• 제목/요약/키워드: cooperative treatment

검색결과 348건 처리시간 0.024초

치과 치료 시 진정법 시행에 대한 실태 조사 연구 (A Survey of Sedation Practices in the Korean Dentistry)

  • 배치훈;김혁;조경아;김미선;서광석;김현정
    • 대한치과마취과학회지
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    • 제14권1호
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    • pp.29-39
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    • 2014
  • Background: Dental phobia or anxiety of patients is the serious impediment to appropriate and effective dental treatment. Sedative technique helps to mitigate patients' fear and anxiety thus make them more cooperative and familiar to dental practices. With increasing attention to sedative dentistry in dentists, educational requirements and technical qualification also become stricter but actual survey on recent sedative dentistry has not been reported yet. Especially there is insufficient study reporting the survey of sedative dentistry subjected to Korean adults. In this paper, we conducted a survey study on the actual condition and practice related to sedation with a questionnaire to dentists in South Korea. Methods: The survey was done for members of The Korean Dental Society of Anesthesiology (KDSA), who had great interest in sedation and for whom survey-by-mail was convenient. 472 members of The KDSA having dental license and solid address and contact information were subjected to the survey by sending them survey questions about their sedative techniques and knowledge. In order to increase the response rate, small gifts were presented to those who accurately responded to the survey questions and text messages and phone calls were made to encourage their participation. We collected their responses over two months and examined the returned surveys. Statistical analysis was performed using IBM SPSS Statistics 21 for each question. Results: Out of 472 dentists, 181 responded (38.4% response rate). 63.0% (114 dentists; 77 male and 37 female) of respondents had experience on sedative technique and their average age was $39.8{\pm}7.6$ year. 74 of them were private practitioners, 17 of them were professors (14.9%), 11 of them were dentists-in-service (9.6%), 11 of them were residents (specialist training) (9.6%) and 1 of them was military doctors (0.9%). There were 89 dentists (78.1%) who were specialists or receiving trainings to be specialist, most of whom were pediatric dentists (55, 48.2%) and oral surgeon (31, 27.2%). The most popular route for drug medications was orderly oral, inhalational, intravenous medication. Combination of oral and inhalational medications or single use of intravenous medication was the most common. The most preferred sedative drug was pocral in oral sedation and midazolam in intravenous sedation. 48.2% of practitioners responded that they experienced side effects and emergency situations. Airway obstruction was the most frequent. Conclusions: Results from the survey show that the protocol and system for sedative dentistry have been improved compared to the past. Nevertheless, quality of emergency protocol, monitoring devices and preparation of sedative drugs was still insufficient to achieve safe sedative procedure. This study acquires novelty since actual survey on recent sedative dentistry for adult patients has not been reported yet.

Talc 늑막유착술 이후 발생한 치명적 저산소증 2 예 (Two Cases of Fatal Hypoxemia after Talc Pleurodesis for Recurrent Malignant Pleural Effusion)

  • 박신애;이한희;김대준;심병용;송소향;김치홍;안명임;조덕곤;조규도;김훈교
    • Tuberculosis and Respiratory Diseases
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    • 제62권3호
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    • pp.217-222
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    • 2007
  • 저자들은 악성흉수 환자에서 가장 많은 치료법으로 선택되고 있는 talc 늑막유착술 이후에 급성 저산소증으로 사망한 환자 2예를 경험하였다. Talc 늑막유착술은 안전하고 효과적인 치료이지만, talc를 5 g 이상 사용하거나, 전신상태가 불량하거나, 반복적인 늑막유착술을 시행한 경우나, 양측에 흉수가 있거나, 늑막유착술 전 2주 이내에 항암요법이나 방사선치료를 한 경우나 폐실질에 전이성병변이 있을 때 예후가 불량하므로 talc 늑막유착술 환자를 선정할 때 주의하여야 하겠다.

