• Journal of Korean Academy of Fundamentals of Nursing
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• v.3 no.2
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• pp.213-233
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• 1996

This study was made on 274 apoplectics patients who received the rehabilitation therapy and tests on physical, psychological and social adaptations as outpatients in 23 general hospitals in the Seoul and Kyungi area. The basic data on degree of improvement of apoplectic patients studied from rehabilitation therapy. Data was collected over a period of 63 days, from February 21st till April, 23, 1996. The assigned physical therapist conducted direct interviews with patients after he answered the distributed questionnaires for each individual patient. The colleted data was processed by the $SPCC/C^+$ method. The results of the tests conducted to meascne the the degree of ADL dependency, depression and social activity corresponding to the physical, psychological, and social adaptation. The details are ; 1) The test to meascne the degree of ADL dependency, corresponding to the study of physical adaptation of CVA patients, indicated a mean score of 2.57(ideal score is 1.0) with a standard deviation of ${\pm}0.75$. The worst score was 3.95 while the best score was a perfect 1.0, representing a severe range of dependency. The distribution was centered with a median of 2.65 and a mode of 2.68. 2) The test to meascne the degree of depression which corresponds to the level of psychological adaptation yielded a mean of 2.99 which is higher than the normal limit of 2.45. The standard deviation was ${\pm}0.52$ and the worst score and the best score were 4.35 and Respectirdy. The distribution was centered with a median of 3.00 and a mode of 3.00. 3) The test to meascne the degree of social activities for the level of social adaptation indicated a very low mean score of 26.52 (perfect score is 144), with the standard deviation of ${\pm}16.23$. Some patients scored as high as 100, but others scored as low as 3. The distribution of social activities at a very low level was shifted to the left with a median of 24.00 and a mode of 20.00. 4) Factors influencing the level of physical, psychological and social adaptation are as follows : Factors significantly influencing the level of physical adaptation measured by ADL dependency are age, personal guardian, payer of medical expenses, and paralysis of the right arm, right leg and facial paralysis. Factors significantly influencing the level of psychological adaptation measured by the degree of depression, are age, marital status, education, medical history of individual and family, speech impediment, and facial paralysis. Factors significantly influencing the level of social adaptation measured by the degree of social activity are age, marital status, education, employment status, and the burden of medical expense. 5) The Corelationship is significant(9.00), between ADL dependeing as degree of physical adaptation and depreseion as degree of psychologial adaptation. ADL dependency is proportional to depression. But social activity is inversely protional to ADL dependeny and depression. In conclusion, the increased care for physical function of the patients is not the only necessary means to better facilitate the appropriate adaptation of CVA patients. The introduction of a solid rehabilitation program for psychological and social adaptation will also play the integral part of the treatment of CVA patients.

• Tuberculosis and Respiratory Diseases
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• v.44 no.3
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• pp.621-628
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• 1997

Background : As the pleural inflammation progresses, exudative pleural fluid becomes loculated rapidly with pleural thickening. Complete drainage is important to prevent pleural fibrosis, entrapment and depression of lung function. Intrapleural urokinase instillation therapy has been advocated as a method to facilitate drainage of gelatinous pleural fluid and to allow enzymatic debriment of pleural surface. This study was designed to investigate the predictors of effectiveness of intrapleural urokinase in the treatment of loculated pleural effusion. Method : Thirty-five patients received a single radiographically guided pig-tail catheter ranging in size from 10 to 12 French. Twenty-two patients had tuberculous pleural effusions, and 13 had non-tuberculous postpneumonic empyemas. A total of 240,000 units of urokinase was dissolved in 240 ml of normal saline and the aliquots of 80mL was instilled into the pleural cavity via pig-tail catheter per every 8hr. Effectiveness of intrapleural urokinase instillation therapy was assessed by biochemical markers, ultrasonography, and technical details. A greater than 50% improvement on follow-up chest radiographs was defined as success group. Result : Twenty-seven of 35 (77.1%) patients had successful outcome to urokinase instillation therapy. Duration of symptoms before admission was shorter in success group ($11.8{\pm}6.9day$) than in failure group ($26.62{\pm}16.5day$) (P<0.05). Amount of drained fluid during urokinase therapy was larger in success group ($917.1{\pm}392.7ml$) than in failure group ($613.8{\pm}259.7ml$) (P<0.05). Pleural fluid glucose was higher in success group ($89.7{\pm}35.9mg/dl$) than in failure group ($41.2{\pm}47.1mg/dl$) (P<0.05). Pleural fluid LDH was lower in success group ($878.4{\pm}654.3IU/L$) than in failure group ($2711.1{\pm}973.1IU/L$) (P<0.05). Honeycomb septated pattern on chest ultrasonography was observed in six of eight failure group, but none of success group (P<0.05). Conclusion : Longer duration of symptoms before admission, smaller amount of drained fluid during urokinase therapy, lower glucose value, higher LDH value in pleural fluid examination, and honeycomb septation pattern on chest ultrasonograph were predictors for failure group of intrapleural urokinase instillation therapy.

