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Clinical Epidemiology for Elderly Patients of Oral Medicine Clinic (구강내과에 내원하는 노인 환자들의 임상 역학 연구)

  • Oh, Hyun-Sun;Kim, Hye-Kyoung;Park, Jo-Eun;Kim, Ki-Suk;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.38 no.1
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    • pp.19-28
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    • 2013
  • With Korea's rapid entry to aged society, elderly population has become a major age group both in the whole society and medical field and its importance will be constantly stressed out. Elderly population is also important in the field of oral medicine which deals with chronic and recurrent diseases in the orofacial region of non-dental origin but there exist few studies indicating epidemiology of elderly patients in this regards. This study aimed to investigate change of age distribution of new patients in a university-based dental hospital and oral medicine clinic for last decade and to investigate clinical epidemiology of elderly patients (${\geq}$ 65 years) of oral medicine clinic. This study was performed retrospectively using medical records of the new patients in Dankook University Dental Hospital in 2001 and 2011. According to the study, percentage of elderly new patients increased in both dental hospital and oral medicine clinic and degree of the increase was greater in oral medicine clinic than in the whole hospital (p=0.000). 13.5% of adult patients ${\geq}$ 18 years of oral medicine clinic were elderly patients ${\geq}$ 65 years. 83% of elderly patients were suffering from one or more systemic diseases. Although TMD was the most common reason for elderly patients who visited oral medicine clinic, oral soft tissue diseases, dry mouth, burning mouth syndrome and oromandibular dystonia was more frequently diagnosed in elderly patients compared to adult patients aged 18 to 64 years. Pain severity and interference of Brief Pain Inventory and depression and anxiety scores of Hospital Anxiety Depression Scales were higher in elderly patients than in the adult patients (p<0.05). Increase of elderly patients with chronic oral diseases and pain needs more attention of dentists and specialists of oral medicine to improvement of assessment and development of tailored management because large portion of the elderly patients have systemic diseases, polypharmacy and impaired communication, possibly restricting treatment options.

EFFECT OF VARIOUS MECHANICAL TREATMENTS OF HYDROXYAPATITE-COATED IMPLANT SURFACES (Hydroxyapatite 피막 처리된 임프란트에 대한 여러가지 기계적 표면처리방법이 임프란트 표면조도 및 성상에 미치는 영향)

  • Yang, Kyung-Ran;Jung, Oh-Chul;Lee, Jae-Mok;Suh, Jo-Young
    • Journal of Periodontal and Implant Science
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    • v.24 no.1
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    • pp.131-143
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    • 1994
  • For maintenance of exposed implant in healthy state, it is necessary to treat the surface of implant fixture and provide the surface adjustable to surrounding tissues. Variable techniques have been introduced such as citric acid and air-abrasive system to treat the failed implant. Although when the rough surface of HA coated implant was exposed to oral environment, the surface treatment method with citric acid or air-abrasive system is effective for removal of bacterial endotoxin, it is unsuccessful to prevent plaque deposition due to difficulty in removal of rough surface of HA coated implant. Thus, in this study the method that removes bacterial endotoxin and makes smooch surface without alteration of surface characteristics was studied. HA coated disc manufactured by IMZ Co. Was treated with high speed diamond bur, low speed diamond bur, stone bur, rubber point, jetpolisher. And then its surface state was examined with profilometer and SEM to evaluate the surface smoothness, and its surface component was analyzed with EDX to evaluate wheter the surface characteristics were altered or not. As a result, following results were obtained. When the surface roughness of each implant disc was measured by profilometer, the group I showed a $R_{max}\;2.11{\mu}m$ and the group II, III, IV, V showed a $R_{max2}\;4.17{\mu}m$, $7.28{\mu}m$, $8.61{\mu}m$ and $39.44{\mu}m$ respectively. That is, surface smoothness was highest in the group I and it has been gradually decreased in the group II, III, IV and V. Under the SEM examination, the group I showed relatively smooth surface and the group II showed slightly rougher surface than the group I due to partially remaining HA particles while most HA particle was removed. The group III and IV showed rough topography due to HA particles that was not grinded, and HA coated surface in group V showed very irregular surface with deep groove and prominence. In cross-sectional view, the group I showed uniform surface, and the group III, IV showed rough surface due to remaining HA particles but the thickness of HA coating was remarkably reduced. The group II has similar pattern in group I, and the group V showed about $40{\mu}m$ thickness although it was not constant. By analysis of surface component with EDX, the group II in which the grinding was effective showed a small quantity of calcium and phosphorous and the group III, IV, in which the grinding was incomplete showed calcium and phosphorus peak. In all experimental group, no other than titanium, aluminum, calcium, phosphorus was observed.

