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Treatment Pattern of Patients with Neuropathic Pain in Korea (한국인 신경병성 동통 환자의 치료 양태 연구)

  • Han, Sung-Hee;Lee, Ki-Ho;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.34 no.2
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    • pp.197-205
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    • 2009
  • The purpose of this study was to investigate the treatment pattern of patients with neuropathic pain (NeP) in Korea through computerized database of Health Insurance Review and Assessment Service (HIRAS) over three years' period from 2003 to 2005. The results showed that the numbers of treatment visits were the highest for diabetic neuropathy (DN), followed by postherpetic neuralgia (PHN) and trigeminal neuralgia (TN) in order. Top 3 specialties for treatment visits due to NeP conditions were neurology, neurosurgery and anesthesiology. While cost of a treatment visit was higher in anesthesiology and emergency clinics compared to other clinics, there was a tendency to increase costs for visits to clinics of rehabilitation medicine and family medicine over the three years. Cost of dental visits was relatively high for TN, atypical facial pain (AFP) and atypical odontalgia (AO). Surgeries frequently applied to patients with NeP were sympathetic plexus or ganglion block, block of peripheral branch of spinal nerve and cranial nerve or its peripheral branch block. Most common prescribed medication were anticonvulsants, anti-inflammatory analgesics and anti-psychotic drugs while anti-inflammatory analgesics were overwhelmingly frequently prescribed for AO and glossodynia. Based on the results of this study, NeP disorders more relevant to dentists were AO, TN and AFP, TN of which seems to be the most important in terms of patients' number and cost for treatment visits. This indicates that dentists, especially oral medicine specialists should actively participate in management of TN, AO and AFP and share relevant information with patients and community.

A Study on Radiation Management Status and Exposure Anxiety Awareness of Dental Hygienist (치과위생사의 방사선 안전 관리 실태 및 피폭 불안감 인식)

  • Kang, Eun-Ju;Hyeong, Ju-Hee
    • Journal of dental hygiene science
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    • v.15 no.2
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    • pp.172-181
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    • 2015
  • This study intends to improve the radiation safety management and the recognition for handling radiation using structured questionnaires to dental hygienists working at Jeollabuk-do from September 1 to October 31 in 2014. As a result, 63% of respondents have not received education for radiation safety management. Moreover, the practical degree for radiation safety management was $2.58{\pm}1.11$, while the degree of knowledge was $3.74{\pm}0.83$ of total 5.0. The results of insecurity for radiation danger were high as $3.88{\pm}0.92$, and insecurity for fetus during pregnancy shows the highest value as $4.43{\pm}0.71$. From the results of statistical significance level, the knowledge degree of radiation safety management is affected by total numbers of radiograpy for a day (p<0.05), and the practical degree of radiation safety management is affected by age group, academic background, monthly income, continuous service year, practice area, present position, and status of radiography in present (p<0.05). In addition, the knowledge degree of radiation safety management have a negative correlation (r=-0.232) with the practical degree, but have a positive correlation (r=0.262) with the insecurity for radiation danger. The high knowledge degree of radiation safety management (${\beta}=0.252$, p<0.001) and the short radiography work period (${\beta}=-0.341$, p<0.05) were the influential factors to the insecurity for radiation danger. Consequently, countermeasures are necessary to encourage dental hygienists to put their radiation safety management knowledge into the practice and to reduce the insecurity degree for radiation danger. Furthermore, it is important to prevent psychological and physical risks by radiation exposure through the improvement of radiation safety management level and recognition for handling radiation to improve medical environment.

Domestic Disabled People's Use of Dental Service Institutes and Their Oral Health Related Quality of Life (재가 장애인의 구강진료기관 이용실태와 구강건강관련 삶의 질)

