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A Survey on Treatment of Breast Cancer Patients with Korean Medicine: Preliminary Research for Clinical Practice Guidelines (한의표준임상진료지침 개발을 위한 유방암 보완치료 실태조사)

  • Kim, Nam-Hoon;Kang, Na-Hoon;Yoo, Eun-Sil;Park, Nam-Chun;Lee, Jin-Wook;Park, Kyoung-Sun;Lee, Jin-Moo;Lee, Chang-Hoon;Jang, Jun-Bock;Jang, Bo-Hyoung;Hwang, Deok-Sang
    • The Journal of Korean Obstetrics and Gynecology
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    • v.31 no.4
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    • pp.165-178
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    • 2018
  • Objectives: To determine the current status of the treatment of breast cancer patients by Korean Medicine doctors (KMDs) and to examine the need for clinical practice guidelines (CPGs) for the supportive care of these patients. Methods: This cross-sectional study used a self-administered questionnaire. Participants were asked about their experience in treating breast cancer patients; the number of breast cancer patients they currently treat; the main complaints expressed by, diagnoses of, and treatments used for such patients; and their opinions about Korean Medicine (KM) as the basis for providing supportive care for breast cancer. Results: The data for this study were collected from 322 respondents. 84 of whom reported having ever treated patients with breast cancer. Most breast cancer patients who visited the KM clinic were classified as stage I or II, and their major complaints were fatigue, general weakness and musculoskeletal pain. The major diagnostic strategies were syndrome differentiation and pulse diagnosis. The major treatments administered were herbal medicine, acupuncture, and moxibustion. KMDs cited a need for medical information, such as CPGs, as their most important concern with regard to the treatment of breast cancer patients. Conclusions: This survey determined the prevalence of the use of KM for Korean breast cancer patients. Our results underscore the need for clinical practice guidelines for using of KM as the basis of supportive care for breast cancer and for informing clinicians and patients about this approach.

A Study on the Temporomandibular Joint Disorder and School Life Stress of High School Student by Department (계열별 남자고등학생의 학교생활스트레스와 측두하악장애에 관한 연구)

  • Lee, Jung-Hwa;Choi, Jung-Mi
    • Journal of dental hygiene science
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    • v.7 no.3
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    • pp.179-185
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    • 2007
  • The purpose of this study targeted on high school student in the department of liberal arts, industry in Daegu metropolitan city, is to get basic data necessary for the development of dental educational program, to discern prevention and treatment of temporomandibular joint disorder by observing the situation temporomandibular joint disorder and contribution element, of relationship of school life stress The results are as follows.: 1. The percentage of occurring temporomandibular joint disorder in the high school resulted in a joint noise at 61.8% and joint dislocation 6.9%, sharp pain 47.5% at time of chewing. 29.8% at the time of the non-chewing, lockjaw 11.3%, a headache appeared at 40.4%.2. In the contribution factor of occurring temporomandibular joint disorder, the cause of joint noise was the clench one's teeth, lip and cheek clench, For the pain at the time of chewing clench one's teeth, one side chewing, over-chewing, lip clench, sideways sleeping showed the difference. (P < 0.01) For the pain at the time of non-chewing, clench one's teeth, bruxism, one side chewing, lip and cheek clench were similar, and for the lockjaw, clench one's teeth, bruxism, sideways sleeping showed the difference. The plum evil thing period at time of the fault writing that statistically showed the difference. For the headache, the contribution factors were the all bad habits mentioned above excluding one side sleeping.(P < 0.01, P < 0.05). 3. The rate of experiencing temporomandibular joint disorder by oral and maxillofacia was 13.4% in industrial department, and 19.6% in liberal arts. And for the factor of wound was that exercise 26.8%, others 24.4%, fall-down 19.5%. And for the industrial, exercise 44.4%, fall-down 22.2%, others 14.9%. The treatment experience appeared at 5.0% in industrial department, 2.9% in liberal arts. And for the medical institutions, liberal arts were dental clinic 50%, orthopedics 50%, and the industrial department orthopedics 40%, oriental medicine clinic 30%, dental clinic 30%. 4. In case of temporomandibular joint disorder, there were no difference by grades or educational background. And at the time of chewing or non-chewing showed similar difference.(P < 0.01). 5. Compared to stress in the high school, it generally showed higher in liberal arts than in industrial department due to school record. Its scope was $3.75{\pm}1.14$ in liberal arts, $3.01{\pm}1.23$ in industrial department. 6. The school record, school life, stress problems by teachers, chewing/non-chewing pain of temporomandibular joint disorder, joint noise had a similar correlation.(P < 0.01, < 0.05).

