No abstract available.
Cause of Death* ; Korea*

No abstract available.

No abstract available.
Adolescent* ; Blood Pressure* ; Humans

In the treatment of chronic adult periodontitis, scaling and root planing have been generally performed prior to periodontal flap surgery. The purpose of this study was to evaluate the clinical significance of non-surgical periodontal therapy prior to periodontal flap surgery in patients with chronic adult periodontitis. Fifty six molars showing bilateral bony defects and 4-6mm periodontal pocket in twelve patients with chronic adult periodontitis were selected. By randomized split-mouth design, in one side, flap operation was performed 4 weeks after scaling and root planing, in the other group, flap operation was only performed without scaling and root planing. Probing pocket depth, gingival recession, clinical attachment level, gingival index, plaque index, and tooth mobility were measured at baseline, before flap operation and post-operation 12 weeks. The difference of clinical parameters between groups and between each measuring time was statistically analyzed. The results were as follows; 1. At 12 weeks after flap operation, there was no significant difference in probing pocket depth, gingival recession, clinical attachment level, gingival index, plaque index and tooth mobility between groups(p<0.05). 2. In both groups, probing pocket depth, gingival recession, clinical attachment level, gingival index, plaque index and tooth mobility were significantly improved at 12 weeks after flap operation compared to baseline(p<0.05). Within the limitation of short period, the results failed to demonstrate that the non-surgical periodontal therapy prior to periodontal flap surgery could have clinical significance in improvement of clinical parameters compared to periodontal surgery without non-surgical periodontal therapy.
Chronic Periodontitis ; Gingival Recession ; Humans ; Molar ; Periodontal Index ; Periodontal Pocket ; Root Planing ; Tooth Mobility

The aim of this study was to recommend the optimal age for prevention of periodontal disease and to investigate the trend of treatment modality according to different period. From the chart recordings of the patients who had been treated periodontally from Jan. 1981 to Dec. 1995 in the dept .of periodontics, Chosun University Dental Hospital, those of the periodontally treated patients on more than 4 sixtants were selected for the present study. The distribution of the patients was counted according to the age group and the gender. And they were divided into 3 groups(group 1: 1981-1985, group 2: 1985-1990, group 3: 1991-1995) by 5 year interval according to the treated year. The periodontal treatment modalities were classified into non-surgical therapy, pocket elimination surgery, regenerative periodontal surgery, mucoginigival surgery, clinical crown lengthening, and others. The results were as follows; 1.In the distribution of the periodontally treated patients according to the age group, 40's age group was the highest, and 30's, 40's, and 50's age groups occupied more than two thirds(73%). 2.The sexual distribution of the periodontally treated patients showed that males(53.4%) were a little more than females(46.6%). Within 20's group female was higher, but within 40's male was higher. 3.Regardless of the age group and the gender, pocket elimination surgery was the most frequent treatment modality. 4.In group 1 and 2(1981-1990) the main treatment modality was pocket elimination surgery and non-surgical therapy, but in group 3(1991-1995) it was regenerative periodontal surgery and pocket elimination surgery. The above results suggest that the prevention of periodontal disease should be initiated from early twenties, and the most frequent treatment modality may be closely related with development of new material and method.
Crown Lengthening ; Female ; Humans ; Male ; Periodontal Diseases ; Periodontics

