The purpose of this study was to evaluate a clinical preventative care program, based on a dental hygiene process (accessment, diagnosis, planning, implementation, evaluation; ADPIE) in a dental clinic, by analyzing patient recognition, knowledge, practice, and satisfaction with respect to oral health. The collected data (in percentages) were analyzed Fisher's exact test and paired t-test using IBM SPSS ver. 21.0 (IBM Co., USA). This study demonstrated a significant difference in oral health knowledge, recognition, and practice before and after the clinical preventive care program (p<0.05). The results were significant in the individual preventive plan within the planning stage, and in the professional teeth cleaning implementation stage (p<0.05). This result can be attributed to the sympathy of the dental hygienist (p<0.05). There was a positive correlation between recommending dental checkups and regular checking of the (r=0.552, p<0.05), undergoing radiography (r=0.434, p<0.01), following an individual preventive plan (r=0.568, p<0.01), undergoing proximal machine teeth cleaning (r=0.437, p<0.05), following tooth brushing instructions (r=0.552, p<0.05), and the evaluation results (r=1.000, p<0.05). Our results demonstrate, that the clinical preventive care program, based on dental hygiene, is an effective program. Given the positive effect of dental revisits and patient recommendations promoting dental hygienists, it is hoped that this preventative program will be widely used.
Dental Clinics ; Dental Hygienists ; Diagnosis ; Hope ; Humans ; Oral Health* ; Oral Hygiene* ; Radiography ; Tooth

PURPOSE: Bispectral index (BIS) is a non-invasive parameter that expresses the level of consciousness using a numerical value that ranges from 0-100. It can be easily conducted at the patient bed-side throughout a day. We studied whether BIS could be used as a predictive factor for neurological outcome in patients who undergo hypothermia after cardiopulmonary resuscitation. METHODS: The prospective study enrolled patients who underwent induced hypothermia with post-resuscitated state after cardiac arrest and presented to Chonnam National University Hospital from June, 2010 to October, 2010. BIS monitoring was conducted from admission at the intensive care unit until normal temperature was attained after the induction of hypothermia. The patients were divided into two groups based on neurological outcome at discharge and the values obtained from BIS monitoring were compared. RESULTS: Fourteen patients were included in this study. The mortality rate was 28.6% and five patients were discharged with Glasgow Pittsburgh Cerebral Performance Categories 1 or 2. The value of BIS at the start of rewarming was significantly different between the two groups according to neurological outcome, while the value of BIS upon reaching normal temperature did not differ statistically. The significant difference between the two groups was observed in the value of BIS from 19 hours after starting hypothermia. CONCLUSION: BIS can be used to predict the neurological outcome of patients who undergo resuscitation after cardiac arrest.
Consciousness ; Consciousness Monitors ; Heart Arrest ; Humans ; Hypothermia ; Hypothermia, Induced ; Intensive Care Units ; Prospective Studies ; Resuscitation ; Rewarming

PURPOSE: Bispectral index (BIS) is a non-invasive parameter that expresses the level of consciousness using a numerical value that ranges from 0-100. It can be easily conducted at the patient bed-side throughout a day. We studied whether BIS could be used as a predictive factor for neurological outcome in patients who undergo hypothermia after cardiopulmonary resuscitation. METHODS: The prospective study enrolled patients who underwent induced hypothermia with post-resuscitated state after cardiac arrest and presented to Chonnam National University Hospital from June, 2010 to October, 2010. BIS monitoring was conducted from admission at the intensive care unit until normal temperature was attained after the induction of hypothermia. The patients were divided into two groups based on neurological outcome at discharge and the values obtained from BIS monitoring were compared. RESULTS: Fourteen patients were included in this study. The mortality rate was 28.6% and five patients were discharged with Glasgow Pittsburgh Cerebral Performance Categories 1 or 2. The value of BIS at the start of rewarming was significantly different between the two groups according to neurological outcome, while the value of BIS upon reaching normal temperature did not differ statistically. The significant difference between the two groups was observed in the value of BIS from 19 hours after starting hypothermia. CONCLUSION: BIS can be used to predict the neurological outcome of patients who undergo resuscitation after cardiac arrest.
Consciousness ; Consciousness Monitors ; Heart Arrest ; Humans ; Hypothermia ; Hypothermia, Induced ; Intensive Care Units ; Prospective Studies ; Resuscitation ; Rewarming

PURPOSE: This study was performed to determine the usefulness of blood culture in the management of febrile immunocompetent patients presenting emergency department. METHODS: We prospectively analysed the medical characteristic and the result of blood culture of febrile immunocompetent patients who presented to Chonnam National University Hospital emergency center form April 2005 to October 2005. RESULTS: The study included 182 patients. The characteristic associated with the positive result of blood culture on multivariate analysis was the low initial level of albumin. Of the 182 culture, only 26 were true positive(14.3%). Of them, the result of blood culture influenced management in five patients (2.7%). CONCLUSION: The blood cultures has usually been ordered in febrile immunocompetent patients at emergency department has the limited usefulness. The emergency physician who initially treats them has to consider this limitation of it.
Emergencies* ; Emergency Service, Hospital* ; Fever ; Humans ; Jeollanam-do ; Multivariate Analysis ; Prospective Studies

