• Journal of agricultural medicine and community health
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• v.23 no.1
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• pp.65-78
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• 1998

This study was conducted to find out the factors which have an effect on the rural aged's natural history by disability in Activities of Daily Living(ADL) and ADL decline with 475 old people which were chosen except the dead 90 and unconfirmable 56 old people by performing follow-up survey for 4 years since 1993 on the basis of presurveyed data about 621 home old people over 60 years residing in 13 villages at Kangdong-myon, Kyongju-city, Kyongsangbuk-do Province, Korea. Such activities of daily living as bathing, dressing, going to toilet, transfer, feeding and continence were examined. 1. In the follow-up survey for 4 years, the ADL distribution of the dead was remarkably lower than the subject group. 2. It was also shown in the 4-year follow-up survey that 82.1% of high ADL group maintained high ADL while 77.8% of low ADL group died within 4 years. 3. The occurrence percentage of disabilities of each group by ADL item for 4 years appeared high in such an order as bathing, continence, dressing, going to toilet, transfer and feeding. 6.7%(8.1% for female and 4.6% for male) of the old people who were the high ADL group at the time of the first survey had disabilities that occurred after 4 years. 4. In the change of ADL according to general characteristics used to analyse the factors which have an effect on ADL decline, there was a significant difference in age and job, that is, the jobless old people had the higher degree of ADL decline. In the change of ADL according to behavioral pattern, for the male old people there was a significant difference in support of living expenses and subjective health condition. In this case, the degree of ADL decline was higher if they depended on their sons & daughters or spouses and felt that they were not healthy.

• Journal of dental hygiene science
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• v.17 no.2
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• pp.123-133
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• 2017

The aim of this study was to analyze in depth the standardized Clinical dental hygiene curriculum of the Fones School in the United States. We investigated the clinical dental hygiene curriculum in 2015~2016 including title, credit, hours, contents, goals, competencies, and evaluation. We obtained the course syllabus and data related to each subject, for each grade, from the professors and students at the university. The goals and competencies, of the clinical dental hygiene program, which were based on the goals of the Fones School and the mission of the University of Bridgeport, were developed in accordance with the dental hygienist practice standards proposed by the American Dental Hygienists Association. The curriculum consisted of theory to teach proper dental hygiene care procedures and incorporated practical exercises that modeled an actual clinical setting. The students had to document the procedures performed for each client/patient and improve their clinical competency through discussion with the professors. Dental hygiene care should be provided for children, adolescents, adults, elderly, and patients, which includes patients with moderate or severe periodontal status. Students were evaluated by a paper test or case study presentation and their clinical evaluation was based on their clinical competency. In particular, professors evaluated students on a rotational basis, so they could evaluate the level of achievement of clinical competency of all students and find ways to improve any weaknesses. Therefore, the current study suggested that clinical dental hygiene program in Korea could be improved if based on the curriculum of Fones School in the United States.

• Journal of Oral Medicine and Pain
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• v.36 no.3
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• pp.169-176
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• 2011

Oromandibular dystonia (OMD) is a form of focal dystonia that affects the masticatory, facial and lingual muscles in any variety of combinations, which results in repetitive involuntary and possibly painful jaw opening, closing, deviation or a combination of these movements. This study aimed to investigate clinical features and treatment type of OMD patients. By retrospective chart review, the study was conducted to consecutive OMD patients who visited a department of Oral Medicine and Orofacial Pain Clinic in a university dental hospital during Aug 2007 to Apr 2010. 78 OMD patients were identified with female preponderance (M:F=1:3.6) and a mean age of 72 years. Their mean duration of OMD was about 10 months. The most common chief complaints at the first visit was jaw ache, followed by uncontrolled, repetitive movement of the jaw and/or oral tissues, pain in the oral region(p=0.000). The most common subtype of OMD was lateral jaw-deviation dystonia, followed by combination and jaw-closing dystonia(p=0.001). While no apparent cause was recognized in over 60% of the OMD patients, peripheral trauma including dental treatment such as prosthetic treatment and extraction was the most frequently reported as precipitating factor(p=0.000). Medication was the 1st line therapy for our patients and anxiolytics such as clonazepam was given to most of them. Based on the results of this study, OMD is the disease of the elderly, particularly of women and causes orofacial pain and compromises function of orofacial region. Some patients considered dental treatment a precipitating factor. Dentists, therefore, should have knowledge of symptoms and treatment of OMD.

