Objectives: The purpose of this study was to examine the association between oral health-related quality of life and adult attachment type among college students. Methods: A total of 557 self-administered questionnaires were collected from undergraduates in Jeonbuk. Data were analyzed using SPSS 22.0. The results were analyzed using t-tests, analyses of variance, Duncan’s multiple range tests, correlation analyses, and multiple regression analyses. Results: The results of this study showed that sex and age were significant factors according to the analysis of the oral health-related quality of life in terms of general characteristics. The variable that had the greatest effect on the oral health-related quality of life was attachment anxiety, followed by age, sex, and attachment avoidance. Conclusions Education and counseling to promote safety of adult attachment will improve the oral health-related quality of life for college students.

OBJECTIVE: We analyzed 200 cases of prenatal amniocentesis and compared them with other reported studies. Thus we propose the necessity of metanalysis for prenatal amniocentesis. METHOD: We analyzed 200 cases that have undergone amniocentesis at Masan Samsung hospital from January 1996 to December 1997. The results of our study was compared with other reported studies of amniocentesis by indication and maternal age. The proportion of age-class and indication are compared between previous study subjects and our 200 cases. RESULTS: Triple marker abnormality was the most common indication of amniocentesis(51%) and the most common age distribution was 25-29 years (43.5%). Chromosomal aberration was diagnosed in 20 cases (10%) of which the numerical aberration was 9 cases (4.5%) and the structural aberration was 11 cases (5.5%). 5 cases (2.5%) out of ll cases of the structural aberration were normal variant. There were 7 cases (trisomy 21) of autosomal aberration and 2 cases (Turner syndrome) of sex chromosome aberration. Arnong the structural aberration, there was only one reported case of 46, t(7:10) reciprocal translocation. There were no cases of fetal death except for a little self limited preterm labor. There were no neonatal complications. In the comparison of indication and maternal age with other studies, abnormal triple test was the most common indication of amniocentesis. The number of young pregnant women under 35 years old who underwent genetic amniocentesis was increased year by year. CONCLUSION: Triple maker screening test and genetic amniocentesis become popular method of antenatal diagnosis in Korea. Now, it is the proper time to establish standard indication of prenatal amniocentesis in this country by systemic and objective statistic examination. So we address the need for metanalysis in our country as comparing with other studies.
Adult ; Age Distribution ; Amniocentesis* ; Chromosome Aberrations ; Female ; Fetal Death ; Humans ; Korea ; Mass Screening ; Maternal Age ; Obstetric Labor, Premature ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnant Women ; Prenatal Diagnosis ; Sex Chromosome Aberrations

BACKGROUND: In this study, we assessed the effectiveness of ketamine as an alternative to non-steroidal anti-inflammatory drugs (NSAID), to manage acute postoperative pain after spinal fusion when given intravenously via a patient-controlled analgesia (PCA) pump in which the dose was proportional to that of fentanyl. METHODS: Forty patients undergoing 1-2 level spinal fusion were enrolled in this study. Patients were intraoperatively randomized into two groups to receive intravenous PCA consisting either of fentanyl 0.4 microg/ml/kg (control group) or fentanyl 0.4 microg/ml/kg with ketamine 30 microg/ml/kg (ketamine group) after intravenous injection of a loading dose. The loading dose in the control group was fentanyl 1 microg/kg with normal saline equal to ketamine volume and in the ketamine group it was fentanyl 1 microg/kg with ketamine 0.2 mg/kg. The verbal numerical rating scale (NRS), fentanyl and ketamine infusion rate, and side effects were evaluated at 1, 24, and 48 hours after surgery. RESULTS: There were no significant differences in patient demographics, duration of surgery and anesthesia or intra-operative opioids administration. We did not find any significant differences in the mean infusion rate of intraoperative remifentanil or postoperative fentanyl or in the side effects between the groups, but we did find a significant difference in the NRS between the groups. CONCLUSIONS: Based on our results, we conclude that a small dose of ketamine (0.5-2.5 microg/kg/min) proportional to fentanyl is not only safe, but also lowers postoperative pain intensity in patients undergoing spinal fusion, although the opioid-sparing effects of ketamine were not demonstrated.
Analgesia, Patient-Controlled ; Analgesics, Opioid ; Anesthesia ; Demography ; Fentanyl ; Humans ; Infusion Pumps ; Injections, Intravenous ; Ketamine ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Piperidines ; Prospective Studies ; Spinal Fusion

