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Indication of Dissection of the 14v Lymph Node in Advanced Distal Gastric Cancer (원위부 진행성 위암에서의 상장간막정맥(14v) 림프절 절제술의 적응증)

  • Lim, Jung-Taek;Jung, Oh;Kim, Ji-Hoon;Oh, Sung-Tae;Kim, Byung-Sik;Park, Kun-Choon;Yook, Jeong-Hwan
    • Journal of Gastric Cancer
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    • v.6 no.3
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    • pp.154-160
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    • 2006
  • Purpose: According to the 2nd English Edition of the Japanese Gastric Cancer Association (JGCA) in 1998, in case of distal gastric cancer, the 14v (superior mesenteric vein) lymph node (LN) is included in the N2 group. However, in Korea, a modified radical gastrectomy is performed, and a 14v LN dissection is not done as a routine procedure. Thus, we investigated the rate of metastatic 14v LNs, evaluated the necessity of dissection of the 14v LN, and searched for indications of 14v LN dissection. Materials and Methods: From April 2004 to August 2005, we enrolled the patients who were diagnosed as having advanced gastric cancer in the distal third portion of the stomach. We peformed a distal gastrectomy with D2 lymph node dissection as defined in the 2nd English edition of the JGCA classification. We calculated the positive rate of metastatic LNs of each station and analyzed the relationship between the positive rates of No.6 LNs and 14v LNs. We also compared the positive 14v LN group with the negative 14v LN group. Results: The total number of patients was 50, the mean age was 56 (range $30{\sim}80$) years, and sex ratio (Male/Female) was 1.63 : 1. In 47 (94%) cases, distal a gastrectomy with gastroduodenostomy was done, and in the remaining 3 (6%) cases, a distal gastrectomy with gastrojejunostomy was done. The most frequently metastatic LNs were nos. 3 and 6 (54%). The metastatic rate of the f4v LN was 10%, which was similar to that of LN no. 9. In the comparison of the 14v positive group with the 14v negative group, there were significant differences in the numbers of metastatic LNs (mean 25.4 vs 4.91, P<0.001) and the numbers of metastatic no. 6 LNs, (mean 6.8 vs 1.42, P<0.001), and if no. 6 LNs were metastatic, the possibility of metastasis to the 14v LN was 19.2%. In the 14v positive group, all cases were more than stage 3 by the UICC 6th edition. Conclusion: In cases of advanced cancer with metastasis to the no. 6 IN, there was a good chance of metastasis to the 14v LN. Thus, in the operative field, if the tumor is advanced to more than stage 3 by the UICC classification and the no. 6 LN is metastatic, a 14v LN dissection is necessary. However, the usefulness of a 14v LN dissection should be evaluated prospectively through an analysis of tumor recurrence and long-term survival.

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Clinical Characteristics and Prognosis of Gastrointestinal Stromal Tumors of Stomach (위의 위장관 간질 종양의 임상적 특징 및 예후)

  • Kim, Min-Hyung;Hur, Hoon;Kim, Sin-Sun;Kim, Sung-Keun;Jeon, Kyung-Hwa;Song, Kyo-Young;Kim, Jin-Jo;Jin, Hyung-Min;Kim, Wook;Park, Cho-Hyun;Park, Seung-Man;Lim, Keun-Woo;Jeon, Hae-Myung
    • Journal of Gastric Cancer
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    • v.6 no.3
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    • pp.146-153
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    • 2006
  • Purpose: Gastrointestinal stromal tumorsm (GISTs) are the most common mesenchymal tumors that arise anywhere in the tubular GI tract. The prognosis for GSTIs is important because f GISTs may metastasiwx in the liver or the abdominal cavity in an early stage. For the reason we examined the tumor size, the mitotic number, ki 67, p53, and c-kit mutation as independent prognostic factor for GISTs. Materials and Methods: A retrospective study was conducted in 76 patients who had been re-evaluated for confirmation of diagnosis between Jan 1998 and Dec. 2001. at Catholic University of medicine. Results: There were significant difference between the turner size, mitotic indices, ki 67, c-kit mutations and the 5-years survival rates. Tumor size (${\geq}5\;cm$) and mitotic index (${\geq}5/50\;HPF$) were statistically related to a significantly poor prognosis (P=0.017 and P=0.042, respectively). c-kit mutations in exon 11 were found in 7 cases c-kit mutation was observed more frequently in high risk patients, and there was a significant difference between c-kit mutation and survival (P=0.037). Elevated ki 67 was noted in 34 out of the 76 cases. High risk patients showed elevated ki67 index more frequently and there was significant relation with the survival rate (P=0.0417). Conclusion: We think that tumor size, mitotic index, Ki 67 and c-kit mutation are as independent prognostic factors for GISTs, but more research is needed.

