• Journal of Korean Academy of Nursing
• /
• v.23 no.2
• /
• pp.207-223
• /
• 1993

Inpatients are mostly occupied in bed with restricted activity, nearly all patient populations are at risk for the occurrence of skeletal muscle atrophy due to decreased level of activity. Restriction of mobility is far greater in pediatric patients compared with adult patients since almost all the activities of daily living is performed by parents or caregivers. It could be assumed that pediatric patients are more vulnerable to skeletal muscle atrophy than adult patients, however, there have been no attempts to reduce the atrophy of developing muscle. Therefore it is important to determine the effect of exercise in developing muscle during decreased activity. The purpose of this study was to determine the effect of periodic weight support during hindlimb suspension on the mass and cross-sectional area of Type I and II fibers in developing soleus(Type I ) muscle. To examine the effectiveness of periodic weight support activity in maintaining mass and fiber size. the hindlimb of young female Wistar rats was suspended(HS) and half of these rats walked on a treadmill for 45min / day(15min every 4h) at 5m / min at a 15 grade(HS-WS). After 7days of hindlimb suspension, soleus wet weight was 28. 57% smaller and relative soleus weight was 28. 21% smaller in comparison with con-trol rats (p〈0.05) Soleus wet weight and relative soleus weight increased by 67.72% and 71.43% each with periodic weight support activity during hindlimb suspension (p〈0.01, p〈0.005), moreover soleus wet weight and relative soleus weight of the HS -WS rats were greater than those of the control group. No change was observed in fiber type percentage of the developing soleus muscle after 1 week of hindlimb suspension plus weight support activity. Type I and II fiber cross-sectional areas of the developing soleus muscle were 50.45% and 43.39% lower in the HS group than in the control group (p〈0.0001), type I and II fiber cross-sectional areas of the developing soleus were 24.49% and 29.93% greater in the HS - WS group than in the HS rats (p〈0.0001), whereas Type I and II fiber cross-sectional areas of HS - WS group were less than those of the control group, The results suggest that periodic weight support activity can ameliorate developing soleus muscle atrophy induced by hindlimb suspension, even in type II fibers that would not have been expected to be recruited by this type of neuromuscular demand. Clinical experimental study is needed to deter-mine the effect of periodic weight bearing exercise on developing atrophied leg muscle based on these results.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.44 no.2
• /
• pp.210-219
• /
• 2017

This study aimed to investigate the prevalence and distribution of enamel hypomineralization, including molar-incisor hypomineralization (MIH), among adolescents and assess their correlation with esthetic satisfaction. A total of 1371 adolescents between the ages of 14 and 16 years in Yangsan city were evaluated for enamel hypomineralization, including MIH, according to the European Academy of Paediatric Dentistry (EAPD) criteria. In a parallel survey, esthetic satisfaction about anterior teeth and its correlation with incisor enamel hypomineralization were analyzed. The prevalence of MIH was 13.8% (n = 189), while that of hypomineralization in any permanent tooth was 23.2% (n = 318), which was substantially greater compared to the national prevalence of MIH. Mandibular first molars exhibited the highest prevalence of hypomineralization, followed by maxillary central incisors and mandibular second molars. Among anterior teeth, the most frequently affected site was the incisal edge of maxillary central incisors. A high degree of hypomineralization in anterior teeth was associated with a high demand for esthetic treatment.

• The Journal of Korean Academy of Prosthodontics
• /
• v.41 no.5
• /
• pp.674-688
• /
• 2003

Statement of Problem : With increasing demand of the implant-supported prosthesis, it is advantageous to use the different platform width of the fixture according to bone quantity and quality of the patients. Purpose : The purpose of this study was to assess the loading distributing characteristics of two implant designs according to each platform width of fixture, under vertical and inclined loading using finite element analysis. Material and method : The two kinds of finite element models were designed according to each platform width of future (4.1mm restorative component x 11.5mm length, 5.0mm wide-diameter restorative component x 11.5mm length). The crown for mandibular first molar was made using UCLA abutment. Each three-dimensional finite element model was created with the physical properties of the implant and surrounding bone. This study simulated loads of 200N at the central fossa in a vertical direction, 200N at the outside point of the central fossa with resin filling into screw hole in a vertical direction and 200N at the buccal cusp in a 300 transverse direction individually Von Mises stresses were recorded and compared in the supporting bone, fixture, and abutment screw. Results : The stresses were concentrated mainly at the cortex in both vertical and oblique load ing but the stresses in the cancellous bone were low in both vertical and oblique loading. Bending moments resulting from non-axial loading of dental implants caused stress concentrations on cortical bone. The magnitude of the stress was greater with the oblique loading. Increasing the platform width of the implant fixture decreased the stress in the supporting bone, future and abutment screw. Increased the platform width of fixture decreased the stress in the crown and platform. Conclusion : Conclusively, this investigation provides evidence that the platform width of the implant fixture directly affects periimplant stress. By increasing the platform width of the implant fixture, it showed tendency to decreased the supporting bone, future and screw. But, further clinical studies are necessary to determine the ideal protocol for the successful placement of wide platform implants.

