The purpose of this study was to examine the impact of the self-perceived stress of high school students on their oral health care and the relationship between stress and oral health care. The subjects in this study were the students in four different high schools located in Chungcheongnam-do, on whom a self-administered survey was conducted. The answer sheets from 939 respondents were analyzed by PASW Statistics ver.18.0 for Windows. The girls were more stressed than the boys about their studies, appearance and material resource, and the sophomores felt more stress about their home and studies. The group whose academic achievement was good in the past semester had the lowest stress about home and material resource, and the group whose economic standard was higher were less stressed about appearance and material resource. As a result of comparing their oral health care by general characteristics, the groups who were sophomores and whose academic achievement was good in the past semester were most excellent in that regard, and the students whose economic standard was higher and whose average weekly allowances were larger took better care of their oral health. Concerning the influential factors for oral health care, stress about peer relationship was positively related, and stress about material resource was negatively related. Given the findings of the study, the development of oral health care programs that include how to relieve stress is required, and more intensive education is necessary as well. Besides, education for school personnel in charge of student health management and the development of related manuals are both required.
Chungcheongnam-do ; Education ; Female ; Humans ; Oral Health* ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to examine the effect of black soybean (CJ-3) testa extracts on lipid profiles in streptozotocin (STZ)-induced diabetic rats. METHODS: One control group and four STZ-induced diabetic groups with different doses of black soybean (CJ-3) testa extracts treatment [0 mg/kg (diabetic control, EX), 250 mg/kg (EX-250), 500 mg/kg (EX-500), 1,000 mg/kg (EX-1000)] were orally administered for 4 weeks. RESULTS: All CJ-3 treatment groups had remarkably lower serum triglyceride (TG) levels than that of EX group (p < 0.05) whereas hepatic TG contents did not show any differences. Results from serum total cholesterol (TC) concentrations of EX-250 and EX-1000 groups were decreased compared to EX group (p < 0.05). Furthermore, protein levels of 3-hydroxy-3-methyl-glutaryl-Coenzyme A (HMG-CoA) reductase from the liver decreased in all treatment groups (p < 0.05). However, significant differences were not observed in serum glucose and insulin, and glucose transporter 4 (GLUT-4) protein expression in skeletal muscle tissue. CONCLUSION: These results suggest that black soybean testa extracts could be useful for improvement of hyperlipidemia and hypercholesteremia in diabetes.
Animals ; Anthocyanins ; Blood Glucose ; Cholesterol ; Glucose Transport Proteins, Facilitative ; Hypercholesterolemia ; Hyperlipidemias ; Insulin ; Liver ; Muscle, Skeletal ; Oxidoreductases ; Rats* ; Soybeans* ; Streptozocin ; Triglycerides

OBJECTIVES: This study aims to investigate the suitability of electronic health record (EHR) systems in Korea for global certification and to propose functions for future global systems by comparing and analyzing the certification criteria for Certification Commission for Health Information Technology (CCHIT) Certified Ambulatory EHR with BESTCare, which is the EHR system at Seoul National University Bundang hospital. METHODS: Domain expert groups were formed to analyze the inclusion of BESTCare functions and the types of differences for each of the CCHIT Certified 2011 Ambulatory EHR Certification Criteria. The types of differences were divided into differences in functions (F), differences in business processes (B), and differences in government policies (P). RESULTS: Generally, the criteria that showed differences in functions pertained to the connection between the diagnosis/problem list and order, the alert and warning functions for medication-diagnosis interactions, and the reminder/instruction/notification messages related to the patient's immunization status; these absent functions were enhanced clinical decision support system (CDSS) functions related to patient safety and healthcare quality. Differences in government policies were found in the pharmacy's electronic prescription functions, while differences in business processes were found in the functions constrained by the local workflow or internal policy, which require some customization. CONCLUSIONS: Functions that differed between the CCHIT certification criteria and the BESTCare system in this study should be considered when developing a global EHR system. Such a system will need to be easily customizable to adapt to various government policies and local business processes. These functions should be considered when developing a global EHR system certified by CCHIT in the future.
Certification ; Commerce ; Electronic Health Records ; Electronic Prescribing ; Immunization ; Korea ; Medical Informatics ; Patient Safety ; Quality of Health Care

PURPOSE: The repair of complex chest wall defects presents a challenging problem for the reconstructive surgeon. In particular, a free flap is often required when the defect is large, in which case suitable recipient vessels must be found to insure revascularization. The authors report a case of persistent bronchopleural-cutaneous fistula developed after undergoing lobectomy for lung cancer. METHODS: The defect area was repaired using a free vertical rectus abdominis muscle flap revascularized by microvascular anastomosis to the 6th intercostal pedicle. The flap obliterated the right chest cavity, closed the site of empyema drainage, and aided healing of a bronchopleuralcutaneous fistula. RESULTS: The patient has remained healed for 14 months without any postoperative complications or recurrent infection or fistula. CONCLUSION: We suggest that a rectus abdominis musculocutaneus free flap and intercostal pedicle as a recipient could be a useful method for repair of chest defects.
Cutaneous Fistula ; Drainage ; Empyema ; Fistula ; Free Tissue Flaps ; Humans ; Lung ; Muscles ; Postoperative Complications ; Rectus Abdominis ; Thoracic Wall ; Thorax

