• 제목/요약/키워드: Treatment Adherence

검색결과 178건 처리시간 0.027초

Taguchi법을 이용한 Ti/TiO2/IrO2-RuO2전극의 부식특성 최적화 (Optimization of Corrosion Properties of Ti/TiO2/IrO2-RuO2 Electrodes via Taguchi Method)

  • 이득용;채경선;최형기;예경환;안중홍;송요승
    • 한국세라믹학회지
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    • 제39권6호
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    • pp.582-588
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    • 2002
  • Ti 기판에 TiO$_2$ 중간층을 플라즈마 용사법으로 증착 후 IrO$_2$-RuO$_2$ 박막을 졸-겔과 dip coating법으로 제조하였다. 코팅 층의 접착력을 향상시키기 위하여 유기화합물과 glass brit을 첨가하였다. Taguchi법의 망대특성과 Lls(2$^1$$\times$3$^{7}$ )의 직교배열표를 이용하여 IrO$_2$-RuO$_2$ 박막의 최적조건인 인자와 수준 조합의 최적화를 전류밀도를 측정 분산분석하였다. 최적의 코팅조건은 각각 ethyl cellulose의 점도는 100cp, 건조온도 및 시간은 17$0^{\circ}C$ 20분, 열처리온도 및 시간은 75$0^{\circ}C$ 10분, 전도성 분말과 glass frit의 무게비는 99:5, 최종열처리시간은 120분, 주입산소량은 5sccm이었다. 분산분석결과, 유의수준이 $\alpha$=0.1인 통계적으로 90%신뢰공정이었다.

Surface Characteristics of Type II Anodized Ti-6Al-4V Alloy for Biomedical Applications

  • 이수원;정태곤;양재웅;정재영;박광민;정용훈
    • 한국표면공학회:학술대회논문집
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    • 한국표면공학회 2017년도 춘계학술대회 논문집
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    • pp.77-77
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    • 2017
  • Titanium and its alloys offer attractive properties in a variety of applications. These are widely used for the field of biomedical implants because of its good biocompatibility and high corrosion resistance. Titanium anodizing is often used in the metal finishing of products, especially those can be used in the medical devices with dense oxide surface. Based on SAE/AMS (Society of Automotive Engineers/Aerospace Material Specification) 2488D, it has the specification for industrial titanium anodizing that have three different types of titanium anodization as following: Type I is used as a coating for elevated temperature forming; Type II is used as an anti-galling coating without additional lubrication or as a pre-treatment for improving adherence of film lubricants; Type III is used as a treatment to produce a spectrum of surface colours on titanium. In this study, we have focused on Type II anodization for the medical (dental and orthopedic) application, the anodized surface was modified with gray color under alkaline electrolyte. The surface characteristics were analyzed with Focused Ion Beam (FIB), Scanning Electron Microscopy (SEM), surface roughness, Vickers hardness, three point bending test, biocompatibility, and corrosion (potentiodynamic) test. The Ti-6Al-4V alloy was used for specimen, the anodizing procedure was conducted in alkaline solution (NaOH based, pH>13). Applied voltage was range between 20 V to 40 V until the ampere to be zero. As results, the surface characteristics of anodic oxide layer were analyzed with SEM, the dissecting layer was fabricated with FIB method prior to analyze surface. The surface roughness was measured by arithmetic mean deviation of the roughness profile (Ra). The Vickers hardness was obtained with Vickers hardness tester, indentation was repeated for 5 times on each sample, and the three point bending property was verified by yield load values. In order to determine the corrosion resistance for the corrosion rate, the potentiodynamic test was performed for each specimen. The biological safety assessment was analyzed by cytotoxic and pyrogen test. Through FIB feature of anodic surfaces, the thickness of oxide layer was 1.1 um. The surface roughness, Vickers hardness, bending yield, and corrosion resistance of the anodized specimen were shown higher value than those of non-treated specimen. Also we could verify that there was no significant issues from cytotoxicity and pyrogen test.

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전투 상황에서 발생한 사지 총상 및 폭발창의 치료 (Treatment of Combat-related Gunshot and Explosive Injuries to the Extremities)

