The purpose of this study was to understand the effectiveness of oral health education (OHE) or oral hygiene instruction (OHI) involving professional plaque control/removal, as compared to conventional plaque control/removal. By means of a systematic review of the literature, in the review of literature by using systematic method, Korean articles of plaque control including OHE or OHI, were studied in order to analyze and conclude the literature to enhance oral health. We found that self and professional plaque control/removal, in addition to tooth brushing instructions, decreased incidence and prevalence of loss of teeth. Taken together, professional mechanical plaque removals were most effective 4~5 visits every 1~2 weeks. Use of disclosing agent was more effective than oral education or model education. In line with oral hygiene education, professional brushing, oral prophylaxis, scaling and root planing, it was advisable to repeat the training according to the characteristics of the patient. Routine OHE or OHI would be help to increase to oral health. For a quality of life related oral health, reliability and validity of data are needed to develop and its data should be applied to dental health insurance policy.
Dental Plaque* ; Education* ; Education, Professional ; Humans ; Incidence ; Insurance, Health ; Korea* ; Methods ; Oral Health ; Oral Hygiene* ; Prevalence ; Quality of Life ; Reproducibility of Results ; Root Planing ; Tooth

The 447 cases of skin tumors were studied at the departments of dermatology and surgical pathology, National Medical Center in Seoul during the period of 18 years and 8 months from January, 1959 to August, 1977. The results were as follows: 1) the total number of specimens surveyed in the study was 447, among which benign tumors accoungted for 234 cases and malignant tumors for 213. 2) Male to female ratio for benign tumors was 1.2:1 and for malignant tumors 2.2:1. 3) Among the 234 cases of benign tumors, 67 cases were epidermal cyst. 53 cases of hemangioma and 34 cases of pigmented neni. 4) Among the 2 cases of malignant melanoma. 5) The peak age incidence for benign tumors were below the 2nd decade, The peak ago incidence for malignant tumors were 50th decade. 6) the sites of predilection of the epidermal cysts were trunk, face and neck. The sites of predilection of the hemangiomas and pigmented nevi were face. 7) The sites of peredilection of the squamaous cell carcinomas were penis(27.1%), lower extremities(25.7%) and face(21.5%) The sites of predilection of the basal cell carcinomas were face(83.3%) 8) The ratio of squamous cell carcinoma ws basal cell careinoma was 4:1. 9) The accuracy of clinical dianosis were 42.7% for benign tumors and 79.3% for malignant tumors.
Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Dermatology ; Epidermal Cyst ; Female ; Hemangioma ; Humans ; Incidence ; Male ; Melanoma ; Neck ; Nevus, Pigmented ; Pathology, Surgical ; Seoul ; Skin*

To study the differenced of bone mineral density according to the gestational ages and the birth weight and get a reference data for the diagnosis of metabolic bone diseases in the newborn infants, bone mineral densities of the lumbar vertebrae were measured in fifty-three newborn infants bone at Yeungnam University Hospital from March 1, 1995 to February 28, 1997, whose gestational ages were between 28+3 and 41+3 weeks and who had no intrauterine growth retardation, using dual energy X-ray absorptiometry (X-R 26, Norland, USA) within seven days of life. 1. There was no sexual difference in bone mineral density. The bone density increased significantly as gestational age increased from 0.149+/-0.009 g/cm2 at 28-30wks to 0.229+/-0.034 g/cm2 at 39-41wks of gestational age (p<0.05), but there was no significant difference between bone mineral density at 33-34wks and 35-36wks. There was positive linear correlation netween gestational age and bone mineral density (Y=7.5?10-3X-0.082, r=0.7018, p<0.001). 2. The bone mineral density increased significantly as the birth weight increased from 0.158+/-0.020 g/cm2 in 1,000-1,499 g to 0.251+/-0.021 g/cm2 in 3,500-4,000 g of the birth weight (p<0.05), but there was no significant difference between bone mineral densities in 1,000-1,499 g and 1,500-1,999 g of the birth weight. There was positive linear correlation between the birth weight and the bone mineral density (Y=3.9?10-5X+0.093, r=0.7296, p<0.001). There were positive correlations between the bone mineral density and gestational age, and between the bone mineral density and the birth weight. It can be used as a reference data for the further study on the bone mineral metabolism in the newborn infants including preterm babies.
Absorptiometry, Photon ; Birth Weight* ; Bone Density* ; Bone Diseases, Metabolic ; Diagnosis ; Fetal Growth Retardation ; Gestational Age* ; Humans ; Infant, Newborn* ; Lumbar Vertebrae ; Metabolism ; Parturition*

