• Asian Pacific Journal of Cancer Prevention
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• 제15권3호
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• pp.1155-1162
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• 2014

Background: Despite mixed survival data, the utilization of contralateral prophylactic mastectomy (CPM) for the prevention of a contralateral breast cancer (CBC) has increased significantly over the last 15 years, especially among women less than 40. We set out to look at our own experience with CPM, focusing on outcomes in women less than 40, the sub-population with the highest cumulative lifetime risk of developing CBC. With an extended follow-up, we hoped to demonstrate differences in the long-term disease free survival (DFS) and overall survival (OS) among groups who underwent the procedure (CPM) versus those that did not (NCPM). Materials and Methods: We performed a retrospective review of all breast cancer patients less than age 40 diagnosed at Mount Sinai Medical Center between January 1, 1980 and December 31, 2010 (n=481). Among these patients, 42 were identified as having undergone CPM, while 195 were confirmed as being CPM-free during the observation period. A univariate and multivariate analyses were performed. Results: The CPM group had a significantly higher percentage of patients who were diagnosed between 2000 and 2010 (95.2% vs 40%, p=0.0001). The CPM group had significantly smaller tumors (0-2cm.: 41.7% vs 24.8%, p=0.04). Among the entire group of patients, the overall five- and 10-year DFS were 81.3% and 73.3%, respectively. CPM was significantly associated [HR 2.35 (1.02, 5.41); p=0.046] with 10-year OS, although a similar effect was not observed for five-year OS. Conclusions: We found that CPM has increased dramatically over the last 15 years, especially among white women with locally advanced disease. In patients less than 40, who are thought to be at greatest cumulative risk of secondary breast cancer, CPM provided an OS advantage, regardless of genetics, tumor or patient characteristics, and which was only seen after 10 years of follow-up.

• 한국치위생학회지
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• 제20권5호
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• pp.753-762
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• 2020

Objectives: This study was aimed at evaluating the effects of changes in the oral environment of the elderly in long-term care facilities after the intake of Weissella cibaria. Methods: The test group ingested the W. cibaria strain Chonnam Medical University (CMU), and the control group ingested the control food. Of all randomized trial subjects, 62 were analyzed (32 in the experimental group and 30 in the control group). In this 8-week demographic study, we evaluated self-perceived halitosis, changes in halitosis, sensory test results, tongue plaque index scores, saliva buffering capacity, and the salivary flow rate. Results: The W. cibaria CMU intake in the elderly in long-term care facilities during the experimental period did not demonstrate statistically significant changes in the salivary flow rate. However, self-perceived halitosis, organoleptic test results, tongue plaque index scores, and salivary buffering capacity demonstrated statistically significant differences between the experimental and control groups. These findings partially confirmed the beneficial effects of the W. cibaria CMU on the oral environment in the elderly. Conclusions: Research results on the role of probiotics in the oral cavity should be summarized, and utilization plans should be sought to obtain a clearer understanding of the clinical efficacy and related factors. The value of probiotic use may be high in improving the oral health of people by enabling treatment and prevention.

• 한국산학기술학회논문지
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• 제18권9호
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• pp.203-215
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• 2017

본 연구는 요양병원 입원 노인환자를 대상으로 섬망예방을 위한 안위증진 프로그램이 섬망발생, 섬망지속정도, 섬망위험요인을 감소시키는데 효과가 있는지 검토하기 위한 비동등성 대조군 전후 설계의 유사실험연구이다. 자료수집 기간은 2016년 7월 3일부터 8월 20일까지 이루어졌으며 연구 대상은 요양병원에 입원중인 65세 이상의 노인 환자로 실험군 34명, 대조군 34명이었다. 자료분석은 IBM SPSS 21.0 Program을 이용하여 independnet t-test, repeated measures ANOVA를 이용하여 분석하였다. 섬망예방을 위한 안위증진 프로그램은 Kolcaba이론을 바탕으로 개발하였고, 개발된 프로그램의 효과는 다음과 같다. 섬망발생률은 실험군 2.9% (1/34명), 대조군 14.7% (5/34명)로 실험군에서 통계적으로 유의하게 낮았으며($x^2=3.98$, p=.047), 섬망심각도는 실험군(0.24)이 대조군(5.1)에 비해 통계적으로 유의하게 낮았다(t=2.27, p=.027). 섬망지속시간은 실험군(2일)이 대조군(2~10일)보다 통계적으로 유의하게 짧은 것으로 나타났다($x^2=3.22$, p=.043). 시간의 변화에 따라 실험군에서 안위는 증가하였으며(F=108.85, p<.001), 불안(F=63.39, p<.001)과 우울(F=89.78, p<.001)은 감소하였다. 수면의 질은 실험군이 대조군에 비해 높았고(F=63.63, p<.001), 통증은 실험군이 대조군에 비해 낮았다(F=93.64, p<.001). 결론적으로 요양병원에 입원한 노인환자의 섬망예방을 위해서 신체, 심리 영적, 사회 문화적, 환경적 접근을 한 Kolcaba이론에 근거한 섬망예방을 위한 안위중재예방프로그램의 효과가 있는 간호중재임이 확인되었다. 따라서 요양병원 입원 노인환자들의 섬망예방을 위해서 신체, 심리 영적, 사회 문화적, 환경적 맥락에서의 섬망예방을 위한 안위중재프로그램을 확대 시행할 필요가 있음을 제언한다.

