• Journal of Korean Academy of Oral Health
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• 제42권4호
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• pp.124-129
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• 2018

Objectives: The objectives of this study were to investigate the effects of oral health-related factors on the oral health knowledge, attitude, and practice of students of the Department of Dental Hygiene major, Health-related major, General major, and to provide primary data to improve the oral care ability of university students. Methods: After institutional review board approval, the study was conducted from May 15 to December 1, 2017. All 363 university students in Busan completed a questionnaire. In total, 332 questionnaires were analyzed. Thirty-one cases were excluded due to unreasonable responses. Data were analyzed using SPSS version 24.0. Results: Analysis of the factors related to knowledge, attitude, and practice of oral health according to the major field of study of the respondents indicated that students in the Dental Hygiene major demonstrated significantly better results. Conclusions: It is necessary to determine a way to manage the oral health of university students. In addition, voluntary participation of universities to improve oral health of university students is desirable. It is also necessary to establish national health policies and a national health care education curriculum for university students.

• 대한치과마취과학회지
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• 제14권2호
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• pp.89-94
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• 2014

Local anesthesia known as the safe and essential procedure to control pain in dentistry may cause sensory changes such as paresthesia or altered taste at the affected sites after even successful local anesthesia. Although the prognosis of the nerve injuries after local anesthesia is favorable, it might cause prolonged problems such as dysesthesia. The lingual nerve is a single fascicle at the level of the lingual among 1/3 of patients and more movable during regeneration compared to the inferior alveolar nerve after the injury. As a result, the lingual nerve is more vulnerable and has poorer outcomes. More vigilant clinical considerations are required to the lingual nerve injury after local anesthesia. Generally, more than 80% of cases are spontaneously resolved within 2 weeks after the local anesthesia even without any specific treatment. However, the patient having long lasting abnormal sensations more than 2 weeks needs specialists' care for further assessment. In case of dysesthesia which is a symptom of neuropathic pain, immediate referral to specialists is mandatory. The exact mechanism, how to prevent its occurrence, or specific treatments of the nerve injury related to the local anesthesia have not been elucidated. To prepare clinical or medicolegal problems, many cautious considerations are given to the patients who complain sensory changes after local anesthesia.

• 한국간호교육학회지
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• 제3권2호
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• pp.163-192
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• 1997

As the population over the age of 65 increases, the demand for nurses who care for this group also continues to grow. Well-prepared nurses who are knowledgeable and skilled for the elderly can be prepared through systematic gerontological nursing curricula. This study was carried out to identify the needs for gerontological nursing curricular contents. The subjects for this study were two participant groups the educators who teach gerontological nursing in three-year and four-year baccalaureate nursing programs, and the nurses who are working with the elderly in hospitals, community health centers, social welfare agencies, and community health practioner's posts. The major findings of the study are as follows : 1. The differences between actual contents and essential contents of the educators : Concerning the actual contents that is actually taught, the educators showed the highest scores on the demographics of older adults and the lowest scores on the cultural variations affecting health care. Regarding the essential contents, the educators showed the highest scores on the demographics and the lowest scores on the economics of aging. Aside from the demographics, all of the items were found to have significant differences between essential and actual contents. This implies that all the content areas except demographics should be emphasized. 2. The differences between actual knowledge and essential knowledge of the nurses : Concerning the nurses' actual knowledge, the nurses showed the highest scores on the common health problems and their treatment and the lowest scores on the politics of aging. Regarding the essential knowledge, nurses showed the highest scores on the chronic illness and common health problems and the lowest scores on their roles and functions. However, they thought all the items to be essential. All of the items were found to have significant differences between actual and essential knowledge. The nurses who studied gerontological nursing in their school years and after graduating had more knowledge. However, they felt more knowledge was needed. This implies that the nurses need more education in all content areas of gerontological nursing. 3. The differences between educators and nurses : Concerning the essential contents, the educators showed higher scores on the demographics and growth and development than the nurses. Whereas, the nurses showed higher scores on the cultural variations, long-term care, economics of aging, politics of aging, legal and ethical issues, and common health problems than the educators. 4. Activities of nursing care for the elderly : Most common activities were related to direct nursing care such as giving physical care, counseling/teaching clients, and assessing and planning care for the clients. Nurses thought that all the items were critical, but they showed relatively low scores on the following :'serve on multidisciplinary committee', 'preparing reports', 'evaluation of outcomes of care', 'determine policy for nursing service', 'set patient care standards', and 'participate in nursing research' The constraints in providing better nursing service were time constraints, administrative restraints, social restraints, and inadequate knowledge.