• Journal of Oral Medicine and Pain
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• v.37 no.3
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• pp.183-188
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• 2012

Previous studies of the relationship of TMJ signs and symptoms in elderly people have provided inconsistent findings. The objective of this study was to retrospectively analyze the prevalence of signs and symptoms of temporomandibular disorders(TMD). Additionally, young subjects were examined as a control group. Forty old patients (28 female, 12 male, mean age: $65.2{\pm}2.5$ years) and forty young patients (30 female, 10 male, mean age: $23.3{\pm}2.6$ years) clinically diagnosed with TMD were screened. Patient records were analyzed regarding: pain on chief complain, amount of range of mouth opening, TMJ noises(clicking sounds, crepitus), pain on palpation of the TMJ and masticatory muscles and neck and upper back muscles. Differences between the groups were assessed using t-test and the chi-squared test. (SPSS v.17) P value <0.05 was considered statistically significant. Geriatric subjects more often exhibited crepitus on mouth opening (25%), muscular palpation pain of masseter muscles (82.5%) and temporal muscles(60%). In contrast, young subjects more frequently exhibited joint sounds (62.5%), more amount of range of passive mouth opening (p=0.043). It was found that the younger subjects (82.5%) and the older subjects (87.5%) suffered from subjective sign (orofacial pain on chief complain). There were not statistically significant relationships between orofacial pain (VAS) and the groups. Differences between the groups with respect to joint sounds, muscular palpation pain and mandibular range of motion were significant. Although older subjects more frequently exhibited objective signs (crepitus on opening, pain on muscular palpation) of TMD, younger subjects more frequently objective signs (clicking sound on mouth opening, amount of mandibular range of motion).

• Journal of agricultural medicine and community health
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• v.28 no.1
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• pp.39-51
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• 2003

Objectives: The oriental medical care has been getting popular in community health centers because of uniqueness, changing of disease patterns, and increasing of elderly population. From 1998, oriental medical doctors has been working in several rural community health centers for their military obligations. At this point of time, it is necessary to evaluate the oriental public health doctors system. This study was performed to investigate the utilization patterns, the degree of satisfactions, needs of oriental medical care service provided by community health center in a designated Gun area. This study focused on the need for extending over Myun area of community health center's oriental medical care services. Methods: Person-to-person interview survey method through a structured questionnaire was done by a personnel at a oriental medical care service room in a Gun community health center. The major statistical method used for the analysis were the t-test, ANOVA, and logistic analysis. Results: The total number of responded subjects in this study was 163 residents. Among these 65.0% were aged 61 or over, and only 13.5% recognized themselves were healthy. 73.7% of the respondents demanded establishment of more oriental medical care services provided by community health center to other Myun area. Factors affecting the need for enlargement of oriental medical care service room were education level, subjective awareness of access to community health center, and cost satisfaction of oriental medical service provided by community health center. Thus, a resident who had graduation of middle school achievement or above(OR=3.35), had a long way to center(OR=2.47), satisfied with oriental medical service cost(OR=2.78) had demonstrated increased chance of need by logistic regression analysis.

• Journal of agricultural medicine and community health
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• v.40 no.3
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• pp.126-136
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• 2015

Objectives: This study was performed to investigate the effects of a health education program for the aged on knowledge about the warning signs and symptoms of acute myocardial infarction and stroke. Methods: Data from 337 elderly people (159 participated and 178 non-participated) at senior centers in Jeju-si were collected by 1 to 1 interview from January to March 2012, one year after the education program provided. Two stages of study were performed: Cross-sectional, case-control study on the level of knowledge about the warning signs and symptoms; and multivariate logistic regression to fine out predictors of optimal awareness. Results: No significant discrepancy of knowledge level between case and control group was found. The knowledge level as high as a surge was shown in both groups one year later. A surge of knowledge had been shown after the education provided in one month. The factors affecting the optimal level of knowledge were education (Odds ratio 3.01; Confidence Interval 1.72-5.26; P-value <0.001) and 7 days of watching TV news per week (2.97; 1.68-5.23; P<0.001). However, participation in the health education was not significant (1.60; 0.98-2.61; P=0.059). Conclusions: The effects of a targeted program in high-risk groups for cardio-cerebrovascular disease are only guaranteed in the enhancement by a population-based mass-media education campaign.

