• Journal of Korean Dental Hygiene Science
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• v.4 no.1
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• pp.39-51
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• 2021

Background: Limited information is available regarding the associations of various nutrients and periodontitis in Korea. Furthermore, these associations have been controversial in previous studies. Therefore, the present study aimed to evaluate the associations between several nutrients and periodontitis. Methods: Pooled data from the 2007~2010 and 2012 Korea National Health and Nutrition Examination Surveys (KNHANES) were used for the present study. Periodontitis was defined using the World Health Organization (WHO) Community Periodontal Index. All participants completed the Food Frequency Questionnaire (FFQ), which was analyzed using CAN-Pro 4.0. Vitamins A, B₁, B₂, and C, iron, phosphorus, calcium, and protein were selected for analysis. Multiple logistic regression analyses were used to estimate the odds ratios (ORs) for periodontitis. Results: Lower intake of phosphorus (adjusted odds ratio [AOR] = 1.86), calcium (AOR = 1.25), and protein (AOR = 1.52) were associated with periodontitis in males, and lower intake of vitamins A (AOR = 1.32), B1 (AOR = 1.21), B2 (AOR = 1.24), and C (AOR = 1.21), iron (AOR = 1.25), phosphorus (AOR = 1.33), and protein (AOR = 1.27) showed significant relationships with periodontitis in females. In the sociodemographic, somatic, and health behavior-adjusted models, lower phosphorus (AOR = 2.68) and protein (AOR = 1.68) intake in younger males, and lower vitamin A intake (AOR = 1.37) in middle-aged females were significantly associated with periodontitis. Conclusions: The results of the present study demonstrated a significant association between periodontitis and nutrient intake. To avoid an insufficient nutrient supply for a patient with periodontal disease, the patient's diet should be closely monitored.

• Journal of Trauma and Injury
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• v.34 no.1
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• pp.21-30
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• 2021

Purpose: The purpose of this study was to determine the influence of seasons and weather on the volume of trauma patients in central Korea. Methods: The records of 4,665 patients treated at Chungbuk National Hospital Regional Trauma Center from January 2016 to December 2019 were retrospectively reviewed. Meteorological data including hourly temperature (℃), precipitation (mm), humidity (%), and wind speed (m/s) for each district were collected retrospectively. Statistical analysis was done using the independent t-test, one-way analysis of variance (ANOVA), and linear regression analysis. Results: Patients' average age was 53.66 years, with a significant difference between men (49.92 years) and women (60.48 years) (p<0.001). Rolling/slipping down was a prominent cause of injury in winter (28.4%, n=283), with statistical significance (p<0.001). Trauma occurred least frequently in winter (p=0.005). Linear regression analysis revealed an increasing number of patients as the temperature increased (p<0.05), the humidity increased (p<0.001), and the wind speed decreased (p<0.001). Precipitation did not affect patient volume (p=0.562). One-way ANOVA revealed a decreased incidence of trauma when the temperature exceeded 30℃ (p<0.001), and when the humidity was more than 75%, compared to 25-50% and 50-75%. Conclusions: At the regional trauma center of Chungbuk National University Hospital, in central Korea, the number of trauma patients was lowest in winter, and patient volume was affected by temperature, humidity, and wind speed.

• Journal of Radiation Protection and Research
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• v.48 no.1
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• pp.9-14
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• 2023

Background: The detectors of both computed radiography (CR) and direct digital radiography (DR) have a wide dynamic range that could tolerate high values of exposure factors without an adverse effect on image quality. Therefore, this study aims to assess patient radiation dose and proposes institutional diagnostic reference levels (DRLs) for two teaching hospitals in Ghana. Materials and Methods: CR and DR systems were utilized in this study from two teaching hospitals. The CR system was manufactured by Philips Medical Systems DMC GmbH, while the DR system was manufactured by General Electric. The entrance skin doses (ESDs) were calculated using the standard equation and the tube output measurements. Free-in-air kerma (µGy) was measured using a calibrated radiation dosimeter. The proposed institutional DRLs were estimated using 75^th percentiles values of the estimated ESDs for nine radiographic projections. Results and Discussion: The calculated DRLs were 0.4, 1.6, 3.4, 0.5, 0.4, 1.1, 1.0, 1.2, and 1.7 mGy for chest posteroanterior (PA), lumbar spine anteroposterior (AP), lumbar spine lateral (LAT), cervical spine AP, cervical spine LAT, skull PA, pelvis AP, and abdomen AP, respectively in CR system. In the DR system, the values were 0.3, 1.6, 3.1, 0.4, 0.3, 0.7, 0.6, 0.9, and 1.3 for chest PA, lumbar spine AP, lumbar spine LAT, cervical spine AP, cervical spine LAT, skull PA, pelvis AP, and abdomen AP, respectively. Conclusion: Institutional DRLs in nine radiographic projections have been proposed for two teaching hospitals in Ghana for the first time. The proposed DRLs will serve as baseline data for establishing local DRLs in the hospitals and will be a valuable tool in optimizing patient doses.

