PURPOSE: This is a qualitative study to identify dimensions of long-term care hospital care quality that provide high-level medical services for long-term care patients in Korea. METHODS: Service consumers and providers were interviewed, and collected data were analyzed into thesis, type and dimension. The focus group method was applied to two provider groups and individual interview was applied to two persons who had experienced a long-term care hospital. RESULTS: The results of analyzing the comsumers and providers was integrated into 8 dimensions: physical environment, staff, clinical care and nursing, multiplicity of activity program, atmosphere, interaction with family, nutrition, and quality improvement system. CONCLUSION: The dimensions of long-term care hospital care quality from this study can be used as a basis of quality indicators. Quantitative studies to test these dimensions are required for establishing quality management systems.
Atmosphere ; Focus Groups ; Humans ; Korea ; Long-Term Care* ; Nursing ; Qualitative Research ; Quality Improvement ; Quality Indicators, Health Care

PURPOSE: This in vitro study was performed to assess the adherence of Porphyromonas gingivalis to a resorbable blast media (RBM) titanium surface pretreated with an ultrasonic scaler or toothbrush and to evaluate the effects of the treatment of the RBM titanium discs on the bacterial removal efficiency of brushing by crystal violet assay and scanning electron microscopy. METHODS: RBM titanium discs were pretreated with one of several ultrasonic scaler tips or cleaned with a toothbrush. Then the titanium discs were incubated with P. gingivalis and the quantity of adherent bacteria was compared. The disc surfaces incubated with bacteria were brushed with a toothbrush with dentifrice. Bacteria remaining on the disc surfaces were quantified. RESULTS: A change in morphology of the surface of the RBM titanium discs after different treatments was noted. There were no significant differences in the adherence of bacteria on the pretreated discs according to the treatment modality. Pretreatment with various instruments did not produce significant differences in the bacterial removal efficiency of brushing with dentifrice. CONCLUSIONS: Within the limits of this study, various types of mechanical instrumentation were shown to cause mechanical changes on the RBM titanium surface but did not show a significant influence on the adherence of bacteria and removal efficiency of brushing.
Bacteria ; Dental Scaling ; Dentifrices ; Gentian Violet ; Microscopy, Electron, Scanning ; Porphyromonas gingivalis ; Surface Properties ; Titanium* ; Toothbrushing ; Ultrasonics*

PURPOSE: This study was conducted to investigate the effects of variations in arm swing during gait on movement of the trunk and pelvis. During the gait task, the angle of the trunk and pelvic rotation were analyzed according to arm swing conditions. METHODS: Seventeen healthy males participated in this study. All subjects were analyzed for gait on a treadmill three times each under three different types of arm swing conditions – natural arm swing, restricted arm swing using a phone, restricted swing in both arms. 3-D motion analysis systems were used to collect and analyze the kinematic data of trunk and pelvic movements, and repeated one-way ANOVA was used to compare the trunk and pelvic kinematic data and symmetry index. The level of significance was α=0.05. RESULTS: The results showed kinematic differences in trunk and pelvic during gait based on the arm swing conditions. Specifically, there were significant differences in trunk rotation, left and right trunk rotation and symmetry index of trunk rotation during gait among the three arm swing conditions. ROM was used to calculate a symmetry index (SI) based on the average left and right trunk rotation in which a value closer to zero indicated better balance. The SI obtained for arm swing restricted with the phone was closer to –1 than the other conditions. CONCLUSION: Restricted arm swing due to use of a phone had the possibility to induce instability of postural control while walking, which could be seen to suggest a risk of falling during gait.
Accidental Falls ; Arm* ; Cell Phones* ; Gait ; Humans ; Male ; Pelvis* ; Walking

OBJECTIVES: We aimed to provide standard data of the individual tests in 7MS that could generalized for Korean elderly according to age and education. We also evaluated diagnostic efficacy of each test in 7MS. METHODS: Data on demographic characteristics of 311 normals were gathered for comparison. We also assessed two differences between normal and dementia group in individual tests of 7MS. RESULTS: All individual tests of 7MS showed significant differences in sex, age, and education, except for ECR. But there were no significant differences in sex controlling age and education. As a result of ROC curve, the ability of the ECR test to discriminate between AD and normal subject appeared superior. The scores of the individual tests of 7MS among CDR 0.5 and 1 group and normal group were compared. It was also found that the ECR test stands out among 7MS tests. CONCLUSION: The 7MS, particularly ECR, had the highest sensitivity and specificity for diagnosis of AD as well as early dementia. It suggests that the individual tests of 7MS are useful to predict early dementia, without using the complex logistic regression equation.
Aged ; Dementia ; Diagnosis ; Education ; Humans ; Logistic Models ; Mass Screening ; ROC Curve ; Sensitivity and Specificity