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Oral Health Status of Some Patients with Chronic Mental Illness in Korea (일부 만성 정신질환자의 구강건강 상태)

  • Seo, Hye-Yeon;Jeon, Hyun-Sun;Park, Su-Kyung;Park, Ki-Chang;Chung, Won-Gyun;Mun, So-Jung
    • Journal of dental hygiene science
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    • v.13 no.4
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    • pp.493-500
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    • 2013
  • The study aims to determine the status of oral health of mental illness patients and establish the preliminary data. The examinations and questionnaire survey were done 92 psychiatric patients to measure sociodemographic characteristics, decayed, missing and filled teeth (DMFT) index, patient hygiene performance (PHP) index, community periodontal index of treatment need (CPITN). Result of the missing teeth index in the state of oral health was higher in the hospital group (6.42) while the filled teeth index was higher in the center group (4.78). In the DMFT index, mental illness patients were higher than the national sample. The oral health status of medical aid recipients was poorer as the subjects were older and less educated (p<0.05). The PHP index was 3.41, close to the bad oral hygiene state. The hospital group (81.7%) required higher need for periodontal treatment. The periodontal health state was much poorer especially when the subject was in the age of 40's and 60's, received less education, and had no family (p<0.05). $CPITN_3$ was higher in the hospital group (13.3%) than the national sample (5.7%). The mental illness patients were socially vulnerable, therefore oral health care program should be needed and age, education level, health insurance type, presence of family and other factors needs to be considered in this approach.

The Association between Types of Smoking and Periodontal Disease according to the Survey Year Using the Fourth and Fifth Korea National Health and Nutrition Examination Surveys (조사연도에 따른 흡연 유형과 치주질환의 관련성 분석: 제4기, 제5기 국민건강영양조사를 이용하여)

  • Kim, Myoung-Hee;Yoon, Mi-Sook;Lim, Youn-Hee;Lee, Sae-Rom;Kim, So-Yeon;Park, Seon-Ju;Shin, Sun-Jung
    • Journal of dental hygiene science
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    • v.17 no.6
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    • pp.487-494
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    • 2017
  • There is little evidence on the effects of environmental tobacco smoke (ETS) on prevalence of periodontal disease. The aims of this study were to explore the trends of prevalence of periodontal disease and types of exposure to smoke, including ETS according to the survey year, identify factors affecting periodontal disease, and compare the effect size of periodontal disease between active smokers and secondhand smokers. Data on 11,643 individuals were obtained from the fourth and fifth Korean National Health and Nutritional Examination Surveys. Information on exposure to ETS at home and work was self-reported. Severity of periodontal disease was evaluated using the community periodontal index. A multivariate logistic regression analysis was performed to model periodontal disease using types of smoking and the survey year. Overall, the prevalence of periodontal disease was 26.0% (n=3,029) and about 9% of the study population were secondhand smokers. The prevalence of periodontal disease among smokers was significantly increased according to smoking types by year. Active smokers showed a statistically significant adjusted odds ratio (aOR) for having periodontal disease except in the year 2007, whereas secondhand smokers had significant associations only in 2010 (aOR, 1.68; 95% confidence interval, 1.05 to 2.70) compared to non-smokers. For secondhand smokers, the statistical relationship of predicting periodontal disease was weaker than that of active smokers. However, ETS should separately be considered as an important risk factor for periodontal disease. This study suggested the need for further investigation of the impact of ETS on prevalence of periodontal disease using in-depth research designs and objective measurements for assessing periodontal disease and ETS.

