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Cephalometric Predisposing Factors of the Snoring and Obstructive Sleep Apnea (코골이 및 폐쇄성 수면 무호흡증의 두부 규격 방사선 계측학적 기여 인자)

  • Seo, Eun-Woo;Lee, Ho-Kyung;Han, Min-Woo;Seo, Mi-Hyun;Kim, Hyun-Jun;Song, Seung-Il
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.3
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    • pp.161-166
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    • 2013
  • Purpose: This study was intended to perform a cephalometric comparison between the patients with and without obstructive sleep apnea (OSA). The factors influencing the OSA in the lateral cephalogram were also investigated. Methods: Fifty patients who had visited the Sleep Disorder Clinic at the Ajou University Hospital and evaluated with the polysomnograph (PSG) and cephalogram, were included in the study. The patients had the apnea-hypopnea episode over 5 times per hour (apnea-hypopnea index $[AHI]{\geq}5$) were diagnosed as OSA after the overnight PSG. To evaluate the hard and soft tissue profiles, the cephalometric radiograms were taken at the maximal intercuspation. The correlation between the patient's age, height, weight, body mass index (BMI) and AHI was inspected in the OSA and control group. The difference between the OSA and control group was evaluated (Mann-Whitney U Test). The cephalometric influencing factors to OSA were analyzed (Pearson's correlation coefficient) statistically using SPSS statistics. Results: The OSA Group had a significantly higher BMI than the control group. The mean lower facial height (ANS-Me) was longer in the OSA group; however, statistically significant difference was not detected in the anteroposterior craniofacial measurements. The distance between mandibular plane and hyoid bone of the OSA group was significantly longer than that of the control group. The hyoid position (MP-Hyoid) had a positive correlation between AHI (P<0.001). However, the measurements of oropharyngeal airway were not different between the two groups. The hypothesis, that the antero-posteriorly narrow oropharyngeal airway may aggravate the airway resistance and give rise to a higher AHI, was rejected in the study. Conclusion: We suggest that the lateral cephalogram may be utilized as a useful method to evaluate OSA. The patients with a lower hyoid position can be expected to have higher risks of OSA. However, a comprehensive intraoral inspection, including the soft palate and tonsilar hypertrophy, is emphasized, as the lateral cepahlogram cannot visualize the oropharyngeal status completely.

A comparative study of quality of life of families with children born with cleft lip and/or palate before and after surgical treatment

  • Emeka, Christian I.;Adeyemo, Wasiu L.;Ladeinde, Akinola L.;Butali, Azeez
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.43 no.4
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    • pp.247-255
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    • 2017
  • Objectives: The aim of this study was to compare the quality of life (QoL) of parents/caregivers of children with cleft lip and/or palate before and after surgical repair of an orofacial cleft. Materials and Methods: Families of subjects who required either primary or secondary orofacial cleft repair who satisfied the inclusion criteria were recruited. A preoperative and postoperative health-related QoL questionnaire, the 'Impact on Family Scale' (IOFS), was applied in order to detect the subjectively perceived QoL in the affected family before and after surgical intervention. The mean pre- and postoperative total scores were compared using paired t-test. Pre- and postoperative mean scores were also compared across the 5 domains of the IOFS. Results: The proportion of families whose QoL was affected before surgery was 95.7%. The domains with the greatest impact preoperatively were the financial domain and social domains. Families having children with bilateral cleft lip showed QoL effects mostly in the social domain and 'impact on sibling' domain. Postoperatively, the mean total QoL score was significantly lower than the mean preoperative QoL score, indicating significant improvement in QoL (P<0.001). The mean postoperative QoL score was also significantly lower than the mean preoperative QoL score in all domains. Only 3.2% of the families reported affectation of their QoL after surgery. The domains of mastery (61.3%) with a mean of $7.4{\pm}1.8$ and finance (45.1%) with a mean score of $7.2{\pm}1.6$ were those showing the greatest postoperative impact. The proportion of families whose QoL was affected by orofacial cleft was markedly different after treatment (95.7% preoperative and 3.2% postoperative). Conclusion: Caring for children with orofacial clefts significantly reduces the QoL of parents/caregivers in all domains. However, surgical intervention significantly improves the QoL of the parents/caregivers of these children.

