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Expectations of the First Visit to Orofacial Pain Clinic for the Patients with Temporomandibular Disorders (구강안면통증클리닉에 처음 내원한 턱관절장애 환자들의 내원 목표)

  • Won, Sang-Yeon;Kim, Hye-Kyung;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.35 no.4
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    • pp.265-273
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    • 2010
  • Understanding patients' expectation for health visits and providing appropriate care may increase patients' satisfaction with health care, leading to more positive treatment outcome. The study aimed to investigate expectations of the patients with temporomandibular disorders (TMD) at their first visit to university-based orofacial pain clinic and to evaluate any relation with duration of pain, presence of previous treatment, pain severity and pain interference. Inclusion criterion was patients aged over and 18 years old and diagnosed as TMD during 3 months' period from Aug to Nov 2010. They were asked to complete the questionnaires for patients' expectation and the Brief Pain Inventory (BPI) at waiting room prior to consultation. 322 TMD patients participated in the study(M:F=1:1.5, mean age=36 years old). The study indicated that the most important top 3 expectations were 'cure of pain', 'understanding their problem' and 'doctor-patient communication' in order. This finding was not affected by gender, duration and previous treatment history but affected by sub-category of TMD and BPI pain severity and pain interference. 'Pain relief' and 'understanding their problems' were relatively highlighted in the patients with muscle disorders and combination (joint-muscle) disorders of TMD than those with joint disorders who wanted communication and further investigation relatively more (p=0.000). While expectation for pain relief was expected more with increase of pain severity and interference, patients with mild level of pain severity and interference expected communication and further investigation relatively more (p=0.000, 0.017, respectively). Based on the results of the study, though pain relief was the primary concern for TMD patients suffering from pain, their satisfaction with care may be increased by explanation for etiology and mechanism of TMD to make them understand their problems better and doctor-patient communication and collaborative decision-making for treatment. Importance of patient-centered consultations and availability of written material or web sites for patient information should be stressed out.

Five Year Experience of Preexposure and Postexposure Rabies Prophylaxis in Korean Children at the National Medical Center (소아청소년에서 공수병 예방접종 및 교상 후 조치 현황: 최근 5년간 국립중앙의료원에서의 경험)

  • Noh, Jin Chul;Park, Hyang Mi;Park, Jong Hyun;Won, Youn Kyung;Lee, Chang Hyu;Kim, Jae Yoon
    • Pediatric Infection and Vaccine
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    • v.20 no.1
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    • pp.9-16
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    • 2013
  • Purpose : This study aims to investigate preexposure prophylaxis and postexposure prophylaxis of rabies that the National Medical Center (NMC) handled and to check whether appropriate measures were performed according to the recent domestic and overseas guidelines after animal bites. Methods : This study surveyed 41 people who were 18 years or under and received preexposure and postexposure prophylaxis of rabies at the NMC from November 2006 to December 2011. Their medical records were reviewed for their age, gender, the reason for preexposure prophylaxis, the body sites of animal bite, the kind of the animal that bit children, the region where the biting occurred and rabies vaccination and inoculation of immunoglobulin. Results : Eleven children took rabies vaccination for preexposure prophylaxis and 30 children received post exposure prophylaxis of rabies. Of patients who were bitten by unvaccinated animals including wild animals or by animals which were not certain to be vaccinated, 50% (13 of 26 children) received postexposure prophylaxis, while 75% (3 of 4 children) of patients who were bitten by vaccinated animals received postexposure prophylaxis of rabies. Ten of 30 bitten patients knew whether or not the biting animals had received rabies vaccination. Of them, four people (40%) were bitten by animals which had received rabies vaccination. Conclusion : To prevent the occurrence of rabies, people and health care providers need to correctly understand latest guideline for rabies preexposure and postexposure prophylaxis and the information for bitten patient, biting animal and area at bitten by animal should be accurately recorded.

