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The opinions of health care workers on the inclusion of dental hygienists in the category of medical personnel (치과위생사의 의료인화에 대한 의료종사자들의 견해)

  • Hyeong, Ju-hee;Jang, Yun-Jung
    • Journal of Korean society of Dental Hygiene
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    • v.17 no.6
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    • pp.1013-1024
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    • 2017
  • Objectives: The study investigated health professionals working in the metropolitan area and Jeolla-bukdo, South Korea, from April 30 to May 17, 2017 to understand their views on the issue of including dental hygienists in the scope of medical personnel of South Korea. Methods:A total of 270 surveys were analyzed in this study. The survey consists of 5 questions on general issues; 10 on the awareness of present work of dental hygienist; and 1 on opposition or approval about including dental hygienist in medical personnel. The collected data were analyzed using SPSS for Windows 18.0, as well as frequency analysis, cross analysis and logistic regression analysis. Statistical significance level (${\alpha}$) is 0.05. Results: 1. Broken down by gender, male subjects showed more oppositions against including dental hygienists in the category of medical personnel while female subjects showed more favorable opinions (p<0.05). In terms of academic background, those who had graduated from graduate school or higher showed a higher propensity for opposition while those who had graduated from a 3-year college showed a higher tendency for approval on the idea (p<0.05), In terms of occupational type, health professionals showed more opposing views whereas medical technologists showed more approvals than others (p<0.001). 2. With respect to the awareness of work specialty and proficiency of dental hygienist according to general characteristics, the higher the age, the higher the awareness level was. In terms of the occupational type, medical technologists were found to have higher awareness level than health professionals (p<0.001). 3. With respect to the relationship between general characteristics and view on including dental hygienists in medical personnel, the occupational type of health professional was found to have 6.33 times more oppositions than medical technologists. When the awareness level on proficiency of dental hygienist was low, opposition was 6.52 times more frequent (p<0.05). Conclusions: Based on the findings above, the inclusion of dental hygienists in medical personnel seems necessary in properly establishing the specialty and role of dental hygienist in the dentist medical environment of the country in order to enhance national oral health related preventive dental service and expand the demand. To this end, it is necessary to provide nationwide promotion, work to change the awareness of health professionals in other occupational types, and facilitate public promotion for legal ground establishment.

Management of Traumatic Diaphragmatic Rupture (외상성 횡격막 손상의 치료)

  • Kim, Seon Hee;Cho, Jeong Su;Kim, Yeong Dae;I, Ho Seok;Song, Seunghwan;Huh, Up;Kim, Jae Hun;Park, Sung Jin
    • Journal of Trauma and Injury
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    • v.25 no.4
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    • pp.217-222
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    • 2012
  • Purpose: Diaphragmatic rupture following trauma is often an associated and missed injury. This report is about our experience with treating traumatic diaphragmatic rupture (TDR). Methods: From January 2007 to September 2012, 18 patients who had a diaphragmatic rupture due to blunt trauma or penetrating injury underwent an operation for diaphragmatic rupture at our hospital. We retrospectively reviewed their medical records, including demographic factors, initial vital signs, associated injuries, interval between trauma and diagnosis, injured side of the diaphragm, diagnostic tools, surgical method or approaches, operative time, herniated organs, complications, and mortality. Results: The average age of the patients was 43 years, and 16 patients were male. Causes of trauma included motor vehicle crashes (n=7), falls (n=7), and stab wounds (n=5). The TDR was right-sided in 6 patients and left-sided in 12. The diagnosis was made by using a chest X-ray (n=3), and thorax or upper abdominal computed tomography (n=15). Ten(10) patients were diagnosed within 12 hours. A thoracotomy was performed in 8 patients, a video-assisted thoracoscopic surgery in 4 patients, a laparotomy in 3 patients, and a sternotomy in one patient. Herniated organs were the omentum (n=11), stomach (n=8), spleen and colon (n=6), and liver (n=6). Eighteen diaphragmatic injuries were repaired primarily. Seven patients underwent ventilator care, and two of them had pneumonia and acute respiratory distress syndrome. There were no operative mortalities. Conclusion: Early diagnosis and surgical treatment determine the successful management of TDR with or without the herniation of abdominal organs. The surgical approach to TDR is chosen based on accompanying organ injuries and the injured side.