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WEAR AND CHEMICAL DEGRADATION OF ESTHETIC RESTORATIVE MATERIALS (심미수복 재료의 마모와 화학적 분해)

  • Yang, Kyu-Ho;Choi, Nam-Ki;Kim, Hun-Ju;Kim, Seon-Mi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.2
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    • pp.190-201
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    • 2004
  • The aim of this study was to evaluate the resistance to degradation and to compare the wear resistance characteristics of four esthetic restorative materials in an alkaline solution. The brands studied were Charmfil, Charmfil flow(composite resin), Compoglass F and PrimaFlow(compomer). The results were as follows: 1. The mass loss were not significantly different among the materials(p>0.05). 2. The sequence of the degree of degradation layer depth was in descending order by Compoglass F, PrimaFlow, Charmfil, and Charmfil flow. There were significant differences between Compoglass F and the others(p<0.05). 3. The sequence of the Si loss was in descending order by Charmfil flow, Charmfil, PrimaFlow, and Compoglass F. There were significant differences among these materials(p<0.05). 4. When observed with SEM, destruction of bonding between matrix and filler was observed and when observed with CLSM, the depth of degradation layer of specimen surface was observed. 5. The sequence of maximum wear depth was in descending order by Comfoglass, PrimaFlow Charmal, and Charmfil flow. There were significant differences among these materials(p<0.05). 6. The correlation coefficient between Si loss and degradation layer depth (r=0.602, p<0.05) Vicker's hardness number and maximum wear depth (r=0.501, p<0.05) were relatively high. These results indicate that wear and hydrolytic degradation may be considered to be evaluation factors of composite resins and compomers.

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CONSIDERATIONS OF ANESTHETIC METHOD OF DEEP IMPACTED MESIODENS (심부 매복 정중 과잉치 수술 시 마취방법 선택)

  • Min, Soo-Young;Song, Je-Seon;Lee, Jae-Ho;Choi, Hyung-Jun;Son, Heung-Kyu;Kim, Seong-Oh
    • Journal of the korean academy of Pediatric Dentistry
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    • v.39 no.1
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    • pp.90-96
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    • 2012
  • Supernumerary tooth occurs most frequently at premaxilla area. Followed by mandibular premolar area, mandibular fourth molar area, maxillary paramolar area. Mesiodens are mainly impacted in the palatal area and surgical approach is made at palatal side. The time of surgery remains controversial. In case of inverted or horizontal impacted supernumerary tooth, intraosseous tooth movement and vertical growth of premaxilla makes surgical extraction more difficult. And also the more quantity of removed bone is, the higher degree of difficulty is. Inverted mesiodens of these cases were impacted superior to apex level of adjacent permanent incisor. Although CT examination revealed exact location of impacted tooth, surgical procedure including ostectomy may take a long time more than expected. So, before surgical extraction, it's need to be considered several factors such as necessity of CT taking, degree of difficulty, direction of surgical approach, necessity of general anesthesia etc.

Retention of CAD/CAM Metal Copings Cemented on Short Titanium Abutments with Different Cements (짧은 티타늄 지대주에 합착된 CAD/CAM 금속 코핑의 시멘트 종류에 따른 유지력 비교)

