• 제목/요약/키워드: impression

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The Experience of Medical Conflict and the Educational Needs of Dental Hygienists (치과위생사의 의료분쟁과 관련한 경험 및 교육 요구도 조사)

  • Yang, Eun Mi;Park, Sang Jun;Kim, Hye-Jin
    • Journal of dental hygiene science
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    • 제15권3호
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    • pp.361-368
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    • 2015
  • The study was conducted to provide data for the development of effective medical conflict prevention programs for dental hygiene by analyzing the dental experience conflicts. A self-administered questionnaire survey was conducted targeting dental hygienists who were performing dental assistance at university hospital, dental hospital and dental clinic in Busan and Gyeongnam regions from April 1 to 30, 2014. Collected questionnaires of 212 dental hygienists were then analyzed with IBM SPSS Statistics ver. 20.0 program. A total of 59.4% had experienced complaints, discontents and medical disputes and 24% of these had experienced a legal trouble developed from such and 95.3% were anxious and doubtful about a possible future medical dispute to some degree. Patient complaints, complaints of non-medical issues raised by 24.3% was the most common, notices, maps and descriptions in relation to the issues raised by 14.4%, is related to the impression issue was raised in the order of 13.5%. Occurrence of disputes did not show a significant difference by place of work, however, a possibility of development of dispute into a legal proceeding showed a significant difference depending on service career and it was investigated that the experienced group feels more pressures with regard to a medical dispute according to their experience of such. All respondents said that education on a prevention and countermeasures of medical disputes is necessary. Understanding of dental hygienists on medical related laws regarding the scope of duty is required to be enhanced and, in order to do so, opportunities to receive an education with regard to a prevention and countermeasures of medical disputes are to be expanded.

의료인의 호스피스가정간호에 대한 지식과 태도 조사연구

  • Kim, Ok-Gyeom
    • Korean Journal of Hospice Care
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    • 제2권2호
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    • pp.28-48
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    • 2002
  • The advances of medical technologies have not only prolonged human life span, but also extended suffering period for the patients with incurable medical diseases. Hospice movement was developed to help these patients keep dignity and lives peaceful at the end of their life. Since many patients prefer to spend the last moment of life at home with their family, hospice home care has become very popular worldwide. The purpose of this study for a promotion and development of hospice home care in Korea, and features basic research on medical profession's knowledge and attitudes to hospice home care. This study which was used for the research questionnaires developed by the researcher that were answered by 100 physicians and 127 nurses in a general hospital. Data were collected from April 22, 2002 to May 10, 2002. The SPSS was used to make a comparative analysis of the frequency, percentile, ANOVA, and x2-test. The results of the study were as follows; 1.The medical profession showed high level of knowledge of the definition and philosophy of hospice. However, the physician group of the examinees showed insufficient knowledge of the fact that hospice care includes bereavement care, while the nurse group's response to the same question showed a significant difference(x2=10.752, p=.001). 2.For whom the hospice home care is provided, 95.6% of the respondents showed very high level of knowledge as answering that the incurable terminal illness patients and their families are the beneficiaries of hospice care. The respondents counted nurses, volunteers, pastors, physicians and social workers, consecutively, as hospice care providers. More nurse were positive toward pastors than physicians in regarding as a hospice care provider by a significant difference(x2=11.634, p=.001). 3.For when to referral hospice home care to the patients, only 34.2% answered that patients with less than 6 months of survival time are advised to receive hospice care, reflecting very low level of knowledge. 23.0% of the physicians and 48.0% of the nurses answered that hospice care should be provided when death is imminent, making a significant difference between the two groups(x2=6.413, p=.000). 4.To promote hospice activities, 87.2% pointed out that it is crucial to make general people, including those engaging in the medical field, more aware of hospice. 79.7% answered that a national hospice management should be developed, marking a significant difference between the physician group and nurse group(x2=10.485, p=.001). 5.Advantages of hospice home care are 87.2% responded that patients can have better rest at home receiving hospice home care. Economical merit was brought forward as one of the advantages also, where there was a significant difference between the physicians group and nurse group(x2=7.009, p=.008). 6.The medical professions' attitude to hospice home care are 92.8% of the physicians answered that they would advise incurable terminally ill patients to be discharged from hospital, with 44.3% of them advising the patients to receive hospice home care after leaving the hospital. From the nurses' point of view, 20.9% of the terminally ill patients are being referred to hospice home care after discharge, which makes a significant difference from the physicians' response(x2=19.121, p=.001). 7. 30.6% of physicians have referred terminally ill patients to hospice home care, 75.9% of whom were satisfied with their decision. Those physicians who have never referred their patients to hospice home care either did not know how to do it(66.7%) or were afraid of losing trust by giving the patients an impression of giving up(27.3%). 94.9% of the physicians responded that they would refer their last stage patients to a doctor who is involving palliative care. 8.Only 36.2% of nurses have suggested to physicians that refer the terminally ill patients discharged from the hospital to hospice home care. Once suggested, 95.8% of the physicians have accepted the suggestion. Nurses were reluctant to suggest hospice home care to the physicians, as 48.8% of the nurses said they did not want to. From the result of this study the following conclusion can be drawn, the medical profession's awareness of general hospice care has been increased greatly compared to the results of the previously performed studies. However, this study result also shows that their knowledge of hospice home care is not good enough yet. There is a need for high recommended that medical education institute and develop regular courses on various types of hospice care. Medical field training courses for physicians and nurses will be very helpful as well. It is also important to train hospice experts such as palliative physicians and develop a national hospice management urgently in order to improve the hospice care in Korea.