Effects of Horticultural Occupational Therapy on the Physical and Psychological Rehabilitation of Patients with Hemiplegia after Stroke (반신마비 뇌졸중 환자의 심리와 정서적 재활에 대한 원예작업치료 효과)

  • Kim, Mi-Young;Kim, Gui-Soon;Mattson, Neil S.;Kim, Wan-Soon
    • Horticultural Science & Technology
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    • v.28 no.5
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    • pp.884-890
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    • 2010
  • To examine the effects of horticultural occupational therapy (HOT) on the physical and psychological rehabilitation of stroke patients with paralysis on one side of the body, a horticultural therapy (HT) program was implemented along with occupational therapy (OT) in 20 patients with hemiplegia after stroke (treatment group). In the control group, another 20 patients with hemiplegia after stroke received OT but no HT. The HOT program consisted of various indoor horticultural activities that proceeded stepwise on a weekly basis over the course of four weeks. The selected horticultural occupations were organized into four-phases: motivation, adaptation, sociality, and interpersonal relationships and communication. The grooved pegboard test (GPT), geriatric depression scale (GDS), and functional independent measure (FIM) were tested to the patients in this study. Unlike control group, the treatment group showed statistically significant differences in GPT, GDS, and FIM ($p$<0.001). In addition, communication, social cognition, and self-care scores as FIM subordinate factors were improved significantly by HOT program which motivated patients to engage in rehabilitation therapy. This finding suggests that HOT has the potential to be used as an OT program for stroke patients with hemiplegia.

The Prevalence Rate of Tuberculin Skin Test Positive by Contacts Group to Predict the Development of Active Tuberculosis After School Outbreaks

  • Kim, Hee Jin;Chun, Byung Chul;Kwon, AmyM;Lee, Gyeong-Ho;Ryu, Sungweon;Oh, Soo Yeon;Lee, Jin Beom;Yoo, Se Hwa;Kim, Eui Sook;Kim, Je Hyeong;Shin, Chol;Lee, Seung Heon
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.4
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    • pp.349-355
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    • 2015
  • Background: The tuberculin skin test (TST) is the standard tool to diagnose latent tuberculosis infection (LTBI) in mass screening. The aim of this study is to find an optimal cut-off point of the TST+ rate within tuberculosis (TB) contacts to predict the active TB development among adolescents in school TB outbreaks. Methods: The Korean National Health Insurance Review and Assessment database was used to identify active TB development in relation to the initial TST (cut-off, 10 mm). The 7,475 contacts in 89 schools were divided into two groups: Incident TB group (43 schools) and no incident TB group (46 schools). LTBI treatment was initiated in 607 of the 1,761 TST+ contacts. The association with active TB progression was examined at different cut-off points of the TST+ rate. Results: The mean duration of follow-up was $3.9{\pm}0.9years$. Thirty-three contacts developed active TB during the 4,504 person-years among the TST+ contacts without LTBI treatment (n=1,154). The average TST+ rate for the incident TB group (n=43) and no incident TB group (n=46) were 31.0% and 15.5%, respectively. The TST+ rate per group was related with TB progression (odds ratio [OR], 1.025; 95% confidence interval [CI], 1.001-1.050; p=0.037). Based on the TST+ rate per group, active TB was best predicted at TST+ ${\geq}$ 16% (OR, 3.11; 95% CI, 1.29-7.51; area under curve, 0.64). Conclusion: Sixteen percent of the TST+ rate per group within the same grade students can be suggested as an optimal cut-off to predict active TB development in middle and high schools TB outbreaks.

