• 대한치과보철학회지
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• 제37권5호
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• pp.698-713
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• 1999

Adherence of Candida albicans(C. albicans) to the surface of a denture is believed to be an initial and essential step in the formation of denture-induced stematitis. Previous studies have provided enormous infomation on the relationship between composition of palatine gland/parotid saliva and upper denture stomatitis. Relatively little information is available on the correlation between lower denture stomatitis and sublingual-submandibular ( SLSM ) saliva. The plaque samples were collected from the two sites($100mm^2$) on the inner surface of lower partial denture corresponding to the stematitis and healthy region of the lower partial dentures of 12 denture stomatitis patients and 6 nor-mal persons who wore lower partial dentures. The samples were plated to isolate C. albicans on a selective Saboraud's dextrose agar plate and the isolates were identified by germ tube test and gram staining. The subjects were divided into group I (stomatitis with C. albican), group II (lesion without C. albicans), group III (no lesion but C. albicans), and group IV (normal and healthy denture wearer). Individual SLSM saliva($20{\mu}g$ of protein) was analyzed by SDS-PAGE (SDS -poly-acrylamide gel electrophoresis) with Coomassie brilliant blue and PAS(Periodic Acid Schinff) stain-ing. The salivary proteins separated in the polyacryamide gels were subjected to immunoblot anaysis using anti-lactoferrin, anti-sIgA, and anti-secretory component of sIgA. In this study using custom made acrylic denture resin beads(5mm in diameter) coated with stimulated individual SLSM saliva, the binding ability of individual C. albicans strains to the beads was observed. Levels of C, albicans adhered to the acrylic resin beads were determined by measuring the optical density of the bound C. albicans to the beads at 580nm. The results showed that a higher number of C. albicans was observed in the lesion site than healthy site. The saliva of group I contained more high molecular weight glycoprotein(mucin, MGI) as compared to group II, III and IV. And lactoferrin and sIgA affected to the binding ability of C. albicans to acylic resin beads. Binding ability of individual C. albicans to the acrylic resin coated with respective individual saliva was found to be greater in group I than the other 3 groups. And when bound cells of C. albicans isolated from individual subject #2 to the saliva coated beads were used binding ability of subject #2 saliva coated beads was founed to be greater than the other sutjects. These results suggested that denture induced stomatitis is related to individual patient's salivary protein composition, especially MG-1. Future studies will be directed toward saliva exam-ination of patients who have general disease and analysis of pellicles formed on prosthesis with respect to oral disease.

• Journal of Chest Surgery
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• 제38권11호
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• pp.746-760
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• 2005

배경: 인공심장판막 시술 후에 환자들은 혈전색전증의 위험성을 감소시키기 위해서 평생 warfarin투여를 받게 된다 한국인 환자에서 목표 INR 2.0-3.0을 유지하는 것은 여러 가지 이유로 어려움이 따른다. 이 연구의 목적은 약사에 의해서 운영되는 anticoagulation service (ACS)을 받는 한국 인공심장판막 외래환자에서 치료 범위를 벗어난 INR의 원인을 분석하고 warfarin치료에의 복약불이행과 관련된 요인들을 확인하고자 하였다. 대상 및 방법: 1997년 3월에서 2000년 9월까지 서울대학교병원에서 ACS를 방문한 모든 환자의 의무기록을 후향적으로 검토하였다. 수술 후 6개월이 경과된 화자로 INR 2.0 미만과 INR 3.0초과가 한 번 이상 있는 환자 866명(5,304회 방문)을 대상으로 치료 범위를 벗어난 INR의 가능한 모든 원인들을 환자 방문 때마다 분석하였다 성별, 연령, ACS 상담을 받은 기간 및 warfarin 치료 기간과 복약불이행과의 상관성은 단변수 분석으로 확인하였다. 걸과· 비치료범위의 INR의 원인은 다음과 같았다: 부적절한 용량 조절$(21\%)$, 복약불이행$(13\%)$, 약물-약물/한약 상호작용$(12\%)$, 식이의 변화$(7\%)$, 확인불가$(42\%)$. 낮은 연령, 짧은 ACS 상담 기간, 장기간의 warfarin 치료가 복약불이행과 관련이 있었다 결론: 이 연구에서 복약불이행, 약물과 식이의 상호작용이 비치료범위의 INR의 중요한 요인임이 확인되었다. 낮은 연령과 장기간의 warfarin치료 기간이 복약불이행과 상관이 있었던 반면 ACS 등록된 기간이 길수록 warf arin에 대한 치료 순응도가 높아졌다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권10호
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• pp.5867-5870
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• 2013

