OBJECTIVES: To explore changes in self-reported oral health in middle-aged Koreans over a period of 9 years. METHODS: This study design was a cross-sectional analysis. This study analyzed the data of 18,845 middle-aged (45-64 years) subjects who participated in 4-6th Korea National Health and Nutrition Examination Surveys (KNHANES). A complex-sample chi-square test was used to analyze self-reported poor oral health according to sex, household income, and education. A complex-sample logistic regression analysis was used to identify the changes in the factors. SPSS 23.0 and the R ver. 3.5.1 statistical package were used for the analyses. RESULTS: Poor oral health have been decreased by 5.3% over the 9-year period. Middle-aged men were more likely to report their oral health as worse than women. The lower income and education groups reported their oral health as poor compared to the higher income and education groups. The factors affecting self-reported poor oral health over the 9-year period were sex, income, and education. CONCLUSIONS: More than half of the aged population reported their oral health as poor. Oral health policies should be established for the aged population, including the middle-aged population, for long-term plans.
Cross-Sectional Studies ; Education ; Family Characteristics ; Female ; Humans ; Korea ; Logistic Models ; Male ; Oral Health

Purpose: This study was to examine the reliability and validity of the Korean version of the Cornell Assessment of Pediatric Delirium (CAPD). Methods: For testing the reliability of the Korean version of the CAPD, this study calculated the internal consistency (Cronbach's ⍺) and the Interrater Correlation Coefficient (ICC) by comparing the independent assessment results of three nurses in Pediatric Intensive Care Unit (PICU). For testing the validity of the Korean version of the CAPD, the assessment result of the Korean version of the CAPD compared with that of the Diagnostic and Statistical Manual of Mental Disorders V (DSM-V). Receiver Operating Characteristics (ROC) analysis was used for measuring sensitivity and specificity. Results: Overall interrater reliability of the Korean version of the CAPD, ICC was .98 (95% CI .96~.99). Cronbach's ⍺ was .91 for eight items. The concordance between the Korean version of the CAPD and psychiatrist’s diagnosis was 90.0%. When the Korean version of the CAPD has the cut point of 9, sensitivity was 93.8%, and specificity was 75.0%. The area under the curve indicated by the ROC analysis was .88. Conclusion The Korean version of the CAPD showed good reliability and validity. This tool will be useful for pediatric delirium screening and management in Korean PICU.

Purpose: : This study aimed to identify the effects of a multifaceted pediatric delirium education program for pediatric intensive care unit (PICU) nurses on their delirium knowledge, confidence in delirium nursing, and delirium evaluation accuracy. Methods: : This study used a one-group pretest-posttest design. The participants were 50 nurses in two units of the PICU at S General Hospital in Seoul. All participants took a 1-hour lecture with case-based practice for the first two weeks, and received feedback as they applied the program to clinical practice over the next two weeks. Test measures were completed before and after the four week intervention period for all participants. The delirium evaluation accuracy was measured using the Korean version of the Cornell Assessment of Pediatric Delirium. Data were analyzed using the chi-square and paired t-tests. Results: : After the Pediatric Delirium Education Program, nurses’ delirium knowledge (x2 =11.65, p =.001), confidence in delirium nursing (t=9.71, p＜.001), and delirium evaluation accuracy (t=6.07, p＜.001) improved significantly. Conclusions : Pediatric delirium education programs for PICU nurses were effective. For active application of the program in clinical practice in the future, various cases of childhood delirium and specific strategies for each subject must be developed. To achieve this, long-term intervention and research for multiple organizations are required.