A COMPARATIVE STUDY ON THE ACCURACY OF PREDICTION METHODS OF UNERUPTED CANINE AND PREMOLARS IN THE MIXED DENTITION (미맹출 영구치 폭경예측방법의 정확도에 관한 비교연구)

  • Lee, Eun-Young;Choi, Yeong-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.23 no.4
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    • pp.788-799
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    • 1996
  • The purpose of this study was to determine the accuracy of the prediction methods which are frequently used in the clinic, such as Moyers', Tanaka and Johnston's, Song's Hixon and Oldfather's, Kaplan's, Smith's. These prediction methods were compared to the data, which were obtained from 100 Kyung-Hee University students (50 males and 50 females) with normal occlusion of permanent dentition, using a retrospective statistical analysis. The standard periapical radiopgraphs for the lower premolars using 16-inch long cone technique and the yellow stone dental casts were taken from each samples. The mesiodistal widths of 4 incisors, canine, premolars were measured on the dental casts, and those of premolars were measured on the radiographs. The correlation coefficients, paired samples t-tests, regression coefficients between the actual measuredments of the samples and the predicted measurements of each methods were analyzed. The results obtained were as follows: 1. The prediction methods using periapical radiographs tended to show a stronger correlation than the methods using dental casts; the correlation coefficients between the actual widths of the lower canine and premolars and the predicted widths of the tested methods were higher in Smith, Kaplan, Hixon & Oldfater, and Tanaka & Johnston (p<0.001). 2. The Moyers' probability chart at 65 % showed a tendency toward the least difference between the actual measurements and the predicted widths of the lower canine and the premolars, and the methods of Smith, Kaplan, Tanaka & Johnston also showed a less difference. 3. By means of evaluation in correlation coefficients and paired smaples t-tests, the Smith and Tanaka & Johnston in male, and the Moyers' 65 % and Song in female showed a high tendency toward accurate methods. 4. The regression equations by models that are derived from the study were as follows: Male(Lt.) :Y=10.799+0.475X Femle(Lt.) :Y= 7.427+0.609X (Rt.) :Y=11.043+0.462X (Rt.) :Y= 8.475+0.556X 5. The regression equations by radiographs that are dericed from the study were as follows: Male(Lt.) :Y=6.5651+0.9720X Femle(Lt.) :Y=4.8656+1.0632X (Rt.) :Y=7.8610+0.9060X (Rt.) :Y=4.5483+1.0843X

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Job Stress, Job Satisfaction, and Organizational Commitment of Customized Home Health Care Nurse (방문건강관리 간호사의 직무스트레스, 직무만족도와 조직애착도)

  • Park, Chan Gyeong;Park, Ki Soo;Kang, Young Sil
    • Journal of agricultural medicine and community health
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    • v.38 no.1
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    • pp.39-48
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    • 2013
  • Objectives: This research was done to identify relationships among job stress, fatigue, job satisfaction, and commitment to organization in customized home health care nurses. Methods: Research participants were 130 nurses who worked in the customized home health care of 20 county in Gyeongnam province. Data collection for this descriptive correlational study was done at August 2010 using self report questionnaires, and analyzed using descriptive statistics, t-test, ANOVA, and we analyzed a four step approach in which several regression analyses were conducted and significance of the coefficients is examined at each step. Results: The results from step 1 showed that, the effect of each job stress was significantly related to job satisfaction. In step 2, the direct effect of commitment to organization on job satisfactions were all significant too. Step 3 analysis showed that the total effect of each job stress on commitment to organization symptoms was significant. Step 4 showed the results of controlling for mediating factor (job satisfaction): job demand and insecurity were significantly associated with commitment to organization(p<0.001), the finding supports that others were fully mediated by each job satisfaction, and, the job demand and insecurity were partially mediated by job satisfaction. Conclusion: Results of this research indicated that job stress in customized home health care nurses was the principal variable affecting job satisfaction and commitment to organization. Appropriate stress management strategies based on assessment of job demand and job security for these nurses lead to development of improved commitment to organization.