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The cephalometric study of skeletal types in Cl III malocclusion with reduced lower anterior face height (전하안면 고경이 작은 III급 부정교합자의 골격유형에 관한 두부방사선 계측학적 연구)

  • Han, Dong-Hun;Cha, Kyung-Suk
    • The korean journal of orthodontics
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    • 제26권2호
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    • pp.205-218
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    • 1996
  • A given facial type can be considered as a syndrome in which various features are aggregated, so a single parameter is not sufficient to accurately identify a given facial type. This study was designed to identify & characterize the skeletal types that blend under the headline-'Cl III,deepbite'. Cephalograms of thirty-four untreated mixed dentition patients, selected mainly on the basis of clinical impression of Cl III with reduced lower face heights were studied. The following conclusion can be drawn. 1. Cl III malocclusion with reduced lower face height could be classified into three types. 2. Subtype 1 was identified by the following features : strong ramus, more anteriorly positioned upper molars without alveolar hypoplasia, acutely reduced Mn. plane angle. 3. Subtype 2 was characterized by a short ramus, sharply reduced postrior alveolar height, and normal Mn. plane angle. In general, this type had hypoplasia tendency in the vertical dimension. 4. In subtype 3, the AUFH occupying more percentage than ALFH was a outstanding feature. Ramal height was in normal range, alveolar hypoplasia and slightly reduced Mn. plane angle was observed. 5. The features of the subtypes were reflected in certain indices, which can be regarded as discriminative index. LAFH: if reduced, regardless of subtypes, indicates reduced lower ant. face height consistently. FHR: when this ratio is increased, it indicates subtype 1. FHI: when this ratio is in normal range, it indicates subtype 2. FPI: if reduced greatly, it indicates subtype 3.

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A LIGHT AND ELECTRON MICROSCOPIC STUDY OF CHANCES IN INTERMAXILLARY SUTURE DURING THE RAPID MAXILLARY EXPANSION OF YOUNG ADULT DOGS (유성견 급속정중이개시 정중구개봉합부위의 조직학적 변화에 대한 연구)

