• Title/Summary/Keyword: Systemic risk

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A Convergence Study on the relationship between Blood lipid and Periodontitis in Korean Men and Women - National Health and Nutrition Survey Data (한국인 남성과 여성의 혈중지질과 치주염의 연관성에 관한 융합적 고찰 - 국민건강영양조사자료)

  • Lee, Seyoung;Sim, Seon-ju
    • Journal of the Korea Convergence Society
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    • v.12 no.1
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    • pp.111-118
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    • 2021
  • This study used raw data from the 2016-2018 National Health and Nutrition Survey to study the correlation between blood lipid and periodontal disease in Korean men and women, and selected the final 11,797 people as subjects of analysis. A stratified analysis of smoking and residential areas was conducted to see the link between blood lipid and periodontal disease in Korean men. In men, non-smokers had a significant correlation of 1.38(95% CI:1.09-1.76), and in men, the risk group had a odds ratio of 1.49(95% CI:1.16-1.91), and in smokers, the risk group had odds ratio of 1.76 (95% CI:1.39-2.23) shows that the warning group is significant in relation to the intersecting ratio 1.14(95% CI:1.16-1.70) and the risk group 1.60(95% CI:1.32-1.94) periodontal disease. In conclusion, men's blood lipids and periodontal diseases are associated with smoking or residential areas, and are especially intended to be used as basic data in developing health education programs related to systemic and periodontal diseases for men in urban areas. In developing education programs for men in urban areas in the future, we want to use them as basic data.

Effects of Laughter Therapy on Depression and Sleep Wake Disorders of the Elderly in Residential Facilities : A Systematic Review and Meta-analysis (웃음요법이 시설거주 노인의 우울과 수면 장애에 미치는 효과 : 체계적 고찰 및 메타분석)

  • Kim, Eun-Jung;Yang, Jin-Hyang
    • Journal of Korea Entertainment Industry Association
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    • v.15 no.8
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    • pp.291-303
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    • 2021
  • The purpose of this study is to identify the effects of laughter therapy on depression and sleep wake disorders among the elderly in residential facilities using a systemic review and meta-analysis. Twelve databases were searched. Two researchers independently performed the selection of the studies, data coding and assessment. The risk of bias was assessed using risk of bias (RoB) and risk of bias assessment tool for non-randomized studies (RoBANs). To estimate the effect size, meta-analysis of the studies was performed using R version 4.04. Out of the 1,122 retrieved articles, one randomized controlled trial (RCT) and eleven non-randomized controlled trials (non-RCTs) were selected for analysis. The overall effect size of eleven studies on depression was determined to be -1.04 (95% Cl: -1.53~-0.54, p<.001). There were statistically significant in the effect of below ten sessions and the effect of below 400 minutes'and 400 to 1000 minutes'interventions on depression. The overall effect size of five studies on sleep wake disorders was 0.83 (95% Cl: -0.26~1.93, p=.136), which was not statistically significant. There was statistically significant in the effect of below 300 minutes'interventions on sleep wake disorders. Laughter therapy was an effective non-pharmacological intervention to reduce depression among the elderly in residential facilities. The findings also suggest that guidelines for laughter therapy need to be developed considering the number of sessions and a duration of intervention to reduce depression and sleep wake disorders of the elderly in residential facilities.

Assessment of Risk Factors for Developmental Defects of the Enamel in Preterm (조산아의 발육성 법랑질 결함의 위험 요인 평가)

  • Shang-yon Park;Jaeho Lee;Hyung-Jun Choi;Chung-Min Kang
    • Journal of the korean academy of Pediatric Dentistry
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    • v.50 no.2
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    • pp.192-204
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    • 2023
  • This study aimed to determine the criteria for quantifying developmental defects of enamel in primary teeth in premature babies and to investigate the severity of developmental defects according to the gestational age, birth weight, systemic complications, and treatments received after preterm birth. Birth information, a history of complications, the duration of parenteral nutrition, and endotracheal intubation were investigated by retrospectively reviewing the admission and discharge records of premature babies in the neonatal intensive care unit. The Preterm Developmental Defects of Enamel (PDDE) index was designed by modifying the existing developmental defects of enamel index. Based on PDDE index, the evaluator scored developmental defects of enamel by classifying them as enamel hypomineralization and hypoplasia. The PDDE scores in the extremely preterm and extremely low birth weight groups were significantly higher than those in other groups. Furthermore, PDDE scores of premature babies with bronchopulmonary dysplasia, rickets, intraventricular hemorrhage, or necrotizing colitis were significantly higher than those in the control group. In addition, more than 50 days of endotracheal intubation and more than 20 days of parenteral nutrition were associated with significantly higher PDDE scores than those in the control group and were risk factors for developmental defects of enamel. This study provides basic information for identifying risk factors for developmental defects of enamel in premature babies.