Nevus sebaceus is a congenital cutaneous hamartoma which has a potential to develop both benign and malignant neoplasm in late life. The most common benign tumor developed within the nevus is syringocystadenoma papilliferum and the most common malignant tumor basal cell epithelioma. Although two different tumors often develop simultaneously on the lesion, it is rare to see more than two different tumors developing on the lesion of nevus sebaceus. In Korean literatures only three such cases were reported. We report an additional case of nevus sebaceus developing three different tumors, syringocystadenoma papilliferum, sebaceous epithelioma, and basal cell carcinoma, in a 67-year-old female patient.
Aged ; Carcinoma* ; Carcinoma, Basal Cell* ; Female ; Hamartoma ; Humans ; Nevus*

9-cis-retinoic acid (9CRA) plays an important role in the immune response; this includes cytokine production and cell migration. We have previously demonstrated that 9CRA increases expression of chemokine receptors CCR1 and CCR2 in human monocytes. To better understand how 9CRA induces CCR1 and CCR2 expression, we examined the contribution of signaling proteins in human monocytic THP-1 cells. The mRNA and surface protein up-regulation of CCR1 and CCR2 in 9CRA-stimulated cells were weakly blocked by the pretreatment of SB202190, a p38 MAPK inhibitor, and PD98059, an upstream ERK inhibitor. Activation of p38 MAPK and ERK1/2 was induced in both a time and dose-dependent manner after 9CRA stimulation. Both p38 MAPK and ERK1/2 phosphorylation peaked at 2 h after a 100 nM 9CRA treatment. 9CRA increased calcium influx and chemotactic activity in response to CCR1-dependent chemokines, Lkn-1/CCL15, MIP-1alpha/CCL3, and RANTES/CCL5, and the CCR2-specific chemokine, MCP-1/CCL2. Both SB202190 and PD98059 pretreatment diminished the increased calcium mobilization and chemotactic ability due to 9CRA. SB202190 inhibited the expression and functional activities of CCR1 and CCR2 more effectively than did PD98059. Therefore, our results demonstrate that 9CRA transduces the signal through p38 MAPK and ERK1/2 for CCR1 and CCR2 up-regulation, and may regulate the pro-inflammatory process through the p38 MAPK and ERK-dependent signaling pathways.
Calcium Signaling/drug effects ; Cell Line ; Chemokines/pharmacology ; Chemotaxis, Leukocyte/drug effects ; Enzyme Activation/drug effects ; Extracellular Signal-Regulated MAP Kinases/*metabolism ; Flavonoids/pharmacology ; Gene Expression Regulation/*drug effects ; Humans ; Imidazoles/pharmacology ; Mitogen-Activated Protein Kinase 1/metabolism ; Mitogen-Activated Protein Kinase 3/metabolism ; Monocytes/drug effects/*enzymology ; Pyridines/pharmacology ; RNA, Messenger/genetics/metabolism ; Receptors, CCR1 ; Receptors, CCR2 ; Receptors, Chemokine/*genetics/metabolism ; Tretinoin/*pharmacology ; p38 Mitogen-Activated Protein Kinases/*metabolism

Critical valvular aortic stenosis(AS) is a life threatening congenital heart anomaly in neonates or infants. The main cause of death is rapidly progressing left ventricular failure. The treatment goal of critical AS is to save left ventricular function early. Before the 1980s, the preferred treatment was surgical valvotomy, however, that operative method had a high mortality rate and risk of re- procedure. These surgical problems encouraged balloon aortic valvuloplasty technique for initial life saving. There were some vascular approaches for balloon aortic valvuloplasty(e.g. femoral artery and vein, umbilical artery and vein, carotid artery). Each approach has some advantages and disadvantages. Balloon aortic valvuloplasty through the right carotid artery makes access to the aortic valve easy, has less vascular complication, and short procedure time and effect of saving femoral artery for reballooning. We had three cases of transcarotid balloon aortic valvuloplasty in infants with critical AS. In our long-term follow up, we had good results, except carotid artery thrombosis in one case. We report the first three Korean cases of balloon aortic valvuloplasty though carotid artery cutdown procedure for critical AS with a brief review of literatures. (J Korean Pediatr Soc 2000;43:820-827)
Aortic Valve ; Aortic Valve Stenosis* ; Arteries ; Carotid Arteries ; Carotid Artery Thrombosis ; Cause of Death ; Femoral Artery ; Follow-Up Studies ; Heart ; Humans ; Infant* ; Infant, Newborn ; Mortality ; Umbilical Veins ; Veins ; Ventricular Function, Left