  • Lee, Doo-Hee;Chung, Kyu-Rhim
    • The korean journal of orthodontics
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    • 제26권2호
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    • pp.153-162
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    • 1996
  • Rapid maxillary expansion is widely used for the correction of anteroposterior discrepancies, constriction of the maxillary arch, etc. This experiment was undertaken to examine the serial changes in the osteogenesis as well as the collagen fiber bundles in the intermaxillary suture during the rapid maxillary expansion treatment. Four young female dogs aged 6 to 8 months old and not showing menarche yet were used for the experiment. The maxillary impression of dogs were taken, expansion device cast and Hyrax screw soldered at the midline in the 1st premolar area. RME device was delivered to the dogs and the activation of 0.25 mm per quarter-turn was done 2 times per day for 10 days until 5 mm separation was made. Separation of the maxilla was confirmed by X-ray. The animals were sacrificed on 0, 15, 30, 60 days from the finish of maxillary separation and preparations for light microscopy and surface electron microscopy were made. The sutures were cut into frontal serial sections for examination of the histological reactions. The following results were obtained and the conclusions made. 1. The edges of the two palatal plates bordering the midpalatal suture which at the beginning of the retention period were mainly composed of compact bone, underwent extensive resorption followed by new bone formation and gradually became spongy bone rich in bone marrow which in the 60 day retention animal became the compact bone with short intermaxillary suture space. During this transformation, newly formed trabecular bone tissues were added to the original margin. 2. Throughout the expansion period, the collagen fibers underwent successive changes such as stretching, loss of polarity, and finally fibrillogenesis. Towards the end of the expansion procedure, sharpey's fiber formation in newly formed bones were observed. 3. Bony spicules were found in the initial stage of retention on occlusal topographic X-rays, which later were confirmed to have ossified. 4. Judging from the histological changes occuring during the experimental expansion, excessive expansion will cause an excessive bleeding, and retard the remodeling of intermaxillary suture. According to the above results, the bone remodeling after rapid maxillary expansion was preceded by the migration of migratory cells into the intermaxillary suture area. The bone remodeling phenomena were on-going during the 2 months retention sample.

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A Clinical Analysis on 8 cases of Pulmonary Sclerosing Hemangioma (폐 경화성혈관종 8예에 대한 임상적 고찰)

  • Chang, Jung-Hyun;Kim, Se-Kyu;Kim, Hyung-Jung;Kwon, Seon-Ok;Chung, Kyung-Young;Shin, Dong-Hwan;Lee, Doo-Yun;Ahn, Chul-Min;Kim, Sung-Kyu;Lee, Won-Young
    • Tuberculosis and Respiratory Diseases
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    • 제40권4호
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    • pp.384-389
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    • 1993
  • Background: Pulmonary sclerosing hemangioma is rare, but still the second most common benign lung tumor, occurring most1y in middle-aged women. Methods: From January 1985 through April 1993, we experienced eight cases of solitary pulmonary sclerosing hemangioma. Results: Subjects studied were 7 female and 1 male patients. They ranged from 14 to 63 years of age(mean age, 43.8 years) at the time of operation. The patients were frequently asymptomatic and the tumor was often shown to be a large lobulated mass on radiographic examination. The tumor can usually be diagnosed on operation because of its subtle clinical and radiographic presentation. All eight cases were diagnosed intraoperatively. The mean interval between initial radiographic detection and operation was 7.9 months. Out of 8 cases, preoperative impression of benign tumor was made in 4 cases, whereas malignant tumor was suspected in the remaining 4 cases. Enucleation, wedge resection or lobectomy was performed which appropriate in each patient. Conclusion: Surgical removal of the tumor preserving as much lung parenchyma as possible is indicated for proper diagnosis and treatment of this condition.

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Efficacy and Safety of Red Ginseng on Women's Health Related Quality of Life and Sexual Function (여성의 건강관련 삶의 질과 성기능에 대한 홍삼의 효과 및 안전성 연구)