A Study on Factors Affecting Emotional Labor of Clinical Dental Hygienists (임상치과위생사들의 감정노동에 영향을 미치는 요인)

  • Lee, Myeong-Ju;Kim, Young Nam;Lee, So-Young
    • Journal of dental hygiene science
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    • v.15 no.2
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    • pp.113-118
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    • 2015
  • This study was conducted to develop a plan for emotional labor of clinical dental hygienists by understanding the factors affecting their emotional labor. Self-administered questionnaires were distributed to 293 dental hygienists who worked in dental hospitals and clinics located in Busan and Gyeongsangnam-do from June to September in 2013. The questionnaire items used in this study consisted of 5 items of general characteristics, 2 items of characteristics related to turnover, and 9 items of emotional labor. t-test, ANOVA, and multiple regression analysis were performed using the SPSS Statistics ver. 17.0 for Windows program for data analysis. The average level of the study subjects was $69.85{\pm}12.82$. With regard to the emotional labor according to the general characteristics, the frequency of emotional expressions (p<0.037) showed significant differences in the marital status. The workplace showed significant differences in the frequency of emotional expressions (p<0.001), attentiveness of emotional expressions (p<0.002), emotional dissonance (p<0.032), and total (p<0.001). The turnover intentions showed significant differences in the frequency of emotional expressions (p<0.001), attentiveness of emotional expressions (p<0.001), emotional dissonance (p<0.001), and total (p<0.001). As a factor affecting emotional labor, turnover intention (p<0.001) and workplace (p<0.001) had an effect on emotional labor. The results showed that turnover intention and workplace were associated with the emotional labor of dental hygienists. There is a need to develop an emotional education program to make it possible to effectively manage emotional labor of dental hygienists for providing high-quality medical services of dental institutions.

Thermographic Assessment in Dry Eye Syndrome, Compared with Normal Eyes by Using Thermography (열화상카메라를 이용한 정상안과 건성안의 서모그래피 비교)

  • Park, Chang Won;Lee, Ok Jin;Lee, Seung Won
    • Journal of Korean Ophthalmic Optics Society
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    • v.20 no.2
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    • pp.247-253
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    • 2015
  • Purpose: The purpose of this study was to compare and analyze the ocular surface and the palpebral conjunctiva of categorized subjects, which were divided into normal eye group and dry eye group, by using a thermal camera. Methods: Subjects were 144 eyes of 72 normal university students, who didn't have any corneal disease, abnormal lacrimal ducts, medical records regarding ocular surgeries, or experience of using contact lens. Subjects were divided into two groups, which were normal eye group and dry eye group, based on the results of TBUT, Schirmer I test, and McMonnies test. After categorizing the subjects, the temperature of the subjects' ocular surface and the palpebral conjunctiva were measured and analyzed by using a thermal camera (Cox CX series, Answer co., Korea). Results: In the normal eye group's Central Ar.1, Nasal Ar.2, Temporal Ar.3, Superior Ar.4, Inferior Ar.5, the measured amount of temperature change on each area was $-0.13{\pm}0.08$, $-0.14{\pm}0.08$, $-0.12{\pm}0.08$, $-0.14{\pm}0.08$, $-0.10{\pm}0.09(^{\circ}C/sec)$. The dry eye group's results were $-0.17{\pm}0.08$, $-0.16{\pm}0.07$, $-0.16{\pm}0.08$, $-0.17{\pm}0.09$, $-0.15{\pm}0.08(^{\circ}C/sec)$. When compared with the normal eye group, the values of Ar.1, Ar.3, Ar.5 were significantly different in the dry eye group(p<0.05). The amount of temperature change, which was observed on the palpebral conjunctiva(Ar.1:central, Ar.2: nasal, Ar.3: temporal) of the normal eyes, measured by thermography, was $34.36{\pm}1.12$, $34.17{\pm}1.10$, $34.07{\pm}1.12^{\circ}C$ on each area. Same values taken from the dry eye group was $33.55{\pm}0.94$, $33.43{\pm}0.97$, $33.51{\pm}1.06^{\circ}C$ on each area. The values of Ar.1, taken from the dry eye group, had a significant difference, compared to the values of the normal eye group(p=0.05). Conclusion: The temperature of the ocular surface decreased faster on the dry eyes, compared to the normal eyes. The temperature measured on the palpebral conjunctiva of the dry eyes were also lower than the normal eyes. The temperature changes on the ocular surface, observed with a thermal camera, were objective values to assess the stability of tear films, and might provide useful data for studies related to dry eye syndrome.