Biotinoyl Domain of Human Acetyl-CoA Carboxylase;Structural Insights into the Carboxyl Transfer Mechanism

  • Lee, Chung-Kyung;Cheong, Hae-Kap;Ryu, Kyoung-Seok;Lee, Jae-Il;Jeon, Young-Ho;Cheong, Chae-Joon
    • Journal of the Korean Magnetic Resonance Society
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    • v.12 no.1
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    • pp.1-13
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    • 2008
  • Acetyl-CoA carboxylase (ACC) catalyzes the first step in fatty acid biosynthesis: the synthesis of malonyl-CoA from acetyl-CoA. As essential regulators of fatty acid biosynthesis and metabolism, ACCs are regarded as therapeutic targets for the treatment of metabolic diseases such as obesity, In ACC, the biotinoyl domain performs a critical function by transferring an activated carboxyl group from the biotin carboxylase domain to the carboxyl transferase domain, followed by carboxyl transfer to malonyl-CoA. Despite the intensive research on this enzyme, only the bacterial and yeast ACC structures are currently available, To explore the mechanism of ACC holoenzyme function, we determined the structure of the biotinoyl domain of human ACC2 and analyze its characteristics using NMR spectroscopy. The 3D structure of the hACC2 biotinoyl domain has a similar folding topology to the previously determined domains from E. coli and P. Shermanii, however, the 'thumb' structure is absent in the hACC2 biotinoyl domain. Observations of the NMR signals upon the biotinylation indicate that the biotin group of hACC2 does not affect the structure of the biotinoyl domain, while the biotin group for E. coli ACC interacts directly with the thumb residues that are not present in the hACC2 structure. These results imply that, in the E. coli ACC reaction, the biotin moiety carrying the carboxyl group from BC to CT can pause at the thumb of the BCCP domain. The human biotinoyl domain, however, lacks the thumb structure and does not have additional non-covalent interactions with the biotin moiety; thus, the flexible motion of the biotinylated lysine residue must underlie the "swinging arm" motion. This study provides insight into the mechanism of ACC holoenzyme function and supports the "swinging arm" model in human ACCs.

Clinical Efficacy of External Application Containing Betula platyphyllae Cortex, Viticis Fructus, Agrimoniae herba in Atopic Dermatitis (아토피 피부염에 대한 화피(樺皮), 만형자(蔓荊子), 선학초(仙鶴草) 함유 외용제의 임상 효과)

  • Hong, Jee-Hee;Jung, Hyun-A
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.27 no.1
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    • pp.1-16
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    • 2014
  • Objectives : The aim of this study is to examine the effect of external application containing herbal extracts (Betula platyphyllae Cortex, Viticis Fructus, Agrimoniae herba) to patients with atopic dermatitis. Methods : Twenty patients (experiment group) were treated with the external application containing herbal extracts (Betula platyphyllae Cortex, Viticis Fructus, Agrimoniae herba) and other twenty patients (control group) were treated with normal external application that doesn't contain herbal extracts for 2weeks. We observed comparisons between experiment and control group after 1week, 2weeks. Degrees of severity of atopic dermatitis were measured by SCORAD index (Scoring of Atopic Dermatitis Index). Statistical significance was achieved if the probability was less than 5% (p<0.05). Results : 1. After 1week of external application treatment, SCORAD Index in experiment group was significantly decreased comparing with control group, which is a marginally significant result between two groups. But after 2weeks the experiment group showed no statistically significant result. 2. After 1week of external application treatment, Intensity Criteria (Erythema, Edema/papulation, Total) in experiment group was significantly decreased comparing with control group, which is a statistically significant result between two groups. But after 2weeks the experiment group showed no statistically significant result. 3. After 1week and 2weeks of external application treatment, comparison of changes in Subjective Symptoms (Pruritus, Insomnia) indicated that the experiment group showed no statistically significant result. 4. After 1week of external application treatment, Total Quality of life through Skindex-29 in experiment group was significantly decreased comparing with control group, which is a marginally significant result between two groups. But after 2weeks the experiment group showed no statistically significant result. Conclusions : As a result of applying the external application containing herbal extracts to patients with atopic dermatitis and watching the progress, we can speculate that the external application containing herbal extracts has especially short-term therapeutical effects in mitigating the symptoms of Atopic Dermatitis. Thus, it is concluded and considered that the external application containing herbal extracts can be used by atopic patients effectively with almost no side-effect.

Does Additional Aortic Procedure Carry a Higher Risk in Patients Undergoing Aortic Valve Replacement?

