• 대한치과의사협회지
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• 제54권11호
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• pp.865-873
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• 2016

Background/Purpose: The purpose of this study was to evaluate the effect of Nd:YAG irradiation on adherence of retrograde filling materials (mineral trioxide aggregate [MTA] and Super-EBA) by micro-computed tomography (CT) measurement and to observe the dentinal surface after irradiation by scanning electron microscopy (SEM). Materials and methods: Forty retrofilling models using extracted human teeth were divided into four groups according to the material and method used: ProRoot MTA (MTA group), Super-EBA (EBA group), MTA with Nd:YAG laser irradiation (LMTA group), and Super-EBA with Nd:YAG laser irradiation (LEBA group). All specimens were stored in 100% humidity for 24 hours until micro-CT was performed. The gap volume of the tooth/material interface was measured using the CTAn program. In six samples, the laser-irradiated dentin surface was observed using SEM. Results: The mean percent difference in gap volume was not statistically significant between the Nd:YAG laser-irradiated groups and non-irradiated in both materials(P > 0.05). The gap volume in the MTA group was significantly lower than that in the EBA group (P < 0.05). Examination of the non-irradiated specimens by SEM showed patent dentinal tubules. In contrast, alterations in the texture of the dentin surface and obliteration of the dentinal tubules were evident in the Nd:YAG laser-irradiated specimens. Conclusion: In this study, changes in the dentinal surface after Nd:YAG irradiation did not affect adherence between the apical filling material and the dentin wall.

• 대한치과보철학회지
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• 제57권1호
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• pp.31-36
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• 2019

고령인구의 수가 증가함에 따라 무치악 환자의 비율이 높아지고 있으며, 전통적인 방식의 의치의 수요 또한 증가할 것으로 분석된다. 전통적인 방식의 의치에서 만족 할 만한 의치를 제작하기 위해서는 상,하악 치조제의 관계 및 형태에 맞춰 치아를 배열하는 것이 중요하다. 본 증례는 79세 여자 환자로 환자의 심리 및 경제적인 이유로 급여 의치 제작을 희망하였다. 치조골이 심하게 위축된 상태로 치조제 간의 위치관계에 대한 정확한 평가를 위해 교합기에 부착한 주모형을 스캔하여 치과용 CAD 소프트웨어를 활용하였고, 프로그램 상에서 치조제 관계를 확인하여 치조정간선 법칙에 따라 구치부는 교차교합 형태로 배열하였다. 완성 후 정기적인 검사 및 치료 결과 의치는 적절한 안정과 유지를 보였으며 환자 역시 높은 만족감을 표현하였다. 본 증례에서는 완전 무치악 환자에서 치조제 간의 측방적 관계를 정확하게 분석하기 위해 디지털 기술을 활용하여 진단 및 치료의 효율성을 높일 수 있었기에 이를 보고하고자 한다.

• 치위생과학회지
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• 제5권2호
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• pp.51-56
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• 2005

