• 구강회복응용과학지
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• 제35권3호
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• pp.123-131
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• 2019

구강작열감 증후군은 점막 이상 등의 임상소견이 없는 상태에서 혀 및 구강점막의 작열감과 구강건조감, 미각이상 등의 불편감을 호소하는 증상으로, 남녀 모두에서 나타날 수 있으나 중년의 폐경기 여성에서 빈발한다. 임상에서 진단이 쉽지 않고 명확한 원인을 밝히기 어려워 증상 경감을 치료목표로 해왔다. 병인은 국소적, 전신적 및 심리적 요인으로 나뉘고 치료는 ${\alpha}$-lipoic acid, clonazepam, 영양보충 등의 약물요법과 인지행동치료 등이 있으며 최근에는 단일 치료법보다는 복합요법의 높은 효과에 대해 관심이 모아지고 있다. 다각적인 면에서 원인요소를 고려하여 약물적 접근과 인지행동요법을 포함한 심리치료 병행으로 환자들의 증상을 경감해주는 것이 필요하다.

• 한국치위생학회지
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• 제11권6호
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• pp.961-971
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• 2011

Objectives : The aim of the study was to identify the need of oral health education and prevention? for over 65 years elderly. Methods : his study was to identify the need of oral health management and oral health impact profile among elderly over 65 years. 200 elderly participated in the study, lived in KungBuk and KungNam areas, visited Senior welfare center, from 1st September to 30st December 2008. Results : 1. This majority of respondents are female(74.0%), 75-79 years(29.5%), none education(42.5%), living alone(45.5%), income from children(46.0%), and health insurance(65.5%). 2. In the need of oral health management category, the need of dental treatment are professional toothbrushing, gum treatment, treatment for dental caries, treatment for xerostomia. In the need of prevention and education, the majority participants are 'required'. In oral health impact profile category, the majority participants are 'feel no difficulty during speaking(59.0%)', and 'feel no difficulty during tasting(47.0%)'. In the category, the positive answers are more than negative answers. 3. According to general characteristic with the need of oral health management, famle, obviously income, high level of life are significantly different in the need of prevention and education category. Obviously income is significantly different in the need of dental treatment category. According to general characteristic with the oral health impact profile, getting older, high education are significantly different in disadvantage category. In the case of no spouse, anxiety, physical difficulty, mental difficulty and disadvantage are high score in oral health impact profile. In the case of living alone, pain, anxiety, and disadvantage are high score in oral health impact profile. In the case of no income, limitation of function, pain, anxiety, mental difficulty and disadvantage are high score in oral health impact profile. In the case of no health insurance, anxiety, physical difficulty mental difficulty and lack of sociality are high score in oral health impact profile. 4. The oral health impact profile are positive correlation with the need of dental treatment and the need of prevention education. The effect of oral health impact profile are significantly different with spouse, average of income, the need of prevention education. Conclusions : In Conclusion, the need of prevention education and dental treatment for individual oral health promotion are related with general life condition and life level. Also these are influence of quality of life relate with oral health. These findings are require of development of oral health services program and system from bottom to top.

• 한국치위생학회지
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• 제11권2호
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• pp.197-211
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• 2011

