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Long-term oxygen therapy in patients with chronic respiratory failure in one university hospital (호흡부전환자의 재택산소치료 실태: 한 대학병원에서의 관찰)

  • Huh, Jin Won;Lee, Jung Yeon;Hong, Sang-Bum;Oh, Yeon Mok;Shim, Tae Sun;Lim, Chae-Man;Lee, Sang Do;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Koh, Younsuck
    • 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.

Contrast-Enhanced Magnetic Resonance Angiography for Evaluation of the Steno-occlusive Disease of the Supraaortic Arteries: Comparison with Computed Tomography Angiography and Digital Subtraction Angiography (조영증강 자기공명 혈관조영술을 이용한 대동맥궁 위 혈관의 협착 및 페쇄 질환 평가: 전산화 단층 혈관조영술 및 디지털 감산혈관조영술과의 비교)

  • Jeh, Su-Kyung;Kim, Bum-Soo;Jung, So-Lyung;Ahn, Kook-Jin;Shin, Yong-Sam;Lee, Kwan-Sung;Kim, Young-In;Lee, Kwang-Soo
    • Investigative Magnetic Resonance Imaging
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    • v.13 no.2
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    • pp.152-160
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    • 2009
  • Purpose : To intra-individually compare diagnostic accuracy of high-resolution contrast-enhanced magnetic resonance angiography (CE-MRA) with computed tomography angiography (CTA) and digital subtraction angiography (DSA) for the assessment of supraaortic steno-occlusive disease. Materials and Methods : Twenty-eight patients (20 men, 8 women, 53-79 years of age) underwent supraaortic CE-MRA, CTA and DSA. CE-MRA was performed on two 1.5T MR scanners (voxel dimension: $0.66{\times}0.66{\times}1.1$ or $1.2\;mm^3$), and CTA on 64-slice CT scanners (voxel dimension: $0.42{\times}0.42{\times}0.63\;mm^3$). All the three examinations were completed within 40 days (median 19 days; range 1-40 days). Retrospective evaluation and measurement of diameter of 6 extracranial and 9 intracranial arterial segments was done by 2 experienced radiologists. Results: A total of 420 arterial segments were examined by CE-MRA, CTA and DSA. On DSA, 34 stenoocclusive lesions were noted at extracranial (n= 19) and intracranial (n = 15) vessels. For extracranial stenosis greater than 70%, sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV) were 94.7%, 98.7%, 90.0% and 99.3% on CE-MRA, and 94.7%, 99.3%, 94.7% and 99.3% on CTA. For intracranial stenosis greater than 50%, sensitivity; specificity, PPV and NPV were 93.3%, 98.3%, 77.8%and 99.6% on CE-MRA, and 86.7%, 97.9%, 72.2% and 99.1 % on CTA, with DSA as the standard of reference. Conclusion : Supraaortic CE-MRA is as reliable as CTA in depicting the arterial stenosis, and is effective in screening of significant stenosis of both extracranial and intracranial arterial stenosis.

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Impacts of Depression, Somatization, and Jaw Disability on Graded Chronic Pain in TMD Patients (우울, 신체화, 턱기능장애가 측두하악장애 환자의 만성통증척도에 미치는 영향)

  • Kim, Cheul;Shin, Eun-Seop;Chung, Jin-Woo
    • Journal of Oral Medicine and Pain
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    • v.30 no.3
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    • pp.353-360
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    • 2005
  • The aim of this study was to investigate the impact of depression, somatization, and jaw disability on graded chronic pain of TMD using Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Ninety-three patients (17 men and 76 women, mean$\pm$SD age of 30.1$\pm$12.5 years) diagnosed with TMD based on RDC/TMD axis I criteria were administered RDC/TMD axis II history questionnaire. The relationships between depression, somatization, jaw disability, and each parameters of graded chronic pain (e.g. pain intensity, pain days, disability score, disability days, graded chronic pain scale) were analyzed by multiple regression analysis. The obtained results were as follows: 1. Among 93 TMD patients, the prevalence of low disability group of graded chronic pain scale was 42.0% and high disability group of graded chronic pain scale was 51.5%. 2. Depression did not show any significant influences on pain intensity, pain days, disability score, disability days, and graded chronic pain scale. 3. Somatization showed a significant effect on pain intensity (p<0.01), disability days (p<0.01), and graded chronic pain scale (p<0.01) except for both pain days and disability score. 4. Jaw disability also showed a significant effect on pain intensity (P<0.001), disability days (p<0.01), and graded chronic pain scale (P<0.001) except for both pain days and disability score. Somatization and jaw disability may closely relate to the pain intensity and degree of disability that TMD patients perceive. Therefore, comprehensive understanding of psychological profile and improvement of functional limitation of jaw movements in the patient should be considered to obtain an excellent outcome of chronic TMD management.

