• 임상이비인후과
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• 제29권2호
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• pp.229-234
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• 2018

Background and Objectives : Vocal nodules occur with a 12-22% prevalence in pediatric populations. Most otolaryngologists recommend voice therapy as the primary treatment. The aim of this study is to evaluate patient compliance with voice therapy and its effect on vocal nodules in children. Materials and Methods : We retrospectively reviewed 44 pediatric patients between 3 and 11 years old diagnosed with vocal nodules between March 2015 and December 2017. We evaluated the treatment adoption rate, dropout rate during voice therapy, and reasons for dropout. For patients who completed voice therapy, we measured the changes in nodule size, perceptual parameters, and acoustic parameters. We evaluated patient satisfaction using the pediatric voice handicap index (P-VHI). Results : Of the 44 pediatric patients diagnosed with vocal nodules, 22 (50%) agreed to voice therapy. Of the 22 patients who started voice therapy, 5 (22.7%) dropped out during therapy because they were unsatisfied with their treatment. Another 4 patients discontinued therapy for reasons unrelated to treatment effectiveness. Vocal nodule disappeared or decreased in all 13 patients who completed voice therapy. All voice parameters were improved and statistically significant changes were observed in perceptual, acoustic, and P-VHI parameters. Conclusions : Although compliance to voice therapy among the pediatric patients with vocal nodules was low, there were significant improvements in voice parameters for those who completed voice therapy. A change toward a positive perception of voice therapy is necessary and a multidisciplinary approach is needed to improve the effect of voice therapy on pediatric patients with vocal nodules.

• Journal of Periodontal and Implant Science
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• 제49권2호
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• pp.60-75
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• 2019

The primary aim of this systematic review was to assess the evidence on periodontal disease progression after treatment in patients receiving supportive periodontal therapy (SPT) and to identify predictors of clinical attachment level (CAL) loss. A protocol was developed to answer the following focused question: In adult patients treated for periodontitis, what is the disease progression in terms of CAL loss after surgical or non-surgical treatment? Randomized controlled clinical trials, prospective cohort studies, and longitudinal observational human studies with a minimum of 5 years of follow-up after surgical or non-surgical treatment that reported CAL and probing depth changes were selected. Seventeen publications reporting data from 14 investigations were included. Data from 964 patients with a follow-up range of 5-15 years was evaluated. When the CAL at the latest follow-up was compared to the CAL after active periodontal therapy, 10 of the included studies reported an overall mean CAL loss of ${\leq}0.5mm$, 3 studies reported a mean CAL loss of 0.5-1 mm, and 4 studies reported a mean CAL loss of >1 mm. Based on 7 publications, the percentage of sites showing a CAL loss of ${\geq}2mm$ varied from 3% to 20%, and a high percentage of sites with CAL loss was associated with poor oral hygiene, smoking, and poor compliance with SPT. The outcomes after periodontal therapy remained stable over time. Disease progression occurred in a reduced number of sites and patients, mostly associated with poor oral hygiene, poor compliance with SPT, and smoking.

• 농촌의학ㆍ지역보건
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• 제27권1호
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• pp.155-164
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• 2002