• Tuberculosis and Respiratory Diseases
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• v.52 no.1
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• pp.46-53
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• 2002

Background: Pulmonary aspergilloma is relatively common in korea. It arises from the colonization and proliferation of Aspergillus in preexisting lung parenchymal cavities, in particular tuberculosis. The most common symptom in this disorder is hemoptysis, which mayor may not be massive and life threatening. A routine chest radiography and computed tomography (CT) are the most important diagnostic procedures. A surgical resection of the aspergilloma has recently been recommended, because of the relatively low incidence of postoperative complications than in the past. A more concentrated sample of patients with aspergilloma, who either underwent a thoracotomy or tested positive for aspergillus antibodies, were reviewed. Method : The medical records of twenty-two patients with aspergilloma, who had a proven thoracotomy (9 cases), or who tested positive for the diagnostic procedure and/or aspergillus antibodies (13 cases) from January 1995 to December 2000, were reviewed retrospectively. Results : The most common underlying lung disease was a current or old healed tuberculosis, and 3 patients had cultures of mycobacterium other than tuberculosis (MOTT). The mean time until the aspergilloma was detected 5.91 years in the healed tuberculosis cases. The others cases involved a lung abscess, bronchiectasis and without lung disease. The extrapulmonary disease was alcoholism and diabetes. Hemoptysis was most common in 72.7%. A computed tomography (CT) is useful for diagnosis. The right upper lobe, especially the posterior segment, is the most common location. Bronchial artery embolization is ineffective for a long term follow-up. A lobectomy is most common in a thoracotomy, and intra-operative and post-operative complications are rare. During follow-up, the mortality rate, not from the aspergilloma but from respiratory failure, was 13.6%. Conclusion : Aspergilloma is a common cavitary lung disease, It mainly arises from tuberculosis, either current or healed, but extra-pulmonary disease including alcoholism or diabetes are other possible risk factors. Their most common problem in aspergilloma is hemoptysis. Surgery has a low risk of post-operative complications and is recommended in relatively preserved lung function or healthy patients. Medical maneuvers including embolization, and the local insertion of certain materials needs to be studied more closely.

• Tuberculosis and Respiratory Diseases
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• v.45 no.2
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• pp.369-379
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• 1998

Background: Platelet-activating factor(PAF) might play an important role in the development of acute respiratory distress syndrome. Since PAF induced lung injury is similar to changes of acute respiratory distress gyndrome, and abnormalities in surfactant function have been described in acute respiratory distress syndrome, the authors investigated the effects of PAF on the regulation of surfactant protein A, B and C mRNA accumulation Method: The effects of PAF on gene expression of surfactant protein A, B and C in 24 hours after intratracheal injection of PAF in rats. Surfactant protein A, B and C mRNAs were measured by filter hybridization. Results: The accumulation of SP-A mRNA in PAF treated group was significantly decreased by 37.1 % and 41.6%, respectively compared to the control group and the group treated with Lyso-PAF(p<0.025, p<0.01). The accumulation of SP-B mRNA in PAF treated group was decreased by 18.7% and 32.2 %, respectively compared to the control group and the group treated with Lyso-PAF but statistically not significant. The accumulation of SP-C mRNA in PAF treated group was significantly decreased by 30.7% and 38.5%, respectively compared to the control group and the group treated with Lyso-PAF(p<0.l, p<0.01). Conclusion: These findings represent a marked inhibitory effects of platelet-activating factor on surfactant proteins expression in vivo. This supports, in turn, 'platelet-activating factor might be related to pathogenesis of acute respiratory distress syndrome.

• Tuberculosis and Respiratory Diseases
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• v.49 no.6
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• pp.703-714
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• 2000

