• Journal of the Korean Dietetic Association
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• v.7 no.3
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• pp.217-226
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• 2001

It is important to supply adequate nutrition to critically ill patients, whose gastrointestinal system is properly functioning, through the enteral tube feeding if oral intake is impossible. In this study we investigated the changes in nutritional status with enteral tube feeding according to the volume required. We investigated the volume ordered according to the patient's requirements, volume infused according to the volume ordered in 41 enteral tube feeding patients in intensive care unit from Jannuary to July, 2000. Body weight, serum albumin level, and total lymphocyte count were evaluated to assess nutritional status. The mean fasting period was 5 days before the enteral feeding and patients whose fasting period over 3 days were 51%. The mean enteral tube feeding period was 29 days and method of feeding was nasogastric, bolus feeding 6 times per day. The volume ordered was 69.7% of the patients' recommended calorie and volume infused was 86.6% of their volume prescribed. Accordingly, the volume infused was estimated 61.7% of their volume required. Only 44.6% of their reqiured volume was infused within 3 days after enteral tube feeding was started. It took 16 days in average to meet the patients' recommended calorie; 56% of subjects still did not fully met their requirements by the end point. Among the impeding factors in supplying enteral tube feeding, factors related to the number of feeding were high residual volume in stomach, vomiting, gastrointestinal bleeding, abdominal distension and surgery. Factors related to the acctual infused volume were diarrhea, gastrointestinal bleeding, abdominal distension, airway management and tube reinsertion. Significant correlations were shown between the volume infused and changes in both the patients' weight and serum albumin level. Deviding the subjects into two groups by their infused volume, less than 70% and more than that, we compared the two to come up with a significant difference in their serum albumin level, -0.23 vs 0.21, and their body weight, -4.52 vs 0.12. In enteral tube feeding, the volume delivered in sufficient to the pateints' energy requirement can affect their nutriitional status in critically ill patient; adequate nutritional management plan is essential. It is necessary to make every effort to educate clinical staff and to set up a unified management program to prescribe adequate ammount of energy for the patient's nutritional requirement.

• Journal of Korean society of Dental Hygiene
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• v.12 no.3
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• pp.563-576
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• 2012

목적 : 본 연구는 업무형태에 따른 측두하악장애의 유병률과 업무 시 노출되는 직무스트레스 및 구강 내 악습관이 측두하악장애와 어떠한 연관성이 있는지 알아보아 보건학적 기초자료를 제공하고자 실시되었다. 방법 : 본 연구의 자료 수집을 위하여 서울과 경기 일부지역에 근무하고 있는 일반사무직, 서비스직, 교직원으로부터 편의 추출된 452명을 대상으로 2010년 1월부터 2010년 4월까지 설문조사를 실시하였고, 수거된 353명을 연구대상으로 하였다. 설문지는 측두하악장애의 증상, 하악사용에 관한 구강 내 악습관, 직무스트레스, 인구사회학적 특성으로 구성되었다. 측두하악장애의 증상의 정도를 구분하기 위해 설문지의 양성응답 수의 빈도에 따라 무증상인 1단계에서 양성응답 수가 가장 많은 4단계 까지 총 4그룹으로 나누었다. 측두하악장애의 유병률을 알아보기 위하여 빈도분석을 시행하였고, 측두하악장애의 증상의 정도에 따른 여러 요인들 간의 연관성 및 관련요인을 알아보기 위하여 교차분석 및 경향성 분석과 다항로지스틱회기 분석을 시행하였다. 결과 : 측두하악장애의 유병률은 75.4%였고, 측두하악장애에 대한 주관적 증상으로는 관절잡음이 56.4%로 가장 주된 증상 중 하나였으나 남녀 간의 차이는 통계적으로 유의하지 않았다. 다음으로는 두통이나 목의 통증이 36.5%이었고, 귀, 관자놀이, 볼 주위의 통증이 22.1%로 높았다. 측두하악장애의 주관적인 증상 수에 따른 인구사회학적 특성은 증상이 없는 경우 여성에서 19.1%, 남성에서 36.6%로 여성에서 더 높은 유병률을 보였다. 연령별로는 40세 이상의 그룹보다 20 - 30대그룹에서 측두하악장애 증상수가 높아지는 경향을 보였다. 하악 사용과 관련된 악습관 및 직무스트레스는 측두하악장애 증상수와 유의한 관련성이 있는 것으로 나타났는데, 하악 사용과 관련된 습관의 개수가 많아질수록 측두하악장애의 증상의 개수도 많아졌고, 습관이 한 가지씩 늘어날수록 측두하악장애 증상이 없는 1단계보다 3단계가 될 위험이 1.45배, 4단계가 될 위험이 1.57배 높아졌다. 스트레스 수준도 가장 하위단계에서 한 단계 높아지면 측두하악장애 1단계에서 4단계가 될 위험이 2.49배, 두 단계 높아지면 3.43배 높아졌다. 결론 : 본 연구의 결과 측두하악장애와 업무특성에 따른 연관성은 설명하지 못하였지만, 직무스트레스가 높은 경우 측두하악장애 증상의 개수 또한 높아짐을 확인할 수 있었다. 이는 측두하악장애의 주관적인 증상을 발생시키는데 있어서 업무형태 보다는 심인적인 부분이 더 중요한 인자임을 의미한다. 그러므로 측두하악장애 평가 시 신체적인 문제뿐 아니라 행동적, 심리 사회적 문제로 예측인자를 폭넓게 인식함으로써 다각적인 접근을 하는 것이 필요하며, 측두하악장애 증상이 발생된 경우 임상적 치료뿐 아니라 행동요법 및 심리 치료와 자가 관리 등이 함께 수반되어 기여요인 조절을 조절하는 것이 중요하다 하겠다.