  • 이정은;이영호;백구현;이경학;조영재;김영철;서길준
    • Journal of Trauma and Injury
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    • 제26권3호
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    • pp.111-124
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    • 2013
  • Purpose: We should prepare proper medical service for disaster control as South Korea is not free from terrorism and war, as we experienced through the two naval battles of the Yeonpyeong, one in 1999 and the other in 2002, the sinking of Cheonan in 2010, and the attack against the border island of Yeonpyeong in 2010. Moreover, North Korea's increasingly bellicose rhetoric and mounting military threats against the world demand instant action to address the issue. The aim of this article is to describe our experience with three patients with combat-related gunshot and explosive injuries to their extremities and to establish useful methods for the management of patients with combat-related injuries. Methods: Three personnel who had been injured by gunshot or explosion during either the second naval battle of the Yeonpyeong in 2002 or the attack against the border island of Yeonpyeong in 2010 were included in our retrospective analysis. There were one case of gunshot injury and two cases of explosive injuries to the extremities, and the injured regions were the left hand, the right foot, and the right humerus. In one case, the patient had accompanying abdominal injuries, and his vital signs were unstable. He recovered after early initial management and appropriate emergency surgery. Results: All patients underwent emergent surgical debridement and temporary fixation surgery in the same military hospital immediately after their evacuations from the combat area. After that, continuous administration of antibiotics and wound care were performed, and definite reconstructions were carried out in a delayed manner. In the two cases in which flap operations for soft tissue coverage were required, one operation was performed 5 weeks after the injury, and the other operation was performed 7 weeks after the injury. Definite procedures for osteosynthesis were performed at 3 months in all cases. Complete union and adequate functional recovery were achieved in all cases. Conclusion: The patient should be stabilized and any life-threatening injuries must first be evaluated and treated with damage control surgery. Staged treatment and strict adherence to traditional principles for open fractures are recommended for combat-related gunshot and explosive injuries to the extremities.

완전 구강 회복술 (Full Mouth Rehabilitation)

  • 이승규;이성복;권긍록;최대균
    • 구강회복응용과학지
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    • 제16권3호
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    • pp.171-185
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    • 2000
  • The treatment objectives of the complete oral rehabilitation are : (1) comfortably functioning temporomandibular joints and stomatognathic musculature, (2) adherence to the basic principle of occlusion advocated by Schuyler, (3) anterior guidance that is in harmony with the envelope of function, (4) restorations that will not violate the patient's neutral zone. There may be many roads to achieving these objectives, but they all convey varing degrees of stress and strain on the dentist and patient. There are no "easy" cases of oral rehabilitation. Time must be taken to think, time must be taken to plan, and time must be taken to perform, since time is the critical element in both success and failure. Moreover, a systematized and integrated approach will lead to a prognosis that is favorable and predictable. This approach facilitates development of optimum oral function, comfort, and esthetics, resulting in a satisfied patient. Such a systematized approach consists of four logical phase : (1) patient evaluation, (2) comprehensive analysis and treatment planning, (3) integrated and systematic reconstruction, and (4) postoperative maintenance. Firstly, we must evaluate the mandibular position. The results of a repetitive, unstrained, nondeflective, nonmanipulated mandibular closure into complete maxillomandibular intercuspation is not so much a "centric" occlusion as it is a stable occlusion. Accordingly, we ought to concern ourselves less with mandibular centricity and more with mandibular stability, which actually is the relationship we are trying to establish. The key to this stability is intercuspal precision. Once neuromuscular passivity has been achieved during an appropriate period of occlusal adjustment and provisionalization, subsequent intercuspal precision becomes the controlling factors in maintaining a stable mandibular position. Secondly, we must evaluate the planned vertical dimension of occlusion in relationship to what may now be an altered(generally diminished), and avoid the hazard of using such an abnormal position to indicate ultimate occlusal contacting points. There are no hard and fast rules to follow, no formulas, and no precise ratios between the vertical dimension of occlusion. Like centric relation, it is an area, not a point.

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일개 지역사회 여성 주민의 자궁경부암 조기검진 수검에 관한 행동변화단계별 교육 프로그램의 효과 (Effectiveness of stages-matched educational program for cervical cancer screening among adult women in a community)