Epidemiological Survey on the Infection of Intestinal Flukes in Residents of Muan-gun, Jeollanam-do, the Republic of Korea

  • Cho, Shin-Hyeong;Cho, Pyo-Yun;Lee, Dong-Min;Kim, Tong-Soo;Kim, In-Sang;Hwang, Eun-Jung;Na, Byoung-Kuk;Sohn, Woon-Mok
    • Parasites, Hosts and Diseases
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    • 제48권2호
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    • pp.133-138
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    • 2010
  • Infection status of intestinal flukes was investigated in residents of Muan-gun, Jeollanam-do, the Republic of Korea. Total 1,257 fecal samples of residents were examined by formalin-ether sedimentation technique and Kato-Katz thick smear method. Helminth eggs were detected from 95 (7.6%) residents, and eggs of heterophyid flukes and Clonorchis sinensis were found from 62 (4.9%) and 40 (3.2%) cases, respectively. The larger heterophyid eggs, somewhat darkbrown in color and $37.7{\times}21.5{\mu}m$ in average size, and found in 32 (2.6%) out of 62 egg positive cases of heterophyid flukes. To confirm the adult flukes, we performed worm recovery from 12 cases after praziquantel treatment and purgation with $MgSO_4$. A total of 1,281 adult flukes, assigned to 7 species, were recovered from 9 cooperative cases. Heterophyes nocens (total 981 specimens) was collected from 9 cases, Stictodora fuscata (80) from 7, Gymnophalloides seoi (75) from 5, Pygidiopsis summa (140) from 3, Stellantchasmus falcatus (3) from 2, and Stictodora lari and Acanthotrema felis (each 1 worm) from 1 case each. The intrauterine eggs of S. fuscata collected from the recovered worm were identical with the larger heterophyid eggs detected in the stool examination. By the present study, it was confirmed that A. felis is a new intestinal fluke infecting humans, and residents in Muan-gun, Jeollanam-do are infected with variable species of intestinal trematodes.

Spatiotemporal Trends of Malaria in Relation to Economic Development and Cross-Border Movement along the China-Myanmar Border in Yunnan Province

  • Zhao, Xiaotao;Thanapongtharm, Weerapong;Lawawirojwong, Siam;Wei, Chun;Tang, Yerong;Zhou, Yaowu;Sun, Xiaodong;Sattabongkot, Jestumon;Kaewkungwal, Jaranit
    • Parasites, Hosts and Diseases
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    • 제58권3호
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    • pp.267-278
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    • 2020
  • The heterogeneity and complexity of malaria involves political and natural environments, socioeconomic development, cross-border movement, and vector biology; factors that cannot be changed in a short time. This study aimed to assess the impact of economic growth and cross-border movement, toward elimination of malaria in Yunnan Province during its pre-elimination phase. Malaria data during 2011-2016 were extracted from 18 counties of Yunnan and from 7 villages, 11 displaced person camps of the Kachin Special Region II of Myanmar. Data of per-capita gross domestic product (GDP) were obtained from Yunnan Bureau of Statistics. Data were analyzed and mapped to determine spatiotemporal heterogeneity at county and village levels. There were a total 2,117 malaria cases with 85.2% imported cases; most imported cases came from Myanmar (78.5%). Along the demarcation line, malaria incidence rates in villages/camps in Myanmar were significantly higher than those of the neighboring villages in China. The spatial and temporal trends suggested that increasing per-capita GDP may have an indirect effect on the reduction of malaria cases when observed at macro level; however, malaria persists owing to complex, multi-faceted factors including poverty at individual level and cross-border movement of the workforce. In moving toward malaria elimination, despite economic growth, cooperative efforts with neighboring countries are critical to interrupt local transmission and prevent reintroduction of malaria via imported cases. Cross-border workers should be educated in preventive measures through effective behavior change communication, and investment is needed in active surveillance systems and novel diagnostic and treatment services during the elimination phase.

유통 중 신선편이 버섯 제품의 포장실태 및 관능적 품질 조사 (Survey on packaging status and sensory quality of fresh-cut mushrooms from retail markets)

