxygen therapy were increasing by every year. Underlying diseases were COPD (n=29), tuberculous destroyed lung (n=18), bronchiectasis (n=15), ILD (n=12), and others. Baseline $FEV_1/FVC$, FVC, and $FEV_1$ of patients were $58.4{\pm}25.2%$, $54.5{\pm}17.1%$ of predicted, and $41.7{\pm}20.6%$ of pred. Mean oxygen flow was 1.5 L/min and mean duration per day was 14.5 hours. During therapy, mean $PaO_2$ values have increased from 51.2 to 77.7 mm Hg and $PaCO_2$ values have increased from 47.5 to 49.6 mm Hg. Only 16.5% of the subjects were monitored by visiting nurses or pulse oximeter. Three year survival rate was 56.6% and hypercapnic patients showed better prognosis. Conclusion : The patients with home oxygen therapy were increasing yearly and a part of them were monitored. The hypercapnea respiratory failure patients would have better prognosis.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.4
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• pp.236-242
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• 2013

Purpose: The objective of this retrospective study is to evaluate the factors affecting the spread of odontogenic infection. Furthermore, this study was performed to apply to future treatments. Methods: A total of 65 patients, who had received treatment for odontogenic infections from 2010 to 2012 for 3 years, were enrolled in this study. The causes of infection, presence of systemic disease, and complications, durations of treatment, treatment methods, and inflammation levels were compared with the data. Results: Patients over 70 years with systemic disease required immediate drainage, systemic antibiotic therapy and hospitalization. We can determine the direction of the early diagnosis and treatment through blood tests (white blood cells, neutrophil, C-reactive protein [CRP]) and computed tomography. Patients over 70 years with systemic disease had the highest percentage. In addition, these patients showed high levels of inflammation index, such as CRP average of 24.8 and needed for a long-term treatment period and a wide range of surgical incision & drainage several times. Systemic diseases, particularly diabetes mellitus and hypertension, accelerate the spread of infection and had a negative effect that delays healing. Eventually, five of the 65 patients showed serious systemic complications. Conclusion: When evaluating cervico-facial infected patients due to odontogenic infection, the most important thing is deciding the appropriate diagnosis and degree of disease. Considering the patient's systemic status and age, we need to decide the treatment plan. Especially, those patients over 70 years with systemic disease should be treated with rapid surgical approach, and the use of a wide range of antibiotics and intensive care. If proper treatment principle does not apply, severe life-threatening complications will result, such as necrotizing fascitis, acute airway obstruction, mediastinitis, and others.

• Korean Journal of Psychosomatic Medicine
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• v.14 no.1
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• pp.47-52
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• 2006

Backgrounds : Depression has been prevalent in women and maintaining optimal glycemic control is an important goal of diabetes management. Although depression is common in adults with diabetes, its relationship to glycemic control remains unclear, espacilly in Korean women. The current study examined the relationship of depressive symptomatology with glycemic control in Korean women. Methods : Beck depression inventory (BDI), $HbA_{1c}$ as an index of long-term glycemic control, fasting glucose level and body mass index (BMI) were measured in sample of 4,567 women of whom 4.7%, 216 women had diabetes, and the relationship between depression and glycemic control was analyzed. BDI Scores of 16 and above is a cut off point to indicate possible clinical depression. Results The frequency of depressed women (p<0.001) and the mean score of BDI (p<0.001) were significantly higher in diabetic women. The mean level of $HbA_{1c}$ (p<0.01) and fasting glucose (p<0.05) were higher in depressed women. There was a graded relationship between the percentile of depressed women and a degree of glycemic control impairment (p=0.001). Conclusion : The current study found the relationship of depressive symptomatology with glycemic control in Korean women. This relationship may be mediated by decreased self-care behaviors or by neurobiological dysregulation. Improving identification and treatment of depression in women with diabetes might have favorable effects on diabetic outcomes.

• The Journal of the Korea Contents Association
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• v.19 no.12
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• pp.113-120
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• 2019

South Korea is an aging society with 10.9 percent of its population over 65 years of age, and the aging population naturally leads to a surge in elderly care costs. Compared to general hospitals and other hospitals that have systematic management strategies in an environment of intensifying hospital competition, the design and management strategies of nursing hospitals are insufficient due to the hospital's characteristics of long-term hospital admission and treatment. In this study, We conducted a symbol mark color and form analysis of nursing hospitals to establish a design strategy to meet the increasing demand on nursing hospitals. The subjects of the study were 131 hospitals that received the first grade of nursing hospitals in Korea, and each symbol mark was collected to analyze its form and color. Analysis of the form of symbol revealed that the most anthropogenic symbols were made with artificial objects, and among them, the number of symbols with crosses, hearts and human forms were higher. The color analysis showed that more than 50% of symbols consisted of two colors and the main colors were blue and green. It is expected that this research data will be used as a reference in the design of the symbolism of nursing hospitals, which will help consumers choose and develop strategies for hospital management in order to compete with the ever-increasing demand of nursing hospitals and hospital competition.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.6
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• pp.2857-2860
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• 2016