Automatic Detection of Stage 1 Sleep (자동 분석을 이용한 1단계 수면탐지)

  • 신홍범;한종희;정도언;박광석
    • Journal of Biomedical Engineering Research
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    • v.25 no.1
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    • pp.11-19
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    • 2004
  • Stage 1 sleep provides important information regarding interpretation of nocturnal polysomnography, particularly sleep onset. It is a short transition period from wakeful consciousness to sleep. Lack of prominent sleep events characterizing stage 1 sleep is a major obstacle in automatic sleep stage scoring. In this study, we attempted to utilize simultaneous EEC and EOG processing and analyses to detect stage 1 sleep automatically. Relative powers of the alpha waves and the theta waves were calculated from spectral estimation. Either the relative power of alpha waves less than 50% or the relative power of theta waves more than 23% was regarded as stage 1 sleep. SEM (slow eye movement) was defined as the duration of both eye movement ranging from 1.5 to 4 seconds and regarded also as stage 1 sleep. If one of these three criteria was met, the epoch was regarded as stage 1 sleep. Results f ere compared to the manual rating results done by two polysomnography experts. Total of 169 epochs was analyzed. Agreement rate for stage 1 sleep between automatic detection and manual scoring was 79.3% and Cohen's Kappa was 0.586 (p<0.01). A significant portion (32%) of automatically detected stage 1 sleep included SEM. Generally, digitally-scored sleep s1aging shows the accuracy up to 70%. Considering potential difficulties in stage 1 sleep scoring, the accuracy of 79.3% in this study seems to be robust enough. Simultaneous analysis of EOG provides differential value to the present study from previous oneswhich mainly depended on EEG analysis. The issue of close relationship between SEM and stage 1 sleep raised by Kinnariet at. remains to be a valid one in this study.

Packing effects on the intracavitary radiation therapy of the utaine lervix cancer ($^{192}Ir$source를 이용할 자궁경부암 강내치료시 사용하는 packing의 효과에 대한 고찰)

  • Cho, Jung-Kun;Lee, Du-Hyun;Si, Chang-Kun;Choi, Yoon-Kyung;Kim, Tae-Yoon
    • The Journal of Korean Society for Radiation Therapy
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    • v.16 no.1
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    • pp.73-77
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    • 2004
  • Purpose of the radio-therapy is maximize the radiation dose to the tumor while minimizing the dose to the critical organ. Carcinoma of the uterine cervix treatment are external irradiation or an interstitial brachtheraphy make use of isotope. Brachytherapy is a method of radiotherapy in advantage to achieve better local control with minimum radiation toxicity in comparison with external irradiation because radiation dose is distributed according to the inverse square low of gamma-ray emitted from the implanted sources. Authors make use of the patients data which 192Ir gives medical treatment intrcavity. Intracavitary radiation of the uterine cervix cancer, critical organ take $20\%$ below than exposure dose of A point in the ICRU report. None the less of the advice, Radiation proctitis and radiation cystitis are frequent and problematic early complications in patients treated with radiation for the uterine cervix cancer. In brachytherapy of uterine cervical cancer using a high dose rate remote afterloading system, it is of prime importance to deliver a accurate dose in each fractionated treatment by minimizing the difference between the pre-treatment planned and post-treatment calculated doses. Use of packing to reduce late complications intracavitary radiation of the uterine cervix cancer. Bladder and rectum changes exposure dose rate by radiotherphy make use of packing.