Background : Surfactant protein A (SP-A) is important in the regulation of surfactant secretion, synthesis and recycling. SP-A has important roles in regulating surfactant metabolism as well as in determining surfactant's physical properties. Since systemic sepsis is one of the common causes of acute respiratory distress syndrome (ARDS) and abnormalities in surfactant function have been described in ARDS, the authors investigated the effects of endotoxemia on the accumulation of mRNA encoding SP-A and SP-A protein content. Methods : Adult rats were given various doses of intraperitoneal endotoxin from Salmonella enteritidis and sacrificed at different times. SP-A mRNA was measured by filter hybridization method. Lung SP-A protein content was determined by double sandwich ELISA assay using a polyclonal antiserum raised in rabbits against purified rat SP-A. Results : 1) The accumulation of SP-A mRNA in the endotoxin treated group 24 hours after 2mg/kg and 5mg/kg endotoxin treatments was significantly increased 50.9% and 27.3%, respectively, compared to the control group (P<0.001, P<0.025). 2) The accumulation of SP-A mRNA 24 hours in the 5mg/kg endotoxin treated group was significantly increased by 26.5% compared to the control group (P<0.01). 3) Total amount of lung SP-A was not altered at 24 hours by various doses of treatment. Total lung SP-A content 144 hours after endotoxin administration was significantly decreased by 51.4% compared to the control group (P<0.01). Conclusions : The specific regulation of SP-A by various time course in vivo is evident. The late decline in SP-A protein content was unexpected and suggests that SP-A may be differentially regulated during lung inflammation. The functional significance of these alterations remains to be clarified.

• Tuberculosis and Respiratory Diseases
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• v.49 no.6
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• pp.715-723
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• 2000

Background : Obstructive sleep apnea syndrome (OSAS) affects systemic blood pressure and cardiac function. The development of cardiovascular dysfunction including the changes of systemic blood pressure and cardiac rhythm, suggests that recurrent hypoxia and arousals from sleep may increase a sympathetic nervous system activity. Continuous positive airway pressure (CPAP) therapy has been found to be an effective treatment of OSAS. However, only a few studies have investigated the cardiovascular and sympathetic effects of CPAP therapy. We evaluated influences of nasal CPAP therapy on the cardiovascular system and the sympathetic activity in patients with OSAS. Methods : Thirteen patients with OSAS underwent CPAP therapy and were monitored using polysomnography, blood pressure, heart rate, presence of arrhythmia and the concentration of plasma catecholamines, before and with CPAP therapy. Results: The apnea-hypopnea index (AHI) was significant1y decreased (p<0.01) and the lowest arterial oxygen saturation level was elevated significantly after applying CPAP (p<0.01). Systolic blood pressure tended to decrease after CPAP but without statistical significance. Heart rates during sleep were not significantly different after CPAP. However, the frequency and number of types of arrhythmia decreased and sinus bradytachyarrhythmia disappeared after CPAP. Although there was no significant difference in the level of plasma epinephrine concentration, plasma norepinephrine concentration significantly decreased after CPAP (p<0.05). Conclusion : CPAP therapy decreased the apnea-hypopnea index, hypoxic episodes and plasma norepinephrine concentration. In addition, it decreased the incidence of arrhythmia and tended to decrease the systemic blood pressure. These results indicate that CPAP may play an important role in the prevention of cardiovascular complications in patients with OSAS.

• Tuberculosis and Respiratory Diseases
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• v.55 no.3
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• pp.257-266
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• 2003

Background : The surfactant protein A(SP-A) is important in the regulation of surfactant secretion, synthesis and recycling. Since the acute respiratory distress syndrome(ARDS) is usually viewed as the functional and morphological expression of a similar underlying lung injury casued by a variety of insults and since abnormalities in surfactant function have been described in ARDS, the authors investigated the different effects of endotoxin and thiourea on the accumulation of mRNA encoding SP-A. Methods : Sprague-Dawley rats were given 5 mg/kg intraperitoneal endotoxin from Salmonella enteritidis and 3.5 mg/kg intraperitoneal thiourea and sacrified at different time periods. Results : 1) SP-A mRNA was significantly increased 67.0% in 6 hours and 73.4% in 24 hours after 5 mg/kg endotoxin treatment respectively(P<0.005, P<0.005). 2) SP-A mRNA significantly decreased 32.9% in 24 hours after 3.5 mg/kg thiourea treatment(P<0.05). Conclusions : These results indicate that the differential regulation of surfactant protein A in vivo is evident and suggest that surfactant protein A might be differentially regulated during different kind of insults of lung injury at different time periods without altering lung wet to dry ratios.

• Journal of Dental Rehabilitation and Applied Science
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• v.28 no.4
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• pp.371-383
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• 2012

