• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.3
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• pp.147-151
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• 2015

The difficult oral healthcare in intellectually disabled patients with poor behavioral control has led to debate over the cost-effectiveness and validity of implant treatment in these patients. The patient in the present report had schizophrenia that had led to poor oral care and severe dental caries in the full mouth. Tooth extraction and a removable prosthesis were planned, but the guardian wanted an implant procedure. Since the guardian showed strong will and cooperation with regard to the patient's oral healthcare, extraction followed by immediate implant placement was performed across two rounds of general anesthesia. Since the outcome appears successful, we present this case report. Immediate implant placement after tooth extraction requires fewer surgeries and rounds of general anesthesia, reduces horizontal bone resorption, and can achieve better esthetic results. Therefore, as long as a certain degree of oral care is possible, this can be a positive option for restoration of a partially edentulous mouth, even in intellectually disabled patients.

• The Journal of the Korea Contents Association
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• v.17 no.2
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• pp.219-229
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• 2017

The purpose of this study is to clarify the changes of life skills of elementary school students who practice kumdo. For this, 579 elementary school students were studied, and exploratory factor analysis, reliability test, and confirmatory factor analysis were conducted. After that, we conceptualized the life skills of elementary school students who practice kumdo. Based on these results, one-way MANOVA was conducted to analyze the difference in life skills perceived by elementary school students according to sex and career. The results are as follows. First, the elementary school students' life skill developed through the kumdo training showed four factors: personality, social skills, problem solving skills, and health care. Second, there was no gender difference of life skill according to the kumdo training, and there were differences in social skill and health care depending on the experience of kumdo training. In addition, life skill factors influencing daily life satisfaction of elementary school students practicing kumdo were social skills, problem solving skills, and character.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.3
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• pp.205-213
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• 2017

Background: This study retrospectively investigated outcomes following dental implantation in patients with special needs who required general anesthesia to enable treatment. Method: Patients underwent implant treatment under general anesthesia at the Clinic for the Disabled in Seoul National University Dental Hospital between January 2004 and June 2017. The study analyzed medical records and radiographs. Implant survival rates were calculated by applying criteria for success or failure. Results: Of 19 patients in the study, 8 were males and 11 were females, with a mean age of 32.9 years. The patients included 11 with mental retardation, 3 with autism, 2 with cerebral palsy, 2 with schizophrenia, and 1 with a brain disorder; 2 patients also had seizure disorders. All were incapable of oral self-care due to serious cognitive impairment and could not cooperate with normal dental treatment. A total of 27 rounds of general anesthesia and 1 round of intravenous sedation were performed for implant surgery. Implant placement was performed in 3 patients whose prosthesis records could not be found, while 3 other patients had less than 1 year of follow-up after prosthetic treatment. When the criteria for implant success or failure were applied in 13 remaining patients, 3 implant failures occurred in 59 total treatments. The cumulative survival rate of implants over an average of 43.3 months (15-116 months) was 94.9%. Conclusion: For patients with severe cognitive impairment who are incapable of oral self-care, implant treatment under general anesthesia showed a favorable prognosis.

• Journal of Chest Surgery
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• v.54 no.1
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• pp.17-24
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• 2021

Background: Although extracorporeal membrane oxygenation (ECMO) is generally performed percutaneously, the technology is deployed under sedation and necessitates endotracheal intubation. However, in some patients, the use of venoarterial (VA) ECMO without intubation may be beneficial. Herein, we describe our experiences with VA ECMO performed without prior endotracheal intubation. Methods: A total of 783 patients treated with VA ECMO at a single center between January 2013 and July 2018 were reviewed retrospectively. We included patients who underwent successful VA ECMO implementation without prior endotracheal intubation, and excluded those who were younger than 18 years, had ongoing cardiopulmonary resuscitation status, and had poor quality of the vessels needed for percutaneous cannulation. The primary study outcome was in-hospital survival. Results: In total, 50 patients were included in this study, 94% of whom showed cardiogenic shock. The mean age of the study participants was 56.3±14.5 years. The median VA ECMO support time was 7 days (range, 2-13 days). Twenty-one patients (42%) did not receive ventilator care during the VA ECMO support period, while 29 patients (58%) progressed to intubation after VA ECMO implementation. The rates of survival at discharge and weaning success were 82% (n=41) and 92% (n=46), respectively, and 80% (n=40) of patients presented good Glasgow-Pittsburgh Cerebral Performance Categories scores at discharge. Conclusion: Even in patients with cardiogenic shock, percutaneous VA ECMO can be introduced safely without prior endotracheal intubation by an experienced care team. The application of nonintubated VA ECMO might be a feasible strategy in selected cases.

• Tuberculosis and Respiratory Diseases
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• v.83 no.1
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• pp.31-41
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• 2020

Background: Chronic cough is defined as a cough lasting more than 8 weeks and socio-economic burden of chronic cough is enormous. The characteristics of chronic cough in Korea are not well understood. The Korean Academy of Tuberculosis and Respiratory Diseases (KATRD) published guidelines on cough management in 2014. The current study evaluated the clinical characteristics of chronic cough in Korea and the efficacy of the KATRD guidelines. Methods: This was a multi-center, retrospective observational study conducted in Korea. The participants were over 18 years of age. They had coughs lasting more than 8 weeks. Subjects with current pulmonary diseases, smokers, exsmokers with more than 10 pack-years or who quit within the past 1 year, pregnant women, and users of cough-inducing medications were excluded. Evaluation and management of cough followed the KATRD cough-management guidelines. Results: Participants with chronic cough in Korea showed age in the late forties and cough duration of more than 1 year. Upper airway cough syndrome was the most common cause of cough, followed by cough-variant asthma (CVA). Gastro-esophageal reflux diseases and eosinophilic bronchitis were less frequently observed. Following the KATRD cough-management guidelines, 91.2% of the subjects improved after 4 weeks of treatment. Responders were younger, had a longer duration of cough, and an initial impression of CVA. In univariate and multivariate analyses, an initial impression of CVA was the only factor related to better treatment response. Conclusion: The causes of chronic cough in Korea differed from those reported in other countries. The current Korean guidelines proved efficient for treating Korean patients with chronic cough.