PURPOSE: We retrospectively analyzed open pulmonary thromboembolectomy in patients with acute and chronic pulmonary thromboembolism. MATERIALS AND METHODS: Between August 1990 and May 2005, 12 consecutive patients with acute and chronic pulmonary thromboembolism underwent open pulmonary thromboembolectomy at Yonsei Cardiovascular Center. Their mean age was 47.5 years, and 7 of the patients were female. Among 12 patients, 5 had acute onset, and 7 had chronic disease, and 9 patients were associated with deep venous thrombosis. Extent of pulmonary embolism was massive in 3 patients with hemodynamic instability, and submassive in 8 patients. Preoperative echocardiogram revealed elevated right ventricular pressure in all patients, and 7 patients were in NYHA functional class III or IV. Pulmonary thromboembolectomy was performed in all patients under total circulatory arrest. RESULTS: There were 2 hospital deaths (16.7%). Among the patients who survived, mean right ventricular pressure was decreased significantly from 64.3mmHg to 34.0mmHg with improvement of NYHA functional class. CONCLUSION: Open pulmonary thromboembolectomy is thought to be an immediate and definitive treatment for massive pulmonary embolism with optimal results. Even though operative mortality is still high, early diagnosis and immediate surgical intervention in highly selective patients may improve the clinical outcome.
Adult ; Aged ; *Embolectomy/mortality ; Female ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Prognosis ; Pulmonary Embolism/mortality/physiopathology/*surgery ; Retrospective Studies ; Vena Cava Filters

PURPOSE: To decide diagnostic titer in a single determination of antibody by indirect particle agglutination test and to characterize the occurrence of Mycoplasma pneumoniae during a 9 year-period in Seoul. METHODS: M. pneumoniae pneumonia diagnosed serologically at the Seoul National University Children's Hospital from 1986 to 1995 were reviewed, retrospectively. Antimycoplasma antibody was measured by indirect particle agglutination test. Diagnosis was based on 4 fold-rise or single high titer. Single diagnostic titer was set up by the value greater than the 90th percentile of the titer at one year of the children who initially had 4 fold-rise or > or =160. RESULTS: The geometric mean titer and the 90th percentile at 1 year of the 15 children who initially had antibody titer > or =160 or 4 fold-rise were 122 and 639, respectively, and single diagnostic titer was established as > or =640. A total of 126 childern were included by our diagnostic criteria. Male and female ratio was 1.17:1 and the mean age was 6 years 4 months. Pneumonia by M. pneumonuae occurred every years during the study period showing increased cases every 3 years. In the epidemic years, the cases occurred in late spring, summer and early fall. CONCLUSIONS: It is concluded that the occurrence of Mycoplasma pneumoniae pneumonia in Seoul from 1986 to 1995 was characterized by epidemics every 3 years as well as its endemicity.
Agglutination Tests ; Child ; Diagnosis ; Epidemiology ; Female ; Humans ; Korea* ; Male ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia* ; Pneumonia, Mycoplasma* ; Retrospective Studies ; Seoul*

Lateral medullary infarction can lead to central respiratory failure. However, in Wallenberg's syndrome, obstructive respiratory failure rarely develops. Here, we report a case of obstructive respiratory failure with stridor caused by unilateral lateral medullary infarction. A 74-year-old woman was admitted for acute right lateral medullary infarction. On the 12th day after the stroke, the patient developed respiratory failure necessitating endotracheal intubation. She could maintain good oxygen saturation and ventilation in intubated status without the assistance of mechanical ventilator, even during sleep. The pharyngo-laryngoscopy demonstrated the hypomobility of bilateral vocal cords. This case suggests that unilateral medullary infarction might be a cause of bilateral vocal cord palsy.
Aged ; Airway Obstruction ; Brain Stem Infarctions ; Female ; Humans ; Infarction ; Intubation, Intratracheal ; Lateral Medullary Syndrome ; Medulla Oblongata ; Oxygen ; Respiratory Insufficiency ; Respiratory Sounds ; Stroke ; Ventilation ; Ventilators, Mechanical ; Vocal Cord Paralysis ; Vocal Cords

A 65-year-old female visited us due to gait disturbance. A neurological examination showed cognitive impairment, dystonia, myoclonus, bradykinesia, postural instability, and freezing of gait (FOG). She was diagnosed with extrapontine myelinolysis based on her history of hyponatremia and high signal intensities (HSIs) in both striata on T2-weighted images. Her neurological problems including FOG improved over 25 days. In a follow-up MRI 50 days after the onset, HSIs disappeared in the striata but new ones appeared in the pons. FOG may have been related to striatal dysfunction in this patient.
Aged ; Cognition Disorders ; Dystonia ; Female ; Follow-Up Studies ; Freezing* ; Gait* ; Humans ; Hypokinesia ; Hyponatremia ; Magnetic Resonance Imaging ; Myelinolysis, Central Pontine* ; Myoclonus ; Neurologic Examination ; Pons ; Weather