Background: Chronic hepatitis B (CHB) infection is one of the important causes of hepatocellular carcinoma (HCC) in Thailand, involved in the pathogenesis and leading to a development of HCC with or without cirrhotic changes of the liver. This study was aimed to investigate the predictive factors for HCC among CHB patients in a tertiary care center in Thailand. Materials and Methods: We conducted a retrospective study of CHB patients with or without HCC during the period of January 2009 and December 2014 at Thammasat University Hospital, Pathumthani, Thailand. Data on clinical characteristics, biochemical tests and radiologic findings were collected from review of medical records. Results: A total of 266 patients were diagnosed with CHB in Thammasat university hospital during the study period. However, clinical information of only 164/266 CHB patients (98 males, 66 females with mean age of 49.4 years) could be completely retrieved in this study. The prevalence of HCC in CHB infection in this study was 38/164 (23.2%). CHB patients with HCC had a mean age older than those without HCC (59.5 vs 47 years, P-value = 0.01). Furthermore, history of upper GI bleeding, tattooing, blood transfusion, and chronic alcoholism were significantly more common in CHB patients with HCC than patients without HCC (13.2% vs 3.2% P-value 0.03, OR = 4.6, 95%CI = 1.2-18.1, 20% vs 3.9%, P-value = 0.01, OR= 6.1, 95% CI= 1.6-23.6, 20% vs 6.3%, P-value = 0.03, OR = 3.8, 95%CI =1.1-12.7, 62.2% vs 30.3%, P-value <0.0001, OR = 3.7, 95%CI= 1.7-8.1 respectively). Interestingly, more CHB patients with HCC had evidence of cirrhosis than those without HCC (78.9% vs 20.4%, P-value <0.0001, OR = 14.6, 95%CI = 5.8-36.7). In CHB patients with HCC, surgical therapy provided longer survival than radiofrequency ablation (RFA) (72 vs 46.5 months, P-value= 0.04). The mean survival time after HCC diagnosis was 17.2 months. Conclusions: HCC remains a major problem among patients with CHB infection in Thailand. Possible risk factors are male gender, history of upper GI bleeding, chronic alcoholism, tattooing, blood transfusion and evidence of cirrhosis. For early stage HCC patients, surgical treatment provided longer survival time than RFA. Most HCC patients presented with advanced disease and had a grave prognosis. Appropriate screening of CHB patients at risk for HCC might be an appropriate approach for early detection and improvement of long-term outcomes.

• Tuberculosis and Respiratory Diseases
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• v.52 no.2
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• pp.156-165
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• 2002

Background: A tracheal stenosis is caused by mucosal ischemic injury related to a high cuff pressure ($P_{cuff}$) of the endotracheal tube. In contrast, aspiration of the upper airway secretion and impaired gas exchange due to cuff leakage is related to a low $P_{cuff}$. To prevent these complications, the $P_{cuff}$ should be kept appropriately because the appropriate $P_{cuff}$ appears to change according to the patient's daily respiratory mechanics. However, the constant cuff volume($V_{cuff}$) has frequently been instilled to the cuff balloon on a daily basis to maintain the optimal $P_{cuff}$ instead of monitoring the $P_{cuff}$ directly at the patients' bedside. To address the necessity of continuous $P_{cuff}$ monitoring, the change in the $P_{cuff}$ was evaluated at various $V_{cuff}$ levels on a daily basis in patients with long-term mechanical ventilation. The utility of mercury column sphygmomanometer for the continuous monitoring $P_{cuff}$ was also investigated. Method: The change in $P_{cuff}$ according to the increase in $V_{cuff}$ was observed in 17 patients with prolonged endotracheal intubation for mechanical ventilation for 2 week or more. This maneuver measured the change in $P_{cuff}$ daily during the mechanical ventilation days. In addition, the $P_{cuff}$ measured by mercury column sphygmomanometer was compared with the $P_{cuff}$ measured by an automatic cuff pressure manager. Results : There were no statistically significant changes of $P_{cuff}$ during more than 14 days of intubation for mechanical ventilation. However the $V_{cuff}$ required to maintain the appropriate $P_{cuff}$ varied from 1.9 cc to 9.6 cc. In addition, the intra-individual variation of the $P_{cuff}$ was observed from 10 $cmH_2O$ to 46 $cmH_2O$ at constant 3 cc $V_{cuff}$. The $P_{cuff}$ measured by the bedside mercury column sphygmomanometer is well coincident with that measured by the automatic cuff pressure manager. Conclusion: Continuous monitoring and management of the $P_{cuff}$ to maintain the appropriate $P_{cuff}$ level in order to prevent cuff related problems during long-term mechanical ventilation is recommended. For this purpose, mercury column sphygmomanometer may replace the specific cuff pressure monitoring equipment.