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Comparison of Gefitinib and Erlotinib for Patients with Advanced Non-Small-Cell Lung Cancer (진행성 비소세포폐암 환자에서 Gefitinib와 Erlotinib의 비교)

  • Lee, Jin Hwa;Lee, Kyoung Eun;Ryu, Yon Ju;Chun, Eun Mi;Chang, Jung Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.4
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    • pp.280-287
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    • 2009
  • Background: The epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), became an attractive therapeutic option for advanced non-small-cell lung cancer (NSCLC). Several studies suggested that there might be some different efficacy or response predictors between gefitinib and erlotinib. We compared the efficacy and toxicity of gefitinib and erlotinib in Korean patients with advanced NSCLC and evaluated specific predictors of response for both gefitinib and erlotinib. Methods: We collected the clinical information on patients with advanced NSCLC, who were treated with gefitinib or erlotinib at the Ewha Womans University Hospital, between July 2003 and February 2009. Median survival times were calculated using the Kaplan-Meier method. Results: Eighty-six patients (52 gefitinib vs. 34 erlotinib) were enrolled. Patient median age was 64 years; 53 (62%) subjects were male. Out of the 86 patients treated, 83 received response evaluation. Of the 83 patients, 35 achieved a response and 12 experienced stable disease while 36 experienced progressive disease, resulting in a response rate of 42% and a disease control rate of 57%. After a median follow-up of 502 days, the median progression-free and overall survival time was 129 and 259 days, respectively. Comparing patients by treatment (gefitinib vs erlotinib), there were no significant differences in the overall response rate (44% vs. 39%, p=0.678), median survival time (301 days vs. 202 days, p=0.151), or time to progression (136 days vs. 92 days, p=0.672). Both EGFR-TKIs showed similar toxicity. In a multivariate analysis using Cox regression model, adenocarcinoma was an independent predictor of survival (p=0.006; hazard ratio [HR], 0.487; 95% confidence interval [CI], 0.292-0.811). Analyses of subgroups did not show any difference in response predictors between gefitinib and erlotinib. Conclusion: Comparing gefitinib to erlotinib, there were no differences in the response rate, overall survival, progression-free survival, or toxicity. No specific predictor of response to each EGFR-TKI was identified.

Effect of Sex Education on Middle School Students' Access to the Obscene Online Computer and Video Film Contents (성교육이 중학생의 컴퓨터와 비디오 음란물 접촉에 미치는 효과)

  • Woo, Hae-Ja;Kim, Chung-Nam;Park, Kyung-Min
    • Research in Community and Public Health Nursing
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    • v.12 no.3
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    • pp.795-814
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    • 2001
  • To evaluate the effect of sex education on middle school students' access to the obscene online computer and video film contents. 154 students were selected as experimental group. and 154 students were selected as control group, sampled randomly from Andong. Kyungbook, Korea. An analysis was performed. A non-equivalent control group pre test-post test research design was used. The data were collected from April 2nd to April 19th. 2001. A pre-survey was done on general characteristics and the condition of accessing obscene online computer and video film contents on both experimental and control group. From the survey results information. sex education contents were put together. The researcher organized 3 ready-made sex education program and explained to the four school health nurses about the ready-made sex education program step by step and they educated their selected students with three classes of 45 minutes lecture. Two weeks after the last lecture, a post-test was conducted. Four weeks from the last lecture, another post-test was conducted. The existing studies by Choi Yongseon(1998) and Kim Hyeok(1998) were reviewed and two professors in the department of community health nursing advised on the study questionnaire writing. An SPSS Win 10.0 was used. The data of respondents' general characteristics were analyzed using frequency and percentage. $X^2$ test was used to verify the homogeneity of the experimental group and the control group. Repeated Measures ANOVA was used to find out whether sex education had an effect on the awareness of obscene online computer and video film contents and under-age prostitution through the online computer networks. and time and frequency of access to the obscene online computer and video film contents. The results of the study are as follow. 1. The results of the verification of homogeneity between the experimental group and the control group showed that there was no significant difference between the experimental group and the control group. 2. The first hypothesis, 'the experimental group which received sex education would have a higher level of awareness of accessing obscene contents than the control group which did not receive the education' was supported at p<0.0001. 3. The second hypothesis. 'the experimental group which received sex education would have a higher level of awareness of underage prostitution on computer networks than the control group which did not receive the education' was supported at p<0.05. 4. The third hypothesis, 'the experimental group which received sex education would spend time less accessing obscene video and computer contents than the control group which did not receive the education' was rejected at p>.05. 5. The 4-1 hypothesis. 'the experimental group which received sex education would access obscene computer contents less frequently than the control group which did not receive the education' was supported at p<0.0001. 6. The 4-2 hypothesis, 'the experimental group which received sex education would access obscene video contents less frequently than the control group which did not receive the education' was supported at p<0.0001. In conclusion, a systematic step-by-step sex education program should be developed to protect middle school students from the harmful online computer and video film access. An effective teaching material for sex education should be prepared to decrease middle school students' access to obscene online computer and video film contents.