  • Kim, Young-Bok
    • 보건교육건강증진학회지
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    • 제24권5호
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    • pp.23-37
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    • 2007
  • 연구 배경: 자궁경부암은 조기검진을 통해 사망률과 의료비 부담을 감소시킬 수 있는 질환으로, 아직까지 우리나라에서는 자궁경부암이 여성암 중 높은 발생률을 보이고 있으나, Pap test를 통해 자궁경부암을 조기에 발견하고, 치료할 수 있는 것으로 알려져 있다. 연구 목적: 이 연구는 자궁경부암 조기검진 수검행동에 영향을 미치는 인지-행동적 요인을 고려하여 행동변화단계별 교육 프로그램을 개발하였고, 이를 40세 이상의 여성 주민에게 적용해봄으로써 행동변화단계별 맞춤형 교육 프로그램의 효과를 평가하고자 하였다. 연구 방법: 이 연구는 서울시 서초구에 거주하는 40세$\sim$59세 사이의 여성 주민을 대상으로 2003년 9월 1일부터 11월 14일까지 자료를 수집하였으며, 서초구의 5개 지역(동)에서 교육 중재군(162명)과 대조군(121명)을 선정하였다. 또한 행동변화단계별 교육 프로그램은 범이론적모형(TTM)을 활용하여 개발되었고, 교육 중재군의 교육내용 전달방법으로 인터넷 서비스와 우편 서비스가 활용되었다. 연구 결과: 조사대상자중 88.9%가 일생 중 1번 이상, 65.4%가 최근 2년 동안 1번 이상 자궁경부암 조기검진을 수검한 것으로 나타났다. 행동변화단계별 교육 프로그램의 효과를 살펴보면, 교육 후 인지 행동적 요인 중 태도와 변화의 과정이 통계적으로 유의하게 높아졌고, 행동변화단계 중 유지단계가 가장 많이 증가하였다. 교육내용 전달 방법은 인쇄된 교육자료를 활용한 우편 서비스가 인터넷 서비스보다 효과적인 것으로 나타났고, 행동변화단계별 전환 양상에서도 우편 서비스 중재군이 인터넷 서비스 중재 군보다 긍정적인 변화를 나타내었다. 한편 행동변화단계별 교육 프로그램에 관한 만족도 평가에서는 전달방법에 따른 유의한 차이가 없는 것으로 나타났다. 결론: 이 연구는 지역사회 여성 주민의 자궁경부암 조기검진에 관한 수검 행동을 증진시키기 위해 행동변화단계에 따른 맞춤형 교육 프로그램을 개발하여 적용하였고, 그 결과, 행동변화단계별 교육 프로그램이 자궁경부암 조기검진의 수검 행동을 증진시키는데 효과적인 것으로 나타났다.

일개 농촌지역 저소득층 당뇨병환자의 관리 상태 (Management of Diabetic Mellitus in Low-income Rural Patients)

  • 김혜연;윤우준;신민호;권순석;안혜란;최성우;이영훈;조동혁;이정애
    • Journal of Preventive Medicine and Public Health
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    • 제42권5호
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    • pp.315-322
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    • 2009
  • Objectives : Knowledge about the management status of diabetic melitus (DM) is essential to improve diabetic management. Moreover, low income is associated with poor adherence to treatment and increased mortality. This study was performed to evaluate the management status of DM in low-income patients in a rural area. Methods : We enrolled 370 patients with type 2 DM living in Gokseong county, JeollaNamdo. A well-trained examiner measured the height, weight, waist circumference, blood pressure, total cholesterol, triglyceride, high density lipoprotein cholesterol, fasting blood sugar and glycosylated hemoglobin (HbA1c) levels. Carotid ultrasonography was used to measure carotid artery carotid artery intima media thickness (IMT) and plaque. anklebrachial index (ABI) was used to evaluate peripheral artery disease. A fundoscopic examination was performed to evaluate diabetic retinopathy. A history of diabetes complications and health-related questionnaires were also completed. Results : The age of diabetic subjects was 68.7$\pm$8.7 years and the duration of diabetes was 8.9$\pm$8.2 years. Most (63.5%) had hypertension, and 45.7% had triglycerides below 150 mg/dl, 38.1% had low density lipoprotein cholesterol (LDL) cholesterol below 100 mg/dl, 48.7% had urine albumin to creatinine ratio (UACR) below 30 mg/g. Less than half (45.9%) achieved the goal of HbA1c less than 7% suggested by the American Diabetes Association (ADA). 10.6% had peripheral vascular disease, 11.9% had retinopathy, and 60.8% had chronic kidney disease. Conclusions : DM management in low income patients is very poor and requires further work to improve.

Schizandrin의 신혈관형성억제에 의한 항암효과 (Antitumor Effect of Schizandrin by Inhibiting Angiogenesis)

  • 윤미소;김도윤;유호진;박주훈;장상희;원경종;김보경;이환명
    • 동의생리병리학회지
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    • 제26권5호
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    • pp.687-692
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    • 2012
  • Schizandra chinensis extract has been known to possess a variety of efficacy including antitumor. However, it remains unclear how schizandrin, which is a major biological active ingredient of Schizandra chinensis, exerts antitumor effect. This study was designed to investigate the mechanism by which schizandrin inhibits tumor growth and metastasis. In in vivo test using tumor model mice injected with B16BL6 cell line, mice treated with 10 and 100 ${\mu}g/ml$ schizandrin showed a significant inhibition by $73.79{\pm}6.43%$ and $90.46{\pm}1.72%$, respectively, compared with positive tumor controls. Schizandrin did not exert a significant toxicity for the normal cells (HUVECs) and tumor cell lines (A549, B16BL6, Du145, Huh7). Treatment with schizandrin at 10 and 100 ${\mu}g$/head significantly inhibited the tumor-induced angiogenesis by $68.04{\pm}32.21%$ and $103.8{\pm}34.99%$ compared with the positive control group, respectively. Using in vivo lung metastasis model, tumor metastasis assay revealed that 10 and 100 ${\mu}g$/head schizandrin significantly decreased the metastatic lung tumor by $37.51{\pm}8.15%$ and $75.53{\pm}4.38%$ compared with positive controls, respectively. On the other hand, schizandrin did not affect the adherence of B16BL6 cell line to extracellular matrix protein. These results demonstrate that schizandrin exerts inhibitory effect on tumor growth and metastasis by inhibiting angiogenesis. This study thus suggest that schizandrin may be a candidate molecule target for cancer drug development.