  • Lee, Hyun-Ok;Yang, Chun-Ho;Kim Jin;Kim, Young-Im
    • Journal of dental hygiene science
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    • v.9 no.5
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    • pp.593-600
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    • 2009
  • In this study, disabled people's life quality according to their use of dental healthcare services were examined, and the factors that influence their life quality were examined. The subjects in this study were 198 domestic disabled people in Jeollabuk-do, on whom a survey was conducted from May 1 to June 1, 2008. After the collected data were analyzed with SPSS WIN 12.0 program, the following findings were acquired: 1. 68.2% of the subjects had an experience of using dental service institutes. Over 80.0% of the physically disabled, the mentally handicapped, and the sensory-disturbance sufferers each used dental service institutes in their locations. Regarding the reason for visiting dental service institutes, 43.4% of the physically disabled visited for regular examination (the largest group for that reason), followed by the mentally handicapped with 37.9%. 43.5% of the sensory-disturbance sufferers visited for pain and fracture. 2. The subjects' life quality level relating to oral health was found to be an average 3.39 point score. There was a statistically significant difference in their life quality levels in terms of demographic features, such as age, religion, marriage/non-marriage, education, and subjective health status variables. Those experienced in using dental service institutes enjoyed higher levels of life quality (p=.011). And, with regard to disability characteristics, the degree of disability and the period of disability influenced the quality of life with a statistical significance. 3. Regarding variables influencing the life quality of subjects, in terms of general characteristic variables, subjective health status were influential variables, and in terms of characteristic variables relating to the use of dental clinics and disability, the experience of using dental service institutes influenced the quality of life. In conclusion, nationwide efforts to nurture separate dental personnels responsible for the disabled, to expand relevant facilities and to improve the health care insurance are required to promote the oral health of domestic disabled people's.

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Womans experience of Risk Situation on the High-Risk Pregnancy (여성의 고위험 임신에 대한 경험)

  • Kim, Kyung-Won;Lee, Kyung-Hye
    • Women's Health Nursing
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    • v.4 no.1
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    • pp.161-178
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    • 1998
  • In spite of the great progress of the theory and skill of the Nursing Care & Medical area in relation to pregnancy, nurses in clinics face up to many challenges in maternity nursing care areas. The reason is that the mobility and mortality of mothers was sharply decreased and the unknown high-risk diseases of pregnancy woman in the past is made public. That's why it is difficult to meet the pregnancy woman in natural process from pregnancy to delivery in recently. Admission rooms are filled with high-risk pregnancy women. As a matter of fact, we have done nursing care into the surface symptoms and diseases of high-risk pregnancy women so far. We have been indifferent to a long period hospitalization, separation from family, and conflict of repeated examination. Therefore, it is widely spread to understand the emotional conflict experienced by high-risk pregnancy women and to need for nursing intervention to bring up about emotional support and the ability of perception in psychological crisis. Although the pregnancy woman judged in high-risk should carry out normal task of pregnancy, she have to be confronted with secondary risk situation. The health of self & fetus threatened by the risk situation could be decreased through care plan, but psychological stress increases. Therefore, the pregnancy brings into non-control state. It is important to ask that what the hospitalized pregnancy women in high-risk think of themselves status. Because misunderstanding or serious anxiety of themselves status put into mother and fetus in danger. And adaptation mode makes all the difference. I would like to consider how nurses could deal with this high-risk circumstances in the position of pregnancy woman on the basis of the above fact. This study uses phenomenological method to suggest the basis material for nurses to do nursing intervention in view of pregnancy woman. Because this method understands the nature of true life of pregnancy woman throughly. The phenomenological method is the sources to describe or explain affluently the process generated in confirmation areas and environment and is the application for readers to understand and recognize clinic reality and then apply this method to reasoning study place or other places. Specifically, the phenomenon study method, one of the phenomenological method, is applied. The use of that method is to describe and generalize the experience in environment exactly. The study of this study is as follows : Among 187 descriptive stamens from 8 study participants are classified into 42 theme cluster at the stage of the first analysis. Those theme is categorized into 8 sub-subjects such as anxiety of uncertainty, foreknowledge about risk circumstance, will power about overcome, unsettled feeling about hospital, relief, optimistic thought, family support, and indifferences. At the last stage of analysis, those things are categorized into 3 subjects. When high-risk pregnancy woman foretell the situation, they feel unsettlement about uncertainty and untrust feeling about hospital. But they are ease with family support and hospital support. On the other hand, they express indifferent 3-way structure response to the situation having will of overcome and exceeding optimistic thought. In those statements, the experience by pregnancy woman shows 3 respect subjects. 1. They are anxious of this situation and are in desperation and don't recognize their role to be carried out 2. They think of this situation as normal process of pregnancy and are not concerned that this can give themselves and fetus fatal damage. 3. The pregnancy women will never confront this situation. This study shows the pregnancy woman has anxiety and optimistic relief about the situation, and ignores and optimistic relief about the situation, and ignores many things. Therefore, nurses in clinic should give pregnancy woman knowledge and information about the high-risk and help them to deal with the situation spontaneously. High-risk pregnancy woman should have the care plan in respect of the right perception. And the nurse know that their support help out pregnancy woman overcome the crisis in this respect of the special nursing intervention.

