• 제목/요약/키워드: Primary dental care system

검색결과 18건 처리시간 0.02초

이염성 백질 이영양증 환아의 치아우식 치료 증례 보고 (DENTAL TREATMENT IN A PATIENT WITH METACHROMATIC LEUKODYSTROPHY UNDER GENERAL ANESTHESIA : A CASE REPORT)

  • 류지연;신터전;현홍근;김영재;김정욱;장기택;김종철;이상훈
    • 대한장애인치과학회지
    • /
    • 제12권2호
    • /
    • pp.96-100
    • /
    • 2016
  • 저자는 후기 영아형 이염성 백질 이영양증으로 인해 신경학적인 퇴행이 관찰되고 섭식 장애로 인한 다발성 우식을 보이는 환아를 전신마취 하 치료하였기에 문헌 고찰과 함께 보고하는 바이다. 저작기능 장애로 인한 영양 결핍으로 환아는 신체 발육이 매우 저하되었으며 긴 식사 시간으로 다발성 치아 우식에 이환된 상태였다. 협조도 부족 및 치료 범위 등을 고려하여 전신마취 하에 치과 치료를 시행하였고 정기적인 검진을 시행 중이다. 진행성, 신경성 퇴행질환의 특징을 이해하고 환아의 상태를 고려한 구강 건강 관리 및 보호자 교육을 제공하는 것이 필요할 것으로 사료된다.

색소실조증 환자의 치과적 특성 : 증례보고 (DENTAL CHARACTERISTICS OF A PATIENT WITH INCONTINENTIA PIGMENTI : A CASE REPORT)

  • 송지혜;이고은;송제선;이제호;최형준
    • 대한장애인치과학회지
    • /
    • 제14권2호
    • /
    • pp.88-91
    • /
    • 2018
  • 본 증례는 유전적 피부질환의 하나로 피부의 착색과 망막의 이상 그리고 다수의 유치 및 영구치 결손과 치아의 형태 이상을 나타내는 색소실조증 환자에 대한 보고이다. 현재 환자는 큰 불편감 없이 유치를 유지하고 있으며 향후 영구치열기까지 정기적인 관찰과 관리가 필요하며, 영구치열 완성 후 영구적인 보철적 수복이 필요할 것으로 사료된다.

아동 치과주치의 프로그램의 필요도와 치과위생사의 역할 (Essential services in children's family dentistry program and the role of dental hygienists)

  • Seung-Hun Lee
    • 한국치위생학회지
    • /
    • 제23권6호
    • /
    • pp.431-439
    • /
    • 2023
  • 연구목적: 연구자는 아동 치과 주치의 프로그램에서 필수 서비스와 중요도, 검진 주기, 치과위생사의 역할을 알아보고자 한다. 연구방법: 최종연구대상자는 치과위생사, 치과의사, 치위생과 학생으로 총 124명이고, 자기기입식 설문지를 작성했다. 수집된 자료는 독립 t-검정, ANOVA로 일반적인 특징에 따라 그 차이를 비교했고, 이들의 관계는 Pearson 상관관계분석으로 분석했다. 연구결과: 검진 대상자에게 구강 검사와 방사선사진 촬영 등은 꼭 필요한 검사항목이고, 칫솔질과 구강용품 사용, 정기 검진의 중요성을 교육해야 하며, 대구치 실런트와 치면세마와 같은 예방 처치를 제공해야 한다고 생각했다. 또한 치료 서비스에서는 광중합형 레진과 GI 충전이 필요하다고 응답했다. 검진 주기를 치료보다는 교육과 예방을 더 짧게 해야 한다고 생각했다. 치위생과 학생이 치과의사와 치과위생사보다 검진, 교육, 예방, 치료 서비스가 더 중요하다고 응답했다. 구강검진과 교육 및 치료 간의 상관관계가 높았고, 필수 서비스와 중요성도 정(+)의 상관관계를 가졌다. 결론: 필수적이고 중요하다고 생각하는 구강 검사, 교육, 예방, 치료 서비스를 치과주치의 프로그램으로 어린이에게 제공해야 한다. 구강보건 교육과 예방관리는 치료보다 더 자주 제공되어야 하고, 그 중요성을 치위생과 학생뿐만 아니라 서비스의 주체인 치과위생사와 치과의사에게도 강조할 필요가 있다.

