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Development of Contents for the Activities of Daily Living Training for Life Care - Korean Version (라이프케어를 위한 한국형 일상생활활동훈련치료 콘텐츠 개발)

  • Lee, Chun-Yeop;Park, Young-Ju
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.7
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    • pp.529-538
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    • 2020
  • This study aims to develop of contents for the activities of daily living training - Korean version that reflexes the domestic situation and can be applied to clinical practice. For contents development, a Delphi survey was conducted with 13 experts. In the first Delphi survey, 133 items of activities of daily living training are derived based on previous studies, and then the extracted items are asked to group of experts, and the derived items are answered for actual domestic clinical application. In the second survey, 118 items were added by excluding items with a low content validity ratio (CVR) including the results of the first survey, and adding items that can be derived from other opinions. In the 3rd survey, while presenting the 2nd Delphi survey items as they are, it provides an opportunity to change their opinions by presenting their 2nd response and the 2nd average score of other expert panels, and adding appropriateness and importance together. The data were analyzed to obtain the mean, standard deviation, interquartile range, CVR, convergence, and consensus. Finally, a total of 69 items were selected and 49 items were excluded so that 105 items for CVR 0.54 or higher, 111 items for convergence degree 0.50 or lower, and 70 items for continuity degree 0.75 or higher. Sexual activity, care of others, care of pets, and child rearing are difficult to apply socially and culturally, driving and community mobility cannot be performed within the clinical room, and home establishment and management may have different roles depending on gender, and religious spiritual activities and expression are so personal. For these reasons, these items were found to have low importance or suitability. This study can be usefully used as an indicator on the activities of daily living training - Korean version in clinic or community setting.

A Study on the Rational Improvement of the Regulation and System about Embryo Preservation (배아 보존에 관한 합리적 제도 개선을 위한 연구)

  • Baik, Sujin;Moon, Hannah;Park, Inkyoung;Cha, Seunghyun;Park, Joonseok;Lee, Gyeonghun;Park, Chun-seon;Cho, Heesoo;Kim, Myung-Hee
    • The Korean Society of Law and Medicine
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    • v.22 no.3
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    • pp.57-95
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    • 2021
  • Korea's period for preservation of embryos is up to five years (the Bioethics Act). However, the study reviewed domestic and foreign laws and drew issues due to the recent demand that the development of related science and technology and the period limitation limit the rights of consent holder for embryo production. the first issue is that preserved embryos are intended for pregnancy, and it is important to ensure that the autonomy of the consent holder is protected through careful consideration based on information such as scientific evidence. the second is that regulations regarding the obligation to manage embryonic preservation institutions are needed. the third is to create a social atmosphere in which embryo creation, preservation, and disposal take place in a minimum range, considering the special status of embryos. based on this issue, the first of the proposals for rational improvement of the regulation and system about embryo preservation is the introduction of an environment in which sufficient explanation and appropriate consent can be exercised and to extend the reasons for the extension of the period, rather than specifying the specific period in law. the second is that institutionalization is necessary considering not only the obligation to manage preservation institutions but also the overall site, such as concerns that may arise as a result. lastly, we propose the introduction of a management method considering the future use of embryos, such as transfer to provide research purposes and donation of pregnancy purposes by others. this process should be a method of sufficient social discussion and consensus, as well as a general consideration of the family relationship with the born child.

The Role of ROS-NF-κB Signaling Pathway in Enhancement of Inflammatory Response by Particulate Matter 2.5 in Lipopolysaccharide-stimulated RAW 264.7 Macrophages (RAW 264.7 대식세포에서 지질 다당류에 의한 미세먼지(PM2.5) 유발 염증 반응 증진에 미치는 ROS-NF-κB 신호 전달 경로의 역할)

  • Kwon, Da Hye;Kim, Da Hye;Kim, Min Yeong;Hwangbo, Hyun;Ji, Seon Yeong;Park, Seh-Kwang;Jeong, Ji-Won;Kim, Mi-Young;Lee, Hyesook;Cheong, JaeHun;Nam, Soo-Wan;Hwang, Hye-Jin;Choi, Yung Hyun
    • Journal of Life Science
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    • v.31 no.12
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    • pp.1110-1119
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    • 2021
  • The purpose of this study was to investigate whether the inflammatory response in lipopolysaccharide (LPS)-treated RAW 264.7 macrophages could be promoted by particulate matter 2.5 (PM2.5) stimulation. To this end, the levels of inflammatory parameters, reactive oxygen species (ROS) and inflammation-regulating genes were investigated in RAW 264.7 cells treated with PM2.5 in the presence or absence of LPS. Our results showed that the production levels of pro-inflammatory mediators (nitric oxide and prostaglandin E2) and cytokines (interleukin-6 and -1β) were significantly increased by PM2.5 stimulation in LPS-treated RAW 264.7 cells, which was correlated with increased expression genes involved in their production. In addition, when LPS-treated RAW 264.7 cells were exposed to PM2.5, nuclear factor-kappaB (NF-κB) expression was further increased in the nucleus, and the expression of inhibitor of NF-κB as well as NF-κB in the cytoplasm was decreased. These results suggest that the co-treatment of PM2.5 and LPS further increases the activation of the NF-κB signaling pathway compared to each treatment alone, thereby contributing to the promotion of transcriptional activity of inflammatory genes. Furthermore, although the generation of ROS was greatly increased by PM2.5 in LPS-treated RAW 264.7 cells, the NF-κB inhibitor did not reduce the generation of ROS. In addition, when the generation of ROS was artificially suppressed, the production of inflammatory mediators and the activation of NF-κB were both abolished. Therefore, our results suggest that the increase in the NF-κB-mediated inflammatory response induced by PM2.5 in LPS-treated RAW 264.7 macrophages was a ROS generation-dependent phenomenon.