Background/Aims: The prevalence of nonalcoholic fatty liver disease (NAFLD) has increased rapidly as a consequence of more sedentary lifestyles and a Westernized diet. Fracture is a major clinical problem in older people, but few large-scale cohort studies have evaluated the relationship between NAFLD and fracture. Therefore, we aimed to determine whether the fatty liver index (FLI), which represents the severity of NAFLD, can predict fracture risk. Methods: We analyzed the relationship between the FLI and incident fracture using multivariate Cox proportional hazards models and data for 180,519 individuals who underwent National Health check-ups in the Republic of Korea between 2009 and 2014. Results: A total of 2,720 participants (1.5%) were newly diagnosed with fracture during the study period (median 4.6 years). The participants were grouped according to FLI quartiles (Q1, 0 to <5.653; Q2, 5.653 to <15.245; Q3, 15.245 to <37.199; and Q4 ≥37.199). The cumulative fracture incidence was significantly higher in the highest FLI group than in the lowest FLI group (Q4, 986 [2.2%] and Q1, 323 [0.7%]; p<0.001). The adjusted hazard ratio indicated that the highest FLI group was independently associated with a higher incidence of fracture (hazard ratio for Q4 vs Q1, 2.956; 95% confidence interval, 2.606 to 3.351; p<0.001). FLI was significantly associated with a higher incidence of fracture, independent of the baseline characteristics of the participants. Conclusions Our data imply that the higher the FLI of a Korean patient is, the higher their risk of osteoporotic fracture, independent of key confounding factors.

Despite reductions in surgical mortality, neurologic sequelae remain a devastating complication after cardiac surgery with cardiopulmonary bypass. Neurologic complications may be induced by a massive air embolism during cardiopulmonary bypass, even with extensive monitoring. This report describes a patient who had a fatal cerebral infarct during aortic valve and ascending aorta replacement surgery. We monitored jugular venous O2 saturation (SjvO2) and cerebral oximetry using near-infrared spectroscopy in the perioperative period. The operation and anesthesia were uneventful until the deep hypothermic total arrest for the replacement of the ascending aorta. However, restarting the cardiopulmonary bypass after deep hypothermic total arrest produced a brief (less than 10 seconds) but large amount of air in the root cannula. At this time, although cerebral oximetry did not show any changes, the SjvO2 decreased to 21% for about 3 minutes and then normalized. At 8 hours after surgery, the patient showed seizures and severe edema in both cerebral hemispheres on the MRI. The patient died 21 days after surgery.
Anesthesia ; Aorta ; Aortic Valve ; Cardiopulmonary Bypass ; Catheters ; Cerebrum ; Edema ; Embolism, Air ; Humans ; Oximetry ; Perioperative Period ; Seizures ; Spectroscopy, Near-Infrared ; Thoracic Surgery