• 문화기술의 융합
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• 제5권4호
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• pp.105-114
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• 2019

커뮤니티케어가 기반이 된 주간활동서비스는 학령기 이후의 성인 발달장애인을 위한 돌봄과 지역사회의 다양한 참여를 결합한 '참여형 지역사회 통합 돌봄(커뮤니티 케어) 서비스를 의미한다. 만 18세 이상의 성인 발달장애인이 낮 시간 돌봄 및 지역사회 참여 프로그램을 제공받는 다는 점에서 부모 및 가족의 돌봄부담을 경감시키고 발달장애인 당사자에게는 생애주기별 평생케어의 성격을 지니고 있다. 본 연구의 목적은 커뮤니티 케어기반의 주간활동서비스내용을 고찰하고, 성인기 발달장애인에게 의미 있는 사회참여가 될 수 있는 돌봄 프로그램을 전개하기 위해 앞으로 전개되어야 할 주간 활동서비스 활성화 방안을 모색하는데 있다. 이에 문헌연구를 통해 커뮤니티케어로서의 성인발달장애인의 주간활동 서비스, 사회활동실태를 분석하고, 우리나라 보다 앞서 주간활동서비스를 제공하고 있는 영국 켄트 주의 주간활동서비스 사례를 살펴보았다. 이상을 바탕으로 활동지원바우처 증액, 주간활동 서비스 시간확대, 주간활동 서비스 대상자 수 확대를 위한 예산편성 확대, 최중증 발달장애인 20% 우선순위를 확대 적용 및 별도의 팀 구성, 발달장애인지원센터의 역할 강화를 제시하였다.

• 한국학교보건학회지
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• 제13권1호
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• pp.131-145
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• 2000

For the purpose of strengthening Dental Hygiene students' confidence and motivation in the Dental Hygiene Department and helping construct proper professionalism, survey on Dental Hygiene students' consciousness of attitude to and satisfaction of the course, career plan and occupation mind set was carried out. 530 three year students in 8 Dental Hygiene academies in Seoul and Kyonggi province were questioned. The results of the survery are as follows:. 1. Dental Hygiene students' motives consisted primarily of employment and a desire for professionalism 25% of them entered the course after one failure in the entrance examination and 17% had family members engaging in the dentistry field 84%, the largest portion, were from an academic high school. 24% had some knowledge of Dental Hygiene, which they had acquired from seniors, friends, and teachers. 2. Patient care and treatment assistance related matters were not considered important in the course. The weak points of the course turned out to be education in computers and foreign languages, but the weakest was the ability of patient care during clinical training. 53% had experiences had thought of changing their major while in the course because it didn't match their aptitude and interest. 3. As for a career after graduation, 49% worried about it Most students wanted to work at a dental hospital or general hospital, The most favored duty was coordination or reception or oral disease preventive work. They wanted to work untill they had a stable living. 68% answered they would get a job at an oral clinic and 70% said they would continue studying for self-realization. 4. Satisfaction with the major was high in students whose aptitude and interest matched the course, who had background knowledge of the major, and who. didn't think of changing the major but would continue studying resulting in statistically slight difference(p<0.001). As to satisfaction with the faculties, it was high in the students whose aptitude and interest matched the major and who didn't think about a career after graduation showing a slight difference(p<05, p<0l). As for satisfaction with clinical training, students whose aptitude and interest matched the major and who didn't consider changing the major answered positively showing a statistically slight difference(p<.001, p<.01). As to satisfaction with the course, it was high in the students who entered with aptitude and interest, who had preliminary knowledge, who didn't consider changing the major, and who didn't think about a career after graduation showing a statistically slight difference(p<.001, p<.05). 5. Occupation mind-set was positive for students who entered with interest and aptitude, who had preliminary knowledge, and who had not considered changing the major showing a statistically slight difference(P<.001). The higher the satisfaction with the major, faculty and clinical training was, the more positive the occupation mind-set was(p<.001).

• Neonatal Medicine
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• 제25권1호
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• pp.23-28
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• 2018

Purpose: Abdominoperineal solid tumors presenting in neonates often require surgical intervention during the neonatal period. Although we report our single-center experience, this study would be meaningful to understand the clinical implications of these neoplasms. Methods: We retrospectively reviewed and analyzed the clinical data and characteristics of 22 patients (${\leq}28$ days old) diagnosed with histopathologically confirmed abdominoperineal solid neoplasms (benign or malignant) after surgical resection. Results: The mean gestational age and postnatal age at the time of operation were $38.3{\pm}1.8weeks$ and $13.5{\pm}8.3days$, respectively. Most patients (18/22, 81.8%) were diagnosed during antenatal care visits; however, 4 (18.2%) were identified after birth. The mean tumor size was $6.4{\times}5.3cm$ (3.5-17.0 cm), and tumors occurred most frequently within the sacrococcygeal region (8/22, 36.4%). Histopathologically, 14 patients (63.6%) demonstrated benign tumors and 8 (36.4%) demonstrated malignant tumors. Germ cell tumors and hepatoblastomas were the most commonly observed tumors. Fortunately, all patients showed a localized pattern of tumor involvement without distant metastasis. No recurrence or mortality was observed during the follow-up period (mean $66.4{\pm}44.2months$). Conclusion: Abdominoperineal solid tumors occurring in neonates show variable clinical patterns during the antenatal and postnatal monitoring/screening periods. We conclude that aggressive and multidisciplinary approaches could achieve good clinical results in these patients.