Surgical outcome and risk scoring to predict survival after hepatic resection for hepatocellular carcinoma with portal vein tumor thrombosis

  • Tae-Seok Kim;Kwangho Yang;Gi Hong Choi;Hye Yeon Yang;Dong-Sik Kim;Hye-Sung Jo;Gyu-Seong Choi;Kwan Woo Kim;Young Chul Yoon;Jaryung Han;Doo Jin Kim;Shin Hwang;Koo Jeong Kang
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.28 no.2
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    • pp.134-143
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    • 2024
  • Backgrounds/Aims: The hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) is classified as the advanced stage (BCLC stage C) with extremely poor prognosis, and in current guidelines is recommended for systemic therapy. This study aimed to evaluate the surgical outcomes and long-term prognosis after hepatic resection (HR) for patients who have HCC combined with PVTT. Methods: We retrospectively analyzed 332 patients who underwent HR for HCC with PVTT at ten tertiary referral hospitals in South Korea. Results: The median overall and recurrence-free survival after HR were 32.4 and 8.6 months, while the 1-, 3-, and 5-year overall survival rates were 75%, 48%, and 39%, respectively. In multivariate analysis, tumor number, tumor size, AFP, PIVKA-II, neutrophil-to-lymphocyte ratio, and albumin-bilirubin (ALBI) grade were significant prognostic factors. The risk scoring was developed using these seven factors-tumor, inflammation and hepatic function (TIF), to predict patient prognosis. The prognosis of the patients was well stratified according to the scores (log-rank test, p < 0.001). Conclusions: HR for patients who have HCC combined with PVTT provided favorable survival outcomes. The risk scoring was useful in predicting prognosis, and determining the appropriate treatment strategy for those patients who have HCC with PVTT.

Predictors of renal relapse in Koreans with lupus nephritis after achieving complete response: a 35-years of experience at a single center

  • Howook Jeon;Jennifer Lee;Su-Jin Moon;Seung-Ki Kwok;Ji Hyeon Ju;Wan-Uk Kim;Sung-Hwan Park
    • The Korean journal of internal medicine
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    • v.39 no.2
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    • pp.347-359
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    • 2024
  • Background/Aims: Renal relapse has known to be a poor prognostic factor in patients with lupus nephritis (LN), but there were few studies that identified the risk factors of renal relapse in real world. We conducted this study based on 35-years of experience at a single center to find out predictors of renal relapse in Korean patients with LN after achieving complete response (CR). Methods: We retrospectively analyzed the clinical, laboratory, pathologic and therapeutic parameters in 296 patients of LN who reached CR. The cumulative risk and the independent risk factors for renal relapse were examined by Kaplan-Meier methods and Cox proportional hazards regression analyses, respectively. Results: The median follow-up period from CR was 123 months. Renal relapse had occurred in 157 patients. Renal relapse occurred in 38.2%, 57.6% and 67.9% of patients within 5-, 10-, and 20-year, respectively. The age at diagnosis of SLE and LN were significantly younger, and the proportions of severe proteinuria and serum hypoalbuminemia were higher in patients with renal relapse. Interestingly, the proportion of receiving cytotoxic maintenance treatment was higher in patients with renal relapse. In Cox proportional hazards regression analyses, only young-age onset of LN (by 10 years, HR = 0.779, p = 0.007) was identified to independent predictor of renal relapse. Conclusions: Young-age onset of LN was only independent predictor and the patients with severe proteinuria and serum hypoalbuminemia also tended to relapse more, despite of sufficient maintenance treatment. Studies on more effective maintenance treatment regimens and duration are needed to reduce renal relapse.