이 연구는 치과진료에서 처방되는 약제를 분석함으로써 해당 치과병 의원의 정보 자료의 제공 등으로 자율적 개선 노력 유도 및 지속적인 처방행태 변화추이 공개로 적정처방 및 벤 치마킹유도와 국민에게 항생제, 주사제 등의 약제 사용실태 홍보로 적정 약제 사용을 위한 인식 변화 유도에 기여하고자 이 연구를 시행하였다. 2003년 7월 1일부터 9월 31일까지 요양기관 34,226개소의 건강보험 외래약제 처방내역을 이용하여 항생제, 주사제의 투약일수율 및 처방률, 투약일당 약품비, 처방건당 약품목수와 고가약품목수의 비중에 대해 분석한 결과 다음과 같은 결론을 얻었다. 1. 항생제에 대한 투약일수율은 치과의원이 90.11%로 전년 동기 및 전분기보다 낮게 나타났으나, 처방률은 15.50%로 전년 동기 및 전분기보다 높게 나타났다. 치과병원의 투약일수율과 처방율은 각각 71.57%와 21.05%로 전분기보다 다소 높게 나타났다. 타종별 요양기관보다는 치과 병 의원의 투약일수율은 매우 높으나 처방률은 낮게 나타났다. 2. 주사제에 대한 투약일수율과 처방률은 치과의원이 각각 0.13%과 0.05%로 전년 동기보다는 감소추세로 나타났으며, 치과병원의 투약일수율과 처방률도 각각 1.03%과 0.88%로 전분기보다 다소 낮게 나타났다. 타 요양기관 종별보다는 치과병 의원의 주사제 투약일수율과 처방률은 매우 낮은 것으로 나타났다. 3. 약품목수는 치과의원이 2.79개로 전년 동기보다는 낮아졌으나 전분기보다는 높게 나타났으며, 치과병원은 2.67개로 전년 동기 및 전분기에 비해 증가된 것으로 나타났다. 타종별 요양기관보다는 치과병 의원 모두 약품목수가 적은 것으로 나타났다. 4. 투약일당 약품비는 치과의원이 863원으로 전년 동기 및 전분기에 비해 증가추세로 나타났으며, 치과병원은 1,385원로 전분기보다 낮게 나타났다. 타종별 요양기관보다는 치과병 의원 모두 낮은 것으로 나타났다. 5. 고가약품목수 비중은 치과의원이 46.43%로 전분기보다 높게 나타났으며, 치과병원은 54.05%로 전분기보다 매우 높게 나타났다. 병 의원에 비해 치과병 의원이 고가약품 목수 비중이 높은 것으로 나타났다. 6. 지역별 외래처방 현황 분석시 항생제 처방률은 광주지역이 가장 높고 대전지역이 가장 낮은 것으로 나타났으며, 주사제 처방률은 2/4분기 결과와 마찬가지로 영남지역이 모두 높은 반면, 수도권 지역은 모두 낮은 처방률로 나타났으며, 지역별 변이도 매우 커 최대지역의 처방률이 최소지역의 처방률의 2배 이상 높은 것으로 나타났다. 투약일당 약품비는 울산지역이 가장 높고 전북지역이 가장 낮게 나타나며, 처방건당 약품목수는 경기지역이 가장 높고 제주지역이 가장 낮게 나타났다.

• Perspectives in Nursing Science
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• 제7권1호
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• pp.10-22
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• 2010

Purpose: Through a thorough examination of the CCSC (Community Comprehensive Support Center) system in Japan, this study suggests a scheme to provide community-based preventive health care services for the elderly in Korea. Methods: The study inquired into the applicability of the Japanese model by reviewing the data related to the CCSC project, aided by both in-depth interviews with staff in the field and consultations with specialists. Results: Rearrangement of the Visiting Health Management Project system is needed to manage the collective or individual visiting care management for frailty prevention of the elderly in communities. The delegated service system for preventive care in the community, including direct management by one of the public health centers, also needs to be reviewed and the application of stricter standards for the selection of the agency or corporation to run the delegated service is necessary. Long-Term Care Insurance, along with national and local grants, is to be considered as a financial resource for the community-based preventive health care model for the elderly. By making active use of education rooms at district offices, senior citizen centers in neighborhoods for the elderly with easy access can be created. The project needs to raise active supports from communities, develop programs which can be absorbed into particular local cultures, and promote the understanding of the preventive project in local communities. The preventive program should focus on first solving the problems of depression, seclusion, and lack of mobility of the elderly. Second, the program should instruct physical self-management for exercise-nutrition-dental maintenance, and third, the program should strengthen the cognitive abilities of the elderly. In addition, it is necessary to systematize and implement counter-plans of the family and community to protect the elderly who has mental and cognitive problems. Finally, by establishing a network of public health welfare resources based upon research on a community level, assessment and planning for the health of the elderly should be one with their family, and comprehensive consultation and recommendations should be provided to the family. Conclusion: Taking into consideration the experience Japan has had with respect to a similar project, it is appropriate to develop and implement a service system which would combine the Visiting Health Management Project system which has already been established and a preventive health care model for the elderly on a community level.