농촌(農村) 주민(住民)들의 의료필요도(醫療必要度)에 관(關)한 연구(硏究) (A Study Concerning Health Needs in Rural Korea)

  • 이성관;김두희;정종학;정극수;박상빈;최정헌;홍순호;라진훈
    • Journal of Preventive Medicine and Public Health
    • /
    • 제7권1호
    • /
    • pp.29-94
    • /
    • 1974
  • Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.

  • PDF

상악 유중절치 재근관 치료에서 차아염소산나트륨의 합병증에 대한 증례 보고 (COMPLICATIONS OF SODIUM HYPOCHLORITE DURING RE-ENDODONTIC TREATMENT OF MAXILLARY PRIMARY CENTRAL INCISOR : A CASE REPORT)

  • 홍소이;김진우;김지연;마연주;안병덕
    • 대한소아치과학회지
    • /
    • 제39권2호
    • /
    • pp.186-191
    • /
    • 2012
  • 차아염소산나트륨은 근관 세척 시 널리 쓰이는 약제이다. 근관계의 멸균에는 효과적이나, 부작용에 대해서는 알려진 바가 많지 않으며 특히 유치에서 근관세척제로 사용 시 부작용에 대한 보고는 거의 없었다. 본 증례는 차아염소산나트륨이 유치의 치근단을 통과하였을 때 심각한 부작용을 일으킬 수 있음을 보여준다. 만 4세 여아가 치과의원에서 차아염소산나트륨을 이용한 상악 유중절치의 재근관 치료 중 급격한 안면 부종과 통증으로 본원 응급실로 의뢰되었다. 전신적 스테로이드제, 항히스타민제, 항생제 및 진통제를 투여하고, 해당 치아는 2차 감염 예방을 위해 발거하였다. 2일 후 부종이 감소하기 시작하였다. 차아염소산나트륨에 대한 알레르기 반응 검사 결과 음성을 나타내었다. 유치의 근관 세척 시에는 차아염소산나트륨이 치주조직으로 압출되지 않도록 철저히 주의해야 하며, 부작용이 일어날 경우 통증 및 부종 완화와 약물 치료가 필요하다.

Regulator of G-Protein Signaling 4 (RGS4) Controls Morphine Reward by Glutamate Receptor Activation in the Nucleus Accumbens of Mouse Brain

  • Kim, Juhwan;Lee, Sueun;Kang, Sohi;Jeon, Tae-Il;Kang, Man-Jong;Lee, Tae-Hoon;Kim, Yong Sik;Kim, Key-Sun;Im, Heh-In;Moon, Changjong
    • Molecules and Cells
    • /
    • 제41권5호
    • /
    • pp.454-464
    • /
    • 2018
  • Crosstalk between G-protein signaling and glutamatergic transmission within the brain reward circuits is critical for long-term emotional effects (depression and anxiety), cravings, and negative withdrawal symptoms associated with opioid addiction. A previous study showed that Regulator of G-protein signaling 4 (RGS4) may be implicated in opiate action in the nucleus accumbens (NAc). However, the mechanism of the NAc-specific RGS4 actions that induce the behavioral responses to opiates remains largely unknown. The present study used a short hairpin RNA (shRNA)-mediated knock-down of RGS4 in the NAc of the mouse brain to investigate the relationship between the activation of ionotropic glutamate receptors and RGS4 in the NAc during morphine reward. Additionally, the shRNA-mediated RGS4 knock-down was implemented in NAc/striatal primary-cultured neurons to investigate the role that striatal neurons have in the morphine-induced activation of ionotropic glutamate receptors. The results of this study show that the NAc-specific knock-down of RGS4 significantly increased the behaviors associated with morphine and did so by phosphorylation of the GluR1 (Ser831) and NR2A (Tyr1325) glutamate receptors in the NAc. Furthermore, the knock-down of RGS4 enhanced the phosphorylation of the GluR1 and NR2A glutamate receptors in the primary NAc/striatal neurons during spontaneous morphine withdrawal. These findings show a novel molecular mechanism of RGS4 in glutamatergic transmission that underlies the negative symptoms associated with morphine administration.