본 연구는 일개 보건지소에 등록된 고혈압 환자의 치료율 및 관리율을 구하고 치료지속성과 관련성이 있는 변수를 파악하고 치료중단 이유를 조사하기 위하여 2000년 11월 이전에 군남면 보건지소에 등록되어 치료받고 있는 고혈압 환자 295명을 대상으로 하여, 의무기록조사와 전화설문조사를 병행하여 실시되었다. 그 결과는 다음과 같다. 1. 대상자 295명중 남자가 108명(36.6%), 여자가 187명 (62.7%)이었으며 평균연령은 남자 64.6세, 여자 66.3 세로 여성에서 더 높았다(p<0.05). 2. 대상자의 54.9%가 지속적인 치료를 받는 것으로 조사되었고, 간헐적 치료군이 19.3%, 치료중단군이 25.8%였다. 3. 성, 연령, 의료보장, 거주지 등 연구대상자의 특성중 거주지로부터 보건지소까지 이동시 소요되는 시간만이 치료지속성과 통계적으로 유의한 관련성이 있었다(p<0.01). 3. 치료중단의 이유로는 증상 또는 몸의 불편함이 없어서가 23.9%를 차지하였고 그 다음으로 타의료기관 이용(18.4%), 교통의 불편(17.9%), 약국 이용(14.9%), 거동 불가능(7.5%), 경제적인 이유(6.0%), 보건지소 서비스에 불만족(4.4%) 순이었다. 4. 전체 대상자 295명의 평균 치료혈압은 $144.9{\pm}12.9/86.9{\pm}8.6mmHg$이었고, 이들 중 평균 치료혈압 이 140/90mmHg 미만으로 적절히 조절되는 환자는 32.5%였다. 이러한 연구결과를 종합해 볼 때, 보건지소 고혈압 환자들의 낮은 치료율, 관리율을 개선하기 위해서는, 적극적인 추후관리와 고혈압에 대한 환자의 잘못된 인식을 교정해주는 효과적인 보건교육을 포함하는 보다 체계적인 고혈압 관리 사업이 요구된다고 하겠다.

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

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

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제15권2호
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• pp.63-73
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• 2012

Development of antiviral resistance to lamivudine is the most important factor for the treatment failure. It is necessary to establish proper guidelines to overcome drug resistance for children with chronic hepatitis B. Primary treatment with lamivudine should be considered if patients are in immune-clearance phase and have persistently elevated ALT levels more than twice the upper limit of normal value. Before initiating the therapy, careful consideration of the patient's status is required to exclude abnormal liver function tests due to other causes. The treatment option should be carefully decided to suppress the viral replication effectively. To obtain good compliance, clinicians should educate patients and their parents. Appropriate monitoring for virologic breakthrough and genotypic resistance is important in deciding to change the treatment plan. Sequential monotherapy should be avoided and a combination of drugs in other categories is recommended. New antiviral agents, such as entecavir and tenofovir, which have high potency and high genetic barrier, are soon expected to be available for use with children.

• 대한조현병학회지
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• 제23권2호
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• pp.45-50
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• 2020

Schizophrenia is one of serious mental illnesses and is often described as a heterogeneous disorder. Approximately one-third of schizophrenia cases are treatment-resistant schizophrenia (TRS). The aim of this study was to review the definitions and clinical features of TRS. Though it was found that the criteria for TRS were considerably diverse, the Treatment Response and Resistance in Psychosis (TRRIP) consensus criteria were recently introduced. According to the TRRIP criteria, TRS should be suspected if symptoms persist alongside psychotic symptoms despite sufficient treatment for ≥12 weeks, or two or more symptoms persist significantly for ≥6 weeks. The clinical characteristics of TRS includes an earlier age of onset, more severe and familial form, possibly more rural residence, unlikely association with male sex, and an increase in cognitive deficits.

• 대한치과교정학회지
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• 제34권2호
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• pp.197-203
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• 2004