Shaping the root canal system to maintain original canal curvature is essential to clinical success in endodontic treatment. Opposed to most root canals that are curved, endodontic instruments are made from straight metal blanks. They have a tendency of straightening the root canal during preparation and frequently result in procedural errors. A new treatment method to maintain original canal curvature during shaping has been introduced for preventing procedural errors. The aim of this study was to compare the ability of instruments to maintain original canal curvature of continuous rotary system and single file system. Thirty ISO 15, 0.02 taper, Endo Training Blocks(Dentsplay Maillefer) were used. Specimens were assigned to 1 of 3 groups for shaping: specimens in group 1 were shaped with ProFile #20/.06 at the WL. Specimens in group 2 were shaped with Mtwo #35/.04 at the WL. Specimens in group 3 were shaped with WaveOne Primary reciprocating files at the WL after the glide path was achieved with PathFile. Pre- and postinstrumentation digital images were superimposed and processed with Matlab r2010b(The MathWorks Inc, Natick, MA) software to analyze the curvature-radius ratio(CRr), representing canal curvature modification. Data for comparison on the ability of instruments to maintain original canal curvature depending on each Ni-Ti file were analyzed with 1-way ANOVA(P<.05). Data for comparison on the ability of instruments to maintain original canal curvature depending on each Ni-Ti file system were analyzed with independent t-test(P<.05). A statistically significant difference(P<0.05) was noted on each Ni-Ti file. ProFile and WaveOne instrumentations maintained the original canal curvature significantly better(P<0.05) than Mtwo file. There were no significant difference(P>0.05) between continuous rotary system and single file system. Under the conditions of this study, ProFile and WaveOne instruments maintained the original curvature significantly better than Mtwo file and were less modification of the canal curvature compared. There was no significant difference between continuous rotary system and single file system in shaping of simulated canals. As clinical practitioners, it may be advantages to use hybrid approach when root canal shapes depending on the design and usage of Ni-Ti files.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.2
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• pp.209-222
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• 2011

Missing anterior teeth can be replaced using any of a number of methods. Patients may choose to replace missing teeth with a prosthesis that is either removable, fixed, or retained with implants. For patients faced with financial, anatomical, and/or esthetic limitations, the edentulous region can be restored successfully and esthetically with a properly designed and fabricated rotational path RPD. The rotational path RPD is a partial removable dental prosthesis that incorporates a curved, arcuate, or variable path of placement allowing one or more of the rigid components of the framework to gain access to and engage an undercut area. The rigid retainer must gain access to the infrabulge portion of the tooth by rotating into place. Either a minor connector or proximal plate provides retention through its intimate contact with a proximal tooth surface. A specially designed dovetails or asymmetric rest seats provides support and embracing effects. Correctly designed and fabricated rotational path RPD can provide improved esthetics, cleanliness, and retention. But rotational path RPDs are technique sensitive since the rotational path RPD has little margin of laboratory error that rigid retainers cannot be adjusted like conventional clasps can, RPD framework must be remade once the retention is lost. The sufficient understanding of the concept for the rotational path RPD is required for clinically successful treatment. This clinical report describes in detail the theoretical, laboratory considerations and the treatment of a patient with an anterior maxillary edentulous area treated by an AP path rotational RPD that had a difficulty in long term maintenance and describes another clinical case in which more reasonable treatment procedures were approached after analyzing the former case.

• Journal of Dental Rehabilitation and Applied Science
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• v.31 no.2
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• pp.75-85
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• 2015

Purpose: The purpose of this study is to evaluate which FRC-posts were more distinguishable from core. Materials and Methods: Nine extracted single-rooted mandibular premolars with similar lengths (${\pm}0.5 mm$) and widths (${\pm}0.5 mm$) were endodontically treated and obturated. One specimen which the three roots were embedded in a cold mounting resin was made. 3 specimens were made by this method. Post spaces were prepared for the following post system: FRC $Postec^{(R)}$ Plus, MACRO-$LOCK^{TM}$ POST $ILLUSION^{TM}$ $XRO^{(R)}$, $Snowpost^{(R)}$. After three different posts were placed in the roots of a specimen, each three specimens received a direct core build-up: $Luxacore^{(R)}$ Dual A3, $Luxacore^{(R)}$ Dual blue, $Filtek^{TM}$ Z350 A1E. Digital images were taken of the post and core with and without air-blowing. We asked to fifty dentists and fifty dental college students which post was more clearly discriminated from the core. Results: In surveys, when core was $Luxacore^{(R)}$ Dual blue, among three types of posts people more easily discriminated the $Snowpost^{(R)}$ from core. When core was $Luxacore^{(R)}$ Dual A3, among three types of posts people similarly more easily discriminated $Snowpost^{(R)}$ from core. When core was $Filtek^{TM}$ Z350 A1E, among three types of posts people more easily discriminated distinguished MACRO-$LOCK^{TM}$ POST $ILLUSION^{TM}$ $XRO^{(R)}$ post from core. People more easily distinguished MACRO-$LOCK^{TM}$ POST $ILLUSION^{TM}$ $XRO^{(R)}$ post from core when temperature was lowered by air-blowing. Conclusion: Ability to discriminate between FRC-post and core is different according to color contrast. MACRO-$LOCK^{TM}$ POST $ILLUSION^{TM}$ $XRO^{(R)}$ posts are more discriminable when temperature is lowered by air-blowing.