  • Kim, Hyo-Jung;Song, Eun-Young;Yoon, Ji-Young;Lee, Si-Ho;Lee, Yong-Keun;Oh, Nam-Sik
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.2
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    • pp.119-126
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    • 2012
  • State of problem: Cement-retained implant-supported prostheses are routinely used in dentistry. The use of high strength cements has become more popular with the increasing confidence in the stability of the implant-abutment screw connection and the high survival rates of osseointegrated implants. No clinical data on retention of metal copings using CAD/CAM. To evaluate retention of metal copings using CAD/CAM system bonded to short titanium abutment with four different cements and compare retentive strength of metal copings with sandblasting or without sandblasting before cementation. Forty titanium abutment blocks were fabricated and divided into 4 groups of 10 samples each. Forty metal copings with occlusal hole to allow for retention testing were fabricated using CAD/CAM technology. The four cements were Fujicem(Fuji, Japan), Maxcem Elite(Kerr, USA), Panavia F2.0(Kurarary, Japan) and Superbond C&B(Sunmedical, Japan). The copings were cemented on the titanium abutment according to manufacture's recommendation. All samples were stored for 24h at 37oC in 100% humidity and tested for retention using universal testing machine(Instron) at a crosshead speed of 1.0mm/min. Force at retentive failure was recorded in Newton. The mode of failure was also recorded. Means and standard deviations of loads at failure were analyzed using ANOVA and Paired t-test. Statistical significance was set at P<0.05. Panavia F2.0 provided significantly higher retentive strength than Fujicem, Maxcem Elite(P<0.05). Sandblasting significantly increased bond strength(P<0.05). The mode of failure was cement remaining principally on metal copings. Within the limitation of this study, Panavia F2.0 showed significantly stronger retentive strength than Fujicem, Maxcem Elite(p<0.05). The Ranking order of the cements to retain the copings was Panavia F2.0, Fujicem = Maxcem Elite. Sandblasting significantly increased bond strength(P<0.05). The retentive strength of metal copings on implant abutment were influenced by surface roughness and type of cements.

Diagnostic Approach to a Patient with a Pleural Effusion Including Ultrasound-guided Paracentesis Performed by a Medical Resident (내과 전공의가 시행한 초음파 이용 흉수천자를 포함한 흉수의 진단적 접근)

  • Lee, Yun Young;Choi, Won Je;Yu, Chang Min;Suh, Seong O;Kim, Eun Sil;Ahn, Seok- in;Chung, Jun-Oh;Park, Sang Joon;Kim, Yun Kwon;Kim, Soyon;Kim, Young Jung;Lee, Se Han;Heo, Heon
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.6
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    • pp.439-444
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    • 2008
  • Background: A patient with a pleural effusion that is difficult to safely drain by a "blind" thoracentesis procedure is generally referred to a radiologist for ultrasound-guided thoracentesis. But such a referral increases the cost and the patient's inconvenience, and it causes delay in the diagnostic procedures. If ultrasound-guided thoracentesis is performed as a bedside procedure by a medical resident, then this will reduce the previously mentioned problems. So these patients with pleural effusions were treated by medical residents at our medical center, and the procedures included bedside ultrasound-guided thoracenteses. Methods: We studied 89 cases of pleural effusions from March 2003 to June 2005. A "blind" thoracentesis was performed if the amount of pleural effusion was moderate or large. Bedside ultrasound-guided thoracentesis was performed for small or loculated effusions or for the cases that failed with performing a "blind" thoracentesis. Results: "Blind" thoracenteses were performed in 79 cases that had a moderate or large amount of uncomplicated pleural effusions and the success rate was 93.7% (74/79 cases). Ultrasound-guided thoracentesis by the medical residents was performed in 15 cases and the success rate was 66.7% (10/15 cases). The 5 failedcases included all 3 cases with loculated effusions and 2 cases with a small amount of pleural effusion. All the failed cases were referred to one radiologist and they were then successfully treated. If we exclude the 3 cases with loculated pleural effusions, the success rate of ultrasound-guided thoracentesis by the medical residents increased up to 83% (10/12cases). Two cases of complications (1 pneumothorax, 1 hydrohemothorax) occurred during ultrasound-guided thoracentesis. Conclusion: Ultrasound-guided thoracentesis performed as a bedside procedure by a medical resident may be relatively effective and safe. If a patient has a loculated effusion, then it would be better to first refer the patient to a radiologist.