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A study of the cause of metal failure in treatment of femur shaft fracture - Fractographical and clinical analysis of metal failure- (대퇴골 간부 골절시 사용한 금속물의 금속부전(Metal failure)의 기전에 대한 연구)

  • Jeon, Chun-Bae;Seo, Jae-Sung;Ahn, Jong-Chul;Ahn, Myun-Whan;Ihn, Joo-Chyl
    • Journal of Yeungnam Medical Science
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    • v.7 no.1
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    • pp.81-93
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    • 1990
  • The author fractographically analyized the cause of metal failure(the first time this procedure has been used for this metal failure)and also analyized it clinically. In this study, I selected eight cases which have been analyized fractographically. In all these cases, the analysis was done after treatment of metal failure of implants internally fixed to femur shaft fractures at the Department of Orthopedic Surgery, Yeung-Nam University Hospital during the six year period from May 1983 to September 1989. 1. Metal failure occured in five dynamic-compression plates, one Jewett nail, one screw in Rowe plate, and one interlocking nail. 2. The clinical cause of metal failure was deficiency of medial butress in five cases, incorrect position of implant in one case, and incorrect selection of implant in two cases. 3. The time interval between internal fixation and metal failure was four months in one case, between five months to twelve months in six cases, three years in one case. 4. The fractographically analytical cause of metal failure was ; first, impact failure, one case, second, fatigue failure, six cases, machining mark(stress liser), four cases type : low consistent cyclic fatigue failure irregular cyclic fatigue failure third, stress corrosion crack, one case. 5. 316L Stainless Steel has good resistance to corrosion. However, when its peculiar surface film is destroyed by fretting, it shows pitting corrosion. This is, perhaps, the main cause of metal failure. 6. It is possible that mechanical injury occured in implants during the manufacturing of implants or that making a screw hole is the main cause of metal failure.

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An Analysis of 94 Percutaneous Renal Biopsies (경피적 신생검 94례에 대한 분석)

  • Kang, Ho-Jung;Lim, Sang-Woo;Do, Joo-Yeung;Yoon, Kyung-Woo
    • Journal of Yeungnam Medical Science
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    • v.12 no.1
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    • pp.84-95
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    • 1995
  • A clinical and histopathological study was performed on ninety-four patients with nephrotic syndrome (91 idiopathic and 3 secondary) who were admitted to Department of Internal Medicine, Yeungnam University Hospital during the period of nine years, from January 1985 to May 1994. The results were as following. 1. the ratio of male to female was 1.76:1. In young age group, minimal change was the most predominant type. In old age group, membranous glomerulonephritis and focal glomerulosclerosis were predominant types. 2. The primary nephrotic syndromes were 96.8% and secondary nephrotic syndromes were 3.2%. Histopathologic findings of 94 renal biopsy tissue were classified into minimal change (43.6%), mesangial proliferative glomerulonephritis (29.8%), membranous glomerulonephritis (12.8%), TypeI membranous proliferative glomerulonephritis (4.3%), focal glomerulosclerosis (3.2%) and others (6.4%). 3. The response of eighty-six patients treated with steroid showed complete remission in 51.2%, partial remission in 20.9%, steroid dependent in 2.3%, and no effect in 25.6% of cases respectively. The response to steroid therapy was most effective in the patients with minimal change lesion. 4. In the patient with membranous proliferative glomerulonephlitis, long-term angiotensin converting enzyme inhibitor treatment showed less deterioration of renal function.