  • Kim, Tae-Hun;Park, Kay-Hyun;Yoo, Jae Suk;Lee, Jae Hang;Lim, Cheong
    • Journal of Chest Surgery
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    • v.45 no.5
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    • pp.295-300
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    • 2012
  • Background: With growing attention to the aortopathy associated with aortic valve diseases, the number of candidates for accompanying ascending aorta and/or root replacement is increasing among the patients who require aortic valve replacement (AVR). However, such procedures have been considered more risky than AVR alone. This study aimed to compare the surgical outcome of isolated AVR and AVR combined with aortic procedures. Materials and Methods: A total of 86 patients who underwent elective AVR between 2004 and June 2010 were divided into two groups: complex AVR (n=50, AVR with ascending aorta replacement in 24 and the Bentall procedure in 26) and simple AVR (n=36). Preoperative characteristics, surgical data, intra- and postoperative allogenic blood transfusion requirement, the postoperative clinical course, and major complications were retrospectively reviewed and compared. Results: The preoperative mean logistic European System for Cardiac Operative Risk Evaluation (%) did not differ between the groups: $11.0{\pm}7.8%$ in the complex AVR group and $12.3{\pm}8.0%$ in the simple AVR group. Although complex AVR required longer cardiopulmonary bypass ($152.4{\pm}52.6$ minutes vs. $109.7{\pm}22.7$ minutes, p=0.001), the quantity of allogenic blood products did not differ ($13.4{\pm}14.7$ units vs. $13.9{\pm}11.2$ units). There was no mortality, mechanical circulatory support, stroke, or renal failure requiring hemodialysis/filtration. No difference was found in the incidence of bleeding (40% vs. 33.3%) which was defined as red blood cell transfusion ${\geq}5$ units, reoperation, or intentional delayed closure. The incidence of mediastinitis (2.0% vs. 0%), ventilator ${\geq}24$ hours (4.0% vs. 2.8%), atrial fibrillation (18.0% vs. 25.0%), mean intensive care unit stay (34.5 hours vs. 38.8 hours), and median hospital stay (8 days vs. 7 days) did not differ, either. Conclusion: AVR combined with additional aortic or root replacement showed an excellent outcome and recovery course equivalent to that after isolated AVR.

Rational Use of Antimicrobial Agents in Traumatic Simple Wounds (외상으로 인한 상처의 치료에 있어서 선택적 항균제의 효과 및 적응증에 관한 연구)

  • Kim, Jae Eun;Suh, Joo Hyun;Choi, Yoon Hee;Bae, Hyun A;Jung, Jin Hee;Eo, Eun Kyung;Cheon, Young Jin;Jung, Koo Young
    • Journal of Trauma and Injury
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    • v.20 no.1
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    • pp.40-46
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    • 2007
  • Purpose: The primary goal of wound management is to avoid infection. Wounds in all patients presenting to the Emergency Department are contaminated with bacteria. Despite this, there is a low incidence of infection. Unfortunately, physicians continue to use antimicrobial agents indiscriminately. The authors intended to determine the effect of selective antimicrobial agents and the indications for appropriate antimicrobial agent use in traumatic simple wounds. Methods: This prospective study was performed from Jul. 2005 to Aug. 2005. A pilot study had been performed from Nov. 2003 to Jul. 2004 at the Ewha Woman's University Mokdong Hospital. Structured data sheets were completed at the times of the patient's visits to the Emergency Department and to the Outpatient Department for follow-up. Infection was determined at the time of follow-up. The indications of antimicrobial agent use are immunocompromised patients, wounds contaminated for 3 hours or longer, devitalized tissue, and extremity wounds except hand wounds caused by sharp objects. Results: The study enrolled 216 injured patients. The general characteristics of patients and wounds between the two groups were not significantly different. The antimicrobial agent use and infection rate of the pilot study were 227 cases (90.4%) and 10 cases (4.0%), and those of this study were 100 cases (46.3%) and 9 cases (4.1%). In this study, antibiotic use was reduced to almost half compared with the previous study, but the infection rate was similar (p<0.001). Conclusion: Rational use of antimicrobial agents in simple wounds reduced the use of antimicrobial agents in the Emergency Department without increasing the infection rate.