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The Early Experience with a Laparoscopy-assisted Pylorus-preserving Gastrectomy: A Comparison with a Laparoscopy-assisted Distal Gastrectomy with Billroth-I Reconstruction (복강경 보조 유문부보존 위절제술의 초기 경험: 복강경 보조 원위부 위절제술 후 Billroth-I 재건술과의 비교)

  • Park, Jong-Ik;Jin, Sung-Ho;Bang, Ho-Yoon;Chae, Gi-Bong;Paik, Nam-Sun;Moon, Nan-Mo;Lee, Jong-Inn
    • Journal of Gastric Cancer
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    • v.8 no.1
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    • pp.20-26
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    • 2008
  • Purpose: Pylorus-preserving gastrectomy (PPG), which retains pyloric ring and gastric function, has been accepted as a function-preserving procedure for early gastric cancer for the prevention of postgastrectomy syndrome. This study was compared laparoscopy-assisted pylorus-preerving gastrectomy (LAPPG) with laparoscopy-assisted distal gastrectomy with Billroth-I reconstruction (LADGB I). Materials and Methods: Between November 2006 and September 2007, 39 patients with early gastric cancer underwent laparoscopy-assisted gastrectomy in the Department of Surgery at Korea Cancer Center Hospital. 9 of these patients underwent LAPPG and 18 underwent LADGBI. When LAPPG was underwent, we preserved the pyloric branch, hepatic branch, and celiac branch of the vagus nerve, the infrapyloric artery, and the right gastric artery and performed D1+$\beta$ lymphadenectomy to the exclusion of suprapyloric lymph node dissection. The distal stomach was resected while retaining a $2.5{\sim}3.0\;cm$ pyloric cuff and maintaining a $3.0{\sim}4.0\;cm$ distal margin for the resection. Results: The mean age for patients who underwent LAPPG and LADGBI were $59.9{\pm}9.4$ year-old and $64.1{\pm}10.0$ year-old, respectively. The sex ratio was 1.3 : 1.0 (male 5, female 4) in the LAPPG group and 2.6 : 1.0 (male 13, female 5) in the LADGBI group. Mean total number of dissected lymph nodes ($28.3{\pm}11.9$ versus $28.1{\pm}8.9$), operation time ($269.0{\pm}34.4$ versus $236.3{\pm}39.6$ minutes), estimated blood loss ($191.1{\pm}85.7$ versus $218.3{\pm}150.6\;ml$), time to first flatus ($3.6{\pm}0.9$ versus $3.5{\pm}0.8$ days), time to start of diet ($5.1{\pm}0.9$ versus $5.1{\pm}1.7$ days), and postoperative hospital stay ($10.1{\pm}4.0$ versus $9.2{\pm}3.0$ days) were not found significant differences (P>0.05). The postoperative complications were 1 patient with gastric stasis and 1 patient with wound seroma in LAPPG group and 1 patient with left lateral segment infarct of liver in the LADGB I group. Conclusion: Patients treated by LAPPG showed a comparable quality of surgical operation compared with those treated by LADGBI. LAPPG has an important role in the surgical management of early gastric cancer in terms of quality of postoperative life. Randomized controlled studies should be undertaken to analyze the optimal survival and long-term outcomes of this operative procedure.