• 보건행정학회지
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• 제32권1호
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• pp.94-106
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• 2022

Background: The efforts to build more "people centered," "patient centered" health system has been emerging all over the world. Aligning with it, the Korean government is conducing the survey called "Medical Service Experience Survey (MSES)." There are critics, however, that MSES is not scrutinizing the medical experiences of patients in various healthcare settings. For this reason, this study aims to perform an empirical analysis of the differences in answers of patients responding to various healthcare settings. Methods: There are two steps in this study. First, explanatory analysis is conducted to compare the tendency of statistical concentration on questionnaires by divided healthcare settings. Second, confirmative analysis is carried out to evaluate the construct validity, reliability, and discriminant validity of the questionnaire in each healthcare setting. The raw data of MSES, which was conducted in 2020 by the Ministry of Health and Welfare in Korea and the Korean Institute for Health and Social Affairs is used. Results: As a result of exploratory factor analysis for all outpatients, the items were classified into four factors statistically: "doctor experience," "nurse experience," "outpatient service experience," and "patient satisfaction." It was confirmed that the reliability of all factors extracted was secured. However, for patients who visited hospitals, questionnaires related to personal privacy, such as "experiences on medical staffs considering physical exposure" or "experiences related to personal information exposure," were answered in conjunction with items of "nurse experience." Besides, patients responded that administrative elements of medical services, such as "experiences of comfort in medical institutions" and "experiences of satisfactory administrative services," were related to the items of "nurse experience." The answers of patients who visited traditional medical hospitals and clinics about "doctor experience" and "nurse experience" were not discerned statistically, and the answers to "doctor experience," "nurse experience," and "medical institution experience" were entangled with the responses of patients who visited dental hospitals and clinics. On the other hand, as a result of the confirmatory factor analysis, it was found that the inquiries of MSES generally had intensive validity. Conclusion: The collection of objective and scientific data is the prominent component to enlighten the patient-centered healthcare system alongside with change of the worldwide paradigm of measuring the healthcare system performance as follows the transition of perspective of health care from provider-centered to patient-centered. This study empirically shows that the patient experience can vary as the healthcare settings. Furthermore, to make an advance in measuring the experience of patients with medical services, this article proposes the deliberate consideration of the different kinds of healthcare settings and articulate design of the survey.

• 치위생과학회지
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• 제17권4호
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• pp.375-381
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• 2017

2002~2013년도 국민건강보험공단 표본 코호트자료를 활용하여 만 40세 이상 치주질환 환자를 대상으로 CVD 누적 치료 경험률 및 개인의 소득과 지역의 CDI의 차이에 따른 치료 경험률을 파악한 본 연구의 결론은 다음과 같다. 첫째, 치주질환이 있는 대상자에서 고혈압은 34.3%, 뇌졸중은 12.6%의 누적 치료 경험률이 확인되었다. 둘째, 치주질환이 있는 대상자에서 지역적 차이(CDI)에 따른 고혈압의 치료 경험률의 차이는, CDI가 높은 집단이 낮은 집단에 비해 치료 경험률이 높은 것으로 나타났다(p<0.001). 셋째, 치주질환이 있는 대상자에서 소득분위에 따른 고혈압 치료 경험률의 차이는, 소득분위가 낮은 집단에서 치료 경험률이 높은 것으로 확인되었다(p<0.001). 넷째, 치주질환이 있는 대상자에서 지역적 차이(CDI)에 따른 뇌졸중 치료 경험률의 차이는, CDI가 높을수록 뇌졸중 치료 경험률이 높은 것으로 나타났다(p<0.001). 다섯째, 치주질환이 있는 대상자에서 소득분위에 따른 뇌졸중 치료 경험률의 차이는, 소득분위가 높아질수록 뇌졸중의 치료 경험률이 낮은 것으로 조사되었다(p<0.001). CVD와 치주질환의 관계에 지역의 CDI와 개인의 소득은 역의 관계를 보이는 것으로 나타났다. 향후 국민의 구강 및 보건의료 소비에 있어 사회경제적, 지역간 격차 해소에 대한 정책적 대안으로, 사회경제적 취약계층에 대한 보건의료서비스 제공으로 보건의료에 대한 접근성 개선과, 공공의료기관의 확충으로 보건의료서비스의 지리적 접근성 취약지를 해결하고 동시에 보건의료서비스의 이용 가능성을 높이는 등 다각적 노력을 기울여야 할 것으로 생각된다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제34권3호
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• pp.365-369
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• 2008