PURPOSE: Autologous breast reconstruction with abdominal tissue is one of the best options after mastectomy. In a free transverse rectus abdominis myocutaneous(TRAM) or deep inferior epigastric artery perforator (DIEP) flap, a preoperative evaluation of the precise location of perforating vessels and vascular run-off systems is required. The objective of this report is to demonstrate the usefulness of multidetector computed tomography (MDCT) in the preoperative planning of patients undergoing breast reconstruction with abdominal flap. METHODS: From June 2006 to January 2008, 28 patients underwent MDCT evaluation before breast reconstruction. All subjects were females with an age ranged from 30 to 55 years. The CT scan was performed using a 64-slice MDCT scanner(Brilliance 64; Philips Medical Systems, Best, Netherlands). RESULTS: One perforator or two major perforators were marked on image in good relation with a hand-held Doppler examination and intraoperative findings. All vascular run-off systems were cleared before operation. CONCLUSION: Preoperative evaluation of perforator arteries with MDCT angiography is beneficial to the patients undergoing breast reconstruction. This technique provides a noninvasive approach of the vascular anatomy of the entire anterior abdominal wall.
Angiography ; Arteries ; Epigastric Arteries ; Female ; Free Tissue Flaps ; Humans ; Mammaplasty ; Mastectomy ; Multidetector Computed Tomography ; Rectus Abdominis ; Tomography, X-Ray Computed

PURPOSE: The clinical syndrome of unilateral finger ischemia, caused by digital artery occlusions from embolization from the palmar ulnar artery associated with repetitive striking of the palm, has been called the hypothenar hammer syndrome(HHS). We report the case of a man with this unique disease probably caused by manual work. METHODS: A 52-year-old male left-hand dominant manual worker complained of pain and coldness in the left 4,5th finger. On physical examination, there was a tip necrosis and the result of Allen's test was mildly positive(sluggish filling of hand from the ulnar artery). Arteriograms confirmed occlusion of the distal ulnar artery without direct perfusion of the superficial palmar arch and distal digital artery. Surgical bypass with reverse autologous vein grafting was performed between ulnar artery and superficial palmar arch, common digital artery. RESULTS: He had an uneventful postoperative course and has remained asymptomatic for 18 months since discharge. Patency has been confirmed by color doppler with resolution of cold intolerance and successful digital preservation. CONCLUSION: We introduce a very unique pattern of vascular ischemic disease and recommend the arterial bypass with vein interpositional grafting.
Arteries ; Cold Temperature ; Fingers ; Hand ; Humans ; Ischemia ; Male ; Middle Aged ; Necrosis ; Perfusion ; Physical Examination ; Strikes, Employee ; Transplants ; Ulnar Artery ; Veins

PURPOSE: Adipose tissue-derived stem cells(ADSC) has an osteoconductive potential and demineralized bone matrix(DBM) is an osteoinductive material. A combination of DBM and ADSC wound probably create osteoinductive properties. The purpose of this study is to determine the effect of the combination of DBM and ADSC mixture on healing of rat calvarial defect. METHODS: Thirty adult male Sprague-Dawley rats were randomized into 3 groups(n=10) as 1) Control, 2) DBM alone, 3) DBM with ADSC mixture. DBM with ADSC mixture group has had a 3-day preculture of ADSC from groin fat pad. An 6 mm critical size circular calvarial defect was made in each rat. Defect was implanted with DBM alone or DBM with ADSC mixture. Control defect was left unfilled. 6 and 12 weeks after the implantation, the rats were sacrificed and the defects were evaluated by histomorphometric and radiographical studies. RESULTS: Histomorphometric analysis revealed that DBM with ADSC mixture group showed significantly higher bone formation than DBM alone group(p<0.05). Although radiographs from DBM alone group and DBM with ADSC group revealed similar diffuse radiopaque spots dispersed throughout the defect. Densitometric analysis of calvarial defect revealed DBM with ADSC mixture group significantly higher bone formation than DBM alone(p<0.05). There was correlation of densitometry with new bone formation(Spearman's correlation of coefficient=0.804, 6 weeks, 0.802, 12 weeks). CONCLUSION: The DBM with ADSC mixture group showed the best healing response and the osteoinductive properties of DBM were accelerated with ADSC mixture. It will be clinically applicable that DBM and ADSC mixture in plastic and reconstructive surgery, such as alveolar cleft and congenital facial deformities that bone graft should be required.
Adipose Tissue ; Adult ; Animals ; Congenital Abnormalities ; Densitometry ; Groin ; Humans ; Male ; Osteogenesis ; Rats ; Rats, Sprague-Dawley ; Transplants

