• Title/Summary/Keyword: Elderly population

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Interalveolar ridge crest relation analysis and rehabilitation of edentulous patient using dental CAD software: A case report (치과용 CAD 소프트웨어를 이용한 무치악 환자의 치조제 관계 진단 및 총의치 수복 증례)

  • Hong, Youngsun;Kim, Jong-Eun;Shim, June-Sung
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.1
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    • pp.31-36
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    • 2019
  • As the number of elderly population increases, the proportion of edentulous patients is increasing, and the demand for traditional dentures will also increase. Arranging the artificial teeth according to the relationship and shape of the upper and lower alveolar ridge is an important factor increasing the stability of the denture. This case is a 79 year old female patient who wishes to make denture covered by national health insurance for psychological and economical reasons. With the alveolar bone severely atrophic, the dental CAD software was used for accurate diagnosis and the posterior teeth were arranged in a cross bite according to the interalveolar crest line angle by the program. After completion, the denture showed adequate stability and maintenance in periodic examinations and treatment, and the patient also expressed high satisfaction.

Development of the Splint Manufacturing Process Using Indirect Coating and Roll Bonding (간접 코팅과 롤 접합을 이용한 의료용 스플린트 제작 및 공정기술 개발)

  • Ha, Kyoung-Ho;Kang, Dae-Min;Lee, Jung-Hee;Kwak, Jae-Seob
    • Journal of the Korean Society of Manufacturing Process Engineers
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    • v.18 no.2
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    • pp.1-6
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    • 2019
  • With the increase in number of the athletic population and elderly demographic, the demand for orthopedic splints, which are used to support a damaged body, has rapidly increased. Current splints mainly consist of inner and outer parts, which are multiple fabrics covered with polyurethane and nonwoven fabrics, respectively. However, the laminated materials with directly applied pre-polymer coating lead to a high defect rate because of the uneven thickness on the surface. Thus, this study proposes an indirect coating method using a precise clearance controller, which enables the even application of the coating material on multiple inner parts while maintaining a constant thickness. In addition, a roll-to-roll (R2R) technique is applied instead of the sewing mechanism to bond the inner and outer materials together and enhance the productivity in the final stage. In the advanced methods, there is a storage tank that contains polyurethane, a clearance controller, and pairs of rollers in the upper and lower rows. To improve the quality of the products and optimize the equipment, three controllable factors are determined: the viscosity of polyurethane, angle of the gap controller and number of pairs of rollers in the R2R system.

Assessment of the Severity of Degenerative Aortic Stenosis: Three Case Reports (퇴행성 대동맥판 협착증의 중증도 평가: 증례보고 3례)

  • Kim, Sung-Hee
    • Korean Journal of Clinical Laboratory Science
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    • v.51 no.2
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    • pp.270-275
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    • 2019
  • The incidence of degenerative valve disease also increasing with the increasing life expectancy of the elderly population. Rheumatic valve disease is decreasing gradually and the incidence of calcified degenerative aortic stenosis (AS) is growing. Echocardiography is a very important tool for evaluating the prognosis and treatment method as well as the time of operation and diagnosis of heart valve disease. When evaluating valvular heart disease, 2-dimensional echocardiography, which observes all heart valves in detail, should take precedence. Understanding the clinical findings of degenerative valve disease and performing precise echocardiography are extremely important. In addition, an assessment of the severity of aortic stenosis is necessary to determine the surgical indications. An assessment of the severity by echocardiography was explained with three cases of degenerative aortic stenosis. To perform echocardiography accurately, it is necessary to understand degenerative valve disease and its clinical findings accurately.

A Study on the Development of China's Barrier-free Design Standards (중국 무장애 디자인 규범의 발전과정에 관한 연구)

  • LI, YUHONG;Lee, Jong-Kuk
    • The Journal of Sustainable Design and Educational Environment Research
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    • v.18 no.1
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    • pp.17-26
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    • 2019
  • Barrier-free design reflects the attention of the disadvantaged groups. As a populous country with the largest population and the largest number of elderly people, China has made great progress in the field of the Barrier-free. The scope of this thesis is from the 1980s to 2012 in China, studying the development process of China's barrier-free design standards by comparing the two barrier-free design standards implemented in the history of such design. In this paper, the two standards are compared and analyzed in the following aspects, which are the numbering, chapters, scope of application, applicable objects and purposes, and so on. Compared with the 2001 barrier-free design standards, the 2012 one can be concluded that the development of barrier-free design in China has been accelerated, the scope of application has been widened than before, the content has been supplemented, and restrictions on terms have been reduced.