This study analyzed the incidence of wound infection after the operation of mandibular third molar extraction in relation with antibiotic prophylaxis with the object of young and healthy patients. The study object was 1,177 mandibular third molars of 850 men of 20 to 25 years old without any specific systemic disease. Three methods of preventive antibiotic medication were selected according to the preventive antibiotic medication previously reported; three experimental groups were selected based on them, and the antibiotic used was amoxicillin($^{(R)}Kymoxin$, Yuhanyanghaeng, Seoul). The group 1 includes the patients that took the antibiotic orally before the operation(one hour earlier, 500mg) and for three days after the operation(250mg per time, three times/day), the group 2 is the ones that took the same antibiotic orally only once about one hour before the operation(500mg), and the group 3 did not take any antibiotics before and after the operation. And to compare the difficulties and the degrees of extraction during operations which can be possibly related to the wound infection after the operations, the mandibular third molars' impacted depths and extraction methods were investigated as well. To check if the wound was infected, observations with an internal of one week were performed twice after the operation, and the meaningfulness of the infection incidence was verified through Chi-square test using SPSS program(SPSS Inc., IL, USA). There was no statistically significant difference between the antibiotic medication methods and the wound infection incidence after the operation among the experimental groups. As examining the relations between the mandibular third molar operation methods and the wound infection incidence after the operation, there existed a statistically meaningful difference in the infection incidence according to the operation methods(p=0.020). And there was no statistically significant difference in the wound infection incidence according to the impacted depth of the mandibular third molar. Therefore, it is thought that there exists little necessity of prophylatic antibiotics medication when extracting the mandibular third molar of young and healthy men without any systemic disease in general; however, in case when it is expected that the possibility of infection will be high or the wound on the tissue will be severe, it is sure that the prophylactic antibiotics medication will be necessary.

• 한국산학기술학회논문지
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• 제17권3호
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• pp.480-488
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• 2016

본 연구는 요양시설에 입소하여 생활하고 있는 노인들을 대상으로 ADL과 IADL을 측정하고 그에 관련된 요인을 검토하고자 실시하였다. 조사대상은 장기요양시설에 입소하여 장기요양급여를 받고 있는 노인 205명으로 하였으며, 조사는 2015년 6월 1일부터 7월 31일까지의 기간 동안에 면접조사를 통해 이루어 졌다. 연구결과, 전체 조사대상자의 ADL 수준은 $16.67{\pm}2.11$점(총득점 합계 범위: 6~18점)이었으며, IADL 수준은 $15.13{\pm}3.79$점(총득점 합계 범위: 7~21점)이었다. ADL에 관련된 요인으로는 배우자 유무, 외출 빈도, 주관적인 건강상태, 치아의 부자유 유무가 선정되었으며, IADL에 관련된 요인으로는 성별, 배우자 유무, 외출 빈도, 주관적인 건강상태, 신체의 부자유 유무, 건망증 유무가 선정되었다. 위와 같은 결과는 요양시설 입소 노인들의 신체적 기능은 인구사회학적 특성, 건강관련행위 및 건강상태 등 여러 요인들이 관련되어 있음을 시사한다.

• 보건교육건강증진학회지
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• 제1권1호
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• pp.83-97
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• 1983