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Relationship of Depression, Irrational Faith and the School Adaptation of Elementary School Students (초등학생의 우울성향, 비합리적 신념, 학교적응의 관계)

  • Lee, Tae-Hyeon
    • 한국초등상담교육학회:학술대회논문집
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    • 2004.01a
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    • pp.223-245
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    • 2004
  • The purpose of this study was to investigate the differences in depression, irrational faith and the school adaptation of elementary school students by their sex and region, to provide basic materials to teach children with the likelihood to be depressed by analyzing the correlation of depression, irrational faith and school adaptation, and help them to have healthy emotion and behaviors. To achieve these goals, following agenda were set. First, what are the differences in the depression, the irrational faith and the school adaptation of elementary school students by their sex and region? Second, what is the relationship between the depression characteristics and the irrational faith of elementary school students? Third, what is the relationship between the irrational faith and the school adaptation of elementary school students? Fourth, what is the relationship between the depression characteristics and school adaptation of elementary school students? : To resolve these agenda, the subjects were selected from Grade 6 students from the elementary schools locatec in Suwon and Hwaseong. The jubjects were selected from the two schools in Suwon and three schools in Hwaseong which were randomly chosen. The subjects were 670 in total. 70 insincere answers were excluded from the analysis. Therefore the subjects used in the analysis were 600 in total(150 male and female students in city respectively and 150 male and female students in rural area respectively). The tools used for this study were Children's Depression Inventory (CDI), Irrational Faith Test (over-self-reliance, dichotomy, determinism, over-concern, evasive faith, over dependent faith), School Adaptation Test (Attitudes to teachers and school environments, hobbies and specialties, academic achievements, peer relationship). Materials were processed with the SPSS program for ANOVA and correlation analysis. All the statistical values were verified at .05 level. The followings are the results of the analysis of the collected data. First, in the analysis of depression, there was significant difference between male and female students (F=4.75, p<.05). Female students (X =56.93) showed a little higher value than male students (X =53.83). There was significant difference between regions (F=13.02, p<.001), too. Rural area students (X =57.93) showed higher value than city area students (X =52.82). When analyzing irrational faith, there was significant difference between male and female students (F=S.60, p<.05). Female students (X =81.32) showed a little higher value than male students (X =77.72). There was no significant difference according to regions. When analyzing the school adaptation, there was no significant difference according to either sex or region. Second, depression and irrational faith showed highly positive correlations in all areas. In particular, over concern and evasive faith showed the highest correlation with depression inclination (r=.68, p<.001). When looking into the results by sex and by region, female students (r=.70, p<.001) and the rural area students (r=.69, p<.001) showed higher correlation between depression and irrational faith than male students and city area students (r=.63, p<.001). Additionally, in all areas including by sex and by region, a positive correlation was shown. In all variables such as male students (r=.63, p<.001), female students (r=.72, p<.001), city area students (r=.66, p<.001), and rural area students (r=.69, p<.001), over concern and evasive faith showed the highest correlation with depression inclinations. Third, irrational faith (overall) and its sub factors such as over-self-reliance, dichotomy, determinism, over-concern and evasive faith had significant negative correlations with school adaptation (overall) and its sub factors in the scope of $r=-.27{\sim}-.52$. Determinism out of the sub factors of the irrational faith had the highest negative correlation with school adaptation (overall) and sub factors at the scope of $r=-.37{\sim}-.51$. However, over-self-reliance showed the negative correlation with school adaptation (overall) and its sub factors only partially. When looking into the results by gender, both genders showed significant negative correlation between irrational faith (overall) and its sub factors with school adaptation. Male students showed highly negative correlations with school adaptation (overall) and its sub factors in determinism ($r=-.35{\sim}-52$) and over-concern and evasive faith($r=-.31{\sim}-.51$), and fern ale students showed in over-self-reliance ($r=-.27{\sim}-.45$). However over-self-reliance showed negative correlation with school adaptation and its sub factors only partially. When looking into by region, both city and rural areas showed significant negative correlation between irrational faith (overall) and it sub factors, and school adaptation. Rural areas showed higher negative correlation in irrational faith (overall) ($r=-.39{\sim}-.53$) and over-self-reliance ($r=-.32{\sim}-.44$) and dichotomy ($r=-.28{\sim}-.39$) than city areas. However over-self-reliance showed negative correlation with school adaptation and its sub factors only partially. Fourth, depression and school adaptation showed the negative correlation in all areas. In particular, academic achievements and peer relationship showed the highest negative correlation with depression (r=-.53 p<.001). When looking into the results by sex and by region, female students (r=-.62, p<.001) and rural area students (r=-.61, p<.001) showed higher negative correlation with depression and school adaptation than female students (r=-.56, p<.001) and city area students (r=-.57, p<.001). Although there was negative correlation in all areas by sex and by region, male students (r=-.52, p<.001) and rural area students (r=-.56, p<.001) showed the highest negative correlation in peer relationship and female students (r=-.57, p<.001) and city area students (r=-.56, p<.001) showed the highest negative correlation in academic records. Based on the results of the study, it is proposed to provide elementary school students sho are likely to be depressed very easily with careful counselling and teaching based on the attention and love in school fields so that they can adapt themselves to home, school and society with positive and reasonable thinking.