BACKGROUND: More laparoscopic low anterior resections (LAR) are being performed in recent years. There has been controversy around the hemodynamic changes affected by the Trendelenburg position and pneumoperitoneum during LAR. The goal of this study was to analyze the effect of nitroglycerin (NTG) on hemodynamic changes during LAR. METHODS: Forty ASA physical status I-II patients undergoing LAR were randomized into two groups: the NTG infused group (N group, n = 20) and the control group (C group, n = 20). Anesthesia was maintained with sevoflurane at 1-3 vol%, air/oxygen (50%/50%) and continuous infusion with remifentanil. The N group patients were given 0.5 microg/kg/min of NTG during anesthesia. Mean arterial pressure (MAP), heart rate (HR), central venous pressure (CVP), cardiac index (CI), stroke volume (SV) and systemic vascular resistance (SVR) were assessed 10 min after induction (T1), 5 min after pneumoperitoneum in the supine position (T2), 10 min after pneumoperitoneum in the Trendelenburg position (T3), 30 min after pneumoperitoneum in the Trendelenburg position (T4), 1 hr after pneumoperitoneum in the Trendelenburg position (T5) in addition to 5 (T6), 10 (T7) and 30 min (T8) after removal of the pneumoperitoneum in the supine position. RESULTS: The increases of MAP were milder in the N group (22.6-7.3%) than the C group (32.3-17.7%) during pneumoperitoneum and while in the Trendelenburg position. The significant decreases of HR were maintained in the C group, but the changes in HR were not significant in N group during the operation. The increases in CVP were less in N group than C group. The increases of SVR were milder in N group (19.4-1.4%) than C group (41.7-16.6%) during pneumoperitoneum in the Trendelenburg position. CONCLUSIONS: Intraoperative NTG infusions were effective to some degree in reducing the hemodynamic changes during pneumoperitoneum with Trendelenburg positioning for LAR.
Anesthesia ; Arterial Pressure ; Central Venous Pressure ; Head-Down Tilt ; Heart Rate ; Hemodynamics ; Humans ; Methyl Ethers ; Nitroglycerin ; Piperidines ; Pneumoperitoneum ; Stroke Volume ; Supine Position ; Vascular Resistance

Central venous catheterization is of vital importance in the management of critically ill neonates and also premature infants for total parenteral nutrition, hemodynamic monitoring, anesthetic care, transfusion or the administration of a few vasoactive drugs. Various complications of this procedure have been reported, such as arterial puncture, pneumothorax, cardiac tamponade, and catheter related kinking or knotting. Due to narrow safety margins, these complications are more dangerous in extremely premature infants compared to adults. We present a case of left subclavian venous catheterization complicated by U-shaped intravascular catheter kinking in premature infant which was successfully repositioned by insertion of a new guidewire through the previous catheter without secondary skin puncture.
Adult ; Cardiac Tamponade ; Catheterization ; Catheterization, Central Venous ; Catheters ; Central Venous Catheters ; Critical Illness ; Hemodynamics ; Humans ; Infant, Extremely Premature ; Infant, Newborn ; Infant, Premature ; Parenteral Nutrition, Total ; Pneumothorax ; Punctures ; Skin