Preventive Effect of Poricoic Acid against Nonalcoholic Steatohepatitis (Poricoic acid의 비알코올성 지방간염 억제 효능)

  • Kim, Hae Ran;Jung, Dae Young;Kim, Say;Jung, Myeong Ho
    • Journal of Life Science
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    • v.32 no.12
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    • pp.962-970
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    • 2022
  • Nonalcoholic steatohepatitis (NASH) is the progressive stage of nonalcoholic fatty liver disease (NAFLD) that highly increases the risk of cirrhosis and liver cancer, and there are few therapeutic options available in the clinic. Poricoic acid (PoA), a component of Poria cocos Wolf, has a wide range of pharmacological activities; however, little is known about its effects on NASH. The preventive effects of PoA on NASH were examined in vivo and in vitro by analyzing triglyceride synthesis, inflammation and fibrosis. In the high fat and methionine-choline deficient diet (HFMCD)-induced NASH mice, PoA reduced the liver weight and the levels of alanine aminotransferase and aspartate aminotransferase compared with non-treated HFMCD group. The staining with Oil Red O and hematoxylin and eosin revealed that PoA administration reduced red staining and the size of lipid droplet. qPCR analysis showed that PoA also reduced the expression of genes related to triglyceride synthesis. Further, immunostaining with CD68 and qPCR analysis revealed that PoA reduced the staining with CD68 and the expression of inflammatory genes induced by HFMCD. Moreover, PoA reduced the staining with sirius red and antibody of α-smooth muscle actin and also reduced the expression of genes related to fibrosis. The treatment of PoA to AML12 cells reduced the increase in triglyceride amount and expression of genes associated with triglyceride synthesis, inflammation and fibrosis. Taken together, our study indicate that PoA has therapeutic effect on NASH through preventing triglyceride synthesis, inflammation and fibrosis.

Image Analysis of Angle Changes in the Forearm during Elbow Joint Lateral General Radiography: Evaluation of Humerus Epicondyle and Elbow Joint (팔꿉관절 측방향 일반촬영에서 아래팔뼈 각도 변화에 따른 영상 분석 : 위팔뼈 위관절융기와 팔꿉관절 평가)

  • Hyo-Soo Shin;Hye-Won Jang;Jong-Bae Park;Ki Baek Lee
    • Journal of the Korean Society of Radiology
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    • v.17 no.4
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    • pp.607-614
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    • 2023
  • Clear overlapping of the bilateral epicondyle and proper separation of the elbow joint are crucial for obtaining accurate lateral general radiographs of the elbow. However, due to the complex anatomical structure of the elbow, achieving optimal positioning is challenging, leading to the need for repeated x-ray examinations. Therefore, the purpose of this study was to investigate the angle of the forearm in patients where accurate lateral images of the elbow joint can't be obtained after vertical incidence using a styrofoam device during elbow joint lateral x-ray imaging. Twenty patients were enrolled in our study following the established protocol. First, a vertical x-ray at an angle of 0° between the forearm and the table was taken (control group). Here, if the lateral image of the elbow joint was deemed inadequate, the forearm angle was adjusted using custom-made styrofoam supports with 5° and 10° inclinations (experimental groups). For the evaluation method, two assessors utilized a 5-point Likert scale to assess the images. The reliability of the assessments was analyzed using Cronbach's alpha coefficient. As a result, patients with inadequate overlap of the bilateral epicondyle and separation of the elbow joint in the initial examination (control group) were able to obtain the best images when setting a 10° angle between the forearm and the table. The subjective evaluation was 1.6 ± 0.8 points at 0°, 2.7 ± 0.8 points at 5°, and 4.4 ± 1.3 points at 10°, respectively. The reliability analysis for the angles of 0°, 5°, and 10° yielded Cronbach's alpha values of 0.867, 0.697, and 0.922, respectively. In conclusion, when it is not possible to obtain accurate images using the conventional position and X-ray beam direction, it is considered that by initially acquiring images with an angle of 10° between the forearm and the table, and gradually decreasing the angle while obtaining images, it would be possible to achieve the optimal image while reducing the number of repeat examinations.