  • 최지원;이혜은;이지현;김용필;김지강
    • 한국버섯학회지
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    • 제12권4호
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    • pp.287-292
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    • 2014
  • 신선편이 버섯의 유통 시 포장실태 및 관능적 품질을 파악하기 위하여 2009년 1월~10월에 계절별로 수도권 인근의 대형할인마트를 직접 방문하여 신선편이 버섯 제품 총 51종을 수집하여 조사하였다. 수집된 신선편이 버섯은 혼합형과 단독형으로는 느타리버섯, 팽이버섯은 송이채 다듬어지거나 큰느타리버섯, 표고버섯은 슬라이스나 다이스 절단되어 바로 조리(튀김, 볶음, 전골, 육개장, 찌개 등) 에 사용할 수 있도록 하였고 대부분이 알루미늄이나 PS, PET, nylon 등을 재료로 한 용기에 담겨 PVC 랩이나 견고한 PP, PS 덮개 형태로 포장되었으며 89%가 제조일이나 유통기한을 표시하였다. 수집된 신선편이 버섯 제품의 관능학적 품질 조사 결과, 갈변 발생이 심한 것이 10%, 이취 발생이 심한 것이 4%를 차지하였으며 전체적 품질은 90%의 제품이 판매 가능한 수준이었다. 계절에 따른 관능학적 품질에 차이를 보여 가을과 겨울에는 상품성이 높게 유지되었으나 봄과 여름에는 갈변이나 이취 발생 억제를 위한 신선도 관리에 유의할 필요가 있는 것으로 판단되었다.

노인장기요양보험제도에 관한 치과종사자의 인식도 연구 (A study on dental professionals' recognition on a system of long-term care insurance for the elderly)

  • 안권숙;지민경;민희홍
    • 한국치위생학회지
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    • 제9권1호
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    • pp.169-180
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    • 2009
  • This study grasped recognition on a system of long-term care insurance for the elderly targeting dental professionals who are working at dental hospitals and clinics where are located in Daejeon Metropolitan City. It developed and utilized materials available for educating the care staff in a system of long-term care insurance for the elderly and the dental professionals who participate in the oral hygiene service. It carried out the effective duty performance for the elderly in a situation of long-term care protection. Thus, the purpose of this study was to contribute to the early settlement in a system of long-term care insurance for the elderly. The following conclusions were obtained as a result of having carried out self-administered questionnaire research targeting 238 people from August 1 to August 30 in 2008. 1. In the general characteristics of the research subject, the present working place was indicated to be 22.7% for dental hospital, 71.8% for dental clinic, and 5.5% for others. As for the main duty field, the medical treatment & cooperative duty was indicated to be the highest with 61.8%, and was statistically significant(p=0.000). 2. The necessity for a system of long-term care insurance for the elderly was indicated to be 77.7% for 'necessary' and 1.7% for 'unnecessary,' and was statistically significant(p=0.016). 3. In the item of dividing the service of long-term care insurance for the elderly, the dental hygienists showed higher recognition than non-dental hygienists, and indicated significant difference(p=0.010). 4. As for recognition on a system of long-term care insurance for the elderly in dental professionals who responded as saying of 'knowing name and contents' about a system of long-term care insurance for the elderly, the recognition level was high in recognition of subjects' age(p=0.000), division in services(p=0.012), contents in at-home care service(p=0.000), execution in oral-hygiene service(p=0.004), procedure of using the long-term care insurance for the elderly(p=0.016), item of judging grade of long-term care insurance for the elderly(p=0.013), medical charge by service according to judging grade of long-term care insurance for the elderly(p=0.015), burden of cost for a system of long-term care insurance for the elderly(p=0.011), qualification of care staff(p=0.002), and contents of oral-hygiene service(p=0.027), and showed significant difference. 5. The service of long-term care insurance for the elderly and the oral-hygiene service indicated the statistically significant correlation. Accordingly, all of dental professionals need to make a desperate effort to improve dental professionals' knowledge on a system of long-term care insurance for the elderly enough to be required a system of long-term care insurance for the elderly. The more systematic and standardized professional education and materials are thought to be needed to be developed aiming at the success in oral-hygiene service within a system of long-term care insurance for the elderly, by strengthening professionalism in dentists and dental hygienists.