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Treat-to-Target Strategy for Asian Patients with Early Rheumatoid Arthritis: Result of a Multicenter Trial in Korea

  • Song, Jason Jungsik;Song, Yeong Wook;Bae, Sang Cheol;Cha, Hoon-Suk;Choe, Jung-Yoon;Choi, Sung Jae;Kim, Hyun Ah;Kim, Jinseok;Kim, Sung-Soo;Lee, Choong-Ki;Lee, Jisoo;Lee, Sang-Heon;Lee, Shin-Seok;Lee, Soo-Kon;Lee, Sung Won;Park, Sung-Hwan;Park, Won;Shim, Seung Cheol;Suh, Chang-Hee;Yoo, Bin;Yoo, Dae-Hyun;Yoo, Wan-Hee
    • Journal of Korean Medical Science
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    • v.33 no.52
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    • pp.346.1-346.11
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    • 2018
  • Background: To evaluate the therapeutic benefits of the treat-to-target (T2T) strategy for Asian patients with early rheumatoid arthritis (RA) in Korea. Methods: In a 1-year, multicenter, open-label strategy trial, 346 patients with early RA were recruited from 20 institutions across Korea and stratified into 2 groups, depending on whether they were recruited by rheumatologists who have adopted the T2T strategy (T2T group) or by rheumatologists who provided usual care (non-T2T group). Data regarding demographics, rheumatoid factor titer, anti-cyclic citrullinated peptide antibody titer, disease activity score of 28 joints (DAS28), and Korean Health Assessment Questionnaire (KHAQ) score were obtained at baseline and after 1 year of treatment. In the T2T group, the prescription for disease-modifying antirheumatic drugs was tailored to the predefined treatment target in each patient, namely remission (DAS28 < 2.6) or low disease activity (LDA) ($2.6{\leq}DAS28$ < 3.2). Results: Data were available for 163 T2T patients and 162 non-T2T patients. At the end of the study period, clinical outcomes were better in the T2T group than in the non-T2T group (LDA or remission, 59.5% vs. 35.8%; P < 0.001; remission, 43.6% vs. 19.8%; P < 0.001). Compared with non-T2T, T2T was also associated with higher rate of good European League Against Rheumatism response (63.0% vs. 39.8%; P < 0.001), improved KHAQ scores (-0.38 vs. -0.13; P = 0.008), and higher frequency of follow-up visits (5.0 vs. 2.0 visits/year; P < 0.001). Conclusion: In Asian patients with early RA, T2T improves disease activity and physical function. Setting a pre-defined treatment target in terms of DAS28 is recommended.

Long-term Outcomes of Conjunctivo-limbal Autograft Alone and Additional Widening of Limbal Incision in Recurrent Pterygia (군날개 재발에 있어서 자가윤부결막이식술 단독 및 추가 윤부절개술의 장기 결과)

  • Chung, In Kwon;Kim, Jin Hyoung;Lee, Jong Hyun;Lee, Do Hyung
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.12
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    • pp.1114-1121
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    • 2018
  • Purpose: We report the clinical outcomes of patients undergoing additional widening of the limbal incision to prevent disease recurrence after conjunctivo-limbal autograft combined with pterygial excision. Methods: We retrospectively compared 95 eyes with primary and 12 eyes with recurrent pterygia randomized to treatment via two surgical methods: conjunctivo-limbal autograft alone and combined with widening of the limbal incision to allow for pterygial removal. We widened the limbal incisions by 1 mm on both the superior and inferior limbal margins and removed the pterygia. The outcomes were compared between 39 eyes undergoing conjunctivo-limbal autograft alone and 68 eyes undergoing conjunctivo-limbal autograft with widening of the limbal incision. Results: The mean overall postoperative follow-up period was $29.6{\pm}10.5months$ and conjunctivo-limbal autograft alone group was $27.4{\pm}11.5months$, combined with widening of the limbal incision group was $30.7{\pm}9.7months$. Six pterygia (15.4%; four primary and two recurrent) developed in those undergoing conjunctivo-limbal autograft alone and two (2.9%; one primary and one recurrent) in those undergoing additional widening of the limbal incision; the recurrence rate differed significantly between the two groups (p < 0.05). In the group treated with conjunctivo-limbal autograft alone, the mean time to development of a new primary pterygium was $6.3{\pm}3.4months$ and that to development of a recurrent pterygium $4.3{\pm}2.5months$; the respective values for the group undergoing additional widening of the limbal incision were $12.1{\pm}2.6$ and $8.4{\pm}4.6months$; the recurrence rates differed significantly (p < 0.05). Conclusions: Conjunctivo-limbal autograft with additional widening of the limbal incision used to treat both new primary and recurrent pterygia was more effective in terms of reducing pterygial recurrence than conjunctivo-limbal aAutograft alone.