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Intake of Snacks, and Perceptions and Use of Food and Nutrition Labels by Middle School Students in Chuncheon Area (춘천지역 중학생들의 간식 섭취 실태와 식품·영양표시에 대한 인식 및 이용실태)

  • Kim, Yoon-Sun;Kim, Bok-Ran
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.41 no.9
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    • pp.1265-1273
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    • 2012
  • The purpose of this study was to investigate the BMI, intake of snacks, and perceptions and use of food and nutrition labels by middle school students (144 boys and 189 girls) in Chuncheon area. The average height and weight of boys were $171.0{\pm}6.4$ cm and $61.0{\pm}11.4$ kg, respectively, whereas those of girls were $160.0{\pm}4.8$ cm and $50.8{\pm}6.6$ kg, respectively. Average body mass index (BMI) of boys and girls were $20.8{\pm}3.3$ and $19.8{\pm}2.4$, respectively (p<0.01). Dietary intake attitude score of girls ($34.39{\pm}5.66$) was higher than that of boys ($33.92{\pm}5.40$) (p<0.05). Subjects bought and ate snacks 1 to 3 times per week (40.2%) by themselves, and most consumed snacks were cookies (23.1%), instant noodles (16.2%), ice cream (13.2%), and candy and chocolates (13.2%). The most important factor in purchasing of snacks was 'taste' ($4.49{\pm}0.67$). When subjects bought processed foods, the rates of reading food labels was 86.6%. The most important factor of the food labels was 'expiration date' (42.9%). The degree of reading food labels on processed foods by girls ($22.70{\pm}5.72$) was higher than that of boys ($20.96{\pm}5.35$) (p<0.01). Of the 13.2% of subjects that did not read food labels, the reason why was that they were not interested (50.0%). Of the 78.4% of subjects that read nutrition labels, the most important component of the nutrition labels was 'calories' (75.9%). The main reason for reading nutrition labels was 'to control weight' (45.6%). In general, use of food labels correlated positively with dietary intake attitude score (p<0.05) and use of nutrition labels (p<0.01). Using multiple regression analysis, we found that 'usefulness of dietary life' was the most significant variable that affects the importance of food and nutrition labels. Therefore, development of an educational program on food and nutrition labels for adolescents will be effective in improving dietary life.