Reliability of Muscle Evaluation with a Tactile Sensor System (촉각센서를 이용한 근육평가의 신뢰도 조사)

  • Oh, Young-Rak;Lee, Dong-Ju;Kim, Sung-Hwan;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.30 no.3
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    • pp.337-344
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    • 2005
  • A tactile sensor employs a piezoelectric element to detect contact frequency shifts and thereby measure the stiffness or softness of material such as tissue, which allows the sensor to be used in many fields of research for urology, cardiology, gynecology, sports medicine and caner detection and especially for cosmetics and skin care. In this study, reliability of the tactile sensor system was investigated with its manual application to the muscles susceptible to temporomandibular disorders. Stiffness and elasticity of anterior temporalis, masseter and trapezius muscles were calibrated bilaterally from 5 healthy men with an average of 24.5$\pm$0.94 years. The tactile sensor used in this study had a computer-controlled and motor-driven sensor unit which automatically pressed down on the skin surface over the muscles being measured and retracted, thereby providing the hysteresis curve. The slope of the tangent of the hysteresis curve (${\Delta}f/{\Delta}x$) is defined as stiffness of the muscle being measured and the distance between the two parts of the curve as its elasticity. To determine inter-examiner reliability, all the measurements were performed by the two examiners A and B, respectively and the same examination were repeated with an interval of 2 days for intra-examiner reliability. The results from this study demonstrated high reliability in measuring stiffness and elasticity of anterior temporalis, masseter and upper trapezius muscles using a tactile sensor system. It is suggested that the tactile sensor system can be a highly reproducible and effective instrument for quantitative evaluation of the muscle in head and neck region.

The Chewing Efficiency of Occlusal Stabilization Appliances by Anatomy of the Occlusal Surface (교합안정장치 교합면의 모양에 따른 저작효율)

  • Im, Yeong-Gwan;Choi, Choong-Ho;Kim, Jae-Hyeong;Rhee, Chong-Ouk;Kim, Byung-Gook
    • Journal of Oral Medicine and Pain
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    • v.30 no.3
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    • pp.361-373
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    • 2005
  • Occlusal appliance therapy has been proven to be very useful and effective in reducing signs and symptoms of patients with TMD. However, there are no reports about the masticatory efficiency of the occlusal appliance. The purpose of this study was, first, to investigate the masticatory efficiency of the conventional stabilization appliance experimentally in normal healthy subjects, by comparing it with that of their natural dentition; and, second, to develop a modified stabilization appliance as an attempt to increase masticatory efficiency. Eleven subjects (mean age 25.3 years, range from 23 to 33) participated in this study. Six were men and five were women. They were healthy and had complete or near―complete natural dentition, and did not present with signs or symptoms of TMD. Two kinds of occlusal appliances―the conventional flat maxillary stabilization appliance (i.e., FSA) and a modified maxillary stabilization appliance with additional anatomic structures on its occlusal surface (i.e., ASA)―were made for every subject. Subjects chewed peanuts that were selected as a food to test the three masticatory conditions of the natural dentition, the ASA, and the FSA. The number of chewing strokes was counted during each 1-minute chewing period. Chewed peanut boluses were recovered and their hardness was measured by texture analysis. Statistical tests were performed. The following results were obtained. 1. The masticatory efficiency of the FSA was 38.6 percent that of the natural dentition. The efficiency of the ASA was 78.2 percent that of the natural dentition. 2. The number of chewing strokes in the natural dentition condition was measured to be 1.5 strokes per second. It decreased to 90 percent in the ASA and FSA conditions. These results indicate that the ASA could serve an improved masticatory capacity as well as its therapeutic effects in TMD. A clinical application of the ASA should be considered to extend the management of TMD patients.