  • Kim, Dong-II;Choi, Min-Sun;Alm, Hong-Yeop
    • Journal of Ginseng Research
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    • 제33권2호
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    • pp.115-126
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    • 2009
  • To evaluate the efficacy and safety of red ginseng on women's health-related quality of life (QOL) and sexual function. A randomized, double-blind, placebo-controlled, crossover clinical study was performed. The main efficacy was measured using the Female Sexual Function Index (FSFl) and the 36-Item Short-Form Health Survey (SF-36). Twenty-four healthy, married women aged 30-45 years with FSFl scores below 25 were randomly divided into two groups: the red-ginseng group (N=12) and the placebo group (N=12). During the first six-week period (Study 1), each group was given red ginseng or placebo twice a day. Before the start of the second six-week period (Study 2), a crossover design was chosen with a two-week break (washout period). Interchanging the two groups after the washout period, red ginseng and placebo were given to each group. The outcomes were measured before and after each six-week period. Overall, 23 participants completed the study. In Study 1, the changes relative to the baseline in the FSFl total score were 22.50% and 22.99% for red ginseng and placebo, respectively. In Study 2, the relative changes were 8.14% for red ginseng and 6.29% for placebo. The results showed a greater improving trend in Study 1 with respect to all of the participants' sexual functions, but no significant difference was found between the groups (P=0.9567). After taking red ginseng, all the participants exhibited an improving trend in the desire domain of FSFl, but no significant difference was shown. In the measurement of SF-36, no significant difference was likewise shown. After taking red ginseng, though, all the participants exhibited an improving trend in the physical functioning (PF) domain of SF-36, with no significant difference. Moreover, there was no significant adverse event related to red ginseng. The QOL and sexual function of the study participants in the red-ginseng group were mostly improved, but no statistically significant effect of red ginseng was shown. It is supposed that this result was partly due to the affirmative impression of red ginseng in Korea. Thus, it is anticipated that a long-term clinical trial will show a significant effect of red ginseng on the QOL and sexual function.

Biological stability of Zirconia/Alumina composite ceramic Implant abutment (지르코니아/알루미나 복합 지대주의 생물학적 안정성에 관한 연구)

  • Bae, Kyu-Hyun;Han, Jung-Suk.;Kim, Tae-Il;Seol, Yang-Jo;Lee, Yong-Moo;Ku, Young;Cho, Ki-Young;Chung, Chong-Pyoung;Han, Soo-Boo;Rhyu, In-Chul
    • Journal of Periodontal and Implant Science
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    • 제36권2호
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    • pp.555-565
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    • 2006
  • The purpose of the present study is to evaluate the biological stability of the zirconia/alumina composite abutment by histologic and radiographic examination in clinical cases. 17 partially edentulous patients (5 men and 12 women, mean age 47) were treated with 37 implants. The implants were placed following the standard two-stage protocol. After a healing period of 3 to 6 months, zirconia/alumina composite abutments were connected. All radiographs were taken using paralleling technique with individually fabricated impression bite block, following insertion of the prosthesis and at the 3-, 6-, 12 month re-examinations. After processing the obtained images, the osseous level was calculated using the digital image in the mesial and distal aspect in each implant. An ANOVA and t-test were used to test for difference between the baseline and 3-, 6-, 12 months re-examinations, and for difference between maxilla and mandible. Differences at P <0.05 were considered statistically significant. For histologic examination, sample was obtained from the palatal gingiva which implant functioned for 12 months. Sections were examined under a light microscope under various magnifications. Clinically, no abutment fracture or crack as well as periimplantitis was observed during the period of study. The mean bone level reduction(${\pm}standard$ deviation) was 0.34 rom(${\pm}\;0.26$) at 3-months, 0.4 2mm(${\pm}\;0.30$) at 6-months, 0.62 mm(${\pm}\;0.28$) at 12-months respectively. No statistically significant difference was found between baseline and 3-, 6-, 12-months re-examinations (p > 0.05). The mean bone level reduction in maxilla was 0.33(${\pm}0.25$) at 3-months, 0.36(${\pm}0.33$) at 6-months, 0.56(${\pm}0.26$) at 12-months. And the mean bone level reduction in mandible was 0.35(${\pm}0.27$) at 3-months, 0,49(${\pm}0.27$) at 6-months, 0.68(${\pm}0.30$) at 12-months. No statistical difference in bone level reduction between implants placed in the maxilla and mandible. Histologically, the height of the junctional epithelium was about 2.09 mm. And the width was about 0.51 mm. Scattered fibroblasts and inflammatory cells, and dense collagen network with few vascular structures characterized the portion of connective tissue. The inflammatory cell infiltration was observed just beneath the apical end of junctional epithelium and the area of direct in contact with zirconia/alumina abutment. These results suggest the zirconia/alumina composite abutment can be used in variable intraoral condition, in posterior segment as well as anterior segment without adverse effects.