Clinical Observation on East-West Integration Treatment in Stroke and Brain Disease (중풍 뇌 질환의 한 방향 협진에 관한 임상적 고찰)

  • Shin, Ae-sook;Lee, ln-whan;Kim, Na-hee;Kim, Hye-rni;Kim, Min-kyung;Sim, So-ra;Cho, Seung-yeon;Park, Seong-uk;Park, Jung-mi;Bae, Hyung-sup;Ko, Chang-nam
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.11 no.1
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    • pp.9-17
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    • 2010
  • Objectives : This study was aimed to evaluate the current status of East-West integrated treatment in stroke and brain disease and to discuss further plans. Methods : The medical records of patients who visited the stroke and brain disease center at Kyung Hee University, East-West Neo Medical Center from May 2006 to August 2010 were evaluated. The general characteristics of patients who underwent integrated treatment, trend in the number of cross referrals were initially evaluated. Later major disorders, the reasons of referrals and the number of visits in outpatients were analyzed. Results : 1. 3496 patients were referred from the eastern medical hospital to the western medical hospital and 2440 patients from the western medical hospital to the eastern medical hospital. The number of patients reached a peak alter the opening of the hospital and has decreased from then on. Referrals of female patients were more than those of male patients and patients over 50 years old were the most. 2. Admitted patients with stroke of chronic stage were most commonly referred from the eastern medical hospital to the western medical hospital and cerebral infarction was most common from the western medical hospital to the eastern medical hospital. Among the outpatients cerebral infarction topped from east to west, and stroke of chronic stage from west to east. 3. 36.6% of the patients from east to west received integrated treatment more than 3 times and 28.6% from west to east. Headache was the second most common reason to be referred from west to east and 36.7% of patients didn't continue to have either of the treatment and 30.3% received eastern treatment only, Conclusions: According to this study, chronic stroke management was successfully performed in the outpatient clinic in the form of East-West integration treatment. Further research on other diseases such as headache is recommended.

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Developing a Tool to Assess Competency to Consent to Treatment in the Mentally Ill Patient: Reliability and Validity (정신장애인의 치료동의능력 평가 도구 개발 : 신뢰도와 타당화)

  • Seo, Mi-Kyoung;Rhee, MinKyu;Kim, Seung-Hyun;Cho, Sung-Nam;Ko, Young-hun;Lee, Hyuk;Lee, Moon-Soo
    • Korean Journal of Health Psychology
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    • v.14 no.3
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    • pp.579-596
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    • 2009
  • This study aimed to develop the Korean tool of competency to consent to psychiatric treatment and to analyze the reliability and validity of this tool. Also the developed tool's efficiency in determining whether a patient possesses treatment consent competence was checked using the Receiver Operating Characteristic curve and the relevant indices. A total of 193 patients with mental illness, who were hospitalized in a mental hospital or were in community mental health center, participated in this study. We administered a questionnaire consisting of 14 questions concerning understanding, appreciation, reasoning ability, and expression of a choice to the subjects. To investigate the validity of the tool, we conducted the K-MMSE, insight test, estimated IQ, and BPRS. The tool's reliability and usefulness were examined via Cronbach's alpha, ICC, and ROC analysis, and criterion related validation was performed. This tool showed that internal consistency and agreement between raters was relatively high(ICC .80~.98, Cronbach's alpha .56~.83)and the confirmatory factor analysis for constructive validation showed that the tool was valid. Also, estimated IQ, and MMSE were significantly correlated to understanding, appreciation, expression of a choice, and reasoning ability. However, the BPRS did not show significant correlation with any subcompetences. In ROC analysis, full scale cutoff score 18.5 was suggested. Subscale cutoff scores were understanding 4.5, appreciation 8.5, reasoning ability 3.5, and expression of a choice 0.5. These results suggest that this assessment tool is reliable, valid and efficient diagnostically. Finally, limitations and implications of this study were discussed.