Relationships between Eating Behavior, Dietary Self-Efficacy, and Nutrition Knowledge of Elementary School Students by Food Service Type in Gangwon Province (강원지역 초등학생들의 급식유형(도시형, 농어촌형 및 도서벽지형) 별식행동과 식이자기효능감 및 영양지식과의 관계)

  • Won, Hyang-Rye;Shin, Gi-Beum
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.41 no.5
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    • pp.638-646
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    • 2012
  • The purpose of this study was to find a relationship between eating behavior, dietary self-efficacy and nutrition knowledge by comparing these items in elementary school students according to food service type. The survey was made through a questionnaire from 759 students in the 6th grade of elementary school in 39 Gangwon Province. The average score of eating behaviors according to food service type was highest for urban type, followed by agri-fishery type, and finally remote island and country type, for the questions asking about the application of nutrition knowledge and the frequency of eating out. The average score of nutrition knowledge according to food service type showed significant differences for the questions about eating snacks before going to sleep and weight increase as well as calorie comparisons between foods. For the correlation of eating behavior, dietary self-efficacy and nutrition knowledge, the agri-fishery type showed positive in all of the three items with significant differences. In the remote island and country type, there was a positive relationship between nutrition knowledge and dietary self-efficacy, and between eating behavior and dietary self-efficacy. However, there was no significant difference of correlation between nutrition knowledge and eating behavior. In order to confirm the predictable variables for eating behavior, a regression analysis was made by injecting variables in every stage with independent variables of dietary self-efficacy and nutrition knowledge, which showed a significant relationship with eating behavior. The results showed that, in the urban type, dietary self-efficacy and nutrition knowledge affected the eating behavior and, in the agriculture type and the remote island and country type, only dietary self-efficacy affected the eating behavior.

The Effect of Structured Information on the Sleep Amount of Patients Undergoing Open Heart Surgery (계획된 간호 정보가 수면량에 미치는 영향에 관한 연구 -개심술 환자를 중심으로-)