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A Study on the Actual Condition of the Adult-smoking in a Region (일 지역 성인의 흡연실태)

  • Chong Young-sook
    • Journal of Korean Public Health Nursing
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    • v.13 no.1
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    • pp.97-113
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    • 1999
  • To investigate the actual condition of the adult-smoking in Chinan County. I used self-reporting questionnaires among 923 residents living in nine districts selected at random among the sites of eleven eup-myons from December 28. 1998 to January 6. 1999. collected data and analyized using SPSS. The smoking rate of adults in Chinan County was $36.9\%$. There was a significant difference in smoking rate according to the age. gender, education and job among general characteristics. The smoking rate in group of above 40s was about $40\%$ and that of the male took $55.5\%$ which was higher than that of female and the smoking rate of the people having high-school education was the highest$(46.2\%)$. With regard to the career. the smoking rate of the farmers ranked first$(46.1\%)$. Therefore anti-smoking business for smokers should be focused on above 40 years old, males. people having high school education and farmers. As the result of the survey of smoking habits of 340 people who smoke currently, the average smoking begining age was 21.8 and $81.5\%$ among them was between 16-25 years old. $4.4\%$ was under 15. during around the elementary school. Most motives to smoke were as followed; curiosity or taste$(33.6\%)$, relief of stress $(31.2\%)$, peer presure$(26.5\%)$ And considering the amount of the cigarette which is smoked per day, the case which is less than a pack of cigarettes was highest as $75.5\%$ and the people who smoke over one pack of cigarettes took $24.5\%$. As for the kind of tobacco which is smoked, how to smoke and the desire for the smoking, most case was toxin was moderate$(47.8\%)$ or mild$(46.9\%)$. shallowly$(49.0\%)$ or deeply$(46.3\%)$ and under stress$(33.4\%)$. after meals$(27.8\%)$, during drink$(15.7\%)$ and so on. The highest point marked among the factors of smoking motives was 'the reduce of negative emotion' $(3.27\pm1.00)$. followed by 'uncomfortable habits' $(2.87\pm1.02)$, 'addiction' $(2.84\pm1.06)$. 'habit' $(2.74\pm1.12)$. 'pleasure' $(2.70\pm1.04)$. 'stimulus' $(2.59\pm.90)$, 'sensation-exercise satisfaction' $(2.42\pm.97)$. Smokers smoke to reduce the negative emotions when angry in most common case. depressed. anxious. uncomfortable. lone. ashamed or embarrased. and intend to solve the certain problem. etc. Other motives are uncomfortable habit. addiction. habit. pleasure and the pursuit of stimulus. The level of nicotine dependence of adults m Chinan County was 10.57 which amount to 'high' wholly. As the resulf of the level of nicotine dependence score. the people who are low in the level of nicotine was $33.5\%$. the people who are high was $48.2\%$. very high was $18.4\%$. The approach for anti-smoking for smokers should be conducted differently according to the level of the nicotine. For the people who are in low level of nicotin dependence the prohibition of the smoking should be guided through the approach to foster strong will. for those who are in 'high' by acquiring proper method for the prohibition of smoking. and for those who are 'very high' the anti-smoking should be induced by providing proper program because of the possibility of the suffer from abstinence syndrome. The difference of the level of nicotine with the general characteristics of the objects had not statistically significant difference. The difference of the level of nicotine dependence accompanied by smoking habit had statistically significant difference according to the amount of smoke, the kind of tobacos. smoke inhale habit. In other words, the group of heavy smokers had higher level of the nicotine dependence than that of the light smokers relatively and the group which smoke strong taboaco has higher level of nicotine than that of which smoke mild or moderate. And the group of smokers who smoke deeply has higher level of nicotine than that who smoke shallowly or nonswallow. Aa a result of the analysis of the correlation between smoking motive factors and the level of nicotine, there was the indication that people who smoke for the decrease of the negative emotion. habit, pleasure. stimulus. sensation-exercise satisfaction had high level of the nicotine dependence. As the result of the anti-smoking will of smokers. $65.0\%$ of them had prohibition of smoking will. $29.3\%$ had no will to quit smoke. The most important reason for anti-smoking was health. $67.9\%$ had experience to try to quit smoke and the biggest reason to fail to quit smoking was the lack of the will power to keep anti-smoking. $52.8\%$ of them were advised to stop smoking from their spouses or children. only $2.8\%$ were by medical. The people who have the opinion to need anti-smoking education were $69.6\%$. Therefore when the business for the hygine of the mouth for adult is set. it should be centered on the people who have intention of prohibition of the smoking and help to quit smoking by way of other affirmative counter-program not smoking under stress.