PURPOSE: To evaluate the loss of bone mineral contents(BMC) in lumbar spine within the radiation field for cervical cancer treatment, BMC in the irradiated patient group was compared with that of a normal control group. METHOD AND MATERIALS: Measurements of BMC in the trabecular bone in lumbar spines(L3-L5) were performed in the both patient and normal control groups. Investigators used dual-energy quantitative computerized tomography(DEQCT) using photon energy of 120 and 80kVp. The numbers of patient and control groups were 43 in each with age distribution of fifth to seventh decade of women. The numbers of control group were 22 in fifth, 10 in sixth, and 11 in seventh decade, those of patient group were 14 in fifth, 14 in sixth, and 15 in seventh decade of women. The radiation field was extended to L5 spine for pelvic irrdiation with 45-54Gy of external radiation dose and 30Gy of high dose rate brachytherapy in cervical cancer. RESULTS: The BMC is decreased as increasing age in both control and patient groups. BMC in lumbar spine of patient group was decreased by about 13% to 40% maximally. The BMC of L3 and L4 a region that is out of a radiation field for the patient group demonstrated 119.5+/-30.6, 117.0+/-31.7 for fifth, 83.3+/-37.8, 88.3+/-46.8 for sixth and 61.5+/-18.3, 56.2+/-26.6mg/cc for seventh. Contrasted by the normal control group has shown 148.0 +/-19.9, 153.2+/-23.2 for fifth, 96.1+/-30.2, 105.6+/-26.5 for sixth and 73.9+/-27.9, 77.2+/-27.2mg/cc for seventh decade, respectively. The BMC of patient group was decreased as near the radiation field, while the lower lumbar spine has shown more large amounts of BMC in the normal control group. In particular, the BMC of L5 within the radiation field was significantly decresed to 33%, 31%, 40% compared with the control group of the fifth, sixth and seventh decades, respectively. CONCLUSION: The pelvic irradiation in cervical cancer has much effected on the loss of bone mineral content of lumbar spine within the radiation field, as the lower lumbar spine has shown a smaller BMC in patient group with pelvic irradiation in contrast to that of the normal control groups.
Age Distribution ; Bone Density* ; Brachytherapy ; Female ; Humans ; Research Personnel ; Spine* ; Uterine Cervical Neoplasms*

OBJECTIVE: To evaluate the maternal and fetal outcomes after transvaginal selective fetal reduction(SFR) in multifetal pregnancy. MATERIALS AND METHODS: Transvaginal SFR using fetal intracardiac puncture with KCl injection and aspiration of amniotic fluid was performed in 58 multifetal pregnancies achieved after assisted reproductive technology(ART). After transvaginal SFR, 55 twin and 3 singleton pregnancies were evaluated and analyzed retrospectively with the medical records of mothers and babies. RESULTS: Of 58 cases, abortion within 4 weeks after SFR occurred in 1 case(1.7%). Miscarriage of all fetuses occurred in 8 cases(13.8%) from 4 weeks after SFR until 24 weeks of gestation. Perinatal death occurred in 8 newborns from 5 mothers due to extreme prematurity in 7 cases and anencephaly in 1 case. Take-home baby rate, that is, discharge with at least 1 healthy baby, was 77.6%(45/58). CONCLUSION: Transvaginal SFR is an acceptable and effective management option in the cases of excessive multifetal pregnancy after infertility treatment. The ultimate successful outcomes of reduced multifetal pregnancy may be enhanced by more extensive experience with SFR.
Abortion, Spontaneous ; Amniotic Fluid ; Anencephaly ; Female ; Fetus ; Humans ; Infant, Newborn ; Infertility ; Medical Records ; Mothers ; Pregnancy ; Pregnancy Outcome* ; Pregnancy Reduction, Multifetal* ; Pregnancy* ; Punctures ; Retrospective Studies

