• Journal of Korean Academic Society of Home Health Care Nursing
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• v.3
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• pp.53-66
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• 1996

Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.

• Journal of Dental Rehabilitation and Applied Science
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• v.23 no.3
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• pp.249-257
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• 2007

State of problem : The use of zirconium oxide all-ceramic material provides several advantages, including a high flexural strength(>1000MPa) and desirable optical properties, such as shading adaptation to the basic shades and a reduction in the layer thickness. Along with the strength of the materials, the cementation technique is also important to the clinical success of a restoration. Nevertheless, little information is available on the effect of different surface treatments on the bonding of zirconium high-crystalline ceramics and resin luting agents. Purpose : The aim of this study was to test the effects of surface treatments of zirconium on shear bond strengths between bovine teeth and a zirconia ceramic and evaluate differences among cements Material and methods : 54 sound bovine teeth extracted within a 1 months, were used. They were frozen in distilled water. These were rinsed by tap water to confirm that no granulation tissues have left. These were kept refrigerated at $4^{\circ}C$ until tested. Each tooth was placed horizontally at a plastic cylinder (diameter 20mm), and embedded in epoxy resin. Teeth were sectioned with diamond burs to expose dentin and grinded with #600 silicon carbide paper. To make sure there was no enamel left, each was observed under an optical microscope. 54 prefabricated zirconium oxide ceramic copings(Lava, 3M ESPE, USA) were assigned into 3 groups ; control, airborne-abraded with $110{\mu}m$ $Al_2O_3$ and scratched with diamond burs at 4 directions. They were cemented with a seating force of 10 ㎏ per tooth, using resin luting cement(Panavia $F^{(R)}$), resin cement(Superbond $C&B^{(R)}$), and resin modified GI cement(Rely X $Luting^{(R)}$). Those were thermocycled at $5^{\circ}C$ and $55^{\circ}C$ for 5000 cycles with a 30 second dwell time, and then shear bond strength was determined in a universal test machine(Model 4200, Instron Co., Canton, USA). The crosshead speed was 1 mm/min. The result was analyzed with one-way analysis of variance(ANOVA) and the Tukey test at a significance level of P<0.05. Results : Superbond $C&B^{(R)}$ at scratching with diamond burs showed the highest shear bond strength than others (p<.05). For Panavia $F^{(R)}$, groups of scratching and sandblasting showed significantly higher shear bond strength than control group(p<.05). For Rely X $Luting^{(R)}$, only between scratching & control group, significantly different shear bond strength was observed(p<.05). Conclusion : Within the limitation of this study, Superbond $C&B^{(R)}$ showed clinically acceptable shear bond between bovine teeth & zirconia ceramics regardless of surface treatments. For the surface treatment, scratching increased shear bond strength. Increase of shear bond strength by sandblasting with $110{\mu}m$ $Al_2O_3$ was not statistically different.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.3
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• pp.267-275
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• 2011

This prospective study was designed to compare clinical outcomes of immediately loaded implant with delayed loaded implant in partially posterior edentulous patients. For test group, 42 GS III (Osstem, Korea) implants in 17 patients were loaded within 48 hours after the placement. Control group was 27 implants in 15 patients loaded at $2.6{\pm}1.7months$ from the placement surgery. Before loading, primary stability was evaluated by ISQ value. Clinical symptoms, mobility, soft tissue state was evaluated at baseline, 3 months, 6 months and 12 months of loading. Marginal bone level change was also measured with periapical radiographs. Mann-Whitney test (${\alpha}$=0.05) and repeated measured ANOVA (${\alpha}$=0.05) was used for marginal bone level change between two groups. At the baseline, mean ISQ value of test group and control group was $80.3{\pm}7.1$ and $69{\pm}17$ respectively. Test group showed 95.23% of success rate and 100% of control group was successful. At 3 and 6months of loading, significantly more bone resorption was observed in test group than in control group (p<0.05). However, there was no significant difference in the bone level change at 12months of loading between two groups (p>0.05). Marginal bone level change showed no significant difference with gender and location (p>0.05). Within the limitation of this study, when primary stability was obtained, immediate loading of GS III implant at posterior region could be predictable treatment option.

• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.3
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• pp.221-239
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• 2010

Bone loss may occur depending on the loading conditions. careful treatment planning and prosthetic procedures are very important factors for the proper distribution of stress. Evaluate the stress distributions according to numbers and location of implants in three-unit fixed partial dentures. A mandible missing the right second premolar, first molar and second molar was modeled. Using the CT data. we modeled a mandible with a width of 15mm, a height of 20mm and a length of 30mm, 2mm-thickness cortical bone covering cancellous bone mallow. An internal type implant and A solid type abutment was used. A model with 3 implants placed in a straight line, offset 1.5 mm buccally, offset 1.5 mm lingually and another model with 3 implants offset in the opposite way were prepared. And models with 2 implants were both end support models, a mesial cantilever model and a distal cantilever model. Three types of loading was applied; a case where 155 N was applied solely on the second premolar, a case where 206 N was applied solely on the second molar and a case where 155 N was applied on the first premolar and 206 N was applied on the first and second molar. For all the cases, inclined loads of 30 degrees were applied on the buccal cusps and vertical loads were applied on the central fossas of the teeth. Finite element analysis was carried out for each case to find out the stress distribution on bones and implants. This study has shown that prostheses with more implants caused lower stress on bones and implants, no matter what kind of load was applied. Furthermore, it was found out that inclined loads applied on implants had worse effects than vertical loads. Therefore, it is believed that these results should be considered when placing implants in the future.

• Journal of Dental Rehabilitation and Applied Science
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• v.24 no.2
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• pp.169-181
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• 2008

The aim of this study was to compare the retention and stability of implant overdenture according to the shape and the number of magnetic attachment. The experimental groups were designed for the number of implants(1, 2, 4) and shape of magnetic attachments(flat, cushion, dome type) resulting in 9 subgroups. 45 attachments were tested attached to $Br{\aa}nemark$ system implants which were planted on a mandibular model. Each attachment was composed of the magnet assembly embedded in a overdenture sample and the abutment keeper screwed into the implants. Dislodging tensile forces were applied to the overdenture samples using an Instron(cross-head speed 50.80mm/min) in 3 directions simulating function: vertical, oblique, and anterior-posterior. The loading was repeated 10 times in each direction for 45 samples. The values of maximum dislodging force of each subgroup were processed statistically using SPSS V. 12.0 at the 0.05 level of significance. The results of this study were as follows: 1. Flat type magnetic overdenture was the most retentive when subjected to vertically directed forces and dome type was the lest retentive when subjected to obliquely directed forces(p<0.05). 2. In case of planting one implant, flat type had a higher vertically retentive force than anterior-posteriorly retentive force. In case of planting two implants, flat type and dome type had a higher vertically retentive force and in case of planting four implants, flat type and cushion type had a higher vertically retentive force than anterior-posteriorly retentive force(p<0.05). 3. The incremental number of dental implant, without regards to the three types of magnetic attachment shapes, showed higher retention of overdenture(p<0.05). From the results, if a patient need much more retention of implant overdenture, flat type magnetic overdenture would be a good treatment. In case of the bruxism where excessive lateral forces are already present, dome type could be expected to produce better results. In case of planting one implant, flat type is more stable than the other shape of magnet and in case of two implant, flat type and dome type are more stable and in case of four implants, flat type and cushion type are more stable. Planting more than two implants and using flat type magnetic attachment would provide better retention and stability of implant overdenture

• Journal of Korean Academy of Fundamentals of Nursing
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• v.7 no.2
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• pp.239-255
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• 2000

The purpose of this study was to explore the care needs of family-caregivers caring for patients with a CVA and the level of self care of the patients. The subjects for the study were 112 patients with a CVA and their caregivers. These patients were seen in a hospital or out-patient-department(OPD) at two oriental medical hospital in Jeonbuk province. The survey instruments used in this study were Kang's ADL checklist for self care of patients and Kim's Likert-style checklist for care needs of family-caregivers to patient with CVA. The survey was conducted from July 4 to August 30, 1999. Internal validity by calculation of Cronbach's alpha was 0.95, which was regarded as high. The survey results were analyzed using the SPSS program, with percentages, means, t-test, ANOVA and Pearson's correlation coefficients. The results of this study are as follows : 1. The level of self care for patients with a CVA was : 1) complete dependence(M=14.9, 13.1%), 2) complete independence(M=23.6, 20.9%), 3) incomplete independence(M=23.9, 21.0%), 4) incomplete dependence(M=26.6, 25.0%), 5) dependence and independence(M=23.0, 20.0%). The items for which there was a high level of self care were : 1) drinking(M=3.62), 2) eating (M=3.25), 3) position returning(M=3.18) : and the items for which there was a low level of self care were : 1) ascending and descending stairs(M=2.08), 2) walking(M=2.47). 3) putting on and taking off trousers(M=2.55). 2. The mean score of the sum of the care needs of the family-caregivers was : 1) need for immediate care and help: 2) need of the way to communicate with patient: 3) need for education and assistance related to physical functional level: 4) need to be informed about the disease, treatment and care: 5) need for social support and consultation: 6) need for appreciation: 7) need for management of nursing problems related to immobility. The highest meed factor was the need for immediate care and help(M=3.47): and lowest need factor was the need for management of nursing problems related to immobility(M=2.80). 3. There were significant differences between the level of care need and general characteristic of the caregivers, there were family-caregivers age(P=0.001), marital status (P=0.276), occupation (P=0.006), monthly income(P=0.000), Patient's relationship to caregivers(P=0.004) and health(P=0.000). 4. There were significant differences between the level of self care and general characteristic of the patients, there were patient paralytic condition(P=0.01), blood pressure(P=0.01), and length of suffering(P=0.03). 5 There were significant differences between the level of care need and the general characteristic factors, which were CVA patient's blood pressure (P=0.05), problem of medical fee (P=0.05). 6. There was significantly correlation with the family-caregivers care need and the level of self care in the CVA patient(r=0.300, P=0.000). As a result, need to promote the level of self care in patients and to meet the care need of family-caregivers for more efficient nursing of CVA patients, is emphasized. Therefore more study is needed on an efficient way to provide rehabilitation and quality nursing interventions for family-caregivers and patients with CVA.

• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.4
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• pp.405-417
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• 2010

Previous studies have already shown that mouthguard is effective in protecting jaw bone, teeth and oral tissue against sports trauma. However, other than severe trauma, repetitive force, such as disorders like clenching, cause teeth or oral tissue damage. These kinds of disorders usually present pathologic attrition in the posterior teeth, resorption in alveolar bone, loss of teeth and destruction of occlusion. Wearing a mouthguard is believed to be effective in preventing these disorders. But its effect is not examined thoroughly enough. The purpose of this study is to identify whether mouthguard is effective in reducing strain caused by clenching. Mandibular first molars in the normal occlusal relationship without any history of dental treatment were chosen. Biaxial type strain gauge was placed on the buccal surface of the tooth. Having maximum occlusal force, measured by load cell, as a standard, clenching intensity were divided into three stages; moment of slightly tooth contact, medium bite force (50% of maximum bite force), maximum bite force. Strain occurring in dentition in each stage with and without mouthguard was measured. Changes in strain (on dentition) between each stage and difference in strain, between with or without mouthguard were recorded by PCD-300 analyzer and PCD-30 soft ware. The data was statistically analyzed by Wilcoxon signed rank test. The following results were drawn; Without mouthguard, strain given on dentition increased as the clenching force increased. With mouthguard, strain given on dentition also increased as the clenching force increased. With mouthguard, strain decreased, in all cases of clenching force stages. Data on the moment of slightly tooth contact stage, had no statistical significance. However, with mouthguard, 50-90% of decrease in strain could be obtained in maximum occlusal force, compared to the group without mouthguard. Mouthguard decreased the strain on the dentition, caused by clenching. Therefore, mouthguard seems to be effective in preventing damage on dentition, by acting against clenching, which occurs both consciously and unconsciously during sports activities.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.10
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• pp.480-489
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• 2017

Blood flow restriction(BFR) exercise is defined as low intensity and short term exercise using pneumatic pressure belts at the top of limbs, which affects the physiological functions of the body. The purpose of this study was to investigate the effects of walking exercise with BFR on inflammatory index, isokinetic muscle function, and thigh circumference in obese women. Eleven obese women(> BMI $25kg/m^2$ & > body fat 30%) wore pneumatic pressure belts on both femurs and performed walking exercise twice per day, 3 days/wk for 4 weeks (walking 2 min; resting 1 min). Data analysis was carried out using paired t-test. Body weight, BMI, and body fat significantly decreased after exercise(p<.05), and right thigh circumference significantly decreased(p<.05). The concentration of plasma IL-6 significantly increased(p<.05) after exercise. TNF-${\alpha}$ level was not statistically different but tended to slightly increase. CRP slightly decreased, although it did not reach statistical significance after exercise. Muscle strength significantly increased in the $60^{\circ}/sec$ of right/left side extension, left side flexion, and $180^{\circ}/sec$ of left side extension after training(p<.05). These results suggest that 4 weeks of blood flow restriction walking exercise has positive effects on inflammatory index and isokinetic muscle function. Therefore, we consider that blood flow restriction exercise can be used for treatment of obesity, related chronic diseases, and metabolic syndrome. Further, blood flow restriction exercise for a short time has similar effects as a high intensity resistance program.