BACKGROUND: Mycobacterium tuberculosis is one of the most clinically significant infectious agents. Especially during mass outbreaks, accurate identification and monitoring are required. The proportion of Beijing family members is very high among infecting strains, and spoligotyping is not suitable for strain typing. Therefore, we studied the homogeneity of isolates using the mycobacterial interspersed repetitive units-variable number of tandem repeats (MIRU-VNTR) method and identified its utility for carrying out molecular epidemiologic analysis. METHODS: Eighty-one clinical M. tuberculosis isolates that had previously been analyzed by spoligotyping were used in this study. We used the 12 standard MIRU loci and further four exact tandem repeat (ETR) loci (ETR-A, -B, -C, and -F). Four strains each of randomly selected Beijing and Beijing-like families were subjected to IS6110- restriction fragment length polymorphism analysis. RESULTS: All 81 samples showed amplification products of all VNTR loci, and all of them showed differences in at least one locus. The calculation of the Hunter-Gaston diversity index (HGDI) for MIRU-VNTR gave the value of 0.965. Discriminatory index in the six loci (MIRU-10, -16, -26, -31, -39, and ETR-F) were found to be highly discriminated (HGDI >0.6). Beijing and Beijing-like family isolates were discriminated into different MIRU-VNTR types. CONCLUSIONS: MIRU-VNTR analysis by using well-selected loci can be useful in discriminating the clinical M. tuberculosis isolates in areas where the Beijing family is predominant.
Bacterial Typing Techniques/*methods ; DNA, Bacterial/analysis ; Genotype ; Humans ; *Minisatellite Repeats ; Mycobacterium tuberculosis/*classification/genetics/isolation & purification ; Polymerase Chain Reaction ; Republic of Korea ; Tuberculosis/diagnosis/*microbiology

Group occupational health service programme started in 1990 is one of the measures to cope with limited human and financial resources in occupational health. The programme has expanded rapidly to include 52 institutions, private as well as public, all over the country. In spite of its potential impact on health of employees and practice of occupational health in small and medium sized industries, comprehensive evaluation in terms of quality has not been tried. This study has aims to develop the criteria to assess the quality of newly developed group occupational health service programme, and to investigate the quality of institutions, and finally to develop policies for the quality improvement. 1) Criteria development : By defining occupational health services, in particular for small and medium sized industries, as one of the primary health care, followings are included as core elements of qualitative occupational health programme ; accessibility, continuity, comprehensiveness, technical quality, intersectoral collaboration, emphasis on preventive services, community participation, and adequacy. Again each element is divided into five major components of national health system infrastructure developed by the World Health Organization ; development of health resources, organized arrangement of resources, delivery of health care, economic support, and management. In turn, each component is categorized into three aspects of quality assessment, structure, process and outcome. Expert panel selected several criteria for each category to evaluate the programme. Criteria were modified according to each group of interviewees, to produce two sets of questionnaire, one for chief operating officer and another for nurses in the institutions, and the chief operating officer and workers in the workplace. 2) Subject : Of all 52 institutions, 25 voluntarily participated in the survey. At individual institution, chief operating officer and practicing nurses were interviewed in depth. After intensive education for interviewees, every interview was performed with standardized guideline and questionnaire. The quality of the 'Group occupational health service programme' was found to be lower than expected. Especially In continuity, comprehensiveness, technical quality, community participation and adequacy, lower quality in structural aspect was commonly identified throughout all the institutions. Quality in terms of accessibility and continuity highly varied among institutions. To improve quality of the programme, more comprehensive and systematic programme such as accreditation has to be introduced. In addition, human resources, governmental fund and information systems for individual workers are to be developed. As a long range plan, integration of occupational health services into the national health systems and pooling of financial resources and planned allocation should be considered.
Accreditation ; Consumer Participation ; Cooperative Behavior ; Delivery of Health Care ; Education ; Financial Management ; Health Resources ; Humans ; Information Systems ; Korea* ; Occupational Health Services* ; Occupational Health* ; Primary Health Care ; Quality Improvement ; Questionnaires ; Social Welfare ; World Health Organization