  • 이소우
    • Journal of Korean Academy of Nursing
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    • v.12 no.2
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    • pp.1-26
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    • 1982
  • The main purpose of this study was to test the effect of the structured information on the sleep amount of the patients undergoing open heart surgery. This study has specifically addressed to the Following two basic research questions: (1) Would the structed in formation influence in the reduction of sleep disturbance related to anxiety and Physical stress before and after the operation? and (2) that would be the effects of the structured information on the level of preoperative state anxiety, the hormonal change, and the degree of behavioral change in the patients undergoing an open heart surgery? A Quasi-experimental research was designed to answer these questions with one experimental group and one control group. Subjects in both groups were matched as closely as possible to avoid the effect of the differences inherent to the group characteristics, Baseline data were also. collected on both groups for 7 days prior to the experiment and found that subjects in both groups had comparable sleep patterns, trait anxiety, hormonal levels and behavioral level. A structured information as an experimental input was given to the subjects in the experimental group only. Data were collected and compared between the experimental group and the control group on the sleep amount of the consecutive pre and post operative days, on preoperative state anxiety level, and on hormonal and behavioral changes. To test the effectiveness of the structured information, two main hypotheses and three sub-hypotheses were formulated as follows; Main hypothesis 1: Experimental group which received structured information will have more sleep amount than control group without structured information in the night before the open heart surgery. Main hypothesis 2: Experimental group with structured information will have more sleep, amount than control group without structured information during the week following the open heart surgery Sub-hypothesis 1: Experimental group with structured information will be lower in the level of State anxiety than control group without structured information in the night before the open heart surgery. Sub-hypothesis 2 : Experimental group with structured information will have lower hormonal level than control group without stuctured information on the 5th day after the open heart surgery Sub-hypothesis 3: Experimental group with structured information will be lower in the behavioral change level than control group without structured information during the week after the open heart surgery. The research was conducted in a national university hospital in Seoul, Korea. The 53 Subjects who participated in the study were systematically divided into experimental group and control group which was decided by random sampling method. Among 53 subjects, 26 were placed in the experimental group and 27 in the control group. Instruments; (1) Structed information: Structured information as an independent variable was constructed by the researcher on the basis of Roy's adaptation model consisting of physiologic needs, self-concept, role function and interdependence needs as related to the sleep and of operational procedures. (2) Sleep amount measure: Sleep amount as main dependent variable was measured by trained nurses through observation on the basis of the established criteria, such as closed or open eyes, regular or irregular respiration, body movement, posture, responses to the light and question, facial expressions and self report after sleep. (3) State anxiety measure: State Anxiety as a sub-dependent variable was measured by Spi-elberger's STAI Anxiety scale, (4) Hormornal change measure: Hormone as a sub-dependent variable was measured by the cortisol level in plasma. (5) Behavior change measure: Behavior as a sub-dependent variable was measured by the Behavior and Mood Rating Scale by Wyatt. The data were collected over a period of four months, from June to October 1981, after the pretest period of two months. For the analysis of the data and test for the hypotheses, the t-test with mean differences and analysis of covariance was used. The result of the test for instruments show as follows: (1) STAI measurement for trait and state anxiety as analyzed by Cronbachs alpha coefficient analysis for item analysis and reliability showed the reliability level at r= .90 r= .91 respectively. (2) Behavior and Mood Rating Scale measurement was analyzed by means of Principal Component Analysis technique. Seven factors retained were anger, anxiety, hyperactivity, depression, bizarre behavior, suspicious behavior and emotional withdrawal. Cumulative percentage of each factor was 71.3%. The result of the test for hypotheses show as follows; (1) Main hypothesis, was not supported. The experimental group has 282 minutes of sleep as compared to the 255 minutes of sleep by the control group. Thus the sleep amount was higher in experimental group than in control group, however, the difference was not statistically significant at .05 level. (2) Main hypothesis 2 was not supported. The mean sleep amount of the experimental group and control group were 297 minutes and 278 minutes respectively Therefore, the experimental group had more sleep amount as compared to the control group, however, the difference was not statistically significant at .05 level. Thus, the main hypothesis 2 was not supported. (3) Sub-hypothesis 1 was not supported. The mean state anxiety of the experimental group and control group were 42.3, 43.9 in scores. Thus, the experimental group had slightly lower state anxiety level than control group, howe-ver, the difference was not statistically significant at .05 level. (4) Sub-hypothesis 2 was not supported. . The mean hormonal level of the experimental group and control group were 338 ㎍ and 440 ㎍ respectively. Thus, the experimental group showed decreased hormonal level than the control group, however, the difference was not statistically significant at .05 level. (5) Sub-hypothesis 3 was supported. The mean behavioral level of the experimental group and control group were 29.60 and 32.00 respectively in score. Thus, the experimental group showed lower behavioral change level than the control group. The difference was statistically significant at .05 level. In summary, the structured information did not influence the sleep amount, state anxiety or hormonal level of the subjects undergoing an open heart surgery at a statistically significant level, however, it showed a definite trends in their relationships, not least to mention its significant effect shown on behavioral change level. It can further be speculated that a great degree of individual differences in the variables such as sleep amount, state anxiety and fluctuation in hormonal level may partly be responsible for the statistical insensitivity to the experimentation.

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INDIVIDUALIZED RECONSTRUCTION OF THE LOWER OCCLUSAL PLANE ACCORDING TO SKELETAL PATTERN (안면 골격 형태에 따른 하악 교합평면의 재구성)