• Korean Journal of Clinical Pharmacy
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• v.33 no.4
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• pp.242-253
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• 2023

Background: Arrhythmia due to QT prolongation is one of the most serious adverse events with drug interactions in the elderly. This study aimed to examine the incidence of arrhythmia in Korean elderly patients who administered both cytochrome P450 3A4 (CYP3A4) substrates and inhibitors. Methods: Patients using CYP3A4 substrate and inhibitor were selected from the 2017 elderly patient dataset (the Korean Health Insurance Review and Assessment Service - Aged Population Sample). Selection criteria were patients with a medication possession ratio over 80%, medication duration of at least 7 days, and a follow-up period of 3 months or more. The patient's basic information is age, gender, health insurance type, and comorbidities. The top 50 drug pairs and comorbidity with high-incidence arrhythmia were presented. Results: In patients with drug combinations for over 7 days, there were 981 incidences of arrhythmia, and 351 incidences in those with combinations for over 30 days. The comorbidities of congestive heart failure and myocardial infarction had a significant association with incidence of arrhythmia. Among patients with 7 days or longer, the drug pairs [substrates-inhibitors] with significant adjusted odds ratio (aOR) were [propranolol-cimetidine] (aOR, 2.25; 95% confidence interval [CI], 1.66-3.04). Among patients with 30 days or longer, the drug pairs with significant aOR were [tramadol-amiodarone] (aOR, 2.87; 95% CI, 1.97-4.19). Conclusions: In elderly patients, the incidence of arrhythmia was high with drug interactions of CYP3A4 substrates and inhibitors. The comorbidity of congestive heart failure was the risk factor.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.28 no.2
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• pp.125-133
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• 2024

Undifferentiated carcinoma with osteoclast-like giant cells (UC-OGCs) of the pancreas is a rare neoplasm that accounts for less than 1% of all pancreatic malignancies. The aim of this study was to review the literature regarding UC-OGC, and to highlight its biological behavior, clinicopathologic characteristics, prognosis, and therapeutic options. A systematic review of the literature in PubMed/Medline and Scopus databases was performed (last search October 31st, 2023) for articles concerning pancreatic UC-OGC in the adult population. Fifty-seven studies met the inclusion criteria, involving 69 patients with a male-to-female ratio of 1.1:1 and a mean age of 62.96. Main symptoms included abdominal pain (33.3%), jaundice (14.5%), weight loss (8.7%), while fourteen patients (20.3%) were asymptomatic. Surgical resection was performed in 88.4% of cases. Survival rates at one, three, and five years were 58%, 44.7%, and 37.3% respectively. Sex, age, size (cut-off of 4 cm), location, and adjuvant treatment did not significantly affect patient survival. UC-OGC of the pancreas is a rare subtype of undifferentiated pancreatic carcinoma with a better prognosis than conventional pancreatic ductal adenocarcinoma or undifferentiated carcinoma without giant cells. The establishment of a dedicated patient registry is imperative to further delineate the optimal treatment for this uncommon clinical entity.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.26 no.1
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• pp.37-45
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• 2024