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Prognostic factors in children with extracranial germ cell tumors treated with cisplatin-based chemotherapy

  • Kim, Jinsup;Lee, Na Hee;Lee, Soo Hyun;Yoo, Keon Hee;Sung, Ki Woong;Koo, Hong Hoe;Seo, Jeong-Meen;Lee, Suk-Koo
    • Clinical and Experimental Pediatrics
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    • 제58권10호
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    • pp.386-391
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    • 2015
  • Purpose: To evaluate the outcomes and prognostic factors in children with extracranial germ cell tumors (GCTs) treated at a single institution. Methods: Sixty-six children diagnosed with extracranial GCTs between 1996 and 2012 were included in the study. Primary treatment was surgical excision, followed by six cycles of cisplatin-based chemotherapy. The survival rates were compared according to the International Germ Cell Cancer Cooperative Group classification used for GCTs in adults to validate the classification guidelines for GCTs in children. Results: The median patient age was 4.4 years. In 34 patients (51.5%), the primary tumor site was the gonad. Extragonadal GCTs were detected in 32 patients. The 5-year overall survival and event-free survival (EFS) were $92.0%{\pm}3.5%$ and $90.4%{\pm}3.7%$, respectively. In univariate analysis, tumor histology, metastasis, and elevated alpha-fetoprotein were not prognostic factors in children with extracranial GCTs. However, EFS was poorer in patients with mediastinal disease (n=12, $66.7%{\pm}13.6%$) than in those with nonmediastinal disease (n=54, $96.0%{\pm}2.8%$) (P=0.001). The 5-year EFS was lower in patients older than 10 years, (n=21, $80.0%{\pm}8.9%$) compared with those younger than 10 years (n=45, $95.2%{\pm}3.3%$) (P=0.04). Multivariate analysis identified the mediastinal tumor site as the only independent prognostic factor. Conclusion: The prognosis of children with extracranial GCTs was favorable. However, nongerminomatous mediastinal tumors were associated with poor survival in children. Further research is needed to improve the prognosis of children with malignant mediastinal GCTs.

Three-dimensional conformal radiotherapy for portal vein tumor thrombosis alone in advanced hepatocellular carcinoma

  • Lee, Ju Hye;Kim, Dong Hyun;Ki, Yong Kan;Nam, Ji Ho;Heo, Jeong;Woo, Hyun Young;Kim, Dong Won;Kim, Won Taek
    • Radiation Oncology Journal
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    • 제32권3호
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    • pp.170-178
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    • 2014
  • Purpose: We sought to evaluate the clinical outcomes of 3-dimensional conformal radiation therapy (3D-CRT) for portal vein tumor thrombosis (PVTT) alone in patients with advanced hepatocellular carcinoma. Materials and Methods: We retrospectively analyzed data on 46 patients who received 3D-CRT for PVTT alone between June 2002 and December 2011. Response was evaluated following the Response Evaluation Criteria in Solid Tumors. Prognostic factors and 1-year survival rates were compared between responders and non-responders. Results: Thirty-seven patients (80.4%) had category B Child-Pugh scores. The Eastern Cooperative Oncology Group performance status score was 2 in 20 patients. Thirty patients (65.2%) had main or bilateral PVTT. The median irradiation dose was 50 Gy (range, 35 to 60 Gy) and the daily median dose was 2 Gy (range, 2.0 to 2.5 Gy). PVTT response was classified as complete response in 3 patients (6.5%), partial response in 12 (26.1%), stable disease in 19 (41.3%), and progressive disease in 12 (26.1%). There were 2 cases of grade 3 toxicities during or 3 months after radiotherapy. Twelve patients in the responder group (15 patients) received at least 50 Gy irradiation, but about 84% of patients in the non-responder group received less than 50 Gy. The 1-year survival rate was 66.8% in responders and 27.4% in non-responders constituting a statistically significant difference (p = 0.008). Conclusion: Conformal radiotherapy for PVTT alone could be chosen as a palliative treatment modality in patients with unfavorable conditions (liver, patient, or tumor factors). However, more than 50 Gy of radiation may be required.