• Proceedings of the PSK Conference
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• 2003.10b
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• pp.71.2-72
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• 2003

This presentation is to enhance the pharmacist's role in Over-The-Counter(OTC) drug selection and patient counseling for diversification of pharmacy management after the separation of prescribing and dispensing practice in Korea. Self-medication by OTC drugs may be viewed as one element of the broader self-care treatment. The patient may use a OTC drug to manage a minor ailment, a process that may be supported by counseling from a pharmacist. Pharmacists involved in self-medication decisions have a greater involvement with patients and an enhanced professional role. (omitted)

• Journal of Periodontal and Implant Science
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• v.40 no.6
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• pp.283-288
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• 2010

Purpose: The aim of this case report is to present a case of incomplete bone formation after sinus augmentation. Methods: A patient having alveolar bone resorption of the maxillary posterior edentulous region and advanced pneumatization of the maxillary sinus was treated with sinus elevation using deproteinized bovine bone in the Department of Periodontology, Kyung Hee University School of Dentistry and re-evaluated with computed tomography (CT) follow-up. Results: Even though there were no significant findings or abnormal radiolucency on the panoramic radiograph, incomplete bone formation in the central portion of the augmented sinus was found fortuitously in the CT scan. The CT scan revealed peri-implant radiolucency in the apical portion of the implant placed in the augmented maxillary sinus. Nevertheless, the dental implants placed in the grafted sinus still functioned well at over 15 months follow-up. Conclusions: The result of this case suggests that patients who received maxillary sinus augmentation may experience incomplete bone formation. It is possible that 1) osteoconductive graft material with poor osteogenic potential, 2) overpacking of graft material that restricts the blood supply, and 3) bone microbial contamination may cause the appearance of incomplete bone formation after sinus augmentation. Further studies are needed to elucidate the mechanism of this unexpected result and care must be taken to prevent it.

• Women's Health Nursing
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• v.10 no.3
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• pp.226-234
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• 2004

Purpose: This study was to examine health status, reproductive health problems and the degree of prenatal management in working women. Method: The subjects were 902 married working women among 2,000 women selected by cluster sampling. The work area was classified to product factory, school, office, etc. After an Informed consent was obtained, participants were asked to fill out a self-administered questionnaire. The instruments included a questionnaire, parity check list, menstrual problems and gynecologic problem check list. Result: Many women have experienced menstrual cycle change during the past year. There was a significant difference in general health, menstrual regularity, reproductive health and prenatal management by occupation type. 40.6 percent of the subjects have gynecological problems such as menstrual cycle change, perineal inflammation, irregular vaginal bleeding, amenorrhea, ovarian/uterine disease, infertility, or abortion. Prenatal care was received in only 28.5% of the total subjects. In addition, 16.3% answered they had experienced low birth weight babies. Conclusion: We can conclude that working woman have changes in menstruation cycle and in reproductive health status. Therefore, we suggest that some occupational characteristics may affect subject's reproductive health, these should be clear and avoided as much as possible.

• Tuberculosis and Respiratory Diseases
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• v.79 no.2
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• pp.74-84
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• 2016

Nontuberculous mycobacteria (NTM) are emerging pathogens that affect both immunocompromised and immunocompetent patients. The incidence and prevalence of NTM lung disease are increasing worldwide and rapidly becoming a major public health problem. For the diagnosis of NTM lung disease, patients suspected to have NTM lung disease are required to meet all clinical and microbiologic criteria. The development of molecular methods allows the characterization of new species and NTM identification at a subspecies level. Even after the identification of NTM species from respiratory specimens, clinicians should consider the clinical significance of such findings. Besides the limited options, treatment is lengthy and varies by species, and therefore a challenge. Treatment may be complicated by potential toxicity with discouraging outcomes. The decision to start treatment for NTM lung disease is not easy and requires careful individualized analysis of risks and benefits. Clinicians should be alert to those unique aspects of NTM lung disease concerning diagnosis with advanced molecular methods and treatment with limited options. Current recommendations and recent advances for diagnosis and treatment of NTM lung disease are summarized in this article.

• Safety and Health at Work
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• v.7 no.4
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• pp.340-346
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• 2016

Background: safety and healthy working environment has received numerous research attention over the years. Majority of these researches seem to have been conducted in the construction industry, with little attention in the health sector. Nonetheless, there are couple of studies conducted in Africa that suggest pressure in hospitals. Therefore the aim of the study was to examine how pressure influence safety behavior in the hospitals. With reference to the relevance of safety behavior in primary health care delivery, there was the need for the study. Method: Data was obtained from 422 public hospital employees. Respondents were assured that all information would be kept confidential to increase the response rate and acquire more accurate information. Collection of questionnaires from participants took four weeks (20 working days), after which the data was analyzed. Results: The result of the study showed that work pressure correlated negatively with safety behavior. General safety climate significantly correlated positively with safety behavior and negatively with work pressure, although the effect size for the latter was smaller. Hierarchical regression analysis showed management commitment to safety to moderate the relationship between work pressure and safety behavior. Conclusion: When employees perceive safety communication, safety systems and training to be positive, they seem to comply with safety rules and procedures than voluntarily participate in safety activities.