• Tuberculosis and Respiratory Diseases
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• v.65 no.5
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• pp.405-409
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• 2008

Churg-Strauss syndrome is a rare form of systemic necrotizing vasculitis that occurs exclusively in patients with asthma, and is associated with blood and tissue eosinophilia. The classic pathology findings in the lung include a combination of eosinophilic pneumonia, granulomatous inflammation and necrotizing vasculitis. However, there are few reports of tracheobronchial mucosal lesions in Churg-Strauss syndrome. We report a case of Churg-Strauss syndrome with multiple tracheobronchial mucosal lesions in a 33-year-old man with a history of bronchial asthma and allergic rhinitis. He had been diagnosed with community acquired pneumonia at another hospital and was treated with antibiotics. However, the chest radiographic findings were aggravated and showed multifocal consolidations in the whole lung fields. He was transferred to the Asan Medical Center. Fiberoptic bronchoscopy revealed multiple nodular mucosal lesions of the trachea and bronchi. The histopathology of the mucosal lesions revealed necrotizing bronchial inflammation with eosinophilic infiltration. Video Assisted Thoracic Surgery was performed. The wedge resected lung tissue revealed chronic eosinophilic pneumonia that was consistent with Churg-Strauss syndrome. Methylprednisolone (1 mg/kg q 8 hr) was prescribed and his symptoms resolved gradually. The chest radiographic findings improved significantly, and a follow-up fiberoptic bronchoscopy performed eight days later showed that the tracheobronchial mucosal lesions had resolved. The patient was prescribed oral prednisolone for 20 months after discharge. Currently, the patient is not taking steroids and is being followed up.

• Journal of Periodontal and Implant Science
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• v.47 no.3
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• pp.143-153
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• 2017