• Korean Journal of Radiology
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• 제25권1호
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• pp.24-32
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• 2024

Despite improvements in operative techniques and perioperative care, post-hepatectomy liver failure (PHLF) remains the most serious cause of morbidity and mortality after surgery, and several risk factors have been identified to predict PHLF. Although volumetric assessment using imaging contributes to surgical simulation by estimating the function of future liver remnants in predicting PHLF, liver function is assumed to be homogeneous throughout the liver. The combination of volumetric and functional analyses may be more useful for an accurate evaluation of liver function and prediction of PHLF than only volumetric analysis. Gadoxetic acid is a hepatocyte-specific magnetic resonance (MR) contrast agent that is taken up by hepatocytes via the OATP1 transporter after intravenous administration. Gadoxetic acid-enhanced MR imaging (MRI) offers information regarding both global and regional functions, leading to a more precise evaluation even in cases with heterogeneous liver function. Various indices, including signal intensity-based methods and MR relaxometry, have been proposed for the estimation of liver function and prediction of PHLF using gadoxetic acid-enhanced MRI. Recent developments in MR techniques, including high-resolution hepatobiliary phase images using deep learning image reconstruction and whole-liver T1 map acquisition, have enabled a more detailed and accurate estimation of liver function in gadoxetic acid-enhanced MRI.

• Journal of Chest Surgery
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• 제57권3호
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• pp.315-318
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• 2024

The HeartWare Ventricular Assist Device (HVAD) was widely used for mechanical circulatory support in patients with end-stage heart failure. However, there have been reports of a critical issue with HVAD pumps failing to restart, or experiencing delays in restarting, after being stopped. This case report describes 2 instances of HVAD failure-to-restart during heart transplantation surgery and routine outpatient care. Despite multiple attempts to restart the pump using various controllers and extensions, the HVAD failed to restart, triggering a hazard alarm for pump stoppage. In one case, the patient survived after receiving a heart transplantation, while in the other, the patient died immediately following the controller exchange. These cases highlight the rare but life-threatening complication of HVAD failure-to-restart, underscoring the importance of awareness among clinicians, patients, and caregivers, and adherence to the manufacturer's guidelines and recommendations for HVAD management.

• Tuberculosis and Respiratory Diseases
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• 제48권6호
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• pp.932-943
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• 2000

배경 : 비특이성 간질성 폐렴(Nonspecific interstitial pneumonitis ; NSIP)은 통상성 간질성 폐렴(usual interstitial pneumonitis ; UIP)에 비해 치료에 대한 반응과 예후가 좋으므로 반드시 감별 진단하여 적극적인 치료가 필요하나 아직까지 일괄적 폐생검 이외에는 확실한 감별이 되지 않는 실정이다. 이에 외과적 폐생검으로 확진 된 NSIP와 UIP 환자들에서 임상적 특징과 방사선학적 소견의 차이점을 비교하고, 미국흉부학회에서 2000년에 제시한 IPF의 임상 진단기준을 적용하여 진단기준의 유용성올 평가해 보고자 본 연구를 시행하였다. 방법 : 1996년 7월부터 2000년 3월까지 삼성서울병원에서 조직검사 상 UIP와 NSIP로 확진된 60명을 대상으로 후향적 조사를 하였다. 각 환자들의 임상 증상과 폐기능 검사, 동맥혈가스분석, BAL 및 흉부HRCT 소견을 비교하고, 미국흉부학회에서 제시한 IPF의 임상 진단기준에 적용하여 임상적 진단율을 비교해 보았다. 결과 : 1) 전체 60명 중 UIP 환자는 42명, NSIP 환자는 18명이었다. 2) UIP 환자의 평균 연령은 59.5$\pm$7.1세(45~74세)였고, NSIP 환자는 55.2$\pm$8.4세(44~73세)였으며 (p=0.046), UIP는 남자 33명, 여자 9명이었으나 NSIP는 남자 1명, 여자 17명이었다(p=0.001). 3) 호흡기 임상 증상의 유무 및 종류에는 차이가 없었으나, 동반 증상 중 발열은 NSIP 환자에서 많았고(p=0.034), 곤봉지는 UIP 환자에서 많았다 (p=0.023). 4) BAL의 세포 구성비는 NSIP 환자에서 림프구가 많았고(23% vs. 11% ; p=0.0001), CD4/CD8의 비는 NSIP가 더 낮았다(0.76$\pm$0.49 vs. 9.71$\pm$0.25 ; p=0.045). 5) HRCT 소견 상 봉와양 음영은 UIP 환자에서 더 흔히 보였다(86% vs. 0%; p=0.0001). 6) 미국흉부학회의 IPF 임상 진단기준에는 UIP 환자에서는 23.3 %(7/30명)가, NSIP 환자에서는 18.8% (3/16 명)이 만족하였다(p>0.05). 결론 : 나이가 비교적 적은 여자이면서 임상 증상 기간이 짧고 발열이 있으며 곤봉지의 소견이 없고, BAL에서 림프구가 많으며, HRCT 상 봉와양 음영이 없을 경우에는 NSIP를 더 시사하는 소견이며, 미국흉부학회의 IPF 임상 진단기준은 한국에서 유용성이 떨어져 앞으로 한국적인 임상 진단기준의 마련이 필요한 것으로 사료된다.