Objective: To review the characteristics of distal middle cerebral artery (MCA) aneurysm treated by microsurgery, the detailed surgical options, and the clinical result. Methods: We retrospectively reviewed cerebral aneurysm in the M2 and M3 segments of the MCA surgically treated between January 2015 and December 2022. The demographic data, aneurysm-related findings, type of surgical approach, surgical technique, and clinical outcomes of the enrolled patients were analyzed. Results: Sixteen distal MCA aneurysms were treated with microneurosurgery (incidence, 1.0%; female, 12; mean age, 58.1 years; ruptured, three). Twelve aneurysms were in the M2 segment (insular segment), two aneurysms at the M2-M3 junction, and two aneurysms in the M3 segment (opercular segment). Twelve aneurysms were saccular (average size, 4.9 mm; multiplicity, 50%; average aneurysms, 3.0; partially thrombosed, 1; sidewall aneurysm, 2). Three aneurysms were fusiform, of which two were ruptured. Of the ruptured aneurysms, one was a ruptured dissecting aneurysm. The trans-sylvian and trans-sulcal approaches were used in fourteen and two patients, respectively. Neck clipping, wrap clipping, and surgical trapping were performed in twelve, one, and one patient, respectively. Proximal occlusion was performed in one patient. Bypass technique was required in two patients (neck clipping and proximal occlusion). The modified Rankin Score was 6 in the two patients with ruptured aneurysms. The remaining patients did not show further neurological deterioration after microneurosurgery. Conclusions: Distal MCA aneurysms had a high incidence of being diagnosed with multiple other aneurysms and were relatively non-saccular.

• Journal of the Korea Society of Computer and Information
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• v.29 no.9
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• pp.187-196
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• 2024

This study investigated the ethical attitudes towards Do Not Resuscitate (DNR) among nursing college students. Data were collected from September to November 2022, involving 209 students in Jeonbuk Province. Analysis was done using SPSS WIN 25.0 with descriptive statistics and the χ²-test. Students generally agreed with respecting patient wishes, providing accurate information, and adhering to DNR guidelines. They supported treatment upon guardian request and maintaining aseptic principles for DNR patients. They showed neutral attitudes towards discontinuing mechanical ventilation upon family request, using all means to prolong life for patients with no chance of survival, the primary physician's DNR decision, etc. There was often opposition to the decline in medical team interest after DNR declaration. Significant differences based on DNR education experience were found regarding the use of all treatments for terminally ill patients (p=.028) and the need to advise if a co-worker treats a DNR patient without aseptic procedures (p=.014). Education on DNR situations and procedures is essential for accurate knowledge and high ethical competence.

• The Journal of Korean Society for Radiation Therapy
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• v.13 no.1
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• pp.14-22
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• 2001

Purpose: The aim of this study is to investigate geometrical and volumetrical changes of liver due to breathing and its impact to NTCP. In order to attain better treatment results it should be considered deliberately during planning session. Mehtods and Materials : Seven patients were examined in this study who have done TACE for accurate tumor margin drawing. After contrast media injection, C-T scan data were obtained in supine position during breathing free, inhalation and exhalation, respectively. For all patients C-T scan were done with same scanning parameters- 5 mm index, 5 mm thickness and pitch 1. Based on C-T data we have measured differences of each variables between breathing status such as changes of total and remained liver volumes, GTV, beam path length and superior to inferior shift. NTCP were calculated using Lyman's effective volume DVH reduction scheme and for this NTCP calculation, the V50 was computed from DVH and each m, n value were referred from Burmans data. Results : The measured total tilter volume and the remained liver volume changed between inspiration and expiration about $1.2-7.7\%(mean+2.7\%)$ and $2.5-13.23\%(mean=5.8\%)$ respectively, and these results were statistically significant(p>0.1). The GTV difference in each patient varied widely from $1.17\%\;to\;30.69\%$, but this result was not statistically significant. Depending on the breathing status, the beam path length was changed from 0.5 cm to 1.1 cm with the average of 0.7 cm, and it was statistically significant(p=0.006). The measured superior to inferior shifts were ranged from 0.5 cm to 3.74 cm. The NTCPs were changed relatively small in each patient, but the variation was large between the patients. The mean NTCP difference was $10.5\%$, with the variation ranged from $7\%\;to\;23.5\%$. Conclusion : Variations of liver volume and of beam path length were changed significantly depending on the breathing statues and the range of variation itself was very different between the patients. Since this variance could seriously affect the clinical outcomes of radiation treatments, the breathing of patients need to be accounted when a final treatment planning is derided.