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Association of Lifestyle with Blood Pressure (생활양식과 혈압의 관련성)

  • Joo, Ree;Chung, Jong-Hak
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.3 s.58
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    • pp.497-507
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    • 1997
  • This study was conducted to evaluate the association of various lifestyle with blood pressure. The data were obtained from the individuals who got routine health examination in Department of Occupational Medicine, Yeungnam University Hospital from June to September, 1996. Among these people, we selected 130 cases of hypertensives (97 males, 33 females) and 150 normotensives(70 males, 80 females) and study was conducted. The authors collected the information of the risk factors related to hypertension such as age, family history of hypertension, fasting blood sugar, serum total cholesterol, alcohol consumption(g/week), smoking history, relative amount of salt intake (low, moderate, high), the frequency' of weekly meat consumption, BMI, daily coffee consumption(cups/day) and the frequency of regular exercise(frequency/week) through questionnaire and laboratory test. By simple analysis, BMI was significantly associated with hypertension in male(p<0.05), and the frequency of weekly meat consumption was significantly associated with hypertension in female(p<0.05). Using logistic regression model, elevated odds ratio was noted for fasting blood sugar, serum total cholesterol, family history of hypertension, alcohol consumption, salt intake and BMI, and reduced odds ratio was noted for coffee consumption and exercise in male but fasting blood sugar(odds ratio=1.022, 95% CI=1.000-1.044), family history in both of parents(odds ratio=3.301, 95% CI=1.864-4.738), salt intake(odds ratio=1.690, 95% CI=1.082-2.298) and BMI(odds ratio=1.204, 95% CI=1.065-1.343) were statistically significant(p<0.05). In female, elevated odds ratio was noted in serum total choles terol, family history of hypertension, BMI and meat consumption. Of all these variables, the family history of hypertension in either of parents(odds ratio=4.981, 95% CI=3.650-6.312), family history in both of parents(odds ratio=16.864, 95% CI=14.577-19.151), BMI(odds ratio=1.167, 95% CI=1.016-1.318) and meat consumption(odds ratio=2.045, 95% CI=1.133-2.963) showed statistically significant association with hypertension in female(p<0.05).

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Association of Serum Vitamin D with Insulin Resistance and Beta Cell Function in Korean Health Checkup Examinees (건강검진 수검자에서 혈청 Vitamin D 수준과 인슐린저항성 및 β-세포 기능과의 관련성)

  • Kim, Han-soo;Ryu, So Yeon;Park, Jong;Han, Mi-Ah;Choi, Seong-Woo;Shin, Min-Ho
    • Journal of agricultural medicine and community health
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    • v.43 no.1
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    • pp.18-30
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    • 2018
  • Objectives: This study was conducted to examine the association of serum Vitamin D with insulin resistance and ${\beta}-cell$ function in Korean health checkup examinees. Methods: This study subjects were 374 healthy adults (199 males, 175 females) over the age of 20, who visited a general hospital medical center located in Haenam-gun, Jeollanam-do. To find the association of Vitamin D with HOMA-IR and $HOMA-{\beta}$, the used statistical analysis were ANOVA and ANCOVA. Results: Of the study subjects, the level of serum Vitamin D defined by deficient group, insufficient group and sufficient group was 38.5%, 48.1% and 13.4%, respectively. According to the level of serum Vitamin D, the mean values of HOMA-IR were $1.92{\pm}1.08$ in sufficient group, $1.99{\pm}1.04$ in the insufficient group and $2.91{\pm}1.05$ in deficient group and there were statistically significant different(p<0.001). The mean values of $HOMA-{\beta}$ were $84.69{\pm}1.07$ in sufficient group, $78.41{\pm}1.04$ in the insufficient group and $80.48{\pm}1.04$ in deficient group, and there were not significant. As a result of ANCOVA, adjusted mean of HOMA-IR were statistically significant different (p<0.001), but those of $HOMA-{\beta}$ were not statistically significant according to the level of serum Vitamin D. Conclusion: The insufficient level of serum Vitamin D was relatively high in healthy adults who live in rural area, and it was found that HOMA-IR significantly increased when Vitamin D was deficient. To prevent insulin resistance or diabetes, it is necessary to provide sufficient information related to sufficient production of Vitamin D such as Vitamin D supplement, sun exposure, food intake and etc.