Background: Plastic waste generates pollutants in the process of incineration or landfilling, and accumulates in water or marine organisms, causing adverse effects on the environment and the human body. Recently, various eco-friendly oral hygiene products (Eco-OHPs) such as bamboo toothbrushes and biodegradable plastic toothbrushes have been developed. Therefore, this study aimed to investigate the current level of awareness and purchasing status of eco-OHPs among adults who are interested in eco-friendly products. Methods: This study included adults aged ＞19 years who regularly visited eco-friendly shops and online sites; the online survey links were distributed during their visits to eco-friendly Internet cafés and companies. Of the 22 questions, seven assessed the participants’ general characteristics, three assessed the general oral hygiene care products used, six assessed the level of awareness of Eco-OHPs, and six assessed the purchasing status of Eco-OHPs. Frequency analysis, chi-square test, and regression analysis were performed using SPSS software. Results: Among the respondents, 108 (51.4%) were aware of Eco-OHPs, and 79 (37.6%) had experience purchasing Eco-OHPs. The most common reason for not purchasing was the lack of information about related brands or products (74, 56.5%). The most common platform used in obtaining information was the Internet (general: 31.5%, eco-friendly: 46.3%), such as Social Network Service, Internet cafes, and blogs. The experience in purchasing Eco-OHPs was affected by whether the respondents recognized the possibility of contributing to environmental preservation, availability of vendors, product safety, and the number of eco-friendly products purchased. Conclusion In order to expand the use of Eco-OHPs, various efforts such as promotion of eco-friendly characteristics, determination of related vendors, reliable analysis of product safety, and expansion of product experience opportunities are required.

BACKGROUNDS: In the absence of distant metastasis, small cell lung cancer (SCLC) patients presenting with supraclavicular lymph node (SCLN) involvement and pleural effusion can benefit from thoracic radiotherapy. But there are some debate as to the prognostic significance of both SCLN involvement and pleural effusion. The purpose of this study was to determine the prognostic significance of SCLN involvement and pleural effusion in SCLC. METHODS: Two Hundred and fifteen patients with histologically confirmed small cell lung cancer, who were treated either at the Keimyung university Dongsan hospital and Kyungpook national university hospital from January 1994 to June 1998, were evaluated retrospectively. The patients were classified as having either limited or extensive stage using the Veterans Administration staging system. RESULTS: SCLN was presented in 10.5% of patients(n=21). The median survival was 247 days for patients with SCLN(n=21) and 264 days for patients without(n=194) (p=0.52). After treatment, the median survival was 298 days for patients with SCLN(n=13) and 348 days for patients without(n=115) (p=0.52). SCLN involvement was not correlated with the presence of distant metastases. Medican survival was 459 days for patients with a limited stage without SCLN(n=66), 650 days for those with a limited stage with SCLN (n=7) (p=0.96). Pleural effusion was presented in 24.7% of patients(n=52). The median survival was 198 days for patients with pleural effusion(n=52) and 275 days for patients without(n=163) (p<0.05). After treatment, the median survival was 294 days for patients with a pleural effusion(n=25) and 286 days for patients without(n=103) (p=0.39). The presence of pleural effusion was not correlated with that of distant metastases. The median survival was 395 days for patients with a limited stage without a pleural effusion(n=63), 451 days for those with a limited stage with pleural effusion(n=10) (p=0.92). CONCLUSIONS: In this study, SCLN involvement does not explain the poor survival rate and the relevance to extensive staged disease. Furthermore, the existence of a pleural effusion did not correlated with the presence of distant metastases. However, the presence of a pleural effusion appears to be a minor prognostic factor in our study. Therefore supraclavicular lymph node justify any amendment to the staging system currently used.
Gyeongsangbuk-do ; Humans ; Lymph Nodes* ; Neoplasm Metastasis ; Pleural Effusion* ; Radiotherapy ; Retrospective Studies ; Small Cell Lung Carcinoma* ; Survival Rate ; United States Department of Veterans Affairs