• Tuberculosis and Respiratory Diseases
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• 제52권1호
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• pp.14-23
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• 2002

배 경 : 부분액체환기 (partial liquid ventilation; PLV) 시 최적의 기계환기의 설정에 대해서는 아직 논란이 많은 상태이다. 이에 정상 폐의 PLV 시 가스교환에 영향을 주는 인자들을 관찰함으로써, PLV 시 최적의 기계환기 설정을 확립하는 데에 이용하고자 본 연구를 시행하였다. 방 법 : New Zealand 산 백색 토끼 7 마리를 기계환기를 시행하였다. 기계환기는 압력 조절 양식으로 일회호흡량 ($V_T$) 8 mL/kg, PEEP 4 $cmH_2O$, 흡기대호기비 (I: E ratio) 1:2, 흡입산소분율 ($F_IO_2$) 0.75로 설정하였고, 호흡수(RR)는 $PaCO_2$가 35~45 mmHg 사이에 유지되도록 조절하였다. 이후 30분마다 기계환기기의 설정을 protocol에 따라 변화시키면서 가스환기(gas ventilation; GV)를 시행하였는데 ; (1) 기저 설정 단계, (2) 역비환기 (inverse I: E ratio) 단계로 I:E ratio 2:1, (3) 고 PEEP 단계로 2단계와 같은 평균흡기압 (MIP)을 유지하는 정도의 PEEP 증가, (4) 고 $V_T$ 단계로 $V_T$ 15 mL/kg, (5) 고RR 단계로 4단계와 같은 분당환기량 (MV)을 유지하는 정도로 RR을 증가시켰다. 그 후 perfluorodecalin 18 mL/kg 주입 후 상기 protocol과 동일하게 PLV를 하였다. 각각에서 동맥혈가스검사와 폐역학 및 혈역학적 지표를 측정하였다. 결 과 : (1) GV 시 $PaO_2$는 다섯 단계를 거치는 동안 의미 있는 변화를 보이지 않았다. $PaCO_2$는 고 $V_T$단계와 고 RR 단계에서 의미 있게 감소하였다(p<0.05). GV 시 폐역학 및 혈역학적 지표의 의미 있는 변화는 보이지 않았다. (2) PLV 군의 기저 $PaO_2$는 $312{\pm}113$ mmHg로 GV군의 $504{\pm}81$ mmHg 에 비해 의미 있게 낮았다(p=0.001). PLV 시 역비환기 단계나 고 RR 단계에서는 기저설정 단계와 비교하여 $PaO_2$의 의미 있는 차이가 관찰되지 않았으나, 고 PEEP 단계 ($452{\pm}38$ mmHg)와 고 $V_T$($461{\pm}53$ mmHg) 단계에서는 기저설정 단계보다 유의한 상승이 관찰되었다. (3) $PaCO_2$는 GV군과 PLV군 모두에서 고 $V_T$ 단계와 고 RR 단계에서 기저설정 단계보다 의미 있게 낮았다. PLV군의 기저설정 단계와 고 RR 단계의 $PaCO_2$는 GV 군보다 의미 있게 증가하였다(p<0.05). (4) PLV 시 폐역학 및 혈역학적 지표의 의미 있는 변화는 보이지 않았다 결 론 : 정상 폐에서 PLV 시 최적의 가스교환을 위해서는 적절한 PEEP과 $V_T$이 중용할 것으로 사료된다.