The Modulation of Radiosensitivity by Combined Treatment of Selective COX-2 Inhibitor, NS 398 and EGF Receptor Blocker AG 1478 in HeLa Cell Line (선택적 COX-2 억제제 NS 398과 EGF 수용체 차단제 AG 1478의 복합투여가 HeLa 세포주의 방사선 감수성에 미치는 영향)

  • Youn Seon Min;Oh Young Kee;Kim Joo Heon;Park Mi Ja;Seong In Ock;Kang Kimun;Chai Gyuyong
    • Radiation Oncology Journal
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    • v.23 no.1
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    • pp.51-60
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    • 2005
  • Purpose : Selective inhibition of multiple molecular targets may improve the antitumor activity of radiation. Two specific inhibitors of selective cyclooxygenase-2 (COX-2) and epidermal growth factor receptor (EGFR) were combined with radiation on the HeLa cell line. To investigate cooperative mechanism with selective COX-2 inhibitor and EGFR blocker, in vitro experiments were done. Materials and Methods : Antitumor effect was obtained by growth inhibition and apoptosis analysis by annexin V-Flous method. Radiation modulation effects were determined by the clonogenic cell survival assay. Surviving fractions at 2 Gy ($SF_2$) and dose enhancement ratio at a surviving fraction of 0.25 were evaluated. To investigate the mechanism of the modulation of radiosensitivity, the cell cycle analyses were done by flow cytometry. The bcl-2 and bax expressions were analyzed by western blot. Results : A cooperative effect were observed on the apoptosis of the HeLa ceil line when combination of the two drugs, AG 1478 and NS 398 with radiation at the lowest doses, apoptosis of $22.70\%$ compare with combination of the one drug with radiation, apoptosis of $8.49\%$. In cell cycle analysis, accumulation of cell on $G_0/G_l$ phase and decrement of S phase fraction was observed from 24 hours to 72 hours after treatment with radiation, AG 1478 and NS 398. The combination of NS 398 and AG 1478 enhanced radiosensitivity on a concentration-dependent manner in HeLa cells with dose enhancement ratios of 3.00 and $SF_2$ of 0.12 but the combination of one drug with radiation was not enhanced radlosensitivity with dose enhancement ratios of 1.12 and SF2 of 0.68 (p=0.005). The expression levels of bcl-2 and bax were reduced when combined with AG 1478 and NS 398. Conclusion : Our results indicate that the selective COX-2 inhibitor and EGFR blocker combined with radiation have potential additive or cooperative effects on radiation treatment and may act through various mechanisms including direct inhibition of tumor cell proliferation, suppression of tumor cell cycle progression and inhibition of anti-apoptotic proteins.

Marine Ecotoxicological Evaluation on HNS Spill Accident : Nitric Acid Spill Case Study (HNS 유출사고가 해양생물에 미치는 생물독성 영향평가 : HNO3 유출사고 대상)

  • Kim, Tae-Won;Kim, Young Ryun;Jo, So Eun;Son, Min Ho;Lee, Moonjin;Oh, Sangwoo
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.21 no.6
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    • pp.655-661
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    • 2015
  • This study intends to evaluate the effect of nitric acid($HNO_3$) spill accidents on the marine ecosystem, while $HNO_3$ is known as one of the typical HNS. For this purpose, we performed (1) the growth inhibition test by using phytoplankton(Skeletonema costatum), (2) acute and chronic toxicity test by using invertebrate(Brachionus plicatilis and Monocorphium acherusicum), (3) fish(Cyprinodon variegatus) and (4) bacteria(Vibrio fischeri). In these tests, we observed the (1) pH changes induced by the nitric acid spill and (2) changes in nitrate($NO_3$) concentration disassociated from nitric acid after the accident, respectively. The toxicity test result on pH changes induced by $HNO_3$ shows that the no observed effect concentration(NOEC), lowest observed effect concentration(LOEC) and 50 % effect concentration($72h-EC_{50}$) values of M. acherusicum are pH 7 (0.3 mM), pH 5(1.1 mM) and pH 5.2(1.4 mM), respectively, indicating that M. acherusicum is the most sensitive species. The chronic toxicity test (population growth rate test) on $NO_3{^-}$ of B. plicatilis show that the NOEC, LOEC and $96h-EC_{50}$ are 5.9 mM, 11.8 mM and 32.6 mM, respectively, indicating that B. plicatilis is the most sensitive species. In conclusion, toxic effecst on the marine organism caused by the nitric acid spill accident is determined to be so slightly except for the most adjacent area of the ship in pH scale and such concentration of nitrate, to the extent of directly influencing the survival and reproduction of the marine organism, is determined practically not to be applicable in the typical accidents in the sea.