• Journal of Acupuncture Research
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• v.33 no.4
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• pp.93-100
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• 2016

Objectives : To find an acupuncture point where more exact Surface Electromyography(SEMG) measurement can be drown, through the study of measurement of orbicularis oris. Methods : Of healthy people from 19 to 40 years of age, who did not fall under exclusion criteria (22 males and 22 females), were selected as subjects, after relaxation for 10 minutes, and they were told how to pronounce 'O' and 'U' with their lips puckered. The SEMG figures were measured with attaching disposable electrode on acupuncture point of right-and-left Hwaryo(LI19) and 1 cun away from Seungjang(CV24) on both sides when the subjects pronounced 'O' and 'U'. Results : The average value was highest on left 1 cun away from Seungjang(CV24) in pronouncing 'O' and 'U', and the average SEMG value was higher in the order of right 1 cun away from Seungjang(CV24), right Hwaryo(LI19), left Hwaryo(LI19). Average of the lower orbicularis oris is statistically higher than that of the upper orbicularis oris, which has significant meaning. However, there was no significant difference when compared by pronunciation. Average of percentage mark of differences of right-and-left measured value of each pronunciation and each acupuncture point : Pronounced 'O' and the upper part of orbicularis oris: $16.76{\pm}11.29%$, pronounced 'O' and the lower part of orbicularis oris: $22.41{\pm}12.92%$, pronounced 'U' and the upper part of orbicularis oris: $17.10{\pm}9.89%$, pronounced 'U' and the lower part of orbicularis oris : $19.20{\pm}10.82%$. Conclusion : The difference of pronunciation will not affect the results in SEMG measurement. In addition, the average of the lower orbicularis oris is statistically and significantly higher than that of the upper orbicularis oris.

• Journal of The Korean Dental Society of Anesthesiology
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• v.8 no.1
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• pp.22-28
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• 2008

Background: Cerebral palsy (CP) is non-progressive disorder of motion and posture. In CP patient, there are difficulties in dental treatment because of uncontrolled movement of limb and head, and conjoined disabilities such as cognitive impairment, sensory loss, seizures, communication and behavioral disturbances. It is reported that CP patients have high incidence in caries and a higher prevalence of periodontal disease. But, despite the need for oro-dental care, these patients often are unlikely to receive adequate treatment without sedation or general anesthesia because of uncontrolled movements of the trunk or head. Methods: We reviewed the 58 cases of 56 patients with CP who underwent outpatient general anesthesia for dental treatment at the clinic for the disabled in Seoul National University Dental Hospital. Results: The mean age was 19 (2-54) years. The number of male patient was 40 and that of female was 18. They all had severe spastic cerebral palsy and 22 had sever mental retardation, 15 epilepsy, 8 organic brain disorder, 1 blindness, 2 deafness and cleft palate. For anesthesia induction, 14 cases was needed physical restriction who had sever mental retardation and cooperation difficulty, but 44 cases showed good or moderate cooperation. Drugs used for anesthesia induction were thiopental (37 cases), sevoflurane (14 cases), ketamine (3 cases ) and propofol (4 cases). All patients except one were done nasotracheal intubation for airway management and 4 cases were needed difficult airway management and 1 patient already had tracheostomy tube. Mean total anesthetic time was $174{\pm}56$ min and staying time at PACU was $88{\pm}39$ min. There was no death or long term hospitalization because of severe complications. Conclusion: If general anesthesia is needed, pertinent diagnostic tests and workup about anomaly, and appropriate anesthetic planning are essential for safety.

• Journal of Convergence for Information Technology
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• v.11 no.7
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• pp.181-188
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• 2021

This study was performed to examine the strategy method for the sustainable stability and effectiveness of small and medium hospital, where the relationship between perceptual satisfaction and expectation factors for special hospital was analyzed. The structural questionnaire was given to the residents of Busan and Gyungnam over the age of 20 and the square contingency and the logistical regression were employed for the analysis of the results. First, the respondent with 68.0% has realized the hospital claiming to be characterization as the special hospital and the Ministry of Health and Welfare designated hospital was identified to the respondent of 21.3%. Second, perceptual satisfaction with expectation level was satisfied to the most visitor in case of visiting special hospitals with subjective perception and was confirmed to the intention of revisiting consistently. Third, for the perceptual satisfaction of visiting with expectation level, the safety and the quality of treatment affected significantly the cause-and-effect. The result has provided the useful information with the establishment of a strategy for the long-term and continued effect through the perceptual satisfaction and the emotional attachment.

• The Journal of Korean Academy of Prosthodontics
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• v.61 no.4
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• pp.284-292
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• 2023

Stable posterior occlusal support is crucial for adequate masticatory function and facial aesthetics. In elderly patients over the age of 65, masticatory ability has a significant impact on nutritional intake and overall health. This case report presents a prosthetic treatment of an elderly patient with edentulous maxilla and bilateral posterior edentulous mandible. The upper jaw was restored with a complete denture to establish an ideal occlusal plane, and the three-dimensional positions of the mandibular implants were determined accordingly. The implants were placed through computer-guided implant surgery and were immediately loaded with fixed provisional restorations. The implant-fixed zirconia final restorations were inserted in the lower posterior region, and the occlusal surface of posterior artificial teeth in the upper denture was substituted with cobalt-chrome alloy to resist occlusal wear. The patient's posterior occlusal support and masticatory function were promptly restored through this treatment process, and long-term stability against wear was also obtained.