• 보건교육건강증진학회지
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• 제17권1호
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• pp.81-93
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• 2000

This study is intended to investigate medication compliance and polypharmacy of the diabetic patients by age group in order to determine the major factors that influence their compliance. 198 ambulatory diabetic patients were interviewed, and the sample was divided into three groups based on the age: Young age group under 55, Borderline age group between 55 - 65, Old age group over 65. According to the study results, medication compliance for the old age group was 72.6% whereas 85.1% for the young age group. Medication compliance significantly decreased as the age of the patients increased. Also the degree of polypharmacy, the rate which patients take more than 6 prescription drugs, was 45.9% for the old group, whereas 31.2% for the young group. As the most important factor of polypharmacy, the number of doctors was statistically significant. With regard to prescription factors related to medication compliance, the amount of prescribed medication is statistically significant between the compliance group and non-compliance group. In addition, the amount of information provided to patients by pharmacists was determined to be a very significant factor. Also the level of ease in understanding the medication instructions varied significantly between the compliance group and the non-compliance group. In light of the empirical data and results for the diabetic patients, it is necessary to develop and implement various programs to improve medication compliance and to decrease the level of polypharmacy among the elderly, or "old", diabetic patients. patients.

• Archives of Plastic Surgery
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• 제38권2호
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• pp.143-147
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• 2011

Purpose: A Tessier classification number 7 cleft is an uncommon malformation that results from a failure of mesenchymal fusion within the maxillary and mandibular prominences of the 1st pharyngeal arch. Many operative techniques of the number 7 cleft repair have been proposed to restore function and improve aesthetics. Fifteen patients underwent repair of a number 7 cleft over 13 years by a modification of the surgical Technique, and an appraisal of the operative outcome is reported herein. Methods: A retrospective review was conducted involving 15 patients with number 7 clefts who underwent surgery from 1996 to 2009. The changes in surgical technique included skin closure, attachment of the orbicularis oris muscle, and position of the repaired commissure; the changes were analysed with a review of the medical records and the outcomes of surgery were analysed via photographs. Specifically, the technique of skin closure was changed from the a Z-plasty to a linear closure, the orbicularis oris muscle overlapped attachment was replaced by a side-to-side approximation with horizontal mattress sutures, and the position of the repaired commissure was changed from 1 mm laterally to 1 mm medially in reference to the non-cleft side. Results: A Z-plasty caused additional cutaneous scarring, an overlapped attachment of the orbicularis oris muscle caused a thick oral commissure, and the repaired commissure migrated to the lateral side, so a 1 mm, laterally-positioned commissure caused asymmetry. The altered procedure included a linear skin closure, a side-to-side orbicularis oris muscle approximation, and a 1 mm, medially-positioned commissure, which together resulted in a good outcome. Conclusion: The altered procedure for repair of a number 7 cleft as described herein, yields a short scar, no functional problems with the orbicularis oris muscle, a thin oral commissure, and symmetry of the repaired commissure.

• 한국치위생학회지
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• 제13권3호
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• pp.509-515
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• 2013

Objectives : This study was performed to evaluate the salivary secretion, salivary pH and cariogenic activity using unstimulated whole saliva in patients with hematologic malignancy. Methods : Nineteen patients (9 male, 10 female) who had hematologic malignancy and were treated with chemotherapy or bone marrow transplantation, and nineteen normal volunteers (7 male, 12 female) as control group were included. The mean age of patients group and control group was 45.1 and 46.7 years, respectively. Patients group was examined salivary secretion, salivary pH, and cariogenic activity using unstimulated whole saliva and was compared with control group. Results : In comparison with control group, salivary secretion, salivary pH and salivary buffer capacity were significantly lower in patients with hematologic malignancy (p<0.01). Both cariogenic activity(p<0.01) and the number of Lactobacilli(p<0.05) are higher in patients group than control group. Conclusions : These results suggest that the unstimulated whole salivary secretion, pH and buffer capacity were lower in patients with hematologic malignancy than control group. Cariogenic activity is higher in patients with hematologic malignancy than control group. Such salivary factor and cariogenic activity can increase the possibility of induction of dental caries.