Alveolar ridge preservation using granulation tissue for esthetic implant restoration on maxillary anterior tooth (상악 전치부의 심미적 임플란트 수복을 위한 육아 조직(Granulation tissue)을 이용한 치조제 보존술)

  • Lee Chang Kyun
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.32 no.1
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    • pp.16-22
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    • 2023
  • Esthetic factors are very important in the success of maxillary anterior implant restoration. However, achieving esthetic results is difficult, especially in cases where periodontitis has resulted in severe alveolar bone loss. In the case of maxillary anterior teeth, the alveolar ridge resorption that begins immediately after tooth extraction interferes with the esthetic implant restoration. Therefore immediate implant placement can be performed to minimize the alveolar ridge resorption. However, in severe bone loss cases, immediate implant placement could result in esthetic failure, and this result might cause irreparable problems. We can also perform alveolar ridge preservation and then place implants later. On JCP published in 2019, there is the consensus of European academy of periodontology on the extraction socket management and the timing of implant placement. This consensus states that alveolar ridge preservation should be considered when there is severe labial bone loss in an esthetically important area such as maxillary anterior region. On performing the alveolar ridge preservation, we cannot obtain the primary wound closure, so secondary wound healing is induced with open membrane technique or soft tissue grafting should be performed for primary wound closure. However, the secondary wound healing can have a negative impact on bone regeneration, and soft tissue grafting such as FGG or CT graft can be burdensome for both patients and dentists. On the other hand, by using the granulation tissue in the extraction socket, primary closure can be achieved without soft tissue grafting. Also some studies have shown that granulation tissue in periodontal defects contains stem cells that may help in tissue regeneration. Based on this, implant restorations were performed on maxillary anterior teeth with severe alveolar bone loss by alveolar ridge preservation using granulation tissue. In spite of the severe bone defect of the extraction socket, relatively esthetic results could be obtained in implant restorations.

Effect of surface sealant on surface roughness of dental composite with different surface roughness (서로 다른 거칠기의 복합레진에 표면 강화제 도포시 표면 거칠기의 변화)

  • Dong-Ah Shin;Seon-Ju Jin;Kkot-Byeol Bae;In-Nam Hwang
    • Journal of Dental Rehabilitation and Applied Science
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    • v.39 no.4
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    • pp.195-203
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    • 2023
  • Purpose: This study aimed to evaluate the influence of surface sealants on the surface roughness of composite resins. Materials and Methods: The study used microfilled composite resin (Metafil CX, Sun Medical Co.) and hybrid composite resin (AeliteTM LS posterior, Bisco). Sixty specimens (8 mm in diameter and 4 mm in height) of each composite resin type were prepared and divided into 3 groups. Each specimen was ground with 600, 1000, and 2000-grit sandpaper. The Surface roughness (Ra) values were measured using a surface roughness tester (SJ-301, Mytutoyo) before and after surface sealant application. Surface sealants, BisCoverTM LV (Bisco), Optiguard® (Kerr), and Seal-n-ShineTM (Pulpdent), were applied to the specimens, as instructed and observed by scanning electron microscope (JSM-7500, JEOL) and atomic force microscope (MultiMode IV, Veeco Instruments). Results: Specimens ground with 600-grit sandpaper coated with surface sealants exhibited significantly lower Ra values than the untreated group (P < 0.05). Specimens ground with 1000 and 2000-grit sandpaper showed statistically no difference. There was no significant difference in surface roughness among BisCoverTM LV, Optiguard®, and Seal-n-ShineTM. SEM and AFM revealed remarkably decreased microdefects on the surfaces of composite resins after surface sealant application. Conclusion: Surface sealants can influence surface roughness when applied on the rough surface of composite resins but not on highly polished composite resins.

The influence of fitness and type of luting agents on bonding strength of fiber-reinforced composite resin posts (섬유강화 복합레진 포스트의 결합강도에 대한 포스트 공간 적합도 및 접착 시멘트의 영향)

  • Kkot-Byeol Bae;Hye-Yoon Jung;Yun-Chan Hwang;Won-Mann Oh;In-Nam Hwang
    • Journal of Dental Rehabilitation and Applied Science
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    • v.39 no.4
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    • pp.187-194
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    • 2023
  • Purpose: A mismatched size in the post and post space is a common problem during post-fixation. Since this discordance affects the bonding strength of the fiber-reinforced composite resin post (FRC Post), a corresponding luting agent is required. The aim of this study was to evaluate the bonding strength of the FRC post according to the fitness of the fiber post and the type of luting agent. Materials and Methods: Thirty mandibular premolar were endodontic-treated and assigned to two groups according to their prepared post space: Fitting (F) and Mismatching (M). These groups were further classified into three subgroups according to their luting agent: RelyX Unicem (ReX), Luxacore dual (Lux), and Duolink (Duo). A push-out test was performed to measure the push-out bond strengths. The fractured surfaces of each cross-section were then examined, and the fracture modes were classified. Results: In the ReX and Duo subgroups, the F group had a higher mean bond strength; however, the Lux subgroup had no significant difference between the F and M groups. In the analysis of the failure modes, the ReX subgroup had only adhesive failures between the cement and dentin. Conclusion: The result of this study showed that the bond strength of an FRC post was influenced by the type of luting agent and the mismatch between the diameter of the prepared post space and that of the post.