A Study on the Intercity Mode Choice Behavior of Daegu Citizens According to the Introduction of Gyeongbu High-Speed Railway (경부 고속철도 개통에 따른 대구시민의 지역 간 통행수단 선택행태 분석에 관한 연구)

  • Yun, Dae-Sik;Yuk, Tae-Suk;Kim, Sang-Hwang
    • Journal of Korean Society of Transportation
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    • v.24 no.1 s.87
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    • pp.29-38
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    • 2006
  • After the first opening of the KTX in April 2004, travel time between major cities has been dramatically reduced. The reduction rates range from 32% to 47%. Considering travel time reduction between major cities, this study concerned about the intercity travel impact of the KTX operation. This study aimed to analyze intercity mode choice behavior of Daegu Citizens according to the first opening of the KTX. This study takes place in two sections. These are (i) the section of KTX between Daegu and Seoul, and (ii) the section of KTX between Daegu and Daejeon. This study estimated empirical models for analyzing intercity mode choice behavior according to the first opening of the KTX. This study makes use of the data from travel survey from Daegu metropolitan area. The main part of the survey was carried out in the KTX Dong-Daegu station. The survey data includes the information on travel from Daegu to Daejeon and from Daegu to Seoul. In order to analyze intercity choice behavior according to the frist opening of the KTX, multinomial model structure is used. For the model specification, a variety of behavioral assumptions about the factors which affect the mode choice, were considered. From the empirical model estimation, it is found that OVTT(Out-of-Vehicle Travel Time), OVTC(Out-of-Vehicle Travel Cost), IVTT(In-Vehicle Travel Time), IVTC(In-Vehicle Travel Cost), travel frequency, travel purpose, sex, age, occupation. household income, individual income are significant in choosing intercity travel mode. However, it is found that the intercity nde choice behavior is different between (i) the section of KTX between Daegu and Seoul, and (ii) the section of KTX between Daegu and Daejeon. Furthermore, some policy implications are discussed in conclusion.

Clinical significance of follow-up laboratory tests, performed at 6 weeks after the onset of Kawasaki disease (가와사끼병에서 발병 6주째에 시행하는 추적검사의 임상적 유용성에 관한 고찰)

  • Oh, Il Ji;Moon, Kyung Hee;Hong, Myung Eun;Kim, Yeon Soon;Lee, Chang Woo;Yoon, Hyang Suk
    • Clinical and Experimental Pediatrics
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    • v.49 no.6
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    • pp.672-676
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    • 2006
  • Purpose : Low dose aspirin is used due to its antiplatelet effect for the subacute phase of Kawasaki disease(KD). It is usually used for 6-8 weeks, then various hematologic laboratory tests and follow up echocardiography for evaluating coronary abnormalities are performed. Our review investigated the usefulness of various follow up laboratory tests performed at 6 weeks after the onset of KD. Methods : Two hundred eighty-two children diagnosed and hospitalized with KD were identified by reviewing patient's charts. Cases which were diagnosed between January 1997 and December 2004 were included in this study. We reviewed laboratory data including leukocytes, platelet counts, antistreptolysin O(ASO), erythrocyte sedimentation rate(ESR), C-reactive protein(CRP), aspartate aminotransferase(AST), alanine aminotransferase(ALT), urinalysis, and echocardiograms performed at admission and 6 weeks after the onset of KD. Paired t-test and Fisher's exact test, as well as logistic regression tests, were used for the statistical analysis. Results : At 6th week data, ESR and CRP were still elevated in 35(12.4 percent) and 12(4.3 percent) patients, respectively. Sterile pyuria were all normalized. But, 36 patients(12.8 percent) showed thrombocytosis, 22(7.8 percent) elevated AST, 15(5.3 percent) leukocytosis, and 6(2.1 percent) coronary abnormalities. Coronary abnormalities at the 6th week were only shown in patients with initial abnormalites. Younger age and initial thrombocytosis were risk factors for thrombocytosis at the 6th week. Conclusion : All children with initial coronary abonormalites should have an echocardiogram at 6 weeks after the onset of fever. In view of case-effectiveness, additional echocardiographic studies are justified only if abnormalities are present at admission. ESR, CRP, and urinalysis performed at the 6 weeks after onset of KD is not significant for clinical information of progression. Platelet count should be estimated at 6th week for a judgement of continuous antiplatelet therapy.