The numb chin syndrome (NCS) is characterized by chin or lower lip numbness restricted to the distribution of the mental nerve (the distal trigeminal nerve). The authors report a patient whose initial symptom of tumor recurrence was unilateral numbness of the chin. A 65-year-old male was admitted because of paresthesia around the left chin and left lower lip. Neurologic examination revealed hypesthesia on the left side of chin, lower lip and buccal mucous mem-brane. Bone scan (Tc-99m MDP) showed focal hot uptakes on the left mandible and left first rib. Brain CT with bone window setting showed a focal osteolytic lesion in the bone marrow of the left mandibular canal without destruction of bone cortex. Both coronal T1 weighted image and axial T2 weighted image showed focal low signal intensities on the left ramus. The pathophysiologic mechanism could be understood by identification of the pathologic focus.
Aged ; Bone Marrow ; Brain ; Chin ; Hodgkin Disease* ; Humans ; Hypesthesia ; Lip ; Male ; Mandible ; Neurologic Examination ; Paresthesia ; Recurrence ; Ribs

BACKGROUND AND OBJECTIVES: To determine the anatomic position of the inferior alveolar nerve (IAN) canal in patients with mandibular prognathism using the cone-beam CT (CBCT). MATERIALS AND METHODS: Fifty rami from 25 patients were evaluated. The images were taken by i-CAT and reconstructed 3-dimensionally using the Simplant 11 program. The linear distances between the IAN canal to the buccal cortex (a, a* and a**), from the IAN canal to the alveolar crest (b and b*) and the anterior margin (b**) and finally the buccal cortical thickness (c, c* and c**) were measured at three reference planes (VP, OP and HP). RESULTS: On the left side, the average distance of a, b and c were 7.12, 15.96 and 3.60 mm on the VP plane, respectively. On the OP, the distance of a*, b* and c* was 6.11, 8.83 and 2.63 mm. For the HP, the distance of a**, b** and c** was 4.84, 10.11 and 2.30 mm. On the right side, the distance of a, b and c, on the VP, was 7.10, 16.13 and 3.42 mm, respectively. On the OP, the distance of a*, b* and c* was 4.77, 8.75 and 2.68 mm. On the HP, the distance of a*, b* and c** was 4.55, 9.84 and 2.38 mm. Regarding the difference between genders, the distance in male's was longer than female's on the VP (p=0.019), and was thicker in males than females on the HP (p=0.002). CONCLUSION: The CBCT data provided accurate information about the location and course of the IAN.
Cone-Beam Computed Tomography ; Female ; Humans ; Male ; Mandibular Nerve ; Prognathism

BACKGROUND AND OBJECTIVES: To determine the anatomic position of the inferior alveolar nerve (IAN) canal in patients with mandibular prognathism using the cone-beam CT (CBCT). MATERIALS AND METHODS: Fifty rami from 25 patients were evaluated. The images were taken by i-CAT and reconstructed 3-dimensionally using the Simplant 11 program. The linear distances between the IAN canal to the buccal cortex (a, a* and a**), from the IAN canal to the alveolar crest (b and b*) and the anterior margin (b**) and finally the buccal cortical thickness (c, c* and c**) were measured at three reference planes (VP, OP and HP). RESULTS: On the left side, the average distance of a, b and c were 7.12, 15.96 and 3.60 mm on the VP plane, respectively. On the OP, the distance of a*, b* and c* was 6.11, 8.83 and 2.63 mm. For the HP, the distance of a**, b** and c** was 4.84, 10.11 and 2.30 mm. On the right side, the distance of a, b and c, on the VP, was 7.10, 16.13 and 3.42 mm, respectively. On the OP, the distance of a*, b* and c* was 4.77, 8.75 and 2.68 mm. On the HP, the distance of a*, b* and c** was 4.55, 9.84 and 2.38 mm. Regarding the difference between genders, the distance in male's was longer than female's on the VP (p=0.019), and was thicker in males than females on the HP (p=0.002). CONCLUSION: The CBCT data provided accurate information about the location and course of the IAN.
Cone-Beam Computed Tomography ; Female ; Humans ; Male ; Mandibular Nerve ; Prognathism