자일리톨 섭취에 따른 Streptococcus mutans의 글루칸 생성관련 유전자 발현 억제효과 (INHIBITION OF GLUCAN SYNTHESIS RELATED GENE EXPRESSION OF STREPTOCOCCUS MUTANS BY XYLITOL TREATMENT)

  • 김지혜;이영은;안상헌;최연희;남순현;송근배
    • 대한소아치과학회지
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    • 제36권4호
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    • pp.531-538
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    • 2009
  • 본 연구에서는 장기적인 자일리톨의 섭취가 Streptococcus mutans의 대표적인 독성인자 중 하나인 글루칸 생성에 미치는 영향을 알아보기 위하여 글루칸 합성효소인 glucosyltansferase의 mRNA 발현을 실시간 역전사 중합효소 연쇄반응을 통해 평가하여 다음과 같은 결과를 얻었다. 1. 24개월 동안 자일리톨껌을 섭취한 군에서 타액 내 Streptococcus mutans의 colony 수는 통계적으로 유의하게 감소하였다(p<0.05). 2. 비수용성 글루칸 합성에 관여하는 유전자인 gtfB, gtfC의 발현은 자일리톨껌을 섭취한 군에서 시간이 지남에 따라 유의 하게 감소하였다(p<0.05). 특히 gtfB의 발현은 12개월과 24개월째 대조군에 비하여 통계적으로 유의하게 낮았고, gtfC의 발현은 24개월째 대조군에 비하여 통계적으로 유의하게 낮았다(p<0.05). 3. 수용성 글루칸 합성에 관여하는 유전자인 gtfD의 발현 역시 자일리톨껌을 섭취한 군에서 시간이 지남에 따라 유의하게 감소하였다(p<0.05). 또한 gtfD의 발현은 12개월과 24개월째 대조군에 비하여 통계적으로 유의하게 낮았다(p<0.05). 이상의 결과들을 종합해 보았을 때, 자일리톨의 섭취는 구강 내 Streptococcus mutans의 글루칸 합성 관련 유전자들의 발현을 억제시킴으로써 Streptococcus mutans의 수적인 감소를 가져오는 것으로 생각된다.

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Study Protocol for the Most Effective Recall Method in a Cervical Cancer Screening Program in Klang, Malaysia

  • Rashid, Rima Marhayu Abdul;Dahlui, Maznah
    • 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.

The Efficacy of Immediate Diet for Reducing Local Adverse Events of Inhaled Corticosteroid: A Pilot Study

  • Lee, Myoung Kyu;Lee, Won Yeon;Yong, Suk Joong;Shin, Kye Chul;Kim, Chong Whan;Lee, Ji-Ho;Jung, Saehyun;Jung, Ye-Ryung;Kim, Hyun Sik;Yu, Tae-Sun;Kim, Sang-Ha
    • Tuberculosis and Respiratory Diseases
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    • 제73권2호
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    • pp.93-99
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    • 2012
  • Background: Local adverse events associated with inhaled corticosteroid use, including dysphonia, pharyngitis and oral candidiasis, can affect adherence for treatment. 'Mouth rinsing method' has been used for reducing local adverse events, but it cannot ensure complete prevention. The goal of this pilot study was to identify whether the 'immediate diet method' can reduce local adverse events in a limited number of patients. Methods: The study was conducted in a total of 98 patients, who had been prescribed a medium-dose fluticasone propionate for the first time, from January to October in 2010. One training nurse had performed the education on how to use the inhaler, including the mouth rinsing method. And with follow-ups at one month intervals, any patient who experienced such adverse events were educated on the immediate diet method, having a meal within 5 minutes after using an inhaler and they were checked on any incurrence of adverse events with one month intervals for 2 months. Results: The mean age of patients was 65.9 years old. The local adverse events had incurred from 18.4% of the study subjects. When performed the follow-up observation in 18 patients with local adverse events after education on the immediate diet method, 14 patients (77.8%) had shown symptomatic improvements. Three of 4 patients did not show any improvement, in spite of implementing the immediate diet method. The other 1 patient did not practice the immediate diet method properly. Conclusion: The immediate diet method may be useful in reducing the local adverse events, caused by the use of inhaled corticosteroid.