Changes in Multi-channel Electrogastrography after Acupuncture Treatmet in Patients with Functional Dyspepsia (기능성 소화불량증 환자에서 침구 처치 후 다채널 위전도 소견의 변화)

  • Kim, Yoo-Seung;Ryu, Bong-Ha;Kim, Jin-Sung;Hong, In-A;Park, Young-Sun;Jung, Yong-Jae;Oh, Seung-Whan;Han, Ga-Jin
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.24 no.1
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    • pp.152-157
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    • 2010
  • The aim of this study was to investigate the effects of traditional Korean medical therapy in patients with functional dyspepsia evaluted using multi-channel electrogastrography. Before the treatment, the EGG of 14 outpatients (male 3, female 11) with functional dyspepsia were recorded and their dominant frequency(DF), percentage of gastric slow waves, percentage of Power ratio, and percentage of slow wave couplings were analysed. For 8 weeks, the patients received acupuncture treatment. After 8 weeks, EGG was rechecked and compared with the previous data. After treatment, normogastria was significantly increased in channel 1 and channel 3($53.70{\pm}18.94$% vs $72.64{\pm}15.49$% in channel 1, P<0.05; $79.74{\pm}18.09$ vs $90.86{\pm}8.86$ in channel 3, P<0.05). arrythmia was significantly decreased in channel 3($14.34{\pm}15.21$ vs $5.93{\pm}6.90$, P<0.05). The patients who had less severe decrease in EGG indexes showed improvement of those indexes through 8 weeks of outpatient care. EGG channel 3 was shown to be the most adequate standard of evaluation. But there was no significant improvement in slow wave coupling rate which is a new index of multichannel EGG.

Effect of Trans-unsaturated Fatty Acid on Serum Lipid Levels in Mice (트랜스형 불포화 지방산이 mice 혈중 지질농도에 미치는 영향)

  • Yu, Sun-Nyoung;Ahn, Jeong-Bin;Park, Eun-Young;Lee, Sun-Jung;Tak, Min-Gi;Kim, Kwang-Youn;Kim, Sang-Hun;Kim, Ki-Dae;Ahn, Soon-Cheol
    • Journal of Life Science
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    • v.22 no.8
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    • pp.1126-1131
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    • 2012
  • The purpose of this study was to investigate the effects of trans-unsaturated fatty acid (TFA), saturated fatty acid (SFA) and general unsaturated fatty acid (USFA) on serum lipid levels in ICR mice. Male ICR 8-week-old mice were divided into six groups; the control group (C) fed with normal diet, the TFA-1 group fed with 10% trans-unsaturated fatty acid, the TFA-2 group fed with 30% trans-unsaturated fatty acid, the TFA-3 group fed with 50% trans-unsaturated fatty acid, the SFA group fed with 50% saturated fatty acid, and USFA group fed with 50% general unsaturated fatty acid. The serum total cholesterol of TFA-3 and SFA was higher than those of other fat groups and C. The serum triglyceride (TG) of TFA-3 and SFA showed the highest levels among all of diet groups. Also the serum HDL cholesterol levels of TFA-3 showed the lowest. LDL cholesterol and atherogenic indices (AI) were remarkedly increased in TFA-3 and SFA, as compared with other fat fed groups and C. Taken together with results, the TFA-3 group showed serum lipid levels similar to the SFA and different from the USFA. These results suggest that intake of high level of trans-unsaturated fatty acid increased serum triglyceride, LDL cholesterol and atherogenic indices, which may affect risk on serum lipid level for lipid metabolism syndrome.

A Study on Health Status of Arthritis Clients in Wonju City (관절염 대상자의 건강상태 조사 - 일개 도.농 복합시를 중심으로 -)