N-acetylcysteine (NAC) is widely recognized as the antidote of choice for acetaminophen overdose. Acetaminophen is a commonly used analgesic and antipyretic agent, and its use is one of the most common causes of poisoning worldwide. Acetaminophen toxicity may occur acutely when supratherapeutic amounts are ingested purposefully or unintentionally. Liver failure may occur in severe toxicity. However, if treated early, patients with acetaminophen poisoning generally recover uneventfully. Acetaminophen is metabolized to N-acetyl-p-benzoquinone imine (NAPQI), which is detoxified by conjugation with glutathione. In overdose, hepatic stores of glutathione are depleted and NAPQI binding to hepatocytes induces cell death and hepatic necrosis. NAC replenishes hepatic glutathione and may also act as a glutathione substitute, combining directly with the toxic metabolite. Intravenous NAC is indicated in patients who present with a history of acetaminophen overdose within the previous 8 to 10 hours, patients unable to tolerate oral NAC, and patients who present with evidence of fulminant hepatic failure. However, caution should be used in patients who have experienced previous hypersensitivity or anaphylactoid reactions to intravenous NAC, as well as in patients with asthma. The most common anaphylactoid reactions include rash, flushing, and bronchospasm. Adults should receive 150 mg/kg administered for 45 minutes, followed by 50 mg/kg administered for 4 hours, followed by 100 mg/kg administered for 16 hours. The total dose is 300 mg/kg delivered over 21 hours. Additionally, caution should always be used when intravenous NAC is prescribed and the amount of diluent is calculated. Monitoring of patients with a should include repeated neurologic and hemodynamic assessment.
Acetaminophen* ; Acetylcysteine* ; Adult ; Antidotes ; Asthma ; Benzoquinones ; Bronchial Spasm ; Cell Death ; Exanthema ; Flushing ; Glutathione ; Hemodynamics ; Hepatocytes ; Humans ; Hypersensitivity ; Imines ; Liver Failure ; Liver Failure, Acute ; Necrosis ; Poisoning*

Fentanyl is a selective and pure agonist to the micron receptor and is about 100 times more potent than morphine. It has been used through intravenously to control acute pain, such as postopreative pain, for a long time. A transdermal fentanyl system, a fentanyl patch, composed of four layers of functional reserviors of fentanyl and one protective layer, delivers a constant amount of fentanyl to systemic circulation thorough passive diffusion for up to 3 days after application on the skin. Due to its pharmacokinetic properties, including delayed onset, relatively constant effect for 3 days, and to the relatively short duration and variable change of acute pain, we recommend that the transdermal fentanyl system should be used to control chronic pain in patients who do not response to lower analgesic agents. However, because of misperception of health care providers, its noninvasive and simple method of administration, and the absence of laws to regulate its usage, abuses of the transdermal fentanyl system have been reported a lot. In conclusion, we reported the cases of two patient who experienced fatal effects after abuse of fentanyl patch, we analyse the pharmacokinetic properties of the fentanyl patch and previous reported cases. We also discuss the appropriate use and regulation of the transdermal fentanyl system by primary health care provider.
Acute Pain ; Analgesics ; Chronic Pain ; Diffusion ; Fentanyl* ; Health Personnel ; Humans ; Jurisprudence ; Morphine ; Primary Health Care ; Respiratory Insufficiency ; Skin

Sodium hypochlorite is commonly used as a household bleaching agent (for example, the Clorox brand). Sodium hypochlorite poisoning with ingestion of a bleaching agent is often observed in clinical practice.Current Concepts: Ingestion (intentional or accidental) is the most common route of exposure to household bleaching agents. Accidental ingestion of household bleaching agents is rarely clinically important. However, ingestion of a large amount of a dilute formulation or a high-concentration preparation of bleaching agents can result in severe and rarely fatal corrosive injury. Therefore, prompt supportive care is essential because a specific antidote is currently unavailable. Severe poisoning requires hospital admission. Emergency endoscopy and thoracic and abdominal computed tomography are warranted to aid with diagnosis and management of hypochlorite-induced corrosive injury in patients with severe poisoning, who develop clinical features suggestive of corrosive injury.Discussion and Conclusion: Intentional poisoning, which accounts for most cases of household bleaching agent poisonings in Korea, is likely to cause severe corrosive injuries. Therefore, it is necessary to gain deeper and accurate understanding of the clinical aspects and treatment of poisoning by household bleaching agents.