A comparison of the fidelity of various zirconia-based all-ceramic crowns fabricated with CAD/CAM systems (수종의 CAD/CAM 시스템으로 제작한 지르코니아 기반 완전도재관의 적합도 비교)

  • Kim, Sung-Jun;Jo, Kwang-Hun;Lee, Kyu-Bok
    • The Journal of Korean Academy of Prosthodontics
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    • 제47권2호
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    • pp.148-155
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    • 2009
  • Statement of problem: The interest in all-ceramic restorations has increased as more techniques have become available. With the introduction of machinable dental ceramics and CAD/CAM systems there is a need to evaluate the quality levels of these new fabrication techniques. Purpose: This study is to evaluate the crown fidelity(absolute marginal discrepancy and internal gap) of various zirconia-based all-ceramic crowns fabricated with different CAD/CAM(computer-assisted design/computer-assisted manufacturing) systems and conventional cast metal-ceramic crowns. Material and methods: A resin tooth of lower right second premolar was prepared. After an impression was taken, one metal master die was made. Then 40 impressions of metal master dies were taken for working dies. 10 crowns per each system were fabricated using 40 working dies. Metal-ceramic crowns were cast by using the conventional method, and Procera, Lava, and Cerec inLab crowns were fabricated with their own CAD/CAM manufactruing procedures. The vertical marginal discrepancies and internal gaps of each crown groups were measured on a metal master die without a luting agent. The results were statistically analyzed using the one-way ANOVA and Tukey's HSD test. Results: 1. Vertical marginal discrepancies were $50.6{\pm}13.9{\mu}m$ for metal-ceramic crowns, $62.3{\pm}15.7{\mu}m$ for Procera crowns, $45.3{\pm}7.9{\mu}m$ for Lava crowns, and $71.2{\pm}2.0{\mu}m$ for Cerec inLab crowns. 2. The Internal gaps were $52.6{\pm}10.1{\mu}m$ for metal-ceramic crowns, $161.7{\pm}18.5{\mu}m$ for Procera crowns, $63.0{\pm}10.2{\mu}m$ for Lava crowns, and $73.7{\pm}10.7{\mu}m$ for Cerec inLab crowns. Conclusion: 1. The vertical marginal discrepancies of, 4 crown groups were all within the clinically acceptable range($120{\mu}m$). 2. The internal gaps of LAVA, Cerec inlab, and metal-ceramic crowns were within clinically acceptable range except Procera crown($140{\mu}m$).

A Study on Morphology and Size of Clinical Crown of Permanent Maxillary Molar in Korean Adult (한국 성인의 상악 대구치 임상치관의 형태와 크기에 관한 연구)