Risk Factor Analysis for $SaO_2$ Instability after Systemic-pulmonary Shunt (전신-폐 단락술 후 산소포화도의 불안정성의 위험인자 분석)

  • Jung Sung-Ho;Yun Sok-Won;Park Jung-Jun;Seo Dong-Man;Kim Young-Hwue;Ko Jae-Kon;Park In-Sook;Yun Tae-Jin
    • Journal of Chest Surgery
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    • v.38 no.4 s.249
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    • pp.277-283
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    • 2005
  • Arterial oxygen saturation $(SaO_2)$ instability frequently takes place after systemic-pulmonary shunt without shunt occlusion. We analyzed actual incidence and risk factors for $SaO_2$ instability after shunt operations, and possible mechanisms were speculated on. Material and Method: Ninety three patients, who underwent modified Blalock-Taussig shunt from January 1996 to December 2000, were enrolled in this study. Adequacy of shunt was verified in all patients, either by ensuing one ventricle or biventricular repair later on or by appropriate pulmonary artery growth on postoperative angiogram. Age, body weight, hemoglobin level at operation were 3 day to 36 years (median: 1.8 months), 2.5kg to 51kg (median: 4.1kg) and $10.7\~24.3$ gm/dL (median: 15.2 gm/dL) respectively. Preoperative diagnoses were functional single ventricle with pulmonary stenosis or atresia in 39, tetralogy of Fallot in 38 and pulmonary atresia with intact ventricular septum in 16. Pulmonary blood flow (PBF) was maintained pre-operatively by patent ductus or previous shunt in 64 and by forward flow through stenotic right ventricular outflow tract (RVOT) in 29. $SaO_2$ instability was defined as $SaO_2$ less than $50\%$ for more than 1 hour with neither anatomic obstruction of shunt nor respiratory problem. Result: 10 patients $(10.7\%)$ showed $SaO_2$ instability after shunt operation. After shunt occlusion was ruled out by echocardiogram, they received measures to lower pulmonary vascular resistance (PVR), which worked within a few hours in all patients. Risk factors for $SaO_2$ instability included older age at operation (p=0.039), lower preoperative $SaO_2$ (p=0.0001) and emergency operation (p=0.001). PBF through stenotic RVOT showed marginal statistical significance (p=0.065). Conclusion: $SaO_2$ instability occurs frequently after shunt operation, especially in patients with severe hypoxia pre-operatively or unstable clinical condition necessitating emergency operation. Temporary elevation of pulmonary vascular resistance is a possible mechanism in this specific clinical setting.

Colorectal Cancer Treatment and Survival: the Experience of Major Public Hospitals in South Australia over three Decades

  • Roder, David;Karapetis, Christos S;Wattchow, David;Moore, James;Singhal, Nimit;Joshi, Rohit;Keefe, Dorothy;Fusco, Kellie;Powell, Kate;Eckert, Marion;Price, Timothy J
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2431-2440
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    • 2015
  • Background: Registry data from four major public hospitals indicate trends in clinical care and survival from colorectal cancer over three decades, from 1980 to 2010. Materials and Methods: Kaplan-Meier productlimit estimates and Cox proportional hazards models were used to investigate disease-specific survival and multiple logistic regression analyses to explore first-round treatment trends. Results: Five-year survivals increased from 48% for 1980-1986 to 63% for 2005-2010 diagnoses. Survival increases applied to each ACPS stage (Australian Clinico-Pathological Stage), and particularly stage C (an increase from 38% to 68%). Risk of death from colorectal cancer halved (hazards ratio: 0.50 (0.45, 0.56)) over the study period after adjusting for age, sex, stage, differentiation, primary sub-site, health administrative region, and measures of socioeconomic status and geographic remoteness. Decreases in stage were not observed. Survivals did not vary by sex or place of residence, suggesting reasonable equity in service access and outcomes. Of staged cases, 91% were treated surgically with lower surgical rates for older ages and more advanced stage. Proportions of surgical cases having adjuvant therapy during primary courses of treatment increased for all stages and were highest for stage C (an increase from 5% in 1980-1986 to 63% for 2005-2010). Radiotherapy was more common for rectal than colonic cases. Proportions of rectal cases receiving radiotherapy increased, particularly for stage C where the increase was from 8% in 1980-1986 to 60% in 2005-2010. The percentage of stage C colorectal cases less than 70 years of age having systemic therapy as part of their first treatment round increased from 3% in 1980-1986 to 81% by 1995-2010. Based on survey data on uptake of adjuvant therapy among those offered this care, it is likely that all these younger patients were offered systemic treatment. Conclusions: We conclude that pronounced increases in survivals from colorectal cancer have occurred at major public hospitals in South Australia due to increases in stage-specific survivals. Use of adjuvant therapies has increased and the patterns of change accord with clinical guideline recommendations. Reasons for sub-optimal use of radiotherapy for rectal cases warrant further investigation, including the potential for limited rural access to impede uptake of treatments at metropolitan-based radiotherapy centres.