• Fire Science and Engineering
• /
• v.29 no.5
• /
• pp.96-103
• /
• 2015

This study investigates the socio-economic and clinical characteristics associated with emergency medical transport use by the elderly based on 2008~2011 Korea Health Panel data. A model of emergency medical transport use was analyzed, and the results indicate that use of 119 ambulances and private ambulances by the elderly accounted for 46.8% of all users, and 35.1% of their emergency room visits. Statistically significant factors associated with emergency medical transport use were gender (OR = 2.19, 95% CI = 1.51-3.17), relationship to household (OR = 2.19, 95% CI = 1.45-3.32), insurance type (OR = 1.41, 95% CI = 1.10-1.82), handicap (OR = 1.44, 95% CI = 1.14-1.83), reason for emergency department visits (OR = 1.53, 95% CI = 1.20-1.97), and treatment after emergency medical service completed (OR = 3.45, 95% CI = 2.80-4.25). The increased elderly population in an aging society will lead to a surge in demand for emergency patient transport services, and emergency medical services that are tailored to the elderly need to be developed accordingly.

• Journal of Korean Academy of Nursing
• /
• v.23 no.1
• /
• pp.68-89
• /
• 1993

This study was conducted to develop a model of a fee schedule for nursing services.'Regardless of the demand for skilled and professional nursing service today, the Korean health insurance system does not furnish a chapter for the nursing service fee schedule. A nation-wide survey of hospital nursing service fee schedules was to provide practical and realistic data about how the variety of nursing services are being charged. From September 1990 to April 1991, data from the fee schedule used by twenty hospitals located in eight large cities which are designated large medical regions in the Korea Health Care and Patient Referral System were collected. Nursing services and the fees charged for them were analyzed. The nursing services were subjected to a secondary analysis with referrence to reports on “nursing services to be charged in Korea”. The total number of nursing services recommended by the literatures was 177 : finally 141 types of nursing services were selected by investigator as chargable nursing services. In addition, data on managerial characteristics of the hospitals were collected to discover influential variables for a nursing fee schedule model. Under the assumption that all the managerial characteristics of the hospitals influenced the fee schedule, the following model was tested : Fee of nursing services (C) = f(A₁, A₂, A₃, A₄, A/sub 5/, A/sub 6/, A/sub 7/, A/sub 8/,) When, A₁ = number of nurses A₂ = the first salary of a nurse educated in a four year A₃ = scale of nursing management division A₄ = location of the hospital A/sub 5/ = the type of hospital management (profit / non-profit) A/sub 6/ = number of hospital beds A/sub 7/ = years of hospital operation A/sub 8/ = number and kinds of clinical divisions The results showed that the model should be built as follows : C = f (A₁, A/sub 4/, A/sub 5/) Each nursing service was applied to the fee schedule with consideration for the professional level and time-taken to provide the services. Detailed fee schedules were presented in the related tables. Of the 141 kinds of nursing services, 24.8% were chargeble to the Korea Health Insurance, 32.6％ of the nursing services were being paid directly by the patienty. The rest of nursing services (42.6％) were not being charged to any source. It was recommened that the Korea Health Insurance Reimbursement system should add a classification system for nursing services that can be used in the national health care program. Further study is needed about how to include 32.6% of the nursing services now being paid for directly by the patients in the health insurance system.