  • Lee, Eun-Hee;Choi, Sun-Ha;Suh, Guil-Hee;So, Ae-Young;Lee, Kyung-Sook;Choi, Jung-Sook;Ko, Kyoung-Dug;Kim, Myoung-Chon;Park, Hyun-Ja;Paek, Seung-Lee;Ryu, Bo-Bby;Yun, Hyun-Suk;Lee, Ae-Ran
    • Journal of muscle and joint health
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    • v.8 no.2
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    • pp.262-277
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    • 2001
  • The purpose of this study was to investigate the health status and to examine the relationship between health related variables of the clients with arthritis. This descriptive-correlational study was measured physical health status(pain, fatigue, physical disability, joint flexibility) and psycho-social health status(social function disability, self-efficacy, depression). The clients were consisted of 127 arthritis clients who were randomly selected from health center, 2 sub health center and 6 primary health care center in Wonju City. The data was collected from November 2000 to January 2001. The results of the study analyzed using a SPSS win were as follows: 1) The subjects' average age was 64.81 years old(female: 86.6%, male: 13.4%). 2) In physical health status, the average score of fatigue was 63 scores and pain was 69.77. Physical disability score was higher than total disability score. In psychosocial disability, housekeeping management disability score was higher than social function disability score. In psycho-social health status, the average score of self-efficacy was 70.86 and the subjects have higher level of depression, more than 20 scores. 3) On pain sites, almost of subjects complained of a knee joint pain. The waist, wrist, and shoulder joint pain were followed. The numbers of pain site were 8.3 per individuals. 4) The flexibility of knee and shoulder joint were lower than another joints. 5) Correlation with fatigue, pain, physical disability, social disability, self-efficacy and depression was revealed highly significant. We suggest that health promotion program considering our research results should be provided for arthritis clients in community level.

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Voice Quality in Patients with Asthma (천식환자에서의 음성의 질)

  • Han, Myung-Woul;Kim, Seong-Tae;Choi, Seung-Ho;Kim, Sang-Yoon;Nam, Soon-Yuhl
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.20 no.1
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    • pp.63-67
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    • 2009
  • Background and Objectives: In patients with asthma, increased obstruction and resistance of airway result in impairment in the generation of voice. Allergy and nasal polyposis, which are frequently observed in patients with asthma, are other factors that affect the vocal performance. Bronchodilators and steroids are commonly used in the treatment of asthma, and these agents also have been reported to be associated with voice changes. The aim of this study is to evaluate the voice quality in patients with mild to-moderate asthma by subjective and objective methods. Materials and Methods: A total of 36 patients with asthma established in the Department of Respiratory Medicine were included in this study. 23 were women and 13 were men, with a mean age of 51.7 years. The average duration of asthma was 77.0 months. All patients had mild-to moderate asthma. Acoustic and aerodynamic analyses were performed and the movements of the vocal cords were examined by videolaryngostroboscopy (VLS). Voice Handicap Index (VHI) and GRABS scales were used for subjective evaluations. Results: 50% of patients suffered from dysphonia and FO was 119.3${\pm}$23.7 Hz in male and 198.2${\pm}$18.4 Hz in female patients. There were no significant differences in average shimmer and NHR between females (4.90${\pm}$2.95% ; 0.1O${\pm}$0.04 dB) and males (4.64${\pm}$2.45% ; 0.20${\pm}$0.15 dB). However, the value of jitter was greater for females (2.60${\pm}$1.92%) than for males (1.21${\pm}$0.84%). The VHI score was above the normal limit in 35%, and VLS findings were shown diverse abnormality in 89% asthmatics from mucosal change to hyperfunction of supragottis and contact granuloma. But duration of illness and steroid dose did not correlate with these findings. Conclusion: Subjective and objective abnormality was shown in more than 50% of asthmatic patients. We suggest that persons who suffer from asthma should be examined for possible voice disorders by laryngologist. Additionally, appropriate medical care and voice therapy should be provided for those who have voice disorders associated with asthma.

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Clinical Review of Pediatric Adenoviral Lower Respiratory Infection (아데노바이러스에 의한 소아 하기도 감염에 대한 임상적 고찰)