A Case Report: Limitation of Mouth Opening in Dermatomyositis (개구장애를 동반한 피부근염 환자 증례)

  • Kim, Hye-Kyung;Kim, Ki-Suk;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.35 no.2
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    • pp.155-163
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    • 2010
  • Dermatomyositis (DM) is an idiopathic inflammatory connective tissue disorder and a systemic autonomic immune disease which shows a progressive muscle weakness and characteristic rash. It is identified by a characteristic rash accompanying, or more often preceding muscle weakness. Pathognomonic skin lesions are a blue-purple discoloration on the upper eyelids with edema (heliotropic rash), a flat red rash on the face and upper trunk, and erythema of the knuckles with a raised violaceous scaly eruption (Gottron's papule). The myopathy represents inflammatory and degenerative changes primarily affecting proximal muscles. DM often involves GI tract and respiratory system with as risk of 15-25% internal malignancy. It's managed with sun protection since muscle weakness as well as a rash could be aggravated by sun exposure. Systemic corticosteroid is an initial therapy and other immunosuppressive agent has been used as alternatives. Facial muscles are unaffected and masticatory muscles are rarely affected in DM. We present trismus close to muscle contracture in a patient with DM. Therefore, it needs continuous mouth-opening exercise to prevent progressive muscle contracture and to ensure normal mouth opening.

Dental hygiene students' knowledge, attitude in an influenza A (H1N1) (일부 치위생과 학생들의 신종인플루엔자 인식도 및 예방태도)

  • Lee, Hyang-Nim;Shim, Hyung-Sun
    • Journal of Korean society of Dental Hygiene
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    • v.11 no.3
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    • pp.301-311
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    • 2011
  • Objectives : In order to identify the awareness of influenza A (H1N1) having currently high frequency and risk as an infectious disease, to find problems and to reflect them on curriculum improvements from students before/after clinical practices. Methods : The data was collected from 279 dental hygiene students of 1st and 2nd years at G health college university from December 6th 2010 to December 10th 2010. The questionnaire were consisted of awareness of influenza A (H1N1), preventive attitude, sociodemographic characteristics. Results : 1. 1st year was 51.6%, the case having dental experience was 51.2%, in the infection control training experience 'had' was 46.6%. In the route acquiring the information, the mass media was 70.6%, in obtained information, personal hygiene was 82.1%. In the impact on human body, 'great impact' was 58.1%. In terms of the most need for response and preparedness, vaccination was the highest, 67.4%. People who experienced influenza A (H1N1) were 10.7%. 2. Awareness of influenza A (H1N1) was 0.71 points, and treatment and spreading mechanism was 0.78 points, prevention was 0.63 points, causes and definition was 0.53 points. 3. In the attitude for infection prevention of influenza A (H1N1), 'washing hands before practice' was the highest, 0.99 points and 'wear the mask only in case of contact with patient within 1~2 meters upon occurrence of no aerosol' was the lowest, 0.72 points. 4. Awareness of influenza A (H1N1) according to sociodemographic characteristics showed the significant differences upon the impacts on systemic health (p<0.05). Preventive attitude didn't show a significant difference in grade, clinical experience, experience in infection control training, acquiring rmation routes, the possibility for occurrence, impact on systemic health, the most need for prevention, experience in influenza A (H1N1) (p>0.05). 5. The significantly correlated between awareness of influenza A (H1N1) and preventive attitude(p<0.01). Conclusions : Information and preventive attitude for influenza A (H1N1) as well as systematic training programs to identify actual affecting factors and to improve the practice are needed. Also government's institutional support is needed.

Prosthetic rehabilitation with digital implant planning for a minimally invasive surgery approach (디지털 임플란트 플래닝을 통한 최소침습 보철수복 증례)

  • Jeong, Areum;Lee, Younghoo;Hong, Seoung-Jin;Paek, Janghyun;Noh, Kwantae;Pae, Ahran;Kim, Hyeong-Seob;Kwon, Kung-Rock
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.3
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    • pp.283-292
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    • 2022
  • For fixed prosthetic treatment using implants, implants must be placed in a suitable location for prosthetic treatment. During surgery, minimally invasive prosthetic restoration is possible using a flapless method using a surgical guide. The patient in this case was an 86-year-old male patient who wanted treatment due to discomfort when using conventional dentures. Due to systemic disease, the patient had difficulty using removable local dentures, so full dentures for the maxilla and fixed implants for the mandible were restored. Because there is a high risk of bleeding due to systemic disease, the implant was placed in a flapless method using a surgical guide. Finally, prostheses were fabricated with maxillary full denture and mandibular screw-retained zirconia, and this report shows satisfactory esthetic and functional recovery.