• Journal of Korean Academy of Nursing
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• v.22 no.2
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• pp.207-226
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• 1992

This study was designed to develop a conceptual framework for the curriculum and develop the details of the learning content for the education of Community Health Practitioners (CHPs). Since education programs for CHPs started 10 years ago, concepts related to CHP services have changed because of changes in society. The objectives of the study were as follows : 1) to analyse the usefulness of the present education program for CHPs, 2) to analyse the Job performance and self -confidence of the CHPs, 3) to identify the health needs of the clients served by the CHPs and the community problems related to health. 4) to develop a conceptual framework for the curriculum, for the education of CHPs, 5) to develops details for the learning content of the education program for CHPs. Phase I of the study was conducted by questionnaires to 150 CHPs who have worked in remote rural areas for more than 2 years. Among them, 147 responded. Data was collected from August 16, to August 25, 1990. In order to identify the health needs of the community people, research within the last five years was reviewed and analyzed. The data on 1, 842 communities gathered by the WHO Nursing Collaborations Center of the College of Nursing, Yonsei University was utilized to identify community problems related to health and the self - confidence in job performance of the CHPs. Psase II of the study consisted of a workshop with 13 professionals including Community Health Practitioners to evaluate the existing education program and a conceptual framework of the curriculum for the job education of CHPs. The results of the study are Summariged below : 1. The only 26 among 45 content items of the education program related to job skills was used by 80% of the responding CHPs. The knowledge of $\ulcorner$Networking community organization$\lrcorner$ was used by only 53.7% of the respondents. Educational content about $\ulcorner$Mental disease$\lrcorner$ was used by less than 50% of CHPs because of a knowledge deficit. 2. The CHPs reported that their activities concentrated on clinical services during the last six months. The survey showed that they seemed to neglect the activities for health promotion and disease prevention. Thus, $\ulcorner$Education for community loaders$\lrcorner$(15.9%), $\ulcorner$Activity for eavironmental health$\lrcorner$(16.3%) and $\ulcorner$Social work for needey people$\lrcorner$(23.3%) were done by less than 30% of CHPs. 3. More than 90% of CHPs reported being self - confident for the activities of $\ulcorner$Health education and counselling$\lrcorner$, $\ulcorner$Medicine prescription$\lrcorner$ and $\ulcorner$Immunization$\lrcorner$. But 50% of CHPs reported that they were not have self - confident in $\ulcorner$Management of water and environmental health$\lrcorner$ and only 25.6% of CHPs could insert an IUD independently. 4. It was identified that respiratory diseases and the gastrointestinal diseases were most common problems for the community people, followed by musculoskeletal and skin problems. 5. The community problems were classified into eight categories : physical environmental problems, environmental hygiene, health problems, health behavior, social problem, lack of resources, financial problem and the problems of the cultural and value system. 6. The conceptual framework consisted of the target population and their health status, nursing process working site and primary health care services such as health promotion, disease prevention, treatment and rehabilitation. 7. The contents of curriculum of education program for CHPs were formulated from the results of this study.

• Journal of Dental Rehabilitation and Applied Science
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• v.16 no.1
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• pp.51-60
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• 2000

The purpose of this study was to compare the microleakage at the interface of cast post and tooth according to the type of cement. Forty anterior teeth with single root were used. The teeth were cut 2 mm coronal from the cementoeamel junction and chamfer finish line was made on 1 mm coronal from the cementoeamel junction. After the routine endodontic treatment, post space was prepared using #5.5 Parapost drill to a depth of 7 mm. After the pick up impression, core building was made to 3 mm of clinical crown with burnout wax, then post and core was cast with nonprecious metal. The teeth were divided into four groups of ten each. In Group I, post and core were cemented with Fleck's(Zinc phosphate cement) In Group II, post and core were cemented with Fuji I(Glass ionomer cement) In Group III, post and core were cemented with Superbond C & B(Composite resin cement) In Group IV, post and core were cemented with Panavia 21(Composite resin cement) All cemented teeth were stored in normal saline at $37^{\circ}C$ for 7 days and thermocycled from $5^{\circ}C$ to $55^{\circ}C$ for 500 cycles with a dwell time of 30 seconds. After thermocycling, teeth were immersed in 1% Basic fuchsin dye for 48 hours. All 40 teeth were then embedded in the epoxy resin and cut buccolingually with a cutting instrument. The degree of penetration of dye at interface was graded on a scale of 0 to 4 using a stereomicroscope at 25 to 40 times magnification. Through the findings of this study, the following conclusion were obtained. 1. All the groups showed the microleakage at the interface of cast post core and tooth. 2. Group I showed the highest microleakage score among the groups with a significant difference(p<0.05). 3. Group II showed higher microleakage score than Group III and Group IV with a significant difference(p<0.05). 4. Group IV showed the lowest microleakage score but there were no significant difference with Group III(p>0.05).