Objectives : OHIP-14 and EQ-5D were used, targeting the residents of farming communities to identify the elements that influence oral cavity's health and quality of life due to health and to identify the importance of oral cavity's health in order to increase health of adults' oral cavity and quality of life via improved health. Methods : This research was conducted from July 17th, 2010 to August 16th, 2010 targeting 600 residents in Goryeong-gun, Gyeongsangbuk-do, aging over 40. The data has been analyzed using Mann-Whitney U test, Kruskal-Wallis test and hierarchical multiple regression through SPSS Win Program 18.0 version. Results : 1. OHIP-14 and EQ-5D based on general characteristics showed lower oral health-related quality of life and health-related quality of life on the following cases: women (p=0.004, p<0.001), older (p<0.001, p<0.001), lower scholastic ability (p<0.001, p<0.001), lower average of average spending money (p<0.001, p<0.001), higher number of chronic disease (p<0.001, p<0.001), less drinking (p=0.012, p=0.008), lower perceived oral health and health status (p<0.001, p<0.001) and non smoking showed only EQ-5D (p<0.001). 2. OHIP-14 and EQ-5D based on oral health behavior showed lower oral health-related quality of life and health-related quality of life on the following cases: no periodic oral check-up (p<0.001, p<0.001), less experience of oral health education (p<0.001, p<0.001), horizontal tooth-brushing method(p<0.001, p<0.001) and lower frequency of tooth-brushing showed only OHIP-14 (p=0.042). OHIP-14 and EQ-5D based on oral health status and subjective oral symptom showed lower oral health-related quality of life and health-related quality of life on following cases: number of existing tooth less than 20 (p<0.001, p<0.001), the number of missing teeth more than 9 (p<0.001, p=0.044), DMFT (Decay, Missing, Filling Teeth) index more than 18 (p<0.001, p<0.001), wears denture (p<0.001, p<0.001), edentulous (p<0.001, p=0.002), have xerostomia (p<0.001, p<0.001) and have chewing discomfort (p<0.001, p<0.001). 3. Factors affecting OHIP-14 were gender, age, perceived oral health status, perceived health status, number of existing teeth, dental status, xerostomia and chewing discomfort, and the of reliability (how well it explains) the final model was 48.7%. EQ-5D showed relevance on gender, age, presence of chronic disease, perceived health status, xerostomia, chewing discomfort and oral health-related quality of life, and the reliability of the final model was 42.9%. Conclusions : In order to improve the quality of life of ruralists, oral health needs to be improved or remained by increasing the rate of possession of the existing teeth and preventing the loss of teeth. In order to do so, improvement of accessibility of dental clinic, change of direction from treatment-centered to prevention-centered health care system, development of oral health education program and various oral health care policies which would vitalize continuous oral health care system are considered to be necessary.

• Journal of Oral Medicine and Pain
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• 제30권4호
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• pp.383-389
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• 2005

구강건조증은 입안이 마르는 느낌의 주관적 증상을 의미하는 것으로 타액분비의 감소에 따른 불충분한 구강점막의 습윤도에 의해 발생할 수 있다. 그러나 구강건조증의 정도는 실제 측정된 객관적인 타액분비율과 상관관계를 보이지 않는 경우도 있어 그 진단과 치료에 어려움을 야기한다. 본 연구에서는 이러한 구강건조증의 진단과 평가를 위해 구강건조증 환자의 문제 해결을 위한 설문지를 개발하고 설문지의 문항들이 갖는 신뢰도를 분석하여 향후 구강건조증의 연구 및 진단 도구로서의 활용가능성을 알아보고자 하였다. 이를 위하여 구강건조감의 정도를 Visual Analogue Scale(VAS) 척도로 답하는 6 가지 문항과 구강건조감에 따른 행동을 파악하기 위한 4 가지 문항을 개발하고 문항들이 갖는 신뢰도를 평가하기 위하여 구강건조증의 증상을 호소하지 않는 건강한 성인 남녀 88 명(남자 44 명, 평균 $25.6{\pm}3.1$세, 여자 44 명, 평균 $24.3{\pm}2.1$세)을 대상으로 2 회에 걸쳐 질문에 답하도록 하여 다음과 같은 결과를 얻었다. 1. 구강건조감의 정도를 묻는 6 가지 문항의 급내상관계수(intraclass correlation coefficient; ICC) 값은 낮 시간의 구강건조감의 정도(Dry-day)가 0.767, 입안에 침이 적다고 느끼는 정도(Am-sal)가 0.850, 구강건조감으로 인한 일상 생활의 불편감 정도(Eff-life)가 0.791로 매우 높은 신뢰도를 나타내었고, 밤 또는 아침 기상시의 구강건조감의 정도(Dry-PM)가 0.563, 식사시의 구강건조감의 정도(Dry-eat)가 0.674, 음식물을 삼키기 힘든 정도(Dif-swal)가 0.641로 높은 급내상관계수 값을 나타내었다. 2. 6 개의 문항들의 내적 일치도를 평가하는 크론바흐의 알파(Cronbach's alpha) 값은 0.928로 매우 높게 나타났다. 3. 구강건조감에 따른 행동을 파악하기 위한 4 가지 문항들의 코헨의 카파(Cohen's kappa) 값은 잠자리 옆에 물을 준비하게 되는 빈도($H_2O$-bed)는 0.850으로 매우 높은 신뢰도를 나타내었고, 입이 말라 잠을 깨는 빈도(Night-awake)가 0.506, 마른 음식 섭취시에 물을 마시게 되는 빈도(Sip-liq)가 0.419, 껌이나 사탕을 먹게 되는 빈도(Gum-candy)가 0.407로 높은 신뢰도를 나타내었다. 이러한 결과로부터 VAS 척도로 답변하는 주관적 구강건조감의 정도를 묻는 6 가지 질문과 주어진 보기를 선택하여 답변하는 구강건조증에 따른 행동을 묻는 4 가지 질문으로 구성된 설문은 중등도 이상의 신뢰도를 가지고 있고 VAS 척도로 답변하는 6 가지 질문은 매우 높은 내적 일치도를 가지고 있음을 알 수 있었다.