Aspergilloma and Allergic Bronchopulmonary Aspergillosis(ABPA) are different types of the pulmonary aspergillosis spectrum of diseases. ABPA is an inflammatory disease that causes hypersensitivity to Aspergillus spores growing in the bronchi, which is characterized by asthma, recurrent pulmonary infiltrations or mucoid impaction, eosinophilia and central bronchiectasis. Aspergilloma is a simple colonization of fungus within a cavitary lung lesion, but these diseases rarely coexist. A case of ABPA, coexistent with Aspergilloma, was experienced in a 31 year-old female. The diagnosis was confirmed by the immediate cutaneous reactivity to Aspergillus fumigatus, elevated total IgE antibodies, peripheral eosinophilia, bronchiectasis, growth of Aspergillus species in a sputum culture and radiographic infiltration. Treatment, with prednisone and itraconazole, led to improvement of the respiratory symptoms, reduction of the cavitary lesion and in the total serum IgE level.
Adult ; Antibodies ; Aspergillosis, Allergic Bronchopulmonary* ; Aspergillus ; Aspergillus fumigatus ; Asthma ; Bronchi ; Bronchiectasis ; Colon ; Diagnosis ; Eosinophilia ; Female ; Fungi ; Humans ; Hypersensitivity ; Immunoglobulin E ; Itraconazole ; Lung ; Prednisone ; Pulmonary Aspergillosis ; Spores ; Sputum

BACKGROUND: Diffusion-perfusion mismatch (DPM) on MRI has been considered an ischemic penumbra. However, several reports have demonstrated limitation of DPM on MRI as a predictable marker of the ischemic penumbra. In this study, we investigated the relationship between DPM and the clinical progression in acute ischemic stroke patients. METHODS: We consecutively recruited fifty-seven patients showing acute ischemic stroke (within 24 hours) in the middle cerebral artery (MCA) territory. The clinical outcomes were determined by serial measurement of National Institute of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) during 30 days after their ischemic event. We also evaluated the relationship among the parameters of perfusion MRI and the clinical worsening in patients with DPM on initial MRI. RESULTS: Nineteen (33.3%) patients had DPM on MRI within 24 hours after stroke onset. Even though the frequency of clinical worsening for 30 days after stroke onset was higher in DPM group (26%) than in non-DPM group (11%), it did not reach statistical significance (p=0.143). However, extent of MCA stenosis (p<0.001) and time to peak (TTP) delay on MRI (p<0.001) were significantly greater in patients with DPM than in those without DPM. Among several parameters of the perfusion MRI, only relative cerebral blood volume (rCBV) was significantly related to the clinical worsening (62.9+/-24.7% vs 96.1+/-19.2%, p=0.007) in patients with DPM. CONCLUSIONS: This study shows that DPM on MRI does not always predict the clinical worsening in acute ischemic stroke. To overcome this problem, we should analyze rCBV map based DPM as well as TTP map based DPM.
Blood Volume ; Brain ; Constriction, Pathologic ; Diffusion ; Humans ; Magnetic Resonance Imaging ; Middle Cerebral Artery ; Perfusion ; Stroke ; Thymine Nucleotides

BACKGROUND: Although degree of motor blockade during high thoracic spinal anesthesia is difficult to determine, pulmonary function may reflect the level of motor blockade. So we checked pulmonary function during spinal anesthesia with two different local anesthetic agents. METHODS: 50 patients, ASA PS 1-2, were randomly divided into two groups. After basal pulmonary function test (FVC: forced vital capacity, FEV1: forced expiratory volume in one second, PEFR: peak expiratory flow rate, PEP: peak expiratory pressure, PIP: peak inspiratory pressure.), the patients received spinal anesthesia with either 0.5% hyperbaric bupivacaine or 0.5% hyperbaric tetracaine. Thirty minutes after injection, level of sensory blockade was checked by pinprick test and pulmonary function test was performed. RESULTS: Almost all the values of pulmonary function reduced after spinal anesthesia, but the degrees of reduction were not differ in two groups except PEP, which reduced more profoundly in tetracaine group than bupivacaine group. CONCLUSIONS: It is more desirable that we use bupivacaine rather than tetracaine as spinal anesthetic agent in the patient with poor pulmonary function.
Anesthesia, Spinal* ; Anesthetics ; Bupivacaine* ; Forced Expiratory Volume ; Humans ; Peak Expiratory Flow Rate ; Respiratory Function Tests ; Tetracaine* ; Vital Capacity