Impact of Weather on Prevalence of Febrile Seizures in Children (소아의 열성경련에 날씨가 미치는 영향)

  • Woo, Jung Hee;Oh, Seok Bin;Yim, Chung Hyuk;Byeon, Jung Hye;Eun, Baik-Lin
    • Journal of the Korean Child Neurology Society
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    • v.26 no.4
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    • pp.227-232
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    • 2018
  • Purpose: Febrile seizure (FS) is the most common type of seizure in children between 6 months to 5 years of age. A family history of febrile seizures can increase the risk a child will have a FS. Yet, prevalence of FS regarding external environment has not been clearly proved. This study attempts to determine the association between prevalence of FS and weather. Methods: This study included medical records from the Korea National Health Insurance Review and Assessment Service. Data were collected from 29,240 children, born after 2004, diagnosed with FS who were admitted to one of the hospitals in Seoul, Korea, between January 2009 and December 2013. During the corresponding time period, data from the Korea Meteorological Administration on daily monitoring of four meteorological factors (sea-level pressure, amount of precipitation, humidity and temperature) were collected. The relationships of FS prevalence and each meteorological factor will be designed using Poisson generalized additive model (GAM). Also, the contributory effect of viral infections on FS prevalence and weather will be discussed. Results: The amount of precipitation was divided into two groups for comparison: one with less than 5 mm and the other with equal to or more than 5 mm. As a result of Poisson GAM, higher prevalence of FS showed a correlation with smaller amount of precipitation. Smoothing function was used to classify the relationships between three variables (sea-level pressure, humidity, and temperature) and prevalence of FS. FS prevalence was correlated with lower sea-level pressure and lower humidity. FS prevalence was high in two temperature ranges (-7 to $-1^{\circ}C$ and $18-21^{\circ}C$). Conclusion: Low sea-level pressure, small amount of precipitation, and low relative air humidity may increase FS prevalence risk.

Synthesis of Ultrasound Contrast Agent: Characteristics and Size Distribution Analysis (초음파 조영제의 합성 및 합성된 초음파 조영제의 특성 분석)

  • Lee, Hak Jong;Yoon, Tae Jong;Yoon, Young Il
    • Ultrasonography
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    • v.32 no.1
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    • pp.59-65
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    • 2013
  • Purpose: The purpose of this study is to establish the methodology regarding synthesis of ultrasound contrast agent imaging, and to evaluate the characteristics of the synthesized ultrasound contrast agents, including size or degradation interval and image quality. Materials and Methods: The ultrasound contrast agent, composed of liposome and SF6, was synthesized from the mixture solution of $21{\mu}mol$ DPPC (1, 2-Dihexadecanoyl-sn-glycero-3-phosphocholine, $C_{40}H_{80}NO_8P$), $9{\mu}mol$ cholesterol, $1.9{\mu}mol$ of DCP (Dihexadecylphosphate, $[CH_3(CH_2)_{15}O]_2P(O)OH$), and chloroform. After evaporation in a warm water bath and drying during a period of 12-24 hours, the contrast agent was synthesized by the sonication process by addition of buffer and SF6 gas. The size of the contrast agent was controlled by use of either extruder or sonication methods. After synthesis of contrast agents, analysis of the size distribution of the bubbles was performed using dynamic light scattering measurement methods. The degradation curve was also evaluated by changes in the number of contrast agents via light microscopy immediate, 12 hours, 24 hours, 36 hours, 48 hours, 60 hours, 72 hours, and 84 hours after synthesis. For evaluation of the role as an US contrast agent, the echogenicity of the synthesized microbubble was compared with commercially available microbubbles (SonoVue, Bracco, Milan, Italy) using a clinical ultrasound machine and phantom. Results: The contrast agents were synthesized successfully using an evaporation-drying-sonication method. The majority of bubbles showed a mean size of 154.2 nanometers, and they showed marked degradation 24 hours after synthesis. ANOVA test revealed a significant difference among SonoVue, synthesized contrast agent, and saline (p < 0.001). Although no significant difference was observed between SonoVue and the synthesized contrast agent, difference in echogenicity was observed between synthesized contrast agent and saline (p < 0.01). Conclusion: We could synthesize ultrasound contrast agents using an evaporation-drying-sonication method. On the basis of these results, many prospective types of research, such as anticancer drug delivery, gene delivery, including siRNA or microRNA, targeted molecular imaging, and targeted therapy can be performed.