  • Son, Jin-A;Lee, Sang-Il;Lee, Nam-Young;Kim, Jung-Hee
    • Pediatric Infection and Vaccine
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    • v.3 no.2
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    • pp.154-162
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    • 1996
  • Purpose : Adenoviruses(Ad) have been shown to play an important role in the etiology of severely acute respiratory diseases, particulary in infants and young children, and the occurrence of fatal outcome and chronic pulmonary sequelae in association with adenoviral infection has been a cause of great interest and concern. This report presents the resul of a retrospective analysis on 30 cases of lower respiratory infection from which adenovirus was isolated. Patients & Methods : The 30 patients in this study represent all detected cases of adenovial infection out of 240 children who were admitted to Sang Sung Medical Center between February to June 1996 showing signs and symptoms of lower respiratory tract infection. The diagnosis of adenovirus infection was based on microscopic visualization of typical cytopathic effect in HEp-2 tissue culture and used monoclonal Ab with nasopharyngeal aspiration. Results : The male/female ratio was 2:1 and the majority of age range was below 36months. Clinical diagnoses in all 30 patients were pneumonia(n=21), bronchitis and Bronchiolitis(n=5) and ARDS(n=4). We recieved the most of patients in the month of May. The chief complaints were fever(93.3%) and cough(80%) and extrapulmonary symptoms were diarrhea(n=5), seizure(n=4), abdominal pain(n=1). The mean duration of fever was $11.95{\pm}6.54$days. Physical examination on admission were crackles(73.3%), coarse breathing sounds(60%), hepatosplenomegaly(33.3%), decreased brething sounds(30%). In WBC counts, 8cases were below $4000/mm^3$ and 14 cases were above $10,000/mm^3$. In platelets counts, 4cases were below $150,000/mm^3$ and 10 cases were above $450,000/mm^3$. 21 cases were above 1 in CRP. GOT and GPT were abnormal in some cases. Chest X-ray revealed diffuse pulmonary infiltration(n=15), pleural effusion(n=6), consolidation(n=4) and hyperaeration(n=3). Seven patients were treated at the peditric intensive care unit with respiratory support and high dose of gammaglobulin. However, one patients died even through he was treated with NO ventilation and high frequency ventilation. Conclusion : Those with adenoviral pneumonia and respiratory infection having long fever duration and symptoms like bacterial pneumonia must be carefully differentiated in order to provide proper treatement and preventive measures due to possible fatal outcome.

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Characteristics of Stable Pelvic Bone Fractures with Intra-abdominal Solid Organ Injury (복부 고형장기 손상을 동반한 안정 골반골 골절의 특성)

  • Park, Sang-June;Kim, Sun-Hyu;Lee, Jong-Hwa;Ahn, Ryeok;Hong, Eun-Seog
    • Journal of Trauma and Injury
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    • v.23 no.2
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    • pp.57-62
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    • 2010
  • Purpose: This study analyzed the characteristics of stable pelvic bone fractures with intra-abdominal solid organ injury. Methods: Medical records were retrospectively reviewed from January 2000 to December 2009 of patients with stable pelvic bone fractures. A stable pelvic bone fracture according to Young's classification is defined as a lateral compression type I and antero-posterior compression type I. Subjects were divided into two groups, one with (injured group) and one without (non-injured group) intra-abdominal solid organ injury, to evaluate the dependences of the characteristics on the presence of an intra-abdominal solid organ injury. Data including demographics, mechanism of injury, initial hemodynamic status, laboratory results, Revised Trauma Score (RTS), Abbreviated Injury Scale (AIS), Injury Severity Score (ISS), amount of transfusion, admission to intensive care unit (ICU), and mortality were analyzed. Results: The subjects were 128 patients with a mean age of 42 years old, of whom were 67 male patients (52.3%). The injured group had 21 patients(16.4%), and the most frequent injured solid organ was the liver. Traffic accident was the most common mechanism of injury and lateral compression was the most common type of fracture in all groups. Initial systolic blood pressure was lower in the injured group, and the ISS was greater in the injured group. Arterial pH was lower in the injured group, and shock within 24 hours after arrival at the emergency department was more frequent in the injured group. Transfused packed red blood cells within 24 hours were 8 patients(38.1%) in the injured group and 11 patients(10.3%) in the non-injured group. Conservative treatment was the most common therapeutic modality in all groups. Stay in the ICU was longer in the injured group, and three mortalities occurred. Conclusion: There is a need to decide on a diagnostic and therapeutic plan regarding the possibility of intra-abdominal solid organ injury for hemodynamically unstable patients with stable pelvic bone fractures and for patients with stable pelvic bone fractures along with multiple associated injuries.