골격성 II급 부정교합을 치료하는데 있어서, Tweed-Merrifield directional force technology는 시계 반대 방향으로의 양호한 골격적 변화 및 균형 잡힌 안모를 얻는데 기여하고 있다. 이는 적절한 방향으로의 J-hook을 통한 headgear force의 사용이 필수적이다. 따라서 환자의 협조에 대한 의존이 절대적이므로 약간의 문제점이 있는 것 또한 사실이다. 하지만 최근 skeletal anchorage를 이용하여 환자의 협조를 최소화하면서도 보다 효과적으로 고정원 보강을 할 수 있는 방법이 많이 시행되고 있어 이를 보완 할 수 있게 되었다. 저자는 HPJH(high pull J-hook)과 skeletal anchorage를 병용하여 directional force를 적용한 결과 상악 구치부에서의 고정원 보강과 상악 전치부의 토크 조절 및 mandibular response를 얻음으로써 양호한 안모의 균형을 얻을 수가 있었다. 이 치료 결과로 보아 skeletal anchorage는 HPJH을 대신하여 상악 견치 및 전치부 견인시 상악 구치부의 전후적 및 수직적 고정원 보강 역할을 할 수 있을 것으로 생각된다 상악 전치부 견인시 상악 전치부의 토크 조절, 압하 및 치체이동을 위해 HPJH을 사용하였지만, 이 또한 mini 혹은 microscrew로 대체한다면 환자의 협조를 최소화하면서도 양호한 치료결과를 얻을 수 있을 것으로 생각된다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권16호
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• pp.6499-6504
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• 2014

Health information-seeking behavior (HISB) is active need-fulfillment behavior whereby health information is obtained from diverse sources, such as the media, and has emerged as an important issue within the transforming medical environment and the rise of medical consumers. However, little is known about the factors that affect HISB and its associations, and the health outcome of HISB. The aim of this study was to examine individual and social contextual factors associated with HISB and to systematically review their effects on health status among post-treatment cancer patients. Individual determinants of HISB included demographic factors, psychosocial factors, perceived efficacy and norms, and health beliefs. Contextual determinants of HISB encompassed community characteristics, neighborhood social capital, and media advocacy. Improving through factors on these two levels, HISB raised individuals' self-care management skills and medical treatment compliance, and enhanced shared decision-making and medical treatment satisfaction. Moreover, because HISB can differ according to individuals' social contextual conditions, it can give rise to communication inequalities. Because these can ultimately lead to health disparities between groups, social interest in HISB and balanced HISB promotion strategies are necessary.

• 한국건강관리협회지
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• 제3권1호
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• pp.55-61
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• 2005

Functional constipation is regarded as a long-standing symptomatic manifestation of abnormal defecation expressed by either a reduced frequency of bowel movements and /or an altered act of evacuation. Patients with constipation can be treated with laxatives, diets and regular habits. Thorough evaluation of functional constipation is considered in those in whom conservative treatment with dietary advice and use of laxatives fails. Patients with normal colonic transit and normal anorectal function may only need reassurance, education and dietary advice with fiber supplementation. For constipated patients in whom such treatment modalities fail, laxatives including bulk-forming and osmotic agents may be used Although most laxatives, if used intermittently, are relatively safe, they must be chosen bearing in mind possible side effects, patient compliance and their action mechanisms. A subgroup of patients with slow transit through the colon ay be unresponsive to conventional laxatives, and, in these subjects, a trial with enteroprokinetics and sometimes stimulant laxatives should be attempted. This article presents our view of the assessment and pharmacologic treatment of functional constipation.

• Biomolecules & Therapeutics
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• 제21권3호
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• pp.181-189
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• 2013

Motilitone$^{(R)}$ (DA-9701) is a new herbal drug that was launched for the treatment of functional dyspepsia in December 2011 in Korea. The heterogeneous symptom pattern and multiple causes of functional dyspepsia have resulted in multiple drug target strategies for its treatment. DA-9701, a compound consisting of a combination of Corydalis Tuber and Pharbitidis Semen, has being developed for treatment of functional dyspepsia. It has multiple mechanisms of action such as fundus relaxation, visceral analgesia, and prokinetic effects. Furthermore, it was found to significantly enhance meal-induced gastric accommodation and increase gastric compliance in dogs. DA-9701 also showed an analgesic effect in rats with colorectal distension induced visceral hypersensitivity and an antinociceptive effect in beagle dogs with gastric distension-induced nociception. The pharmacological effects of DA-9701 also include conventional effects, such as enhanced gastric emptying and gastrointestinal transit. The safety profile of DA-9701 is also preferable to that of other treatments.