Effects of Occlusal Condition and Clenching Force on the Mandibular Torque Rotational Movement (교합조건 및 이악물기 힘의 변화가 하악의 비틀림 회전운동에 미치는 영향)

  • Oh, Min-Jung;Han, Kyung-Soo
    • Journal of Oral Medicine and Pain
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    • v.30 no.4
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    • pp.411-426
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    • 2005
  • The purpose of this study was to investigate the effects of occlusal condition and clenching level on the mandibular torque rotational movement. For this study, healthy 14 men without any symptoms and signs of temporomandibular disorders were selected. Mandibular torque rotational movement was observed in each circumstance of combination of three occlusal conditions such as natural dentition, with wafer of 3.6 mm thickness, and wafer with resin stop of 14 mm thickness total during hard biting of bite stick at maximum voluntary contraction(MVC) and 50% of MVC level of surface EMG activity of masseter muscle. Electromyographic activity and mandibular torque rotational movement were observed using BioEMG and BioEGN in $BioPak^{(R)}$ system. Each biting movement in each circumstance was composed of clenching one time and hard biting of wooden stick two times. The observed items were opening distance, velocity and amount of torque rotational movement in mandibular movement, and the data were statistically processed with $SPSS^{(R)}$ windows (ver.10.0). The results of this study were as follows: 1. There were no differences in the mandibular movement distance between those value in both biting sides, and between those in both clenching forces, but the mandibular velocity showed a different results by clenching force. For the amount of torque rotational movement, there were no difference in the value of the frontal plane but some significant difference was in the value of the horizontal plane by biting side. 2. The mandibular movement distance and the mandibular velocity in both planes were higher by maximum voluntary contraction than those by half maximum voluntary contraction, and amount of torque rotational movement in the horizontal plane was also increased by maximum voluntary contraction. 3. The opening distance in both planes were decreased with the increase of vertical dimension of occlusion, namely, by the occlusal appliances, and this pattern was also showed in the mandibular velocity in case of hard biting by maximum voluntary contraction. However, the amount of torque rotational movement were not different by the increase of vertical dimension of occlusion. 4. The value of angle and distance of the torque rotational movement in the hard biting of wooden stick were generally higher than those in the clenching without wooden stick in both planes without regard to occlusal conditions and/or clenching forces.

Association between Cognitive Impairment and ADL of the Elderly in Rural Area (농촌 노인들의 인지기능장애와 일상생활 활동도와의 관련성)

  • Kim, Seok-Beom;Kang, Pock-Soo;Kim, Sang-Kyu
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.1
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    • pp.65-71
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    • 1999
  • Objectives. The purpose of this investigation was to study the correlation between cognitive impairment and activities of daily living(ADL) In the elderly of rural area. Methods. The study population consisted of 210 elderly people aged 65 years and older, living in a district of Kyongju City. The cognitive impairment was measured with the Korean version of mini-mental state examination(MMSE-K) and newly constructed the Korean version of mini-mental state examination (K-MMSE). Bristol activities of dally living scale developed specifically to be used with people with dementia was used to measure ADL Results. The mean scores of both MMSE-K and K-MMSE were significantly different by sex groups and by .age groups, respectively(p<0.05). The mean scores of ADL were significantly different by age groups(p<0.01) not by sex groups. Among the 4 components of ADL(instrumental activities of daily living(IADL), self care, orientation, and mobility), the mean score of the orientation was significantly higher in men(p<0.01); and IADL, orientation and mobility components were significantly different by age groups(p<0.01). ADL correlated well with MMSE-K (r=0.54) and K-MMSE(r=0.52) and showed higher correlation in female (r=0.73, 0.71) than male(r=0.27, 0.29). IADL and orientation showed significant correlation with MMSE-K(r=0.52, 0.62) and K-MMSE(r=0.50, 0.63), respectively(p<0.01). Conclusions. In developing and establishing a care model for people with dementia in the community, both cognitive impairment and the activities of daily living(ADL) need to be considered.