• Journal of the Korean Data and Information Science Society
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• 제26권6호
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• pp.1327-1334
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• 2015

난치성 암환자의 암성통증은 암환자의 삶의 질을 지극히 떨어뜨리는 중요한 요인이다. 전 세계적으로 암성 통증을 줄이기 위한 노력으로 양방과 한방의 통합적 치료방법이 증가하는 추세이다. 국내외 적으로도 통합적 접근을 통한 암성통증과 관련된 연구가 지속적으로 이루어지고 있으며 암 치료에 있어서는 화학요법으로 인한 오심이나 구토를 조절하기 위해 표준화된 항구토제와 병용한 침 치료가 효과적임을 보고한 무작위대조군 임상연구가 있다. 여러 연구에서 암으로 인한 피로, 방사선 치료로 인한 구강 건조증, 그리고 불면, 불안, 삶의 질 등에 침치료가 효과적이라고 보고한 바 있다. 그러나 침치료의 실제적인 임상적 효과와 다양한 증례 보고 에도 불구하고, 침을 이용한 통합치료의 진통 감소효과의 유의성에 대해서는 아직 이견이 많다. 이에 따라 본 연구에서는 전 세계 출판된 논문검색을 통하여 침을 이용한 양 한방 통합치료로 인해 암성통증의 감소효과를 파악하고 각 논문에서 제시하는 값을 종합하여 침을 이용한 통합치료의 효과가 어느 정도인지를 평가하기 보았다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권8호
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• pp.4567-4570
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• 2013

Background: Nasopharyngeal carcinoma (NPC) is the commonest radiocurable cancer in Malaysia. This study aimed to determine the treatment outcomes and late effects of radiotherapy for NPC patients treated in University Malaya Medical Centre (UMMC). Materials and Methods: All newly diagnosed patients with NPC referred for treatment to the Oncology unit at UMMC from 2004-2008 were retrospectively analyzed. Treatment outcomes were 5 years overall survival (OS), disease free survival (DFS), cause-specific survival (CSS), locoregional control (LRC) and radiotherapy-related late effects. The Kaplan-Meier method was used for survival analysis and differences in survival according to AJCC stage was compared using the log-rank test. Results: A total of 176 patients with newly diagnosed NPC were treated in UMMC during this period. Late presentation was common, with 33.5% presenting with T3-4 disease, 84.7% with N1-3 disease and 75.6% with AJCC stage 3-4 disease. Radical RT was given to 162 patients with 22.7% having RT alone and 69.3% having CCRT. The stipulated OTT was 7 weeks and 72.2% managed to complete their RT within this time period. Neoadjuvant chemotherapy was given to 14.8% while adjuvant chemotherapy was administered to 16.5%. The 5 years OS was 51.6% with a median follow up of 58 months. The 5 years OS according to stage were 81.8% for stage I, 77.9% for stage II, 47.4% for stage III and 25.9% for stage IV. The 5 years overall CSS, DFS and LRC were 54.4%, 48.4% and 70.6%, respectively. RT related late effects were documented in 80.2%. The commonest was xerostomia (66.7%). Other documented late effects were hearing deficit (17.3%), visual deficit (3.1%), neck stiffness (3.1%), dysphagia (3.4%), cranial nerve palsy (2.5%), pneumonitis (0.6%) and hypothyroidism (1.2%). Conclusions: The 5 years OS and LRC in this study are low compared to the latest studies especially those utilizing IMRT. Implementation of IMRT for NPC treatment should be strongly encouraged.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제32권2호
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• pp.168-173
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• 2006