Purpose: The aim of the present exploratory study was to evaluate extraction socket healing at sites with a history of periodontal and endodontic pathology. Methods: The mandibular 4th premolar teeth in 5 adult beagle dogs served as experimental units. Periodontal and endodontic lesions were induced in 1 premolar site in each animal using wire ligatures and pulpal exposure over 3 months (diseased sites). The contralateral premolar sites served as healthy controls. The mandibular 4th premolar teeth were then extracted with minimal trauma, followed by careful wound debridement. The animals were sacrificed at days 1, 7, 30, 60, and 90 post-extraction for analysis, and the healing patterns at the healthy and diseased extraction sites were compared using radiography, scanning electron microscopy, histology, and histometry. Results: During the first 7 days of healing, a significant presence of inflammatory granulation tissue was noted at the diseased sites (day 1), along with a slightly accelerated rate of fibrin clot resolution on day 7. On day 30, the diseased extraction sites showed a greater percentage of persistent fibrous connective tissue, and an absence of bone marrow formation. In contrast, healthy sites showed initial signs of bone marrow formation on day 30, and subsequently a significantly greater proportion of mature bone marrow formation on both days 60 and 90. Radiographs exhibited sclerotic changes adjoining apical endodontic lesions, with scanning electron microscopy showing collapsed Volkmann canals protruding from these regions in the diseased sites. Furthermore, periodontal ligament fibers exhibited a parallel orientation to the alveolar walls of the diseased sites, in contrast to a perpendicular arrangement in the healthy sites. Conclusions: Within the limitations of this study, it appears that a history of periodontal and endodontic pathology may critically affect bone formation and maturation, leading to delayed and compromised extraction socket healing.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.20
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• pp.8661-8666
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• 2014

Background: Docetaxel and cisplatin in combination with fluorouracil (DCF) regimen is accepted to be one of the standard regimens in the treatment of advanced gastric cancer. However, substantial toxicity has limited its use in daily clinical practice. Therefore, modification of DCF regimens, including introduction of capecitabine has been investigated to improve the safety profiles. In the present study, the efficacy and toxicity of a regimen with a modified dose of docetaxel and cisplatin in combination with oral capecitabine (DCX) was evaluated in untreated patients with HER2-negative advanced gastric cancer. Materials and Methods: Fifty-four patients with HER2-negative locally advanced or metastatic gastric cancer were included in this cohort. Patients received docetaxel $60mg/m^2$ plus cisplatin $60mg/m^2$ (day 1) combined with capecitabine $1650mg/m^2$ (days 1-14) every 3 weeks. Treatment response, survival, and toxicity were retrospectively analyzed. Results: The median age was 54 years (range: 24-76). The majority of patients (70%) had metastatic disease, while 11 patients (21%) had recurrent disease and underwent curative gastrectomy, and 5 patients (9%) had locally advanced disease (LAD). The median number of DCX cycles was 4. There were 28 partial responses and 11 complete responses, with an overall response rate of 72%. Curative surgery could be performed in four patients among five with LAD. At the median follow-up of 10 months, the median progression-free survival (PFS) and overall survival (OS) of the entire cohort of patients were 7.4 and 12.1 months, respectively. Dose modification was done in 12 patients due to toxicity in 8 and noncompliance in 4 patients. The most common hematological toxicity was neutropenia, which occurred at grade 3-4 intensity in 10 of 54 patients (27.7%). Febrile neutropenia was diagnosed only in two cases. Conclusions: DCX regimen offers prominent anti-tumor activity and considered to be effective first-line treatment with manageable toxicity for patients with HER2-negative advanced gastric cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.8
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• pp.3495-3501
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• 2014

Melanoma-associated antigen (MAGE) family genes have been considered as potentially promising targets for anticancer immunotherapy. MAGED4 was originally identified as a glioma-specific antigen. Current knowledge about MAGED4 expression in glioma is only based on mRNA analysis and MAGED4 protein expression has not been elucidated. In the present study, we investigated this point and found that MAGED4 mRNA and protein were absent or very lowly expressed in various normal tissues and glioma cell line SHG44, but overexpressed in glioma cell lines A172,U251,U87-MG as well as glioma tissues, with significant heterogeneity. Furthermore, MAGED4 protein expression was positively correlated with the glioma type and grade. We also found that the expression of MAGED4 inversely correlated with the overall methylation status of the MAGED4 promoter CpG island. Furthermore, when SHG44 and A172 with higher methylation were treated with the DNA demethylating agent 5-aza-2'-deoxycytidine (5-AZA-CdR) reactivation of MAGED4 mRNA was mediated by significant demethylation in SHG44 instead of A172. However, 5-AZA-CdR treatment had no effect on MAGED4 protein in both SHG44 and A172 cells. In conclusion, MAGED4 is frequently and highly expressed in glioma and is partly regulated by DNA methylation. The results suggest that MAGED4 might be a promising target for glioma immunotherapy combined with 5-AZA-CdR to enhance its expression and eliminate intratumor heterogeneity.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.5
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• pp.2703-2706
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• 2013