• Sleep Medicine and Psychophysiology
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• v.5 no.1
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• pp.103-110
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• 1998

Objectives : High co-morbidity of periodic limb movements during sleep(PLMS) and obstructive sleep apnea syndrome(OSAS) is well known and their incidences tend to increase in the elderly. Previous studies have inconsistently rep0l1ed increase or no change of periodic limb movement index(PLMI) by nasal continuous positive airway pressure(CPAP) in OSAS without analyzing possible variables affecting PLMI. We attempted to examine PLMI change evoked during CPAP titration and also factors affecting it in OSAS. Methods : Twenty-nine OSAS patients(M:F=26:3, mean age: $51.6{\pm}10.6\;yrs$) without other sleep disorders except for PLMS were selected, based on the nocturnal (baseline) polysomnograhy. Another night of noctumal polysomnography was performed for CPAP pressure titration. We compared between those two nights PLMI, mean and lowest $SaO_2$, and sleep variables. We also calculated PLMI differences between baseline and CPAP nights, named as delta PLMI (value of CPAP night PLMI minus value of baseline night PLMI). Correlations were calculated between delta PLMI and factors such as age, body mass index, applied CPAP pressure, baseline night values of respiratory disturbance index, mean and lowest $SaO_2$, and sleep parameter differences between baseline and CPAP nights. Results : Decrease of RDI(p<.01) and increase in mean and lowest $SaO_2$ (p<.05, p<.01) were observed during CPAP night. No sleep parameters showed significant change except for the decrease of total stage 1 sleep%(p<.01) during CPAP night. Ten out of 29 patients showed PLMI increase, while the other 19 patients showed either no change(n=14) or even PLMI decrease(n=5) during CPAP night. The 10 patients showing PLMI increase during CPAP night showed a significant positive correlation between delta PLMI and baseline night RDI(p<.05), which meant that PLMI increase was found to be more prominent in higher RDI patients than in lower RDI ones. There were no significant correlations between delta PLMI and other factors in the other 19 patients. Conclusions : We suggest that during the baseline night PLMS would have been underscored and/or masked due to the overlapping of PLMS and apneas/hypopneas or the arousals induced by apneas/hypopneas. Despite its still unknown mechanism, the CPAP application may unmask PLMS and increase PLMI in a subgroup of OSAS patients. It needs to be evaluated further whether the chronic CPAP use sustains the above finding.

• Journal of Life Science
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• v.21 no.1
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• pp.1-8
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• 2011

The purpose of this study was to investigate whether 12-weeks of movement training would increase the psoas major cross-sectional area (CSA) in senior men and women. Fifty eight men and women aged 65 to 80 years old ($69.6{\pm}3.7$, 30 male, 28 female) were divided into a control (n=19) and exercise group (n=39). Subjects were assessed before and after the training program for stature, body mass, and magnetic resonance imaging of the psoas major and the quadriceps muscle. The experimental group performed exercises using machines designed to improve the movement of the hip at a frequency of twice every week, with a total of 23 trainings in 12-weeks. Magnetic resonance images of both thighs and the abdomen and psoas major were obtained, aimed at 50% of the length of the greater trochanter and the lower edge of the femur and between the fourth (L4) and fifth (L5) lumbars. A 9.4% increase in the psoas major CSA in the training group was observed. In the male and female breakdown, a 11.5% and 8.4% change was observed in males and females, respectively. In the quadriceps, there was no significant statistical improvement in either males or females. Furthermore, in the control group, there was no significant change seen in either the psoas major or the quadriceps. As a result of conducting training that enables upkeep of posture and smooth linkage of the lumbar spine, the pelvis and thighbone, the psoas major CSA of older adults were improved in a short period of time. For this reason, the possibility of improving the psoas CSA, which decreases remarkably with increased age, by improving the linkage of the body trunk is also suggested.