• 한국산학기술학회논문지
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• 제13권12호
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• pp.5816-5825
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• 2012

인구가 고령화되면서 치매환자는 매년 급증하고 있고 이로 인한 치매환자의 치료 및 관리비용 등 사회적 비용은 크게 늘고 있어 이에 대한 대책이 절실하다. 외국에서도 국가차원에서 치매에 관한 국가전략을 수립하거나 효율적인 치매관리를 위한 국가차원의 대책을 세우거나 관련 법제도를 마련하고 있다. 치매에 대한 법제도적 대응방안으로 노인복지법, 노인장기요양보험법, 치매관리법이 존재한다. 보다 효과적인 치매관리 대책을 위해 관련법과 정책의 추진에 있어서 다음과 같은 개선이 필요하다. 첫째, 치매 검진을 65세 이상노인에 대한 국민건강보험의 건강검진 항목에 반드시 포함시키고 1차 검진에서 이상이 발견되면 진료를 계속 받을 수 있도록 하는 것이 필요하다. 둘째, 치매의 특성상 치매는 증상이 심해질수록 치료 효과가 적고 가족들의 부담도 급격히 증가한다. 치매예방사업과 조기 검진을 통해 치매 발병을 예방하거나 발병 시기를 늦추고 조기 발견하여 치료를 받도록 하여 사회적 비용을 최소화하는 것이 필요하다. 셋째, 현재와 같은 노인장기요양보험법상의 장기요양급여내용의 획일성으로는 경증 치매 등 요양노인의 욕구를 다양하게 충족시키기 어려우므로 등급판정기준 완화와 서비스 이용대상의 확대가 필요하다.

• 지역사회간호학회지
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• 제27권1호
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• pp.1-8
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• 2016

Purpose: The purpose of this study was to examine the depression and cognitive function of community-dwelling older adults. Methods: 243 aged over 65 in Won-Ju in South Korea participated in this study. Data were collected from April to June 2013 through interviews. This study utilized the Geriatric Depression Scale Short Form, the Korean version of MMSE-DS (MMSE for Dementia Screening), and infirmity testing for basic health status. Descriptive statistics, ${\chi}^2$, t-test, ANOVA, $Scheff{\acute{e}}^{\prime}s$ test, and Pearson's correlation coefficient were used. Results: 75.3% of the participants belonged to the depression group, and the prevalence of cognitive impairment was 17.3%. There were significant differences in depression and cognitive function according to gender, educational level, type of insurance, subjective health, frailty, and whether to be a client of home care service. The level of depression was significantly higher and the level of cognitive functions was significantly lower in older adults in home care services than in community-dwelling older adults. Conclusion: This study is meaningful in that it included older adults in home care services to provide information to develop effective prevention programs for improving cognitive functions. The results of this study can be used to develop future community prevention and intervention.

• 가정∙방문간호학회지
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• 제15권1호
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• pp.37-43
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• 2008

This paper provides the guidelines from which to develop a visiting health care program at the Public Health Center in Korea and involves an expanded payment compensation system of preventive services based on the new long-term health insurance system in Japan. The function and management methods to achieve the goals practiced in a community contact center for elderly support which have recently been established will guide the specific directions and strategies that the Public Health Center should pursue. That is to say, comprehensive and continuous efforts will be put forth in preventive home visiting care targeting the elderly in certain jurisdictions. At this point in time in which the visiting care nursing program has not yet started, visiting health care provided by the Public Health Center oversees chronic diseases of a vulnerable population. But after it has been developed nationwide, the visiting health care system at the Public Health Center will be distinctive and focused on health promotion and prevention.