농약의 사용과정과 중독에 관한 사회의학적 고찰 (A Socio-medical Study on the Usage and Poisoning of Pesticides)

  • 차민영;차형훈;염용태
    • 농촌의학ㆍ지역보건
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    • 제9권1호
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    • pp.18-26
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    • 1984
  • With the increase of using pesticides, pesticide poisonings become more frequent. In the previous epidemiological study on pesticide poisoning and the reports of the authorities concerned, it is carefully affirmed that pesticide poisonings are caused by farmers' ignorance and negligence in using the pesticides. But the pesticide poisoning should be taken into account in terms of the person who sprays the pesticides, its spraying process, farming style and farmers' socio-economic conditions. And based on the understanding mentioned above, preventive measures for pesticide poisoning should be established. In this socio-medical point of view, this study examined the public health problems caused by using pesticides and the treatment of pesticide poisoning, based on the interviews with farmers in a area of Kyunggi-Do about the spraying process of pesticides, poisoning experiences and its treatments. The results are as follows ; 1) The style of spraying pesticides in the target area is mostly an individual one, not cooperative one. And the subjects of spraying are householders, whose educational backgrounds are beneath notice. More than 2~5 of the subjects are women or old men of 60 years old or so. These are seen to derive from the socio-economic status of Korean agricultural families; their younger generation's moving to greater cities and their petty farming styles. 2) As for the safety measures for the spraying of pesticides, those which have nothing to do with the economic, problems such as efficient spraying and productivity, are well obeyed. On the other hand, some safety measures as the use of safety devices, and spraying time, the degree of dilution of pesticides and the spraying method In windy days, are not obeyed very well, for to keep those makes spraying difficult to do and productivity worse. These facts indicate that the safety measures for using pesticides must be directly concerned with the spraying process, farming style and farmers' socio economic status, rather than the subject's knowledge or carefulness. 3) Even In cases of poisoning they do rarely consult the doctors. This is caused by the problem of their locality and transportation since one should pass away a day even in the busiest season to consult doctors, and by their low socio-economic status. 4) The epidemiological studies on pesticide poisonings should be necessarily led to a socio-medical one which are concerned together with the spraying process of pesticides, farming style, farmer's socio-economic status and discrepancies in public health policies between agricultural communities and urban ones.

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완화적 시술을 받은 악성 위장관 폐색 말기 암환자의 임상적 예후인자 (Clinical Prognostic Factors of Terminal Cancer Patients with Palliative Procedures for Malignant Gastrointestinal Obstruction)

  • 문도호;최화숙
    • Journal of Hospice and Palliative Care
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    • 제8권2호
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    • pp.200-208
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    • 2005
  • 목적: 악성 위장관 폐색 환자에서 완화적 시술이나 수술은 폐색의 다양한 증상을 조절할 뿐만 아니라 삶의 질을 향상시킨다. 본 연구는 완화적인 시술을 받았던 악성 위장관 폐색 말기암 환자의 임상적 특징과 예후인자를 알아보고자 하였다. 방법: 2002년 5월부터 2005년 5월까지 본원에서 악성 위장관 폐색으로 진단받아 완화적인 시술을 받았던 48명의 말기암 환자를 대상으로 후향적으로 조사하였다. 완화적인 암절제 환자는 제외하였다. 임상적 특성과 시술내용을 조사하였고 예후인자는 log-rank test를 이용한 단변량 분석을 하고 통계적으로 의미 있는 인자는 Cox's proportional hazard model을 사용하여 다변량 분석을 하였다. 결과: 연령의 중앙값은 65세이고 남자가 25명(52%), 여자가 23명(48%)이었다. 가장 많은 암은 대장직장암으로 26명(55%)이고 다음으로 10명(21%)의 위암이었다. 치료를 전혀 받지 않았던 환자는 25명(58%)이었고 20명(42%)은 치료를 받았으며 이 중 18명은 항암 치료를 받은 과거력이 있었다. 가장 흔한 증상은 통증으로 15명(31%)이었다. 활동도 1점 혹은 2점이 23명(48%), 3점 혹은 4점이 25명(52%)이었다. 가장 많은 완화적인 시술은 대장루술로 19명이 받았다. 완화적 시술로 인한 사망은 없었다. 단변량과 다변량 분석에 의해서 전체 생존기간과 무증상 생존기간에 대하여 활동도 만이 의미있는 독립 예후인자였다. 전체 중간 생존기간은 150일이었으며 무증상 중간 생존기간은 90일이었다. 결론: 완화적 시술을 받은 악성 위장관 폐색 환자의 전체 중간 생존기간과 무증상 중간 생존기간에 대하여 활동도만이 유일한 독립 예후인자였다.

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