Clinical Utility of Visualized Memory Training Program Using the Picture Book for Mild Dementia (경도치매 환자를 위한 그림책 활용 시각화 기억훈련 프로그램의 임상 유용성 연구)

  • Ju, Yumi
    • Journal of Convergence for Information Technology
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    • v.11 no.4
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    • pp.146-152
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    • 2021
  • This study aims to develop a protocol for the visualized memory training program using the picture book and evaluate its clinical utility. A total of 5 sessions were conducted for 5 elderly people with mild dementia. Rey-Kim II, GDS-Short, word test were conducted to observe its effectiveness before and after the program. As a results overall memory was improved but was not statistically significant. Overall depression was also improved and statistically significant. The effect of word memory varies depending on individuals' degenerative conditions. In conclusion, the visualized memory training program using the picture book is effective in improving the memory to some extent and had an emotional effect of reducing depression in mild dementia. In the future it is necessary to research its effects in larger population.

Medication Use Review Tools for Community Dwelling Older Patients: A Systematic Review (지역사회 거주 노인을 위한 약물사용검토 도구에 대한 체계적 문헌고찰)

  • Park, Ji-Young;Jun, Kwanghee;Baek, Yang-Seo;Park, So-Young;Lee, Ju-Yeun
    • Korean Journal of Clinical Pharmacy
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    • v.31 no.1
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    • pp.61-78
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    • 2021
  • Background and Objective: The use of potentially inappropriate medications (PIMs) increases the risk of negative health outcomes, including drug-related admissions. Tools for structured medication review have been developed to ensure optimal medication use and safety. Here, we aimed to evaluate medication use review (MUR) tools for community-dwelling older patients. Methods: We performed a systematic review of the literature according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA). We searched PubMed, Embase, and the Cochrane Library from 1991 to 2020, excluding tools that are specifically applied to hospitalized patients or nursing home residents. We identified the most common inappropriate medications, drug-disease interactions, drug-drug interactions and prescribing omissions presented among tools. Results: From among 9,788 identified reports screened, 60 met our inclusion criteria; finally, 27 were eligible for data analysis considering originality and up-to-dateness. Most tools presented explicit criteria (93%), and only one was specific to community-dwelling elderly. The most common PIM was tricyclic antidepressants. Use of diltiazem and verapamil in patients with heart failure and the combination of nonsteroidal anti-inflammatory analgesics and warfarin were the most frequent disease-specific PIM and drug-interaction, respectively. Conclusions: Although several medication review tools have been developed for older adults, specific guidelines for community-dwelling populations remain limited. Furthermore, the list of PIMs differed among available tools. In future, specific but integrating MUR tools need to be developed for clinical practice considering this population.

A Study on the Prescription Patterns of Gastrointestinal Protective Agent with Non-Steroidal Anti-Inflammatory Drugs in Korean Elderly Patients with Osteoarthritis (골관절염을 진단받고 비스테로이드성 항염제 복용 중인 65세 이상 환자의 위장관보호제 처방양상 연구)

  • Chun, Seongmin;Choi, Yoonhee
    • Journal of The Korean Society of Integrative Medicine
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    • v.8 no.4
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    • pp.79-92
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    • 2020
  • Purpose : The purpose of this study was to evaluate the prescription pattern of NSAIDs and GPAs in the arthritis patients over 65 years old to prevent the GI adverse events. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most commonly used agents to treat arthritis, can cause gastrointestinal (GI) adverse effects. Recent guidelines recommend that moderate risk patients who have one or two risk factors, should be prescribed either combination of non-selective NSAID (nsNSAIDs) and gastroprotective agent (GPAs) or selective NSAID alone. Methods : Study population was National Patient Sample of 2011. Number of drugs used were 138 for NSAIDs and 21 for GPAs. Chi-square test was used to compare prescribing patterns. Results : The appropriate prescription rate follows the guideline was 11.2%: co-prescription with nsNSAID and proton pump inhibitor (PPI) or misoprostol was 1.6% and selective NSAID alone was 9.6%. Inappropriate prescription rates were as follows: co-prescription with nsNSAID and Histamine-2 receptor antagonist (H2RA) or antiacid was 53.8% and nsNSAID alone was 35.0%. The appropriate prescription rate among the types of medical institute was 54.4% in tertiary hospital, 31.2% in secondary hospital, and 6.0% in primary hospital. The appropriate prescription rate among the regions was 19.4%, highest in Seoul and 4.2%, lowest in Jeju. The appropriate prescription rate among the medical departments was as follow: 12.2% in orthopaedic surgery, 11.0% in internal medicine, and 7.7% in other departments. Conclusion : This finding suggests the needs to revise the national medical insurance imbursement policy, provide continuing medical education about the guideline of medical doctors.