• Archives of Plastic Surgery
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• 제45권1호
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• pp.58-61
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• 2018

Background Venous anastomosis is an important component of digital replantation, but is not always feasible, as some cases require external bleeding to treat venous congestion in the replanted tissue. In the present study, we evaluated the relationship between the number of vein anastomoses and the survival rate of Tamai zone I replantations. Methods A retrospective review was performed of all patients who underwent replantation of a fingertip amputation between 2014 and 2016. Patient charts were reviewed for demographic information, the mechanism of injury, the number of venous anastomoses, and the use of anticoagulation, external bleeding, and/or leeches. The cohort was divided into 3 groups depending on the number of venous anastomoses: no veins (group 1), a single vein (group 2), and 2 or more veins (group 3). Survival rates and external bleeding rates were analyzed across the groups. Results The review identified 143 fingertip replantations among 134 patients. The overall survival rate was 94% (135 of 143). Failures were due equally to venous complications (n=4, 50%) and to arterial complications (n=4, 50%). Our analysis did not identify any correlation between the number of veins anastomosed and the replant survival rate (P=0.689). However, a greater number of anastomoses was associated with a significantly lower frequency of external bleeding (P=0.017). Conclusions The number of venous anastomoses was not correlated with the survival rate. However, a greater number of venous anastomoses was associated with a decreased need for external bleeding, corresponding to a significant decrease in the need for postoperative monitoring and leech therapy.

• Journal of Periodontal and Implant Science
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• 제54권2호
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• pp.75-84
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• 2024

Purpose: This study investigated the relationship between the number of days that hospital visits were postponed and changes in clinical parameters due to the spread of coronavirus disease 2019 (COVID-19), after the Japanese government declared a state of emergency in April 2020. Methods: Regarding the status of postponement of appointments, we analyzed the patients who had visited the Nihon University Hospital at Matsudo for more than 1 year for supportive periodontal therapy (SPT) and classified them into low-, moderate- and high-risk subgroups according to the periodontal risk assessment (PRA). Clinical parameters for periodontal disease such as probing depth (PD), full-mouth bleeding score (FMBS), full-mouth plaque score, periodontal inflamed surface area (PISA), and periodontal epithelial surface area (PESA) were analyzed in 2 periods, from October 2019 to March 2020 and after April 2020. Correlation coefficients between days of deferral and the degree of changes in clinical parameters were calculated. Results: The mean age of the 749 patients was 67.56±10.85 years, and 63.82% were female. Out of 749 patients, 33.24% deferred their SPT appointments after April 2020. The average total of postponement days was 109.49±88.84. The number of postponement days was positively correlated with changes in average PD (rs=0.474) and PESA (rs=0.443) in the high-risk subgroup of FMBS, and average PD (rs=0.293) and PESA (rs=0.253) in the highrisk subgroup of tooth number (TN). Patients belonging to the high-risk subgroups for both FMBS and TN had a positive correlation between postponement days and PISA (rs=0.56). Conclusions: The findings, the spread of COVID-19 appears to have extended the visit interval for some SPT patients. Moreover, longer visit intervals were correlated with the worsening of some clinical parameters for SPT patients with high PRA.

• Child Health Nursing Research
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• 제6권2호
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• pp.249-261
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• 2000

The purpose of this study were to identify the quality of life for the mothers of hospitalized chronic pediatric patients, and to explore the factors affecting the QOL of those mothers. The subjects were 201 mothers whose children had hospitalized at one University hospital with chronic diseases. Data were collected from the December, 1997 to December, 1998. We used a revised QOL instrument consisting of 34 items, 5 point likert scale based on the Noh's QOL instrument. The revised QOL consists of six subscales, those are physical status and function, self esteem, emotional status, economic status, relationship with family members, and relationship with neighborhood. Data were analyzed by t-test, ANOVA, Pearson's correlation using SPSS-PC. The results were as follows: 1. The mean score of quality of life for the mothers of chronic pediatric patients was 100.31, and item mean was 2.95. In subscale analysis, item mean of economic status was the lowest, and that of relationship with family members was the highest. 2. Correlations between characteristics of chronic pediatric patients, their mothers and QOL of mothers were as follows; 1) Total QOL of mothers had a significant positive relationship with progressing time relapse after diagnosing and age of mothers. There was a significant negative relationship between the total QOL of mothers and number of hospitalization of their children. 2) QOL on self esteem and economic status had a significant relationship with age of pediatric patients, the time relapse after diagnosis, and age of mothers. Total number of family members and QOL on economic status showed a significant positive relationship. QOL on emotional status, economic status, and relationship with family members of mothers showed negative correlations with the number of hospitalization of their children. 3. Followings were the result of difference in QOL among different demographic cha- racteristics of the subjects. 1) QOL on economic status of mothers was significantly higher when fathers of pediatric patients had jobs. 2) Total QOL score, QOL on emotional status, and QOL on relationship with neighborhood were significantly higher when mothers of pediatric patients had spouses. 3) QOL on self esteem of mothers was significantly higher when mothers had religion. 4. Followings were the result of difference in QOL among different diagnosis of the children. 1) Total QOL score of mothers whose children had congenital heart disease was higher than that of mothers whose children had leukemia and cancer. 2) QOL on emotional status, economic status, and relationship with family members of mothers whose children had congenital heart disease were higher than those of mothers whose children had leukemia, cancer, and epilepsy.