Successful Weaning is very important to provide adequate nutrients for nomal growth and to induce a good diet habit. We conducted a survey on the Knowledge and attitudes of women who live in Taegu toward weaning in infants, to figure out how much they know about weaning diet for the infants, which source they prefer to get the information about weaning diet, whether their knowledge affect their practice about weaning in infants, and the most effective way to educate them. A survey was conducted with the prepared questionnaire on women who responded all the residential area and market place, and those who visited Department of Pediatrics, Yeungnam University hospital from July 25 to September 15, 1997. Statistical analysis was done with student t-test and ANOVA using SPSS program. Among total 303 responders, those who aged between 30 and 39 year were 37.2%. Scores for the six questions about weaning policy showed highest in the age group between30 and 39 years. Higher score was recorded in the more educated group, in those who get informations about weaning diet from books, magazines and pediatricians. The majority of the responders had wrong concepts, such as feeding weaning diet using bottle(69.1%), feeding mixed with formula in the same bottle(64.5%), addition of salt(68.4%), Those who had higher educational level preferred books, magazines rather than neighbors or mother to get informations about weaning diet. Those who preferred books or magazines started weaning, stopped bottle feeding, and used spoon earlier, and their children had unbalanced diet habits less frequently. Home-made food was most frequently, and commercial products were used less frequntly. Those who ewre employed preferred home-made good rather than commercial products, it may be caused by the difference of the educational backgrounds from those of the unemployed. In conclusion, most responders ask neighbors and mother to get informations about weaning, and the incorrect knowledge from them colud cause inadquate weaning practice and induced bad diet habit in their children. We have to find the reasons why they did not refer books or magazines frequently, and the way to resolve the problem.
Bottle Feeding ; Child ; Daegu* ; Diet* ; Female ; Food Habits ; Humans ; Infant* ; Mothers ; Pediatrics ; Periodicals as Topic ; Surveys and Questionnaires ; Weaning*

Primary ovarian ectopic pregnancy has remained a rare event. It is difficult preoperatively to diagnose and differentiate ovarian pregnancy from hemorrhagic ovarian cyst and tubal ectopic pregnancy. However, improved diagnosis of acute hemoperitoneum of ovarian origin may reveal a higher incidence than reported earlier. The diagnostic criteria were described in 1878 by Spiegelberg, which comprise that the pregnancy is in the ovary and does not involve the tube. Ovarian pregnancy occurs within the ovary and on the corpus luteum, usually with rupture of the ovary and a massive hemoperitoneum. We report a relatively intact primary ovarian pregnancy with a brief review of the literatures.
Corpus Luteum ; Diagnosis ; Female ; Hemoperitoneum ; Incidence ; Ovarian Cysts ; Ovary ; Pregnancy ; Pregnancy, Ectopic* ; Rupture

PURPOSE: To test the hemodynamic and biochemical sequences of secondary cerebral energy failure after acute reversed hypoxic ischemic brain insult (HI) can be reproduced in newborn piglets. METHODS: Fifteen anesthetized, ventilated newborn piglet (<3 day) were studied. Eight (HI) were induced transient HI by breathing 8% oxygen and complete occlusion of bilateral common carotid arteries for 30 minutes followed by reoxygenation and reperfusion. Seven (control) were given a sham operation. Both groups were maintained for 48 hours with intensive care and monitoring of cerbral hemodynamics and [delta Cyt aa3] using near infrared spectroscopy (NIRS). Finally, brain cortex was harvested and determined activities of Na+, K+/-ATPase, level of conjugated dienes, ATP and phosphocreatine (PCr) biochemically. RESULTS: No changes took place in the 48-hour control group. In HI group, PaO2, pH, and MABP decreased, and heart rate, glucose, lactate level in blood and lactate level in CSF increased during acute HI. These variables subsequently returned to normal with time. In continuous NIRS monitoring, [delta Cyt aa3] were not changed in the control group. But in HI group [delta Cyt aa3] decreased significantly in acute HI and then normalized with resuscitation but gradually decreased and was significantly lower than control group at 48 hours. Cerebral Na+, K+/- ATPase activity and ATP, PCr level of experimental group significantly decreased compared to control group. Cerebral level of conjugated dienes were not significantly different between both group. CONCLUSION: We successfully reproduced secondary cerebral energy failure after acute HI in thenewborn piglet and this animal model may be useful for testing cerebroprotective strategies.
Adenosine Triphosphatases ; Adenosine Triphosphate ; Animals ; Anoxia ; Brain ; Carotid Artery, Common ; Glucose ; Heart Rate ; Hemodynamics ; Humans ; Hydrogen-Ion Concentration ; Infant, Newborn ; Critical Care ; Ischemia ; Lactic Acid ; Models, Animal ; Oxygen ; Phosphocreatine ; Polymerase Chain Reaction ; Reperfusion ; Respiration ; Resuscitation ; Spectroscopy, Near-Infrared* ; Spectrum Analysis