Prioritizing Noxious Liquid Substances (NLS) for Preparedness Against Potential Spill Incidents in Korean Coastal Waters (해상 유해액체물질(NLS) 유출사고대비 물질군 선정에 관한 연구)

  • Kim, Young-Ryun;Choi, Jeong-Yun;Son, Min-Ho;Oh, Sangwoo;Lee, Moonjin;Lee, Sangjin
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.22 no.7
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    • pp.846-853
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    • 2016
  • This study prioritizes Noxious Liquid Substances (NLS) transported by sea via a risk-based database containing 596 chemicals to prepare against NLS incidents. There were 158 chemicals transported in Korean waters during 2014 and 2015, which were prioritized, and then chemicals were grouped into four categories (with rankings of 0-3) based on measures for preparedness against incident. In order to establish an effective preparedness system against NLS spill incidents on a national scale, a compiling process for NLS chemicals ranked 2~3 should be carried out and managed together with an initiative for NLS chemicals ranked 0-1. Also, it is advisable to manage NLS chemicals ranked 0-1 after considering the characteristics of NLS specifically transported through a given port since the types and characteristics of NLS chemicals relevant differ depending on the port. In addition, three designated regions are suggested: 1) the southern sector of the East Sea (Ulsan and Busan); 2) the central sector of the South Sea (Gwangyang and Yeosu); and 3) the northern sector of the West Sea (Pyeongtaek, Daesan and Incheon). These regions should be considered special management sectors, with strengthened surveillance and the equipment, materials and chemicals used for pollution response management schemes prepared in advance at NLS spill incident response facilities. In the near future, the risk database should be supplemented with specific information on chronic toxicity and updated on a regular basis. Furthermore, scientific ecotoxicological data for marine organisms should be collated and expanded in a systematic way. A system allowing for the identification Hazardous and Noxious Substances (HNS) should also be established, noting the relevant volumes transported in Korean waters as soon as possible to allow for better management of HNS spill incidents at sea.

Site Characteristics and Vegetation Structure of the Habitat of Cauliflower Mushroom (Sparassis crispa) (꽃송이버섯 자생지의 입지특성 및 식생구조)

  • Oh, Deuk-Sil;Park, Joon-Moh;Park, Hyun;Ka, Kang-Hyeon;Chun, Woo-Jae
    • The Korean Journal of Mycology
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    • v.37 no.1
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    • pp.33-40
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    • 2009
  • From 2006 to 2008, natural habitat of Sparassis crispa were surveyed for investigating ecological conditions at sixteen different sites in Korea. The investigated sites showed very wide altitudinal distribution ranged from 240 meters to 1,100 meters above the sea level. In general, S. crispa showed distinct feature of heart-rot fungi as it occurs on soils around the stems of larch (Larix kaempferi) and Korean white pine (Pinus koraiensis). But it also could be found on stems or on the stumps of dead trees, which indicated that the fungus might have several invasion routes and capabilities to grow on various ecological conditions. All of the sixteen sites were pure stands consisted with conifers such as larch or Korean white pine. The dominant tree layer showed $15.3{\sim}38.0$ meters for tree heights, thicker than twenty centimeters for the diameter at breast height (DBH), and all of them were older than thirty years. Since the stands were pure stand, species diversity of trees in the sites was extremely low. While the dominant tree layer showed only pure coniferous stand, the co-dominant tree layer, shrub layer and herbaceous layer showed more diverse features with higher Shannon-Wiener (H') indices. Soil texture of thirteen sites among sixteen investigated sites were loamy soils, and the contents of organic matter in soil were more or less higher than general forest soils in Korea with $3.79{\sim}14.32%$. The cation exchange capacity (CEC) was also relatively higher than general forest soils with $16.1{\sim}27.2$ cmol+/kg. The data indicated that the cauliflower mushroom occurring sites were relatively fertile than general forest soils. The soils were acidic with pH ranged from 4.2 to 5.2, which were typical features for conifer stands in Korea.