• Journal of Society of Preventive Korean Medicine
• /
• v.6 no.1
• /
• pp.1-14
• /
• 2002

The proportion and role of public sector in health care industry is very small in Korea. Asymmetric distribution of health care resources is one of the major health care concerns. This issue is so important that it raises a question of accessibility, availability, continuity of care and equity of rural area people's health care utilization. To solve these problems and to satisfy the basic demand of oriental medical service in rural areas, the oriental public health doctors were placed in rural health centers since 1998. The main objectives of this study are twofold: to measure the cognition and attitude of health center directors on the strategies for utilizing oriental public health doctors and to provide basic data for improving the health manpower management program. Data have been collected by way of the self-administrative questionnaires. Developing the questionnaire, the literature review on the previous studies and delphi method were carried out. The response rate was 38.7%. The results of this study are summarized as follows; 1. community people respond positively on the oriental medical service activity in health center. 2. In regard to workloads of oriental public health doctor, 'appropriate' was 81.1% and 'burdensome' was 18.2%, respectively. 3. The 94.0% of respondents thought that the oriental medical service will be continued. 4. To activate oriental medical service in health center, the sufficient budget and provision of aid workers is a necessity. 5. The 75.5% of health center directors respond positively on the allocation of oriental public health doctor to health sub-centers. 6. Health center directors agreed that oriental public health doctor should perform the clinical service as well as prevention and health promotion activity. These results recommend that oriental medical service in health center should be continued gradually, and oriental public health doctors working at health center perform their work efficiently. Undoubtedly, their activity should be more focused on health promotion and disease prevention than daily patient care. For achieving this objective, more support of governmental policy is essential for utilizing oriental public health doctor and better health of the rural area community people.

• Journal of Chest Surgery
• /
• v.53 no.6
• /
• pp.339-345
• /
• 2020

Background: Iliac artery aneurysm is frequently found in patients undergoing surgical repair of an abdominal aortic aneurysm. The use of commercial bifurcated grafts is insufficient for aorto-biiliac replacement with complete iliac artery aneurysm resection. We evaluated the effectiveness of handmade composite grafts for this purpose. Methods: A total of 233 patients underwent open surgery for abdominal aortic aneurysm between 2003 and 2019, including 155 patients (67%) treated with commercial grafts and 78 patients (33%) treated with handmade composite grafts. Their operative characteristics, postoperative outcomes, and late outcomes were retrospectively reviewed. Results: The early mortality rate did not differ significantly between the groups. On average, the handmade composite graft technique took approximately 15 minutes longer than the commercial graft technique (p=0.037). Among patients who underwent elective surgery, no significant differences between the conventional and composite groups were observed in the major outcomes, including red blood cell transfusion volume (2.8±4.7 units vs. 3.1±4.7 units, respectively; p=0.680), reoperation for bleeding (2.7% vs. 3.1%, respectively; p>0.999), bowel ischemia (0% vs. 1.6%, respectively; p=0.364), and intensive care unit stay duration (1.9±6.6 days vs. 1.6±2.4 days, respectively; p=0.680). The incidence of target vessel occlusion also did not differ significantly between groups. Conclusion: The increased technical demand involved with handmade composite grafting did not negatively impact the outcomes. This technique may be a viable option because it overcomes problems associated with commercial grafts.

• Journal of Korean Neurosurgical Society
• /
• v.29 no.6
• /
• pp.763-771
• /
• 2000

Objectives : Thoracolumbar burst fractures(TBLF) result in not only compressive deformity of vertebral body but also spinal cord compression by bony fragments. Many thoracolumbar burst fractures demand both anterior decompression and intervertebral fusion. Most of spinal surgeons use anterior instrumentation for anteior intervertebral bony fusion. The use of Z-plate has been increased recently, however there has been only a few reports regarding its clinical long-term strength. We studied nineteen patients with TBLF to find out the long-term stability of Z-plate. Methods : We have operated 19 patients from March 1996 to August 1998. They were treated with anterior decompression through either a transthoracic, retroperitoneal extrapleural or retroperitoneal approach. Retropulsed bony fragments were removed completely by corpectomy. Iliac bone graft was used for interbody fusion in all of the cases. They were evaluated by plain X-ray films including flexion and extention lateral films. Cobbs angle was used to evaluate kyphotic and lateral wedging deformity. Results : Burst fractured sites were T11 in two, three T12, nine L1, and five L2. Mean follow-up duration was fifteen months. Preoperative average kyphotic angle was 23.7 degree. Immediate postoperative kyphotic angle was 10.2 degree. Follow-up resluts of average kyphotic angles revealed 14 degrees. Four patients(21%), including two spinal 3-column injury, showed increasement of kyphotic angle more than 5 degree or breakage of intrumentation. Two patients showed the difference of kyphotic angle more than 3 degree. Five patients(26%) revealed lateral wedging deformity more than 3 degrees. Postoperative complications were two meralgia parestheticas, one pulmonary atelectasis and two donor site infections. Four of the eight patients, who initially showed incomplete spinal cord deficits, were nerologically improved by Frankel's grade. Conclusion : Z-plate fixation and iliac bone graft after anterior decompression in thoracolumbar burst fractures is a safe and easy method. Immediate postoperative results revealed excellent correction of posttraumatic kyphosis, but long-term follow-up evalution showed insufficient strength. Therefore we believe that use of Z-plate should be carefully decided, especially in the case of large lumbar fracture or 3-column injury.