• Asian Oncology Nursing
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• v.1 no.1
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• pp.44-53
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• 2001

Despite the advances in cancer therapy in the last 20 years, cancer continues to be a life-threatening illness, and the newly diagnosed individual faces a crisis that emphasized his or her mortality. Patients who suffer from cancer may have psychological problems, especially depression. Most tend to seek the meaning of suffering when continuing pain was experienced. Then the search for meaning, which is one of the primary needs of humans, begins. This meaning is "unique and specific" to the individual, and it must be fulfilled by the individual alone. This study was conducted to provide a basis of data for a nursing intervention program to minimize a cancer patient's suffering and to understand the relationship between life satisfaction, depression, and the meaning of suffering in cancer patients. The sample was composed of 160 cancer patients who were inpatients or outpatients of three general hospitals in Seoul. Data collections were carried out from February 25th to April 20th of 2000. The data was analyzed using a SAS program for descriptive statistics, Pearson Correlations, ANOVA, and Duncan tests. The results were as follows: 1. The scores on the depression scale ranged from 20 to 65 with a mean of 40.76 (SD 9.6) The mean score on the suffering scale was 97.72 (SD 12.7), and the score of the life satisfaction ranged from 15 to 37 with a mean of 25.51 (SD 5.2). 2. There were significant correlations between the amount of life satisfaction and depression (r=-.61, P=.00), the life satisfaction and the meaning of suffering (r=.30, p=.00), and the depression and the meaning of suffering (r=-.24, p=.00). 3. The factors influencing the depression in patients with cancer are age (F=2.52, p=.04) and education level (F=3.98, p=.00). The level of the meaning of suffering in cancer patients differed by education level (F=4.13, p=.00). Also, the level of the life satisfaction in cancer patients differed by education level (F=2.72, p=.04). In conclusion, the correlation between the depression, the meaning of suffering, and life satisfaction can be used as a concrete and practical datum for the development of nursing intervention. This may assist patients with cancer, overcome their suffering and lead to a hopeful life by understanding the meaning of suffering.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.7 no.2
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• pp.256-270
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• 2000

Invasive hemodynamic monitoring has become a valuable assessment parameters in critical care nursing in patients undergoing open heart surgery patients. During cardiac surgery, the Swan Ganz catheter is placed in the pulmonary artery. Critical care nurses routinely obtain cardiac output, cardiac index, and pulmonary arterial pressure in these patients. Traditionally, patients are positioned flat and supine for cardiac output measurement. Numerous studies have dealt with the effects of changing position on the hemodynamic variables. However, there are a few studies dealing with patients who undergo cardiac surgery in Korea. Thus, the purpose of this study was to determine the effects of changing position on cardiac output, PAP, CVP, BP, HR and discomfort in patients after cardiac surgery. A sample of 21 adults who had CABG and/or valve replacement with Swan Ganz catheters in place was studied. The data were collected in the cardiac ICU of a university hospital in Seoul during the period from July 28, 1999 to August 30. 1999. In this study, the independent variable is patient position in the supine, 30 degree, and 45 degree angles. Dependent variables are C.O., C.I., CVP, PAP, MAP, HR and patients' perceived discomforts. Subject discomfort was measured subjectively by visual analogue scale. Other hemodynamic data where collected by the thermodilution method and by direct measurement. The data were analyzed by percentile, t-test, ANOVA, Linear regression analysis using SPSS-/WIN program. The results are as follows : 1) Changes in cardiac output were absent in different angle positions, 0, 30. 45 degrees(F=.070, P=.932). Changes in cardiac index were absent in different angle positions, 0. 30, 45 degrees(P>.05). 2) Changes in central venous pressure were absent in different angle positions, 0, 30, 45 degree(P>.05). 3) PAP had no change in different angle 0, 30, 45 degree positions; systolic PAP(P>.05), diastolic PAP(P>.05). 4) Changes in systolic blood pressure were absent in different angle positions, 0, 30, 45 degree(P>.05). 5) Changes in heart rates were absent in different angle positions, 0, 30, 45 degree(P>.05). 6) Patients' perceived discomfort was absent in different angle positions, 0, 30, 45 degree(p<.05). In conclusion, critical care nurses can measure C.O., C.I., PAP, BP, & CVP in cardiac surgery patients at 30 degree or 45 degree positions. This can improve the patients' comfort.