  • Hyun, Seong-Wook
    • The korean journal of orthodontics
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    • v.25 no.4
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    • pp.465-485
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    • 1995
  • The purpose of this study is to locate the proper position of the lower occlusal plane according to individual skeletal pattern. Cephalometric films of 234 subjects of the control group, 358 of the pretreatment group and 358 of the treated group were analyzed to study proper relationships between vertical dimension ratio(VDR) and lower occlusomandibular plane angle(LOM). The control group was divided into two subgroups by the age. The first subgroup consisted of 113 subjects of the age 14 years and under and with the mean age of 10.82 years. The other subgroup consisted of 113 subjects of the age 18 years and above with the mean age of 23.76 years. The pretreatment group was divided into three subgroups by the age. The first subgroup consisted of 274 subjects of the age 14 years and under with the mean age of 11.36 years. The second subgroup consisted of 54 subjects of the age 14 through 18 years with the mean age of 15.4 years. The last subgroup consisted of 30 subjects of the age 18 years and above with the mean age of 21.35 years. The treated group was also divided into three subgroups by the age. The first subgroup consisted of 145 subjects of the age 14 years and under with the mean age of 12.91 years. The second subgroup consisted of 166 subjects of the age 14 through 18 years with the mean age of 15.64 years. The last subgroup consisted of 47 subjects of the age 18 years and above with the mean age of 21.61 years. Cephalometric films of the sample were traced. Measurements were made to a hundredth using a program specifically prepared for this study, and the results were entered into a 486DX PC. Means and Standard deviations of all the veriables were calculated for each group. Correlation coefficients between pertinent variables were calculated. Significance tests on those coefficients, one-way ANOVA and t-tests between variables or groups were performed. On the basis of the results studied above, certain subjects were selected from the control and the treated groups to locate the proper position of the occlusal plane, and designated as the optimal occluaion group. The subjects of this optimal occlusion group had 1-3 mm overbite, 1-3 mm of overjet and less than 1.75 mm of curve of Spee. A total subjects of 187 in this group consisted 104 treated subjects and 83 control group. Regression analysis was carried out between VDR and LOM, and regression equations were tabulated for this optimal occlusion group. The results were as follows : 1. Highly significant correlations were observed between various variables useful for identifying vertical component of skeletal frame, but any one particular variable did not accurately indicate the magnitude of anterior vertical overbite. 2. Of the variables useful identifying vertical component of skeletal frame, The VDR showed the highest correlation to the LOM. 3. Of the total sample, 80 percent had overbite within the normal range, irrespective of VDR. 4. The optimal occlusion group was divided into 9 subgroups by the age and the anteroposterior skeletal pattern, and correlation coefficient and determination coefficient between VDR and LOM of each group were calculated. Correlation coefficients and determination coefficients were found to be significantly high in all groups. 5. Regression equation was induced for each of the optimal occlusion group to find proper LOM according to the VDR. 6. It was found that the mean value of the cant of occlusal plane itself is not enough for a diagnosis and a treatment plan. Rather, It is very important to locate the proper occlusal plane for an Individual skeletal pattern.

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The Changes in Patients and Medical Services by Separation of Prescribing and Dispensing Practice in Health Center (의약분업 실시 전후 보건소 내소환자 진료내용 변화)