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Characteristics of Growth and Oil Production of Peppermint Cells in an Air-bubble Bioreactor (기포 생물반응기에서 페퍼민트 세포의 생육 및 정유 생산 특성)

  • 송은범;이형주
    • KSBB Journal
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    • v.8 no.5
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    • pp.495-503
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    • 1993
  • To investigate the characteristics of growth and oil production of peppermint cells during a batch culture, cells derived from peppermint callus was cultivated in an air bubble reactor. During the batch culture, effects of inoculum size, abiotic stress, yeast elicitor, and two stage culture on the cell growth, the productivity of oleolesin, and the formation of flavor components were determined and also the sugar concentrations and kinetics of cell growth were analyzed. Among the various sizes of inoculum, the culture with 2.0% packed cell volume inoculum showed the optimum condition for cell growth in the proposed bioreactor, and the cell yield and essential oil production reached to 5.7g/1 and 0.109g/1, respectively. When the abiotic stress of daily 8hr dark and $10^{\circ}C$ cold treatments were given to the culture cell growth decreased but essential oil production increased to 0.546g/l. In a modified Lin-Staba medium in which 100mg/l yeast extract as an elicitor was added to the culture, the cell growth and oil production increased, and menthol content was 22.5% of oil. In the two stage culture, in which the basic culture conditions of 27$^{\circ}C$, light, and without elicitor were employed during the first six days followed by the second stage with daily 8hr treatment of cold and dark condition, and also with yeast extract as an elicitor, cell growth decreased after eight days, essential oil production was not increased, and menthol was not detected. Dry cell yield was 0.38g dry cell/g sugar and specific growth rate was 0.25 day-1. The major terpenoid in the oil was not the menthol but pulegone and piperitone, precursors of menthol were accumulated. However, when yeast elicitor was added, menthol was produced to the level of 22.5% which was the highest value in the peppermint cell culture reported so far.

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A study on knowledge, self-efficacy and compliance in Reumatic arthritis Patients (류마티스 관절염 환자의 지식, 자기효능감 및 치료이행과의 관계연구)

  • Kim, Soon-Bong
    • Journal of muscle and joint health
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    • v.5 no.2
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    • pp.238-252
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    • 1998
  • Reumatic arthritis is a disease with joint pain being one of the key symptoms. The patient suffers from the pain, stiff sensation and edema due to the inflammation taking Place In one or more joints. Accompanying these problems are fatigue, unusual exhaustion, fever, tachycardia and weakness. Inaddition, joints are often deformed and muscles shrink along with the progress of edema, coupled with depression and psychological instability resulting from the loss of the mobile function and limitations on the daily life. Some patients become fed up with the long and hard flight with the disease and just give up, which aggravates the symptoms. Others come to the hospital only when the conditions have become serious. We need to prevent these and guide the patients in the right direction. Against this backdrop, this study aims to look into the relations between the knowledge on the part of the patients together with their feeling of self-efficacy and the compliance. The results are expected to help the patients improve their life, In addition to providing useful materials for setting up appropriate plan for nursing intervention. The study was conducted by distributing questionnaire to 88 patients selected from the out-patient department of a university hospital in Inchon, from April 6 to 27, 1998. The following tools were used the yardstick of self-efficacy, developed in 1997 by the Society for the Health of Rheumatism Patients, was used for measuring the levels of knowledge and the feeling of self-efficacy. The degree of compliance was measured by the data collected from documents in addition to the results of the analysis of the interviews with the patients. The reliability of the tools was confirmed. In the analysis, the general characteristics were expressed in figures and percentages. The levels of knowledge, feeling of self-efficacy, and compliance were expressed in the average values and standard deviations. The relations among the variables following the general characteristics were analysed by the t-test and one-way ANOVA. The Pearson correction coefficient was used for the analysis of factors. Multiple-loop analysis was used to identify the variables affecting the compliance. The following are the results of this study. 1. Among the 88 patients, 18 were men and the remaining 70 were women, with a ratio 1 : 3.87. Regarding the age groups, 23 were between 50 and 59 years old, with those between 50 and 69 accounting for 51.1% of the total. High school graduates or higher amounted to 58%. Religious patients was 67% or 59 persons. Fifty nine percent were unemployed, and 58.3% (49 persons) had two children or fewer. The period of suffering from rheumatism varied between 2 months and IS years, with 70% less than years. 2. The average figure In relation to the of knowledge was 17.63 points over 30 or 58. 76%, which means a medium level. 3. The average figure of the feeling of self-efficacy was 60.06 points. 4. The level of compliance was 3.26, which was above average. 5. The relation between the feeling of self-efficacy and compliance showed an "r" value of 0.37, which was significant. It means that the higher the feeling, the greater the compliance points. 6. The analysis of the knowledge level revealed that the difference is found only between the college graduates and junior-high graduates or lower. 7. The feeling of self-efficacy varied along with the age and education level. 8. The general characteristics of patients as discussed above did not show significant difference with the compliance. 9. Regarding the elements influencing the compliance, the number of children, period of suffering, income, age, feering of self-efficacy, knowledge, and compliance had 54% of significance. In conclusion, rheumatism victims can lead a better life if they are appropriately educated, based on efficient training program from the early days of the disease ; if they become able to manage themselves thanks to the training ; and if they are helped by a program focusing on the increase of the feeling of self-efficacy aimed at changing patient's behavior.