• 대한치과기공학회지
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• 제22권1호
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• pp.129-143
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• 2000

With increasing number of dental patients, it is also increasing patient's desire to get better medical service. As the concern for improvement of dental medical service quality is growing, satisfaction degree of dental patients is becoming very important. This study was to investigate difference of patients' satisfaction degree concerned with installation of dental labs and the reason. The data for this study were collected through Self-Administered Questionnaires from 284 patients who had visited dental clinics more than two times. The results are as follows: Female respondents ratio was as twice much as male ones. And 54.2% of the respondents were found out to have completed university education. Dental clinics with dental labs scored higher than others in patients' satisfaction and recommendation willingness degree. Dental clinics without dental labs scored higher in patients' revisiting willingness degree. With simple Correlation Analyses it was found out that the most influential variable concerned with patients' general satisfaction degree was medical facility in dental clinics with dental labs, dentist ability to cure in dental clinics without dental labs. There were some discrepancies with other subordinate variables. Through Stepwise Multiful Regression Analyses it was found out that the most influential variable with patients' general satisfaction degree was dentist ability to cure in total and dental clinics without dental labs and medical facility in dental clinics with dental labs. There were also some discrepancies with other subordinate variables.

• Clinical and Experimental Pediatrics
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• 제52권10호
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• pp.1153-1160
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• 2009

목 적:최근 다양한 치료 방법의 발전과 지지요법의 발달로, 소아 종양/혈액 질환 환자의 생존율이 향상되었으나, 적극적이고 다양한 치료를 하게 되면서 이와 관련된 여러 합병증으로 소아 중환자실에 입실하는 경우 또한 많아졌다. 이에 본 연구에서는 소아 중환자실에 입실한 소아 종양/혈액 질환 환자의 임상양상과 사망률을 살펴보고, 소아 종양/혈액 질환 환자에게 적합한 중증도 측정 체계와 사망률에 영향을 미치는 위험 요인에 대해 알아보고자 했다. 방 법:2005년 9월부터 2008년 7월까지 서울아산병원 소아 중환자실에 입실한 소아 종양/혈액 질환 환자 중 3일 이상 재실한 환자를 대상으로 후향적으로 의무기록을 조사했다. 생존군과 비생존군으로 나누어 나이, 성별, 재실 일수에 대하여 조사했고, 기저 질환과 중환자실 입원 이유, 인공호흡기 적용 여부, 투석 및 승압제 투여 여부, CRP 및 ANC에 따른 사망률을 알아보았다. 또, 생존군과 비생존군의 OSF number, SOFA score, PRISM III score, O-PRISM score를 비교하고, 점수에 따른 사망률을 알아보았다. 결 과:총 88예 중 30예가 사망하여 사망률은 34.1%이었다. 남아가 49예, 여아가 39예이었고, 평균 나이는 $7.0{\pm}5.7$세, 평균 재원일수는 $18.1{\pm}22.2$일로 이었다. 기저 질환은 혈액 질환이 68예(77.3%)로 가장 많았으며, 중환자실 입실 이유는 호흡기능 부전이 35예(39.8%)로 가장 많았고, 패혈쇼크가 19예(21.6%)이었다. CRP는 생존군에서 $9.1{\pm}9.0$, 비생존군에서 $16.4{\pm}11.2$로, 비생존군에서 유의하게 높았고(P<0.01), 비생존군에서 인공호흡기 치료나 투석이 필요했던 경우가 많았으며(P<0.01), 조혈모세포 이식을 받은 군의 사망률이 유의하게 높았다(P<0.05). 중증도 측정 체계 중에서는 initial OSF number, highest OSF number, SOFA score, PRISM III score가 비생존군에서 의미있는 증가를 보였고(P<0.01), 이들을 수용자 작업특성곡선을 사용하여 비교하였을 때, highest OSF number가 곡선하면적 0.845로 가장 높았고, 중환자실 입실 24시간 이내에 측정한 PRSIM III score와 SOFA score의 곡선하면적이 각각 0.723, 0.751로 유의한 결과를 보였다. 총 21예에서 조혈모세포 이식을 받았으며 이들의 O-PRISM score는 비생존군에서 높은 경향을 보였으나, 통계적으로 유의하지는 않았다. 결 론: 본 연구에서 소아 중환자실 입실한 소아 종양/혈액 질환 환자 사망의 위험인자로는 CRP, 인공호흡기 치료, 투석, 조혈모세포 이식이 있었으며, 예후 예측지표로는 highest OSF number, PRISIM III score, SOFA score가 의미 있는 것으로 분석되었다.