• Journal of Radiopharmaceuticals and Molecular Probes
• /
• v.2 no.2
• /
• pp.123-131
• /
• 2016

Increasing clinical demand for carbon-11 labeled radiopharmaceuticals has triggered technological advances in fields of radiochemistry and automated modules. Even though carbon-11 has a short half-life ($t_{1/2}=20.4min$), the consecutive second production of carbon-11 labeled radiopharmaceutical in one $^{11}C$-synthetic module should be delayed at least over 4 h to avoid the high radiation exposure. We herein aimed to produce two different carbon-11 labeled radiopharmaceuticals ([$^{11}C$]PIB and [$^{11}C$]methionine) by sharing of [$^{11}C$]methylation source in one $^{11}C$-synthetic module. The synthesis of $^{11}C$-labeling reagents ($[^{11}C]CH_3I$ or $[^{11}C]CH_3OTf$) is fully automated using the commercial TRACERlab $FX_{C-pro}$ module and is readily adaptable to $^{11}C$-labeling reactor for [$^{11}C$]PIB as well as another $^{11}C$-labeling apparatus for [$^{11}C$]methionine via the three-way valve. After completing the [$^{11}C$]PIB production, the re-synthesized $[^{11}C]CH_3I$ was passed through the three-way valve connected the polyetheretherketone (PEEK) line and loaded into the C18 Sep-Pak cartridge including the methionine precursor. The labeled product [^${11}C$]methionine was purified by a simple cartridge separation and reformulated into saline. The radiochemical yield of [$^{11}C$]PIB and [$^{11}C$]methionine were $5.3{\pm}0.6%$ and $18.7{\pm}0.8%$ (n.d.c.), respectively, with over 97% of radiochemical purity. The specific activity of [$^{11}C$]PIB was over $110GBq/{\mu}mol$. Total production time of two radiopharmaceuticals needs about 2 h from $1^{st}$ beam irradiation including quality control tests. Final [$^{11}C$]PIB and [$^{11}C$]methionine were satisfied all quality control test standards.

• The Journal of Korean Academy of Prosthodontics
• /
• v.38 no.2
• /
• pp.129-146
• /
• 2000

An increasing demand for esthetic restorations has led to the development of new ceramic systems. In-Ceram, a glass-infiltrated alumina ceramic has three to few times greater flexural strength than other ceramic glass material. Because of its high strength, In-Ceram has been suggested as inlay, crown, laminate veneer and core material for resin bonded fixed partial dentures. This clinical application requires a stable resin bond to In-Ceram core. The purpose of this study was to evaluate the shear bond strength between In-Ceram core and resin cements according to various surface treatments and storage conditions. The surface of each In-Ceram core sample was subjected to one of the following treatments and then bonded to Panavia 21 or Variolink II resin cement. ; (1) sandblasting with $110{\mu}m$ aluminum oxide powder, (2) sandblasting and silanization, (3) sandblasting and Siloc treatment, (4) sandblasting and Targis link application. Each of eight bonding groups was tested in shear bond strengths after the following storage times and thermocycling. ; A) 24 hours storage in distilled water at $37^{\circ}C$, B) 5 weeks storage in distilled water at $37^{\circ}C$ C) 5 weeks storage in distilled water at $37^{\circ}C$ and thermocycled 2,000 thormocycling for every 10 days(totally 10,000 thermocycting) in $5^{\circ}C-55^{\circ}C$ bath. The bond failure modes were observed with scanning electron microscope(SEM). The results were as fellows : 1 The shear bond strengths of sandblasting group were significantly lesser than the other groups after 24 hours water storage. No significant difference of bonding strengths was found between storage time conditions(24 hours and 5 weeks). The shear bond strengths showed a tendency to decrease in Variolink II bonding groups and to increase in Panavia 21 bonding groups. 3. After thermocycling, the shear bond strengths of all groups were significantly decreased(p<0.01) and Targis link group exhibited significantly greater strengths than the other groups(p<0.05). 4. Panavia 21 bonding groups exhibited significantly greater bonding strengths in sandblasting group(p<0.01) and silane group(p<0.05) than Variolink II bonding groups. 5. In observation of bond failure modes, Targis link group showed cohesive failure in resin part and silane group and Siloc group showed complex failure and sandblasting group showed adhesive failure between In-Ceram and resin.