  • Cha, Kwon-Sil;Oh, Sang-Chun;Dong, Jin-Keum
    • Journal of Dental Rehabilitation and Applied Science
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    • 제16권2호
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    • pp.79-92
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    • 2000
  • The purpose of this study was to estimate the morphology and the size of permanent maxillary molar in Korean Adult. The 100 dental college students with a normal dentition and without any dental prosthesis and severe caries were selected for this study. The subjects were taken impression to make study model. On the study model, authour three times measured those sizes and estimated morphological structures with a calipers, a Boley gauge and a protractor. The results were as follows; 1. In the maxilary first molar's clinical crown height, mesiolingual cusp height was 6.34mm, mesiobuccal cusp height was 6.05mm, distobuccal cusp height was 5.20mm. And in the maxillary second molar's clinical crown height, mesiobuccal cusp height was 5.85mm, mesiolingual cusp height was 5.71mm, distobuccal cusp height was 5.51mm, distolingual cusp height was 3.53mm. This result considered that the maxillary first molar inclined to distobuccal, and the maxillary second molar more upright than the maxillary first molar. 2. In the width of clinical crown, the maxillary first molar was 10.43mm, the maxillary second molar was 10.20mm, and the difference between the first molar's width and the second molar's width was 0.23mm. 3. The crown thickness was measured divided into mesial buccolingual half and distal buccolingual half. The mesial buccolingual half was 11.14mm, and distal buccolingual half was 10.35mm in the maxillary first molar, and in the maxilary second molar, mesial buccolingual half was 11.25mm, and distal buccolingual half was 9.72mm. This result considered that height of convergency located in mesial half of crown. 4. In the buccal groove length, total length and ratio, the maxillary first molar was 52.5%, the maxillary second molar was 50%. And the development of buccal groove in the maxillary first molar was 59% in case of the well developed buccal groove and 41% in case of the weak developed one. And frequency of buccal pit of the maxillary first molar was 12.5%. Whereas, the frequency of buccal of the well developed buccal groove in the maxillary second molar was 37% and that of the weak developed one was 63%. And frequency of buccal pit of the maxillary second molar was not seen. 5. The 3 cusp type tooth cannot be found in the maxillary first molar and the frequency of 3 cusp type tooth in the maxillary second molar was as small as 6% 6. In the case of 4 cusp type tooth, the size of distal lingual cusp molar was difference between in the maxillary first molar and in the maxillary second molar by about 1mm. 7. The intercuspal distance was similar in the maxillary first premolar and second molar. And intercuspal distanc of mesial half of the maxillary first molar and the maxillary second molar was silmillar, too. 8. The an measurement of occlusal surface in 4 cusp type tooth showed that the angle of occlusal surface between the distobuccal and mesiolingual was an obtuse angle, and the angle of occlusal surface between mesiobuccal and distolingual was an acute angle in the both cases of maxillary first and second molar. 9. The measurements of the development of Carabelli cusp showed that the frequency of the well developed one was 7% and that of the weak developed one was 56% in the maxillary first molar. And there cannot be found the well developed one and can be found 2.5% only in the case of the weak developed one in the maxillary second molar. 10. The well developed oblique ridge in the maxillary first molar showed the 100% frequency and that in the maxillary second molar showed the 85.5% frequency. The frequency of mesiomarginal ridge tubercle in the maxillary first molar was 82% and that in the maxillary second molar was 30.5%. And the frequency of distal accessory tubercle in the maxillary first molar can be seen about 19% and that in the maxillary second molar can be seen about 12%.

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EVALUATING THE RELIABILITY AND REPEATABILITY OF THE DIGITAL COLOR ANALYSIS SYSTEM FOR DENTISTRY (치과용 디지털 색상 분석용 기기의 정확성과 재현 능력에 대한 평가)

  • Jeong, Joong-Jae;Park, Su-Jung;Cho, Hyun-Gu;Hwang, Yun-Chan;Oh, Won-Mann;Hwang, In-Nam
    • Restorative Dentistry and Endodontics
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    • 제33권4호
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    • pp.352-368
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    • 2008
  • This study was done to evaluate the reliability of the digital color analysis system (ShadeScan, CYNOVAD, Montreal. Canada) for dentistry. Sixteen tooth models were made by injecting the A2 shade chemical cured resin for temporary crown into the impression acquired from 16 adults. Surfaces of the model teeth were polished with resin polishing cloth. The window of the ShadeScan handpiece was placed on the labial surface of tooth and tooth images were captured, and each tooth shade was analyzed with the ShadeScan software. Captured images were selected in groups, and compared one another. Two models were selected to evaluate repeatability of ShadeScan, and shade analysis was performed 10 times for each tooth. And, to ascertain the color difference of same shade code analyzed by ShadeScan, CIE $L^*a^*b^*$values of shade guide of Gradia Direct (GC, Tokyo, Japan) were measured on the white and black background using the Spectrolino (GretagMacbeth, USA), and Shade map of each shade guide was captured using the ShadeScan. There were no teeth that were analyzed as A2 shade and unique shade. And shade mapping analyses of the same tooth revealed similar shade and distribution except incisal third. Color difference (${\Delta}E^*$) among the Shade map which analyzed as same shade by ShadeScan were above 3. Within the limits of this study, digital color analysis instrument for dentistry has relatively high repeatability, but has controversial in accuracy.