The side effects of head and neck radiation therapy include mucositis, xerostomia, loss of taste, radiation caries, oral infection, osteoradionecrosis and trismus. When a patient is arranged to begin head & neck radiotherapy, oral pathologic lesions are examined and managed for the prevention of oral complications. The advanced odontogenic infection should be especially controlled before the radiotherapy and the patient must be instructed for proper oral prophylaxis. Generally the more conservative treatments, such as, scaling, restoration, endodontic treatment, are the care of choice and dental extraction is performed in advanced periapical and periodontal pathologic conditions. If the dental extraction should be done, the radiotherapy consequently will be delayed until there is epithelium covering the extraction socket, leaving no exposed bone. The cancer patient with severe emotional stress pray for the early radiation therapy, in spite of possibility of the recurrent odontogenic infectious lesions. So, the authors attempted to do the early radiation therapy by the conservative endodontic drainage and surgical incision & drainage without extraction of the infected teeth, and resulted in relatively good prognosis without the severe side effects of head and neck radiotherapy.

• 구강생물연구
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• 제42권4호
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• pp.208-215
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• 2018

The purpose of this study was to identify the risk of dysphagia among patients that visited prosthodontics department, and evaluate the difference in risks arising from oral conditions and disease in order to preliminarily intervene the various influencing factors of dysphagia. A questionnaire was given to patients that were aged 65 years or older who visited the prosthodontics department between September to December 2017. The data was collected and analyzed using the t-test, $x^2-test$ and logistic regression analysis. The mean age of the patients was 75 years. Out of 300 patients, 206 patients (68.7%) had a risk of dysphagia. There were statistically significant differences between the -non-risk and risk groups, which included the number of natural teeth, total number of teeth including prosthesis, denture use, denture discomfort, number of tooth brushing, oral dryness, digestive system diseases, and musculoskeletal diseases. Among these, oral dryness was a risk factor while the total number of teeth, including natural teeth and prostheses, served as a protective factor. More than half of the elderly patients were at risk of dysphagia. Oral dryness is influenced by many factors and it should continuously be managed. Patients should fully recover their masticatory function by preserving the remaining teeth and compensating for the missing teeth. A dental practitioner should be fully aware of the risk of dysphagia in elderly patients and be able to intervene and offer proper patient health care in advance through treatment guidelines and education.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권3호
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• pp.265-269
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• 2010

Radiation therapy for malignancy of head and neck leads to secondary effects, such as mucositis, xerostomia, dental caries and osteoradionecrosis. Osteoradionecrosis is a delayed complication which causes chronic pain, infection and constant deformity after necrosis. It occurs spontaneously or after primary oncologic surgery, dental extraction or by trauma of prosthesis. To reduce the incidence of osteoradionecrosis, appropriate antibiotic usage, atraumic procedure, tension-free primary suture and hyperbaric oxygen therapy are essential. This case is about a 74 years old woman who was treated for osteoradionecrosis after extraction of right lower molar at year 2006. She had received radiation therapy for angiosarcoma on tongue at year 2004. At year 2008 the patient came to our hospital for extraction of the opposite premolar but despite careful treatment, osteoradionecrosis occurred again. She was successfully treated by surgical procedure so we report this case.

• 대한암한의학회지
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• 제22권1호
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• pp.23-35
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• 2017

Backgrounds: The demand of complementary and alternative medicine (CAM) including Korean Medicine (KM) is increasing worldwide. But cancer patients (CP) still have a difficulty in gathering CAM information or communicating with their doctors, and clinical status in cancer care is unclear in the field of KM in Korea especially. The aim of this study is to examine clinical status of KM for cancer symptom care by KM doctors in medical service institutions. Methods: Total forty nine KM doctors completed the site survey questionnaire. The questionnaire items were to list chief symptom complaints of CP treated with KM and effective KM therapies. Results: The majority of the respondents were general physicians without KM specialist board (67.4%) who have 10-20 years clinical experience with CP (55.1%). Primary cancer lesion, diagnostic status, and treatment period were not different in KM clinical service institutions. In chief symptom complaints of CP treated with KM, gastrointestinal (32.9%), musculoskeletal (19.9%), circulatory & respiratory (16.2%), psychiatric (14.1%), urinary (5.8%) symptoms were in turn. In effective KM therapies assessed by KM doctors, xerostomia (45.7%) and cancer-related fatigue (44.8%) were more effective with herbal treatments. Peripheral neuropathy (43.4%), depression, insomnia (38.2%), and cancer pain (31.9%) were preferred to treat using acupuncture. Conclusion: The CP treated with KM used evenly KM medical service institutions regardless of hospital size, and there will be further survey for CP treated KM in the future.