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A Study on Make-up Culture of Korea, China and Japan (한국.중국.일본 여성의 색조대장문화)

  • 박보영;황춘섭
    • Journal of the Korean Society of Costume
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    • v.39
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    • pp.217-237
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    • 1998
  • The present research is to study the make-up culture of Korea and its neighboring countries such as China and Japan during the period from the prehistoric age to the 19th cen-tury. The research was made by documents analysis. The results are summerised as follows : (1) A man has a basic instinct to beautify himself. There was not a significant difference between the make-up behavior of men and women in its primal stage. It was by the start of farming and the division of labor that made the make-up behavior as a feminine culture. The difference of sexual role caused the con-ceptual difference between manly beauty and womanly beauty. It was very natural for women to regard the make-up as the best way for showing their feminine beauty. In Korea, China and Japan, there were vari-ous kinds of primal actions such as tattooing, body-painting, and tooth make-up which were used in the purpose of body protection, incantation, ornament, and so on. Ass their ornamental purpose was becoming more important, these primal actions became the basis of the feminine make-up culture. Nowadays make-up, having mental and emo-tional function, is helpful to increasing self-satisfaction, promoting good personal relation-ship, and attracting attention from the other sex. It also has other functions of showing social status, wealth, age, sex, courage, power, and so on. (2) The representative make-up product used widely in the three countries was Boon (powder) which decides the overall color of face. The key point in the production of Boon was to increase its power of adsorption. The invention of Yunboon (power mixed with lead) solved this major problem of Boon. Yeonji which decides the color of cheek was the mixture of Boon and the powder of Honghwa (a kind of red-colored flower or tree). Mimook (eyebrow pencil) was developed to match up with the various and changing currencies of penciling eyebrows in each nation and times, Yeonji and Joosa (red sand) were used as Jinji (lip stick). The predominant color of Jinji was red. As miscellaneous methods of partial make-up, there were Kon-ji used in a wedding cer-emony in korea, Aek-hwang, Hwa-jeon, Sa-hong, and Myun-yup in China, and Chi-heuk, a peculial method of partial make-up in japan. (3) There were various factors which decided the characteristics of make-up culture usually reflects international atmosphere, the form of government, economic situation, re-ligious and social ideology, aesthetic sense, symbolizing meanings of colors, and so on. The up and down of an influentian country was one of the major factors which decided the characteristics of the make-up culture of its neighboring countries. When a country took a liberal form of government, it had diverse and splendid tendencies in its make-up culture. The better a nation's economic situation is, the more abandant and various its make-up culture is, and sometimes, the more eccentric and decadents it was. In the field of make-up production, the three countries had their own characteristics. But, as a whole, China was the leading nation who spread the culture and products of make-up to Korea and Japan. Though the Chinese make-up culture and products were usually spread to Japan through Korean, there was some evidence of direct exchanges between China and Japan through its dispatches of Kyun-Tang-Sa(Japanese delegation to the Tang Dynasty). While religion had a positive influence on the development of make-up culture by introducing new methods of make-up, Confucianism exercised strict control over the make-up cul-ture. The currencies in arts and changes of esthetic sense introduced new methods and booms to the make-up culture. Literature made people pay increasing attentions to the countenances of women and changed the standards of esthetic sense. We can find out that the social status of woman was also reflected in the make-up culture. As the social status of women became higher, the feminine make-up culture also developed more then ever. As mentioned above, the make-up cultures of the three countries reflected their social values, esthetic senses, and emotional feelings. Through their cultural exchanges, the three countries could develop various make-up products and methods.

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