PURPOSE: There are some reports presenting that peripheral blood contain circulating hematopoietic cells as well as, in significantly smaller quantities, mesenchymal stem cells. The purposes of this study is to isolate and characterize circulating mesenchymal progenitor cells with osteogenic potential from human peripheral blood. METHODS: Human buffycoat containing mononuclear cells was harvested from peripheral blood of normal persons and isolated using a density gradient centrifugation and serially subcultured in osteogenic media for 1-4 weeks. The proliferation capability, phase-contrast microscopy, transmission electron microscopy, immunophenotype FACS analysis, Alizarin red staining and RT- PCR assays for osteogenic differentiation potential were performed. RESULTS: The phenotype of cultured cells changed from small round or cuboidal cells at passage 1 into large spindle-shaped fibroblastic morphology cells at passage 4. Surface marker expressed CD14, but did not express CD34, CD80, CD83. Strong positive staining was observed for Alizarin reds in osteogenic medium on day 14, Using RT-PCR, the mRNA levels of bone- specific genes, such as ALP, c-bfa-1 and osteocalcin were detected. CONCLUSION: A new subset of peripheral blood derived progenitor cells described here has the ability to proliferate and differentiate into osteogenic cell lineages in vitro, and to be candidate for regenerative therapy.
Anthraquinones ; Cell Lineage ; Cells, Cultured ; Centrifugation, Density Gradient ; Durapatite ; Fibroblasts ; Humans ; Mesenchymal Stromal Cells ; Microscopy, Electron, Transmission ; Microscopy, Phase-Contrast ; Osteocalcin ; Osteogenesis ; Phenotype ; Polymerase Chain Reaction ; RNA, Messenger ; Stem Cells

PURPOSE: Traditionally, titanium miniplate has been used for rigid fixation of mandible fractures. However, the limitations of metal plate have been reported such as hypersensitivity, interference with the cranio-facial growth of growing child, secondary bone resorption around the plate, foreign body reaction, declination of primary callus formation, and bone atrophy, and so forth. Recently, biodegradable miniplate has been introduced and used as an alternative to the metal plate despite of its lower strength. This study evaluated the usefulness and stability of biodegradable plate and screw for treatment of mandible fractures. METHODS: In this study, 61 patients(92 areas) diagnosed as mandible fracture in the last 2 years have been reviewed. We used titanium plate and screw in 32 patients, and biodegradable plate and screw(INION?) in 29 patients. Stability of plates and screws, bony healing process and its side effects were observed by clinical and radiographic assessment. RESULTS: In the titanium material group, one of malocclusion, two of mouth opening limitation, three of pain, three of palpation were shown. The plate of six patients involved in these complications were removed. In the biodegradable group, two of mouth opening limitation, two of pain, one of localized wound infection were shown and one plate was removed secondarily. CONCLUSION: There was no statistical difference between two groups in bony healing and complication rates. Biodegradable implants show efficient stability during initial bone healing and low side effects in long-term follow up periods.
Absorbable Implants ; Atrophy ; Bone Resorption ; Bony Callus ; Child ; Follow-Up Studies ; Foreign-Body Reaction ; Fracture Fixation ; Humans ; Hypersensitivity ; Malocclusion ; Mandible ; Mouth ; Palpation ; Titanium ; Wound Infection

PURPOSE: Prevention of acute rejection in skin allografts without continuous immunosuppression lacks reports in worldwide literature. Needs for chronic immunosuppression preclude the use of tissue allograft as a routine surgical reconstructive option. Recently dendritic cells(DC) gained considerable attention as antigen presenting cells that are also capable of immunologic tolerance induction. This study assesses the effects of alloantigen-pulsed dendritic cells in induction of survival increase in a rat skin allograft model. METHODS: Recipient-derived dendritic cells were harvested from rat whole blood and cultured with GM- CSF(200ng/mL) and IL-4(8ng/mL) for 2 weeks. Then donor-specific alloantigen pulsed dendritic cells were reinjected into tail vein before skin graft. The rat dorsal skin allografts were transplanted in 5 subgroups. Groups: I) untreated, II) anti-lymphocyte serum(ALS, 0.5 mL), III) FK-506(2mg/kg), IV) DCp, VI) DCp and FK- 506. Graft appearance challenges were assessed postoperatively. RESULTS: The group V(DC and FK-506 treated) showed longest graft survival rate(23.5 days) than other groups; untreated(5.8 days), ALS(7.2 days), FK-506 (17.5 days), DCp(12.2 days). CONCLUSION: Donor antigen