Ownership of Long-Term Care Facility and Incidence of Pressure Ulcers among Republic of Korea

  • Chun, Sung-Youn;Park, Hyeki;Kim, Woorim;Joo, Yeong-Jun;Lee, Tae-Hoon;Park, Eun-Cheol
    • Health Policy and Management
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    • v.30 no.4
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    • pp.522-530
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    • 2020
  • Background: In 2008, Korea implemented a new type of social insurance known as "long-term care insurance". We examined the association between ownership of long-term care facilities and the incidence of pressure ulcers after the implementation of "long-term care insurance". This study is a population-based retrospective cohort study from 2006 to 2013. Methods: We used medical claims data from the Korean National Health Insurance Corporate Elderly Cohort Database from 2006 to 2013. These data comprise a nationally representative sample. To avoid confounders, only patients admitted to one long-term care facility and who stayed for >70% of the follow-up time were included; as a result, 3,107 individuals were enrolled. The main independent variable was the operating entity of the long-term care facility (local government, corporate bodies, and private for-profit owners), and the dependent variable was the 1-year incidence of pressure-ulcers. Survival analysis (Cox proportional hazard model) was used as an analysis method. Results: Compared to patients admitted to local government long-term care facilities, patients admitted to private long-term care facilities had a significantly higher 1-year risk of pressure ulcers (hazard ratio [HR], 1.94; 95% confidence interval [CI], 1.29-2.91); the risk was especially high among patients who were cognitively dependent (HR, 2.34; 95% CI, 1.25-4.37). Conclusion: Patients admitted to private for-profit long-term care facilities were more likely to have pressure ulcers compared to those in local government and corporate body long-term care facilities. Appropriate assessment tools and publicly available information, as well as more restricted legal requirements, are needed to improve the care quality and outcomes of patients in long-term care facilities.

Concurrent Use of Korean Herbal Medicines and Western Chemical Medicines: Evidence from HIRA-NPS (건강보험 급여 한약제제와 양방 처방의약품의 병용투여 현황)

  • Lee, Hye-Jae;Yoon, Nan-He;Park, So Hyun;Shin, Seungwon;Park, Minjung
    • Journal of Society of Preventive Korean Medicine
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    • v.25 no.2
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    • pp.1-11
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    • 2021
  • Objective : The purpose of this study is to analyze Korean patients' characteristics, who were concurrently treated with both Korean herbal medicines and Western chemical medicines using nation-wide database. Method : Using the patients sample data (HIRA-NPS 2018) provided by Health Insurance Review and Assessment Service, a group of patients who co-administered Korean herbal and Western medicines was selected, and their basic characteristics, diagnosis, and prescribed chemical medicines were analyzed. Results : Out of the 1,481,921 sample population, 17,629 patients (1.2%) were selected as a concurrent medication group. Compared to the whole sample, the concurrent medication group was composed of more women (65.8% vs. 51.1%), the more elderly people (65 or older years old) (44.5% vs. 14.6%), and the higher prevalence of chronic diseases (49.1% vs. 22.2%). The most frequent diagnosis treated with Western medicines was mental and behavioral disorders, musculoskeletal and circulatory disorders. Frequently used drugs among concurrent medication group were anti-anxiety drugs, gastric ulcer treatment drugs, and senile diseases treatment drugs. Conclusion : The evidence reported in this study is expected to provide herb-drug interaction researchers with important reference to set the priorities of research topics in the future.

Precise control of mitophagy through ubiquitin proteasome system and deubiquitin proteases and their dysfunction in Parkinson's disease

  • Park, Ga Hyun;Park, Joon Hyung;Chung, Kwang Chul
    • BMB Reports
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    • v.54 no.12
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    • pp.592-600
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    • 2021
  • Parkinson's disease (PD) is one of the most common neurodegenerative diseases in the elderly population and is caused by the loss of dopaminergic neurons. PD has been predominantly attributed to mitochondrial dysfunction. The structural alteration of α-synuclein triggers toxic oligomer formation in the neurons, which greatly contributes to PD. In this article, we discuss the role of several familial PD-related proteins, such as α-synuclein, DJ-1, LRRK2, PINK1, and parkin in mitophagy, which entails a selective degradation of mitochondria via autophagy. Defective changes in mitochondrial dynamics and their biochemical and functional interaction induce the formation of toxic α-synuclein-containing protein aggregates in PD. In addition, these gene products play an essential role in ubiquitin proteasome system (UPS)-mediated proteolysis as well as mitophagy. Interestingly, a few deubiquitinating enzymes (DUBs) additionally modulate these two pathways negatively or positively. Based on these findings, we summarize the close relationship between several DUBs and the precise modulation of mitophagy. For example, the USP8, USP10, and USP15, among many DUBs are reported to specifically regulate the K48- or K63-linked de-ubiquitination reactions of several target proteins associated with the mitophagic process, in turn upregulating the mitophagy and protecting neuronal cells from α-synuclein-derived toxicity. In contrast, USP30 inhibits mitophagy by opposing parkin-mediated ubiquitination of target proteins. Furthermore, the association between these changes and PD pathogenesis will be discussed. Taken together, although the functional roles of several PD-related genes have yet to be fully understood, they are substantially associated with mitochondrial quality control as well as UPS. Therefore, a better understanding of their relationship provides valuable therapeutic clues for appropriate management strategies.