Surgical Experience of the Remnant Thoracoabdominal Aortic Replacement after Aortic Surgery (대동맥수술 후 잔존 흉복부대동맥치환술에 대한 임상 경험)

  • Cho, Kwang-Jo;Woo, Jong-Su;Choi, Pil-Jo;Bang, Jung-Hee
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.49-54
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    • 2008
  • Background: Aortic diseases tend to involve the entire aorta. Hence, there is the constant possibility of the need for a secondary operation at the remnant aorta. This study analyzed our cases of secondary aortic surgery in order to determine its characteristics and problems. Material and Method: Between April 2003 and June 2007, 12 patients (6 male and 6 female) underwent thoracoabdominal aortic replacement as a secondary aortic operation. Their clinical courses were analyzed. Four of the patients underwent lower thoracobadominal aortic replacement under the normothermic femorofemoral bypass, and the others underwent an entire thoracobdominal aortic replacement under deep hypothermic circulatory arrest. Result: There was no death or paraplegia. As local complications, there were 3 cases of wound infection and 2 cases of an immediate reoperation caused by bleeding and one case of delayed wound. revision for a contaminated perigraft hematoma. As a systemic complication, there was one case of renal insufficiency, which required hemodialysis and one case of respiratory insufficiency that needed prolonged ventilator care. The mean admission period was $30{\pm}21$ days. All the patients were followed up for $626{\pm}542$ days without reoperation or other problems. Conclusion: Using properly selected patients and a careful approach, thoracoabdominal aortic replacement can be performed safely as a secondary aortic surgery.

Atrial Septal Defect Closure: Comparison of Vertical Axillary Minithoracotomy and Median Sternotomy

  • Poyrazoglu, Huseyin Hakan;Avsar, Mustafa Kemal;Demir, Serafettin;Karakaya, Zeynep;Guler, Tayfun;Tor, Funda
    • Journal of Chest Surgery
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    • v.46 no.5
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    • pp.340-345
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    • 2013
  • Background: This study aims to evaluate whether or not the method of right vertical axillary minithoracotomy (RVAM) is preferable to and as reliable as conventional sternotomy surgery, and also assesses its cosmetic results. Methods: Thirty-three patients (7 males, 26 females) with atrial septal defect were admitted to the Cardiovascular Surgery Clinic of Cukurova University from December 2005 until January 2010. The patients' ages ranged from 3 to 22. Patients who underwent vertical axillary minithracotomy were assigned to group I, and those undergoing conventional sternotomy, to group II. Group I and group II were compared with regard to the preoperative, perioperative and postoperative variables. Group I included 12 females and 4 males with an average age of $16.5{\pm}9.7$. Group II comprised 14 female and 3 male patients with an average age of $18.5{\pm}9.8$ showing similar features and pathologies. The cases were in Class I-II according to the New York Heart Association (NYHA) Classification, and patients with other cardiac and systemic problems were not included in the study. The ratio of the systemic blood flow to the pulmonary blood flow (Qp/Qs) was $1.8{\pm}0.2$. The average pulmonary artery pressure was $35{\pm}10$ mmHg. Following the diagnosis, performing elective surgery was planned. Results: No significant difference was detected in the average time of the patients' extraportal circulation, cross-clamp and surgery (p>0.05). In the early postoperative period of the cases, the duration of mechanical ventilator support, the drainage volume in the first 24 hours, and the hospitalization time in the intensive care unit were similar (p>0.05). Postoperative pains were evaluated together with narcotic analgesics taken intravenously or orally. While 7 cases (43.7%) in group I needed postoperative analgesics, 12 cases (70.6%) in group II needed them. No mortality or major morbidity has occurred in the patients. The incision style and sizes in all of the patients undergoing RVAM were preserved as they were at the beginning. Furthermore, the patients of group I were mobilized more quickly than the patients of group II. The patients of group I were quite pleased with the psychological and cosmetic results. No residual defects have been found in the early postoperative period and after the end of the follow-up periods. All of the patients achieved functional capacity per NYHA. No deformation of breast growth has been detected during 18 months of follow-up for the group I patients, who underwent RVAM. Conclusion: To conclude, the repair of atrial septal defect by RVAM, apart from the limited working zone for the surgeon in these pathologies as compared to sternotomymay be considered in terms of the outcomes, and early and late complications. And this has accounted for less need of analgesics and better cosmetic results in recent years.