• Journal of Korean Neurosurgical Society
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• 제48권6호
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• pp.485-489
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• 2010

Objective : To introduce the frequency and segment analysis of in-stent stenosis for intracranial stent assisted endovascular treatment on complex aneurysms. Methods : A retrospective study was performed in 158 patients who had intracranial complex aneurysms and were treated by endovascular stent application with or without coil embolization. Of these, 102 patients were evaluated with catheter based angiography after 6, 12, and 18 months. Aneurysm location, using stent, time to stenosis, stenosis rate and narrowing segment were analyzed. Results : Among follow-up cerebral angiography done in 102 patients, 8 patients (7.8%) were shown an in-stent stenosis. Two patients have unruptured aneurysm and six patients have ruptured one. Number of Neuroform stents were 7 cases (7.5%) and Enterprise stent in 1 case (11.1%). Six patients demonstrated in-stent stenosis at 6 months after stent application and remaining two patients were shown at 12 months, 18 months, respectively. Conclusion : In-stent stenosis can be confronted after intracranial stent deployment. In our study, no patient showed symptomatic stenosis and there were no patients who required to further treatment except continuing antiplatets medication. In-stent stenosis has been known to be very few when they are placed into the non-pathologic parent artery during the complex aneurysm treatment, but the authors found that it was apt to happen on follow up angiography. Although the related symptom was not seen in our cases, the luminal narrowing at the stented area may result the untoward hemodynamic event in the specific condition.

• 대한치과보철학회지
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• 제47권3호
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• pp.266-272
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• 2009

연구목적: 전 세계적인 고령화 추세에 따라 무치악 환자들이 증가하고 이들의 임플란트 보철 수복에 대한 수요와 관심이 증가하고 있다. 부분 무치악 또는 완전 무치악에서 임플란트를 이용한 보철 치료는 효과적이며 그 성공율 또한 높게 보고되고 있다. 하지만 임플란트 사용 범위가 다양해짐에 따라 여러 가지 실패가 보고되고 이러한 실패를 줄이기 위한 방법들이 연구, 개발되고 있다. 이에 본 연구에서는 임플란트 생존율을 조사하고, 이를 토대로 향후 임플란트의 생존율에 대해 예측하고자 한다. 연구 방법: 1998년 8월부터 2003년 8월까지, 2003년 9월부터 2007년 4월까지 두 차례로 나누어 진료기록부 조사를 통해 최근 10년 동안 단국대학교 치과병원에서 임플란트를 치료받은 환자들의 임플란트 생존율에 대해 조사하였다. 결과: 진료기록부 조사를 통해 식립된 임플란트의 수, 임플란트 위치 및 분포, 1차 수술 후부터 2차 수술까지의 기간, 생존율 등을 조사하여 다음과 같은 결과를 얻었다. 1. 1차 조사에서 612명 환자에게 1680개의 임플란트가 식립되고, 2차 조사에서는 933명 환자에게 2438개가 식립되어 총 1545명의 환자에게 4118개 임플란트가 식립되었다. 2. 총 1545명 환자의 성비는 남성이 57.2% (884명), 여성이 42.8% (661명)였고, 총 4118개 임플란트에서 상악에 1739개 (42.2%), 하악에 2379개 (57.8%)가 식립되었으며 하악 구치부에 2043개 (53.2%)가 식립되어 제일 높은 비율을 차지하였다. 3. 1차 조사에서는 총 1680개의 임플란트 중 57개가 실패하였고 2차 조사에서는 2438개의 임플란트 중 17개가 실패하여 총 4118개의 임플란트 중 74개가 실패 하여 98.2%의 생존율을 보였다. 4. 1차 수술 이후 2차 수술이 시행되기까지의 기간은 상악에서 평균 7.4개월에서 6.8개월로, 하악에서 평균 5.6개월에서 5.0개월로 2차 조사 기간에서 0.6개월 단축되었다. 결론: 이상의 결과로 볼 때 1차 조사에서보다 2차 조사시에 식립된 임플란트의 수 및 생존율이 증가하였고 1차수술 후부터 2차 수술 전까지 기간도 단축되고 있음을 알 수 있었다. 앞으로도 임플란트에 대한 관심과 수요가 계속 증가 할 것이고 그 성공율 또한 증가하리라 사료된다.