• KDI Journal of Economic Policy
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• v.34 no.3
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• pp.31-65
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• 2012

We study the sustainability of the current fiscal policy of Korea, and the effects of the social welfare policy expansion, which has been recently discussed among the political circles, on the government budget and the generational equity, using generational accounting. We follow the generational accounting approach, considering the fact that most of the social welfare policies are the entitlement programs, which imposes the limitation of the policy maker's discretion to control the cost of their provision. The social welfare expenditure will change due to the change in the policy environments of the future, such as population aging. Therefore, we need to take into account the government cash flow of the future as well as of the present to investigate its effects on the fiscal sustainability, which implies that the national debt or the budget balance is not a proper index for the investigation. Our findings are as follows. The current fiscal policies are not sustainable, and the long-term budgetary imbalance is shown very serious. The required tax adjustment, which is defined as the percentage change of tax burden required to attain the long-term budgetary balance, is very large. Unless the level of the government expenditure is properly controlled, the tax burden and the social contribution level will rise to the untolerable level. Moreover, the expansion of the social welfare policies, which has been discussed among the political circles, will substantially increase the fiscal burden of the future generations. Even though the provision of the free lunch to the primary and the secondary school students, the free child care, and the discounted college tuition do not increase the fiscal burden much, because their magnitude at present is not large and will decrease due to the decrease in the number of the newborns and the students resulting from the fall in the fertility rate, that of the free health care service will increase tax burden of the future generations very much, because the magnitude of the government expenditure needed at present is very large and the population aging will further increase the magnitude of the health care expenditure. The findings indicate that the structural reforms, to prevent the explosive increase in the social welfare expenditure in the future, are necessary before the implementation of the welfare policy expansion. In particular, the cost control of the social transfers to the elderly needs to be made, because the speed of the population aging of Korea is among the highest in the world. The findings also indicate that the budget balance or the national debt can cause the fiscal illusion, which makes the Korean government budget look sound, even though the fiscal policy will rapidly increase the social welfare expenditure in the future, as the population ages. The generational accounting, which takes into account the cash flow of the future as well as of the present, unlike the budgetary balance and the national debt, which shows the results of the government financial activities of the past and the present, is a useful method to overcome the fiscal illusion.

• Journal of Chest Surgery
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• v.33 no.12
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• pp.941-947
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• 2000

Background: Central nervous system complication after coronary artery bypass grafting(CABG) is one of the major prognostic determinants and the use of the cardiopulmonary bypass(CPB) may increase the incidence of this devastating complication. In this study, the outcomes after off-pump CABG were studied and compared with those following the conventional CABG using CPB. Material and Method: Among the consecutive isolated CABG's performed in SNUH during Feb. 1995 and Jun. 1999, 338 coronary artery bypass grafting were divided into two groups. 223 patients underwent CABG using the CPB(Group I), and 115 patients underwent CABG without CPB(OPCAB)(Group II). All patients enrolled in this study received extensive preoperative examinations including thorough neurologic examination before and after surgery, transcranial doppler study, carotid duplex ultrasonography, and magnetic resonance angiography if necessary. Central nervous system(CNS) complications were defined as stroke, seizure, metabolic or hypoxic encephalopathy and transient delirium after surgery. Result: There were 61 cases(27.3%) who developed postoperative CNS complication in Group I, whereas 8 cases(7.0%) of CNS complications developed postoperatively in group II(p<0.05). Statistically significant predictors of postoperative CNS complications in group I were age and the use of cardiac assist devices perioperatively. Conclusion: This study suggested that omitting the use of CPB in CABG resulted in significant decrease of the postoperative CNS complications. OPCAB should be more widely applied especially to the elderly who have preexisting cerebrovascular disease.