Purpose: This study was to determine the efficacy and safety of pemetrexed based chemotherapy in treating patients with metastatic gastric cancer who failed to respond to first and (or) second line chemotherapy. Patients and Methods: Metastatic gastric cancer patients who failed first and (or) second line chemotherapy, were enrolled. All patients were recruited from Jiangsu Cancer Hospital & Research Institute, and were treated with pemetrexed $500mg/m2$ (intravenous; on day 1), and a platinum (or irinotecan) every 3 weeks until disease progression, or intolerable toxicity. Evaluation on efficacy was conducted after two cycles of chemotherapy using the Response Evaluation Criteria for Solid Tumors. Toxicity was recorded according to National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0. Results: From Jun 2011 to May 2013, 23 patients were enrolled. All eligible 23 patients completed at least 2 cycles of chemotherapy with pemetrexed based chemotherapy, and were evaluable. Their median age was 55 years (range 40 to 78 years). Seventeen patients were male and 6 female. Three patients (13%) achieved partial response, five patients (22%) stable, 15 patients (65%) with disease progression, and none with complete response. Grade 2 neutrophil suppression occurred in 4.3%, grade 3 in 13% of patients, and no grade 4 was reported. Thrombocytopenia was encountered as follows: 4.3% grade 2, 4.3% grade 3 and 4.3% grade 4. Incidence of anemia was 34.8% in grade 2, 8.7% grade 3 and 0% grade 4. Only 4.3% of patients required packed red blood cell infusion. Elevated transaminase were 4.3% in grade 2 and 0% in grade 3 or 4. Other toxicity included oral mucositis. Conclusions: Pemetrexed based chemotherapy is mildly effective in treating patients with metastatic gastric cancer with tolerable toxicity.

• Journal of Periodontal and Implant Science
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• v.30 no.2
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• pp.305-324
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• 2000

This study compared the short-term(4 months) clinical results of regenerative therapy with bioabsorbable membranes($BioMesh^{(R)}$) and bone allograft for the treatment of periodontal(intrabony and furcation) defects in smokers and nonsmokers.(16 smokers) 32 subjects with 92 defects participated in the study(46 in smokers and 46 in non-smokers). This study also evaluated a bioresorbable barrier with and without decalcified freeze-dried bone allograft(DFDBA). The 92 periodontal defects were randomly treated with either the resorbable barrier alone or resorbable barrier in combination with DFDBA following thorough defect debridement and root preparation with tetracycline. Each patient received both types of treatment modalities. Clinical examinations(probing depth, gingival recession, clinical attachment level, plaque index and gingival index) were carried out immediately before and 4 months after surgery. Significant(p<0.001) gains in mean attachment level were observed for both smokers(2.93mm) and non-smokers(3.30mm) but there were not significant difference between two groups. Similarly, significant reductions in mean probing depthshowed for smokers(4.52mm) and non-smokers(4.26mm). However, when comparing gingival recession, smokers were found to exhibit significantly poorer treatment results(1.59mm vs 0.96mm, p<0.05). Using the split-mouth-design, no statistically significant difference between the two modalities could be detected with regard to pocket depth reduction, gingival recession, or attachment gain. These results illustrate that the attachment gain is better in the non-smoker and the best in the non-smoker with the combination therapy of resorbable barrier and DFDBA than with resorbable barrier alone but smoking had no significant effect on clinical treatment outcome, even though smokers show more significant gingival recession. In addition, both treatments, either resorbable barrier plus DFDBA or resorbable barrier alone, promoted significant resolution of periodontal defects but the addition of DFDBA with a bioabsorbable membrane appears to add no extra benefit to the only membrane treatment.