User Behavior and Improvement for Kumgang Pine Eco-Forest in Uljin (울진금강송 생태숲의 이용자 행태분석과 개선방안)

  • Oh, Nam-Hyun
    • Korean Journal of Environment and Ecology
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    • v.22 no.3
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    • pp.249-259
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    • 2008
  • The purpose of this study was to analyze the users' behaviors and to suggest development strategies in Uljin Kumgang pine tree(Pinus densiflora for. erecta) eco-forest(UKPEF), which is located in Kyeongbuk. The data were collected by interviewing 122 visitors to september 3 from august 29, 2007 with a constructed questionnaire. The results of the analysis are as follows. 1. The major visitors of UKPEF are male and the age between 20 to 30, the residents of the Uljin county with relatively high academic background. 2. The motive of visiting UKPEF is mainly by the beauty and taste of Kumgang pine tree and the condition of the forest. The visitors are mainly composed of family, not big group. 3. The visitors of UKPEF have obtained information about the Kumgang fine tree forest mainly from friends, not from the internet or travel agency. 4. The visitors of UKPEF pointed out lack of convenient facilities such as toilets and water-supply facilities. However, visitors are satisfied by the condition of the forest. 5. The visitors of UKPEF set a high value on Kumgang fine tree, So, more active marketing strategy about Uljin Kumgang pine tree has to be established. 6. The visitors of UKPEF are more satisfied by the Uljin Kumgang pine tree forest than expected. The development strategies of UKPEF are suggest as follows. (1) Auto tram system has to be set up and new trail should be constructed to attract more visitors and people of other regions. (2) To attract group tourists, new program should be developed. (3) Advertisement through internet or travel agency has to be developed. (4) Government(local) should make a plan to register the forest as World natural heritage. (5) Monitoring and evaluation system has to be developed to satisfy tourists. In conclusion, the efforts of taking care of and preserving the UKPEF should be made at the national level. I hope that more Koreans can have chance to feel and experience the value and excellence ofthe Uljin Kumgang pine tree(Pinus densiflora for. erecta)

Diastolic Function in Patients with Hypertrophic Cardiomyopathy: Evaluation Using the Phase-contrast MRI Measurement of Mitral Valve and Pulmonary Vein Flow Velocities (비대성심근증 환자의 이완기능평가: 승모판과 폐정맥 유속을 측정한 위상차 MRI의 이용)

  • Kim, Eun Young;Choe, Yeon Hyeon;Kim, Sung Mok;Lee, Sang-Chol;Chang, Sung-A;Oh, Jae K.
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.4
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    • pp.314-322
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    • 2014
  • Purpose: Diastolic dysfunction is a common problem in patients with hypertrophic cardiomyopathy (HCM). The purpose of this study was to assess the role of MRI in the assessment of diastolic function using mitral valve and pulmonary vein flow velocities in HCM patients. Methods and Results: Phase-contrast MRI (mitral valve and pulmonary vein) and transthoracic echocardiography was successfully performed for 59 HCM patients (44 men and 15 women; mean age, 51 years). Forty-nine patients had a diastolic dysfunction; grade 1 (n = 20), grade 2 (n = 27), and grade 3 (n = 2) using echocardiography, and ten patients had normal diastolic function. The transmitral inflow parameters (E, A, and E/A ratios) obtained by MRI showed positive correlation with the same parameters measured by echocardiography (Pearson's r values were 0.47, 0.60, and 0.75 for E, A, E/A, respectively, all P < 0.001). With the flow information of the pulmonary vein from cardiac MRI, pseudo-normalized pattern (n = 8) could be distinguished from true normal filling pattern (n = 17), and the diastolic function grades by cardiac MRI showed moderate agreement with those of echocardiography (kappa value = 0.45, P < 0.001). Conclusions: Assessment of left ventricle diastolic function is feasible using phase-contrast MRI in HCM patients. Analysis of pulmonary vein flow velocity on MRI is useful for differentiating pseudo-normal from normal diastolic function in HCM patients.