중학교 체질검사 실태에 관한 연구 (A study on physical examination of middle school students)

  • 박성희
    • 한국학교보건학회지
    • /
    • 제14권1호
    • /
    • pp.131-143
    • /
    • 2001
  • The primary aim of this dissertation is to contribute to the improvement of methods in physical examination by providing quality information for the current school system and advice for improving status. Present status, controversial points and possible remedies in physical examination were analyzed on a frequency and percentage basis. An $x^2$-test was used to verify the statistics between the results from the examination and each variable. In case of multiple categories of variables, an $x^2$ cs was adopted. Chronological data as well as both total and sampling physical examination data verified the statistics using an $x^2$-test. This thesis is based both on the data from middle school health care specialists in Gyunggi Province and on the analysis of physical examinations reported from local schools to the municipal education agency from 1997 to 1999. The results of the study are as follows: First, according to the survey, only 29.0% of the total schools had their school doctors examine all the students while most of the educational institutions failed to implement the whole process of physical examination on the list. It also turned out that the more students the schools have, the lower the rate of implementation of physical examination by school doctors(p=0.014). Second, the average time a school doctor spends for checkup turned out to be approximately 1.7 minutes per student This means that the quality of the physical examination is not guaranteed in the process. Third, 47.7% of those surveryed say that a dental examination was performed, each taking 21.24 seconds on average. In addition, it shows that some 31.5% wanted to have a task force team for dental checkups at the local health center. Given the fact that dental caries among students is progressively on the rise, the dental health centers that are now set up in some elementary schools should be expanded to cover the whole educational institution in order to raise awareness of the importance of dental care. Fourth, 48.5% of those surveyed say that a comprehensive physical examination should be adopted to promote the health of high schoolers. Since it takes a lot of public funds to implement a comprehensive method, it is essential to make sure that in-depth studies should be based on the frequency and methods of physical examination. Fifth, regarding such diseases among 3rd year middle school students in 1999, statistics shows that there was a slight difference in the prevalence rate of color blindness, and allergic diseases for male students ; and color blindness, hearing disturbance and allergic disease for female students. For those items, however, it is too little to say that there is a significant difference and accordingly it is assumed to be a problem of the measuring process. Sixth, the result of analysis on the sample physical examination and the total physical examination of the year 1999 shows as follows: For male students in the 3rd year of middle school, a slight difference appeared to those students in 11 items including eye problems and eye disease, otitis media, tonsillar hypertrophy, spinal shape, respiratory urinary allergic disease and other abnormal diseases(p<0.05). Particularly, the prevalence rate between students with and without disease was shown to be two times more in the following: eye problems, otitis media, tonsill hypertrophy, allergic diseases, etc. For female students in the 3rd year, prevalence rate showed little difference in 14 items(p<0.05). For items including eye problem, otitis media, tonsill hypertrophy, allergic disease, etc. it was shown that the rate was two times more between students with and without diseases. Physical examinations under the current school system are not producing any fundamental results for the health of the students. Methods and results are not trustworthy. Accordingly, a drastic overhaul of the current practices is needed in frequency, methods and items on the list in order to promote the health of the students. Cost-benefit studies as well as political considerations to ensure the development of efficient methods for physical examination are urgently needed at this moment.

  • PDF

정신요양시설 거주인의 건강 실태 및 정책 대안 (Health Condition of Residents of Mental Health Sanatoriums and Policy Options)

  • 조한진;이승홍
    • 대한통합의학회지
    • /
    • 제10권2호
    • /
    • pp.49-59
    • /
    • 2022
  • Purpose : The purpose of this study is to directly understand the health condition of residents of mental health sanatoriums nationwide, which has been difficult to ascertain in surveys conducted to date. The study presents specific measures for improving the health of these residents. Methods : A "physical examination questionnaire for residents of mental health sanatoriums" was developed to check the basic physical condition of residents, and 20 out of 59 mental health sanatoriums nationwide were randomly selected. Medical personnel visited the sanatoriums, interviewing and examining the residents in person. A total of 396 health surveys were completed. Results : Many of the residents were underweight but had abdominal obesity. It was confirmed that chronic diseases among the residents were not diagnosed early or were not properly managed. Among the subjective symptoms complained of by the residents, musculoskeletal symptoms were the most common. Oral examinations revealed a serious level of oral health problems among the residents, including dental caries and missing teeth. Basic physical examinations found health problems that required additional examination or medical treatment. Blood pressure abnormalities made up the highest percentage of the health problems. Conclusion : Regular health surveys are needed to determine the health condition of residents of mental health sanatoriums. Access to and quality of primary medical services within the sanatoriums need to be dramatically improved. A delivery system for severe diseases and emergency medical care in the sanatoriums should also be specifically presented. The residents should be notified upon admission and during their stay that they have the right to the enjoyment of the highest attainable standard of mental and physical health. The issue of health rights should be addressed within a larger framework of reorganizing management plans for people in the community - not only residents - with chronic mental illness.