PURPOSE: We evaluated the effects of surgery for rectal cancer on postoperative voiding and sexual function over the course of time. MATERIALS AND METHODS: Data from 28 patients who underwent autonomic nerve preserving rectal cancer surgery were retrospectively analyzed. Operations were performed between October 2005 and July 2007 and all patients were followed-up for more than 3 years. Preoperatively, all patients underwent urodynamic studies including uroflowmetry, and filled out the International Prostate Symptom Score (IPSS). The evaluation of sexual function consisted of Erectile Function domain score in International Index of Erectile Function (IIEF-EFD) and Ejaculation domain score in Male Sexual Health Questionnaire (MSHQ-EjD). Data from uroflowmetry and questionnaires were examined. RESULTS: At 3 years postoperatively the prostate volume was similar to the preoperative value (P=0.727). There were no statistically significant postoperative changes in the average maximum flow rate (15.9 ml/s vs. 16.2 ml/s, p=0.637) and post-void residual urine volume (34.7 ml vs. 36.8 ml, p=0.809). No statistically significant differences were observed in the IPSS (13.2 vs. 12.2, p=0.374). However, although pelvic autonomic nerve preservation have been performed, a significant proportion of rectal cancer patients suffer from sexual dysfunction and the average of IIEF-EFD and MSHQ-EjD scores was decreased postoperatively until 3 years (25.1 vs. 16.1 and 28.3 vs. 14.2 respectively, p<0.001). CONCLUSIONS: Voiding function was not affected after autonomic nerve-preserving rectal cancer surgery, however sexual function was significantly aggravated. We recommend that the baseline genitourinary function should be evaluated before the treatment for male rectal cancer patients, and penile rehabilitation is necessary for their quality of life after treatment.
Autonomic Pathways ; Ejaculation ; Humans ; Male ; Postoperative Complications ; Prostate ; Quality of Life ; Rectal Neoplasms ; Reproductive Health ; Retrospective Studies ; Urination ; Urodynamics

PURPOSE: Extremely hazardous pesticides are classified as World Health Organization (WHO) hazard class Ia. However, data describing the clinical course of WHO class Ia OP (organophosphate) poisonings in humans are very scarce. Here, we compare the clinical features of patients who ingested hazard class Ia OPs. METHODS: This retrospective observational case study included 75 patients with a history of ingesting ethyl p-nitrophenol thio-benzene phosphonate (EPN), phosphamidon, or terbufos. The patients were divided according to the chemical formulation of the ingested OP. Data regarding mortality and the development of complications were collected and compared among groups. RESULTS: There were no differences in the baseline characteristics and severity scores at presentation between the three groups. No fatalities were observed in the terbufos group. The fatality rates in the EPN and phosphamidon groups were 11.8% and 28.6%, respectively. Patients poisoned with EPN developed respiratory failure later than those poisoned with phosphamidon and also tended to require longer mechanical ventilatory support than phosphamidon patients. The main cause of death was pneumonia in the EPN group and hypotensive shock in the phosphamidon group. Death occurred later in the EPN group than in the phosphamidon group. CONCLUSION: Even though all three drugs are classified as WHO class Ia OPs (extremely hazardous pesticides), their clinical courses and the related causes of death in humans varied. Their treatment protocols and predicted outcomes should therefore also be different based on the chemical formulation of the OP.
Cause of Death ; Classification ; Clinical Protocols ; Humans* ; Mortality ; Organophosphates* ; Pesticides ; Phosphamidon* ; Pneumonia ; Poisoning* ; Respiratory Insufficiency ; Retrospective Studies ; Shock ; World Health Organization

OBJECTIVES: Cyberbullying has recently become a major concern in Korea and especially poses a serious threat to adolescents. The object of this study is to examine the psychopathology of perpetrators and victims of cyberbullying. METHODS: In a cross-sectional study, 490 middle school students completed questionnaires on bullying and victimization experiences in cyberspace. Korean-Youth Self Report (K-YSR) was included to evaluate the psychopathology of the students. RESULTS: The prevalence rates of victims and perpetrators of cyberbullying were 6.92% and 3.33%, respectively. Among 9 sub-scales of K-YSR, the scores of depressed/anxious (p=0.049), thought problems (p=0.002), and attention problems (p=0.039) were significantly different between victim, perpetrator, victim/perpetrator, and control group. Multinomial logistic regression indicated that the victim group was associated with depressed/anxious [odds ratio (OR)=1.10], social immaturity (OR=1.24), thought problems (OR=1.32), and self-destructive identity problems (OR=1.16). The perpetrator group was associated with thought problems (OR=1.37) and attention problems (OR=1.21). The victim/perpetrator group was associated with delinquent behavior (OR=2.04). CONCLUSION: Middle school students involved in cyberbullying were associated with psychopathologies including depression, anxiety, thought problems, attention problems, and delinquent behaviors. The risk of cyberbullying is escalating with the rapid advancement in technology. Therefore, a comprehensive approach should be employed for prediction and prevention of cyberbullying in adolescents.
Adolescent ; Anxiety ; Bullying* ; Crime Victims ; Cross-Sectional Studies ; Depression ; Humans ; Korea ; Logistic Models ; Prevalence ; Psychopathology* ; Surveys and Questionnaires ; Self Report