  • Chun, Jae-Kyung;Kam, Sin;Han, Chang-Hyun
    • Journal of agricultural medicine and community health
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    • v.27 no.2
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    • pp.75-86
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    • 2002
  • This study was conducted to investigate the changes in patients and medical services before and after the Separation of Prescription and Dispensing in Health Center. For the purpose of this study, prescription data of 5,890 prescribed patients in March 2000(before the Separation of Prescription and Dispensing) and 3,496 prescribed patients in March 2001(after the Separation) in 4 Health Centers located in Gyeongsangbuk-do and Gyeongsangnam-do were collected. For investigation of the change of character of prescribed patients and the disease, sex, age, chief diagnosis, the hind of medical insurance, days of visit, days of prescription were investigated by using National Health Insurance claim data. And for investigation of change of prescription, prescribed drugs per each claim, the use rate of antibiotics, injection, and high-price antiphlogistic drug were investigated for acute respiratory disease and musculoskeletal disease. The major results were as follows: For the changes of prescribed patients of each disease, patients with acute respiratory disease were decreased by 49.7% after the Separation of Prescription and Dispensing than before the Separation of Prescription and Dispensing and patients with hypertension(18.1%), patients with musculoskeletal disease(70.5%), patients with diabetes(8.5%), patients with digestive organ disease(71.2%), patients with chronic respiratory disease(76.4%) were decreased. But patients with urethritis were increased by 66.7%. The mean Health Center visited days of prescribed patients decreased significantly after the Separation of Prescription and Dispensing than before in both male and female(p<0.01) and in health insurance patients(p<0.01). For the each of the disease, hypertension, diabetes, musculoskeletal disease decreased. The mean prescribed days increased after the Separation of Prescription and Dispensing than before(p<0.01). According to the kine of disease, the mean prescribed days increased after the Separation of Prescription and Dispensing than before in all the diseases except the urethritis(p<0.01). For acute respiratory diseases, number of prescribed drugs per each claim decreased significantly after the Separation of Prescription and Dispensing(4.7 drugs) than before(4.9 drugs) and the prescription rate of injection decreased significantly from 63.8% to 7.70%, and the prescription rate of antibiotics decreased significantly from 337% to 19.1%(p<0.01). For musculoskeletal diseases before and after Separation of Prescription and Dispensing, number of prescribed drugs per each claim decreased significantly from 3.7 to 3.2 and the prescription rate of injection decreased significantly from 64.9% to 1.7%, and the prescription rate of high-price antiphlogistic drugs increased significantly from 29.1% to 397%(p<0.01). In consideration of above findings, the mean visited days decreased and on the contrary, the mean prescribed days per each prescription increased after Separation of Prescription and Dispensing than before in health centers. For the prescription pattern of physicians, number of prescribed drugs and the prescription rates of injection and antibiotics per each claim decreased, but the prescription rate of high-price antiphlogistic drugs increased after Separation of Prescription and Dispensing.

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Comparison of Health Status and Activities for the Pain and No-pain Groups in the Elderly (노인의 만성동통 유무에 따른 건강상태 및 일상활동장애 비교)

  • Kim, Hyo-Jung;Kim, Myung-Ae;Park, Kyung-Min
    • Journal of agricultural medicine and community health
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    • v.24 no.1
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    • pp.79-89
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    • 1999
  • The purpose of this study is to compare health status and activities for the pain and no-pain groups in the elderly. The study subjects included 189 elderly people(65 years and older) living in an urban area. They were surveyed at their homes through interview using a closed-ended questionnaire from Nov. 6th. to Nov. 16th. 1997. The instrument used in the study was selected after carefully reviewing pain-related articles and records well described the characteristics of the elderly. The data were analysed by using descriptive statistics and chi-square tests. The findings were as follows : Of the 189 subjects, 83.6% reported experiencing the pain for the last year. By the age, there were significant differences between the pain and no-pain group(${\chi}^2$=9.572, p=.023). The percentage of the pain complainers was the highest in 80 years and older(100.0%), followed by 70~74(89.1%), 75~79(81.3%), 65~69(76.8%) which presented crude increase according to age. By sex, men had lower pain prevalence(69.5%) than that of women(90.0%). The number of pain complainers was higher in women than men(${\chi}^2$=12.448, p=.023). There were significant differences between the pain and no-pain groups by spouse distribution(${\chi}^2$=10.736, p=.001), educational state(${\chi}^2$=13.020, p=.000), occupation(${\chi}^2$=18.807, p=.000). Pain prevalence in the subjects having no spouse(59.3%) was higher than those having spouse(40.7%), Illiteracy rate was higher in pain group(49.0%) than no-pain group(13.3%). The number of the subjects having occupation(full time or part time) was fewer in pain group than no-pain group. By health status, there were significant differences between two groups(${\chi}^2$=40.055, p=.000). : the pain group showed poor(61.4%), followed by moderate(22.1%), good(16.5%) while no-pain group showed good(64.5%), moderate(29.0%), poor(6.5%). By activities, there were significant differences between the pain and no-pain groups. The pain group was disturbed more severely than the no-pain group in movement(${\chi}^2$=57.829, p=.000), sleep(${\chi}^2$=12.785, p=.000), usual activities(${\chi}^2$=39.196, p=.000), receiving guests(${\chi}^2$=13.163, p=.000), and hobbies and recreation(${\chi}^2$=28.177, p=.000).

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