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The Diagnosis for Educational Behavioral Strategies of Community Health Nurse-Community Health Worker for Control of Hypertensive Urban Young Black Men in America (간호사-지역사회건강상담자팀의 미국 도시지역 젊은 흑인 남자 집단의 고혈압 관리를 위한 전략 활동의 교육-행위진단)

  • Park, Kyung-Min
    • Research in Community and Public Health Nursing
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    • v.7 no.1
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    • pp.80-99
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    • 1996
  • Young black men(YBM) have the most severs levels of high blood pressure(HBP) and, in all reports but one, the lowest of HBP control of any age /sex /race group. To increase entry into care, remaining in care, and BP control for young(18-49 years) Black men, It is needed to review socio-demographic, medical characteristics, and behaviors(importance of and difficulty with HBP control behaviors, or worry about mdication) for experimental intervention study(educational- behavior strategies) of hypertensive urban young black men. The 204 participants had an average age of 38.8+7.0 years and an average educational level of $11.0{\pm}2.4$ years; only 23.1% were employed full- or part-time while 26% were on disability ; and 6% were married. Only 35.3% had an MD for HBP care and 37.3% had some form of health insurance. The average BP of those men currently being in care on medication(35.3%) was $148.2/95.1{\pm}19.5/11.3$ compared to those men not taking HBP care $153.7/99.1{\pm}14.0/9.8(p<.05)$. The average creatinine level was 1.3(excluding 3 marked elevations of 15.9, 9.6, and 7.7) for the 163 men consenting to have their blood drawn. Self-reported co-morbidity induded heart disease 7.8%, diabetes 8.9%, high cholesterol 18.2%, CVA 3.4%, alcohol and drug related problems 27.9% and 22.5% respectively. The kidney disease of those men currently being in care & on medication was 9.7 compared to those men not taking HBP care 0.8(p<.05). The problems of with sex life, physicl activity and dearly thinking of those men currently being in care & on medication was higher compared to those men not taking HBP care(p<.05). Questions of 'during the past month, on how many days did you have 5 or more drinks (bottles) of any alcoholic beverag?' and smoking of those men currently being in care & on medication was 18.1% and 72.2% compared to those men not taking HBP care 27.3 and 82.6%, respectively. HBP control behaviors was assessed with 1-5 point Likert subscales(5=extreme, 1-none at all), In general, th men reportd low levels of perceived psychological barrier to HBP care and control behaviors; importance of and difficulty with HBP control behaviors, or worry about mdication. For example, on a five point scale(1=none at all, 5=extreme), average ratings for perceived important and difficulty with BP care and behaviors were 2.8(SD=1.2) and 2.5(SD=1.1). Average ratings for perceived benefit with BP care and behaviors worry about medication of those men currently being in care on medication was 4.0(SD=0.9) and 2.2(SD=1.1) compared to those men not taking HBP care 3.6(SD=0.8), 2.8 (SD=1.6) respectively(p<.05). These data support the need for educational-behavioral strategies of community health nurse to improve high blood pressure control in this high risk group through perceived barriers to treatment, health care skills and use of resources, and social support.

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