The present study is to provide information for the improvement of school health services through research on the current condition of its organization and practice in universities, colleges and junior colleges. The scope of this study is consisted of four components including health organizations/units, school health services, environmental sanitation and health education for the 30 universities, the 20 colleges and the 32 junior colleges in Korea. The major findings are summarized as follows: (1) Among the sampled schools, around 73% of them have the health service organization/unit. When we break down health service organization/unit into the types by the level of school, around 73% of the universities have formal organization called "health center" and 20.0% of them have an informal organization called "health room". For the colleges level, 30.0% of them have the "health center" and 40.0% of them have the "health room". The figure of junior colleges is a quite different from universities and colleges, 56.3% of junior colleges have the "health room" only but the other have no service organization at all. (2) It was found that only 22.0% of 82 schools have the health committee for the school health services. It might be necessary to have a kind of expert committee to establish an annual health service program, budget and health policy in the school. (3) Approximately 29% of those schools having formal health organizations/units appointed directors as a medical persons. 13.4% of the sampled schools are appointed doctors (including the dentists) at health service organization/unit, 9.8% are appointed pharmacist and 65.9% are appointed nurses. Therefore, the data imply that the school health services are depending mainly on nurses. (4) The major activities of school health services are covering primary medical care (84.1%), health counseling (72.0%), physical examination (68.3%), vaccination (58.5%), tuberculosis control (54.9%), parasite control (29.3%) and dental health case(9.8%). Also 69.5% of the schools have the program on the environmental sanitation and the health education program. (5) In regard to health budget taking account of 34 schools, approximately 92% of them have less than 5,000 won per students and only 8.8% of them have more 10,000 won per students. At the average health budget per students is 4089.8 won in universities, 1617.1 won in colleges and 475.0 won in junior colleges. (6) The students enjoy the benifit of medical insurance at 11.0% of 82 schools surveyed. They are all universities. (7) The study found that 56 universities, colleges and junior colleges provide the annual physical examination. Only 21.4% of them have provided it for all students and school employees. (8) 64.3% of the 56 schools surveyed keep a record of the regular physical examinations. Records must be utilized as the basic data for the evaluation of the student's health condition and so the individual student is encouraged to take care of his own health. (9) At the 59 schools which practice health counseling, the main concerns of the counsellees are venereal disease, tuberculosis and psychoneurosis. This shows the need to practice health education in the area of preventive medicine. (10) 69.5% of the 82 universities, colleges and junior colleges surveyed are concerned with supervision of the environmental sanitation in their school, but non-professionals are in charge at 70.1% of them. This indicates negligence in environmental sanitation. (11) 53.7% of the 82 schools responded that they have no special instructive measure for the students' health and 54.9% are found to be negative in the use of a health education method. This reveals a problem. They are not positive to the recognition of their function as the initiative organization for the students' health. (12) The supplementary education for the faculty of the school health services is executed only at 8.5% of all the schools surveyed.

• Asian Pacific Journal of Cancer Prevention
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• 제14권5호
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• pp.3017-3021
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• 2013

Background: Health Related Quality of Life (HRQoL) is an important aspect in identifying cancer patients' perceptions of being diagnosed with cancer and the assessment of treatment outcomes. The present study aimedto assess the profile and predicators of HRQoL of Malaysian oncology patients. Materials and Methods: A cross sectional study adopting the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) was conducted. All cancer patients attending Penang General Hospital between August-November 2011 were approached. Descriptive statistics were used to assess demographic and disease related characteristics of the patients. All analyses were performed using SPSS v 16.0. Results: Three hundred and ninety three cancer patients met the inclusion criteria and were enrolled in the study. The mean age was 53.9 ($SD{\pm}13$) years. The cohort was dominated by females (n=260, 66.2%). Nearly half (n=190, 48.3%) of the participants were of Malay ethnicity, practicing Islam as their religion (n=194, 494%). Two hundred and ninety six (n=296, 75.3%) had beene diagnosed with cancer within six months to 3 years previously. The most common primary cancer site was breast (n=143, 36.4%). The mean Global Health Status (GHS) score was 60.7 (SD=21.3). Females (mean GHS score of 62.3, p=0.035) with Malay ethnicity (mean GHS score of 63.8, p=0.047), practicing Islam as their religion (mean GHS score of 63.0, p=0.011) had better GHS scores. Patients having medical insurance had good scores (mean 65.6, p-0.021). Marital status was significantly associated with GHS scores (p=0.022). Bone cancer patientshad the lowest mean GHS score of 49.2 (p=0.044). Patients at very advanced stages of cancer featured a low GHS mean score of 52.2 (p<0.001). Conclusions: The present study identified many demographic and disease related factors which may contribute to the HRQoL of cancer patients, pointing to the necessity for improved management of disease symptoms and provision of psychological and financial support.