PURPOSE: Acalculous cholecystitis (ACC) is a rare, but potentially lethal disease, which occurs in critically ill patients and those recovering from non-biliary tract operations. Recently, an increase in the presentation of mild form ACC was noted to occur in outpatients. This study was performed to assess the clinical features and prognosis of ACC. METHODS: One thousand consecutive laparoscopic cholecystectomies, performed by a single surgeon at the Eulji Medical Center, between September, 2001 and May, 2005, were retrospectively analyzed. According to the clinical data, the preoperative findings, operative results and pathology reports, 35 patients were diagnosed with acalculous cholecystitis. RESULTS: No significant differences were found in the age and sex distributions, laboratory findings between ACC and calculous cholecystitis (CC) or incidence of associated diseases. The number of cases undergoing PTGBD, or with an inflammatory grade score during the operation, were higher for those with an ACC, but the operative times and conversion rates to open cholecystectomy were no different. Of the 35 ACC patients, only 20 had the true criteria of acute acalculous cholecystitis. However, the other 15 patients showed no strong evidence typical of acalculous cholecystitis. CONCLUSION: We experienced acalculous cholecystitis different from rare and lethal form of acalculous cholecystitis. But diagnosis of this mild form of ACC is also delayed due to lack of objective findings. High suspicious index of these diagnostic entities should be kept in mind and we should rule out other disease entities as soon as possible if ACC is questionable, so we can perform laparoscopic cholecystectomy safely on these mild forms of ACC.
Acalculous Cholecystitis* ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Cholecystitis ; Critical Illness ; Diagnosis ; Humans ; Incidence ; Operative Time ; Outpatients ; Pathology ; Prognosis ; Retrospective Studies ; Sex Distribution

BACKGROUND/AIMS: Healthcare-associated pneumonia (HCAP) occurs outside hospitals, but its characteristics are similar to those of hospital-acquired pneumonia (HAP). We evaluated the clinical and microbial characteristics of HCAP in Korea. METHODS: Of 130 subjects with suspected pneumonia, 49 were classified as HCAP and 81 as HAP. We retrospectively examined the clinical presentations, outcomes, pathogens, and drug resistance rates of Pseudomonas aeruginosae in both groups. RESULTS: The clinical presentations, including the symptoms and laboratory findings, at the time of hospitalization were comparable in both groups. The hospital mortalities of HCAP (28.6%) and HAP (34.6%) did not differ significantly; the length of the hospital stay was similar for all of the survivors (14 vs. 17 days, respectively). Of the identified pathogens, methicillin-resistant Staphylococcus aureus was significantly less common in HCAP than in HAP (two vs. 18 cases, respectively, p<0.01), whereas Klebsiella pneumoniae was more common in HCAP (five vs. zero cases, respectively, p<0.01). The frequency of other Gram-negative rods was similar in both groups. The rate of resistance to antibiotics in P. aeruginosae in both groups was substantial, with the highest resistant rate to ciprofloxacin (50% and 61.5% in HCAP and HAP, respectively). CONCLUSIONS: Although the clinical features and outcomes of HCAP were comparable to those of HAP in the study population, the frequency of methicillin-resistant S. aureus was significantly lower in HCAP compared to HAP.
Anti-Bacterial Agents ; Ciprofloxacin ; Drug Resistance ; Hospital Mortality ; Hospitalization ; Humans ; Klebsiella pneumoniae ; Korea ; Length of Stay ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Pneumonia ; Pseudomonas aeruginosa ; Retrospective Studies ; Survivors

OBJECTIVES: Korea faces a number of challenges to meet demands in the area of geriatric professional medicine in a country with a rapidly ageing population. We evaluated the satisfaction and feasibility of the current education certification for geriatric physicians. METHODS: Geriatric physicians who were deemed qualified by the Korean Geriatrics Society during the period of 2001 to 2005 (n=2,200) were asked to complete structured questionnaires sent to them by mail about their satisfaction of and need for certificates of education, as well as their opinions on their geriatric specialty training. A total of 419 physicians responded. Descriptive analysis and hierarchical regression were performed to rate the respondents.satisfaction, the characteristics of the need for clarity and utility in education certification, and the characteristics of their patients. RESULTS: Although most respondents were satisfied with their education certification, those who had more elderly patients, aged 65 or older, and those who had more cognitively impaired patients, rated their education as significantly lower than did other physicians. Both groups expressed the need for more the comprehensive care and assessment concerning of their education. Multiple regression analysis indicated that satisfaction with geriatric physician qualification was associated with a physician's age, specialty, and percentage of elderly patients. CONCLSIONS: This study suggests that the current system of education certification is limited in terms of feasibility and physician satisfaction.
Adult ; Aged ; *Certification ; Education, Medical/*standards ; Female ; Geriatrics/*education/standards ; Humans ; Korea ; Male ; Middle Aged ; Questionnaires