• 한국응급구조학회지
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• 제12권2호
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• pp.71-84
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• 2008

The usual reasons for elderly safety accidents include lack of care for disaster, physical disability, and an error of judgment and so on. But it is true that accidents will occur continuously with the afore-mentioned causes. Against the elderly safety accidents, safety is the main prerequisite for leading the successful and easy life in the elderly. Therefore, this study is purposed to provide the way of thinking about elderly safety issues by suggesting the methods and contents of education program. This study is specifically focused on developing audio-visual materials involved in all the safety accidents and researching the effect of safety education ability through materials with a view to identify the substantial problems. Education program should make a continuous and long term study so that the curricula of the safety accidents prevention education can be done systematically.

• 한국노년학
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• 제36권3호
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• pp.869-881
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• 2016

본 연구의 목적은 요양병원 간호사들의 언어적, 신체적, 성폭력 전반에 걸친 폭력피해경험, 반응과 대처 양상을 분석하여, 폭력예방과 대처를 위한 체계 구축을 위한 기초자료를 제공하는 것이다. 연구방법은 J도 소재 12개 요양병원 소속 간호사 226명을 대상으로 2016년 4월 15일부터 4월 29일까지 구조화된 설문지를 이용하여 자료 수집하였고, 빈도와 백분율, 평균과 표준편차, ${\chi}^2-test$를 이용하여 자료를 분석하였다. 연구결과, 조사 대상 간호사들 중 126명(55.8%)이 지난 1년간 1회 이상 폭력피해경험이 있었고, 가해자는 65세 이상이 54.6%, 인지기능 저하 상태가 60.0%였다. 폭력피해 유형으로 언어적 폭력이 가장 많았고(90.5%), 신체적 위협, 신체적 폭력, 성적 폭력 순이었다. 폭력피해경험 후 반응은 정서적 반응 점수($2.8{\pm}0.8$점)가 가장 높았다. 폭력피해경험 후 대처양상은 '동료에게 말함'(84.1%), '기분이 상하지만 감정을 삭이고 일함'(75.4%) 순이었다. 본 결과들은 요양병원이라는 환경과 입원환자의 특성을 고려한 폭력예방과 대처를 위한 체계 구축, 실제적으로 적용 가능한 교육의 필요성 및 방안 모색이 필요함을 보여준다. 이에, 폭력예방교육과 효율적이고 적극적인 대처방법을 찾는데 노력을 기울여야 할 것이다.

• Pediatric Infection and Vaccine
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• 제18권1호
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• pp.15-22
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• 2011

Invasive Candida infections (ICI) have become the third most common cause of late-onset infection among premature infants in the neonatal intensive care unit (NICU). Risk factors include birth weight less than 1,000 g, exposure to more than two antimicrobials, third generation cephalosporin exposure, parenteral nutrition including lipid emulsion, central venous catheter, and abdominal surgery. Candida colonization of the skin and gastrointestinal tract is an important first step in the pathogenesis of invasive disease. Strict infection control measures against the infection should be done in the NICU. The following practices are likely to contribute to reducing the rate of ICI: (1) restriction of broad-spectrum antibiotics, antacids and steroid; (2) introduction of early feeding and promoting breast milk. Fluconazole prophylaxis may be an effective control measure to prevent Candida colonization and infections in individual units with high incidence of fungal infection. In addition, there is a need of further data including the development of resistant strains and the effect on long-term neurodevelopmental outcomes of infants exposed to drugs before the initiation of routine application of antifungal prophylaxis in the NICU.

• 대한치과마취과학회지
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• 제13권3호
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• pp.121-126
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• 2013

Temporomandibular joint (TMJ) dislocation is an acute paintful condition that causes severe functional limitation. So, manual reduction is the treatment of choice and should be performed as early as possible. Long-term dislocation of the TMJ that has persisted for more than 1 month is comparatively rare. This may include severe illness, neurological diseases and prolonged intensive care hospitalization with oral intubation and sedation. A joint that remains prolonged dislocated undergoes morphological change which is also true for periarticular tissue, especially in ligaments and muscles. Treatment of long-term TMJ dislocation should be different from acute TMJ dislocation, as simple reduction is difficult to achieve and it's likely to redislocate. The prevention of redislocation after reduction should be considered. This is a case report of about manual reduction of temporomandibular joint long-standing dislocation under general anesthesia.