PURPOSE: The purpose of this study was to determine the clinical features of focal nodular hyperplasia (FNH) and investigate its diagnosis and treatment. METHODS: Eleven patients with FNH treated from January 1997 to January 2007 were analyzed. The clinical findings of pathologically proven FNH were retrospectively reviewed. RESULTS: Among the eleven patients with 18 masses, the mean age was 29.5 (11~57) and the gender ratio (male:female) was 4:7. Four patients had clinical symptoms. Six patients had a solitary mass and five had multiple masses. The mean tumor diameter was 2.73 +/- 1.82 cm. The overall rate of a correct preoperative diagnosis was 0% (0/4) by ultrasound, 36.3% (4/11) by CT and 20.0% (2/10) by MRI. Only two patients had a central stellate scar in the mass. All patients underwent hepatic resection without complication. CONCLUSION: The results of this study showed that the combination of Dynamic CT and dual contrast MRI are important diagnostic methods for FNH. However, a definite preoperative diagnosis of FNH, without a central stellate scar, is very difficult. Surgical resection is recommended for patients with an uncertain diagnosis or clinical symptoms.
Cicatrix ; Diagnosis ; Focal Nodular Hyperplasia* ; Humans ; Liver* ; Magnetic Resonance Imaging ; Retrospective Studies ; Ultrasonography

This study was performed to compare the effect of intratesticular (IT) injection of xylazine/ketamine combination for canine castration with those of intramuscular (IM) or intravenous (IV) injection. Xylazine and ketamine was administered simultaneously via intratesticularly (IT group), intramuscularly (IM group) or intravenously (IV group) at doses of 2 and 10 mg/kg, respectively. Pain response at the time of injection, mean induction time, mean arousal time, mean walking time and cardiopulmonary function during anesthesia were monitored after the xylazine and ketamine administration. In IV and IM groups, heart rates were significantly decreased 30 and 45 min after xylazine and ketamine administration, respectively (p < 0.05). Respiratory rates were significantly decreased in the IV group (p < 0.05). In the IT group, there was no significant changes in heart and respiratory rates. The occurrence of cardiac arrhythmias was less severe in IT group compared with those in IM and IV groups. The route of administration did not affect rectal temperature. Mean induction time was significantly (p < 0.05) longer in IT group than in IM and IV groups. On the contrary, mean arousal time and mean walking time were shortened in IT group. Clinical signs related to pain response at the time of injection and vomiting were less observed in IT group than in IM group, and head shaking was less shown in IT group than in IM and IV groups during recovery period. These results indicated that intratesticular injection of xylazine/ketamine for castration has several advantages such as less inhibition of cardiopulmonary function and fast recovery from anesthesia without severe complications, and would be an effective anesthetic method for castration in small animal practice.
Anesthesia, Intravenous/veterinary ; Anesthetics, Combined/adverse effects/*therapeutic use ; Anesthetics, Dissociative/adverse effects/*therapeutic use ; Animals ; Body Temperature/drug effects ; Castration/*veterinary ; Dogs ; Drug Administration Routes/veterinary ; Electrocardiography/drug effects/veterinary ; Heart Rate/drug effects ; Injections/veterinary ; Injections, Intramuscular/veterinary ; Ketamine/adverse effects/*therapeutic use ; Male ; Pain, Postoperative/prevention&control/veterinary ; Pulmonary Ventilation/drug effects ; Testis/*drug effects ; Vomiting/chemically induced/veterinary ; Xylazine/adverse effects/*therapeutic use

A nasal-type extranodal natural killer/T-cell lymphoma is considered an aggressive form of non-Hodgkin's lymphoma, with approximately half of all patients relapsing during the follow-up period, and most relapses occurring within the first 2 years of remission. Here we report an unusual case of a 42-year-old man who experienced recurrence in single pleura after 8 years of remission.
Adenosine Deaminase ; Adult ; Follow-Up Studies ; Humans ; Lymphoma* ; Lymphoma, Extranodal NK-T-Cell ; Lymphoma, Non-Hodgkin ; Pleura ; Pleural Effusion ; Recurrence*