• Journal of Biosystems Engineering
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• v.39 no.2
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• pp.122-133
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• 2014

Purpose: This study was to develop an effective process for fabricating biocompatible calcium phosphate powders (CPPs) using horse bones, and to investigate the characteristics of them. Methods: The characteristics of horse bone powders (HBPs) were investigated according to the different osseous tissue types (compact bone and cancellous bone), bone types (spine and tibia), pretreatment methods (cold water, $H_2O_2$, and hot water), sintering time (4, 8 and 12h), and sintering temperature (600, 900, 1100 and $1300^{\circ}C$). In addition, the grinding methods were compared based on the wet grinding (ball mill) and dry grinding (blade grinder) method to make it as powders. Finally, their cytotoxicity and cell viability were checked. Results: Regardless of the types of osseous tissues and bones, HBPs were well fabricated as biocompatible CPPs. It was also found that the pretreatment methods did not influence on the resultants, showing well-fabricated HBPs. Considering the processing time, the hot water method was the most suitable compared to other pretreatment methods. Further, 12h-sintering time was sufficient to remove residual organic compounds. The sintering temperatures greatly affected the properties of bone powders fabricated. The x-ray diffraction (XRD) peak of horse bone sintered at $600^{\circ}C$ was most closed to that of hydroxyapatite (HA). Our bioactivity study demonstrated that the HBPs fabricated by sintering horse bones at $1300^{\circ}C$ showed the best performance in terms of cell viability whereas the HBPs $1100^{\circ}C$ showed the cytotoxicity. Conclusions: Using various types of horse bone tissues, biocompatible CPPs were successfully developed. We conclude that the HBPs may have a great potential as biomaterials for various biological applications including bone tissue engineering.

• Journal of Korean society of Dental Hygiene
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• v.5 no.1
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• pp.39-51
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• 2005

This study was conducted to investigate the dental health and physical & psychological health status of the aged. The subjects were 61 old persons, women who were over 65, living at Sahagu in Pusan. The data for this study were collected by using direct interviewing method from October 22th, 2004. The data were analysed by using a computerized program named statistical package for social science including frequency, percentage, ANOVA. The results of the study were summarized as follows: 1. The dental status and the use of dental care institute 1) In status of denture use, it was found to be no denture(45.2%), full denture(35.5%), partial denture(19.4%). 2) In the questionaire of "when did you go to the dental care institute recently?", it was found to be uncertain(41.9%), less than one year(38.8%), 2~3years(16.1%), 1~2years(3.2%). 3) In the questionaire of "what type of the dental care institute did you use?", it was found to be in the dental clinic(80.6%), others(9.7%), dental hospital(6.5%), department of dentistry in general hospital(3.2%). 4) In the questionaire of "why did you select the dental care institute?", it was found to be in the nearly distance(80.6%), relative advice(16.1%), advertisement(3.2%). 5) In the questionaire of "how did you go to the dental care institute?", it was found to be walking(71.0%), bus & subway(22.6%), car(3.2%) and others(3.2%). 6) In the questionaire of "how long did it take to the dental care institute?", it was found to be 10~30min(48.4%), less than 10min(38.7%), 30min~1h(6.5%), 1~2h(3.2%), more than 2h(3.2%). 7) In the questionaire of "what kind of dental care did you take?", it was found to be denture making(45.2%), extraction of tooth, dental surgery, general exam(12.9%), caries(9.7%), denture repair(6.5%), others(3.2%). 8) In the questionaire of "how much did you pay for dental care recently?", it was found to be less than 5,000won(35.5%), 20,000~100,000won(19.4%), 1~3million won(16.1%), 5,000~20,000won, 100,000~300,000won, 500,000~1million won, more than 3million(6.5%), 300,000~500,000won(3.2%). 9) Average score of the subject's physical health status was 4.11 and psychological health status, 4.01 in a 5 point Likert scale. 10) The physical and psychological health status showed the significant differences according to the frequency of eating snack(pE0.05) and snack type(pE0.01). Above findings suggest that geriatric oral health program is necessary in improving the dental health & health status of the aged.