Background: Cervical cancer is the second most common cancer among Malaysian women with an ASR of 17.9 and a mortality rate of 5.6 per 100,000 population in 2008 (GLOBOCAN, 2008). The 5 year prevalence was estimated to be 14.5 per 100,000 population. As the second most common cancer affecting productive females, cervical cancer imposes an impact to the socioeconomic aspect of the country. However, the poor uptake of cervical cancer screening is a major problem in detecting early pre-cancerous lesions and thus, delay in initiating treatment for cervical cancer. Realizing the urgency to increase the uptake of PAP smear, besides enhancing the promotion of PAP smear screening for women above 35 years old, the call-recall system for pap smear screening had been piloted in one of the suburban districts which aimed to improve regular participation of women for cervical and breast cancer screening. This is of public health importance as identifying the best feasible option to increase patient's respond to participate in the screening program effectively in our setting will be helpful in implementing an organized regular population based screening program tailored to our setting. The pilot program of cervical cancer screening in Klang was an opportunity to assess different options in recalling patients for a repeat pap smear to increase their participation and adherence to the program. Methods and Results: This was a population based randomized control trial. Women aged 20-65 years in the population that matched the inclusion and exclusion criteria were re-called for a repeat smear. There are four different intervention groups; letter, registered letters, short messages services (SMS) and phone calls where 250 subjects were recruited into each group. Samples were generated randomly from the same population in Klang into four different groups. The first group received a recall letter for a repeat smear similar to the one that has been given during the first invitation. The intervention groups were either be given a registered letter, an SMS or a phone call to re-call them. The socio-demographic data of the patients who came for uptake were collected for further analysis. All the groups were followed up after 8 weeks to assess their compliance to the recall. Conclusions: The study will provide recommendations about the most effective methods for recall in a population based pap smear screening program on two outcomes: i) patients response; ii) uptake for repeat pap smear.

• 대한간호학회지
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• 제17권3호
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• pp.204-217
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• 1987

It is generally accepted that the delivery of health care is undergoing many changes specially those related to acute, contagious disease care and to the increase of chronic illnesses which can not be cured but are controlable. The health care practitioner can not be soley responsible for the control of their clients' care. Because the clients will play a vital role in controlling their illnesses, long term participation by both the health care provider and the client is necessary. Since most individuals with hypertension do not experience signs or symptoms, the disease is difficult to detect and even when diagnosed, clients do not comply well with their hypertension regimens. The noncompliant client is at increased risk for compliants involving the heart, brain, kidney and other organs. In an effort to explore methods of increasing patient participation in and adherence to treatment programs for hypertension, the researcher used health contracting to promote self care. The research questions are; 1) Will the health contracting increase compliance in health behavior and reduce the blood pressure\ulcorner 2) If clients comply with their regimens will this reduce their blood pressure\ulcorner The research design utilized in this study was a quasi-experimental design. A purposive sample, was abtained from two churches in the 1. area, consisting of 64 clients with hypertension. The data was collected from the middle of January to the 1st of September 1985. Randomization was only of the two church groups into experimental and control groups. Compliance with health behavior related to the hypertensive regimen, blood pressure and body weight were measured, compared and analyzed. In the experimental group measurements were made 6 times; one month before the education program after education program when health contracting was done and 4 more times once a month for 4 months. In the control group measurements were made 3 times; one month before the education program after the education program, and once 4 months later. There was no health contracting. The data were analyzed by t-test, Pearson correlation and ANOVA according to purpose of the study. The result of this study may be summarized as follows: The result related to the hypothesis on the effect of health contracting are as follows: H$_1$; “The hypothesis that the experimental group, with a health contractual agreement will demonstrate increased compliance levels for health behavior than the control group” was supported(t＝-5.29, df＝62, p＝.000). H$_2$; “The hypothesis that the experimental group, with a health contractual agreement, will demonstrate a greater reduction in blood pressure than the control group” was supported (for systolic blood pressure t＝2.72, df＝62, p＝.009, for diastolic blood pressure t＝1.95, df＝62, p＝.050). H$_3$; The hypothesis that the greater the compliance of the client with health behavior the lower the client's blood pressure will be was partially supported (for systolic pressure r＝-.2981, p＝.008, for diastolic pressure r＝-.1720, p＝.087). From the examination of the results of this study it can be concluded that the interaction between the nurse and the client, contracting to define goals and reinforcing compliant behavior, leads to improved compliance with health care behaviors and thus to an increase in the effectiveness of nursing care. Further consideration need to be given to the inclusion of the concept of health contracting in primary nursing and to further research in this area.

• 대한임상검사과학회지
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• 제55권3호
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• pp.143-150
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• 2023

2019년 12월에 발생한 COVID-19는 세계적으로 대유행하였고, 이로 인해 폐기능검사실의 안전한 감염관리가 절실히 요구되었다. 그러나 국내 유관 기관에서 제공하는 지침과 규제는 이 심각한 공중보건 위기에 대응하기에는 부족한 실정이었다. 이에 본 연구에서는 2021년 10월 1일부터 2021년 11월 2일까지 국내 2차 이상 의료기관 51개를 대상으로 감염관리 기본규정, 일회용품 사용, 환기 시설, 공간 분리, 출입문의 형태 등에 대해 조사하였다. 그 결과, 공기 주의, 비말 주의, 접촉 주의를 위한 인식과 보호용구착용은 상당 부분 적절히 이루어지고 있었으나, 1인 검사 후 환경소독을 항상 시행하는 기관이 39.22%로 낮은 수준으로 조사되었다. 또한, 일회용품 사용(81.05%), 환기 시설(45.75%), 검사 전용 공간(80.39%), 사무 공간 분리(15.69%), 자동문 설치(19.61%)의 경우 조사 항목에 따라 큰 차이가 있는 것으로 나타났다. 본 연구는 국내 폐기능검사실의 감염관리의 일반적 사항과 시설의 실태조사를 통해 폐기능검사실의 감염관리의 중요성을 재고하고, 국내 의료기관의 감염병 위기 대응을 위한 후속 연구에 기초 정보를 제공함으로써, 폐기능검사실의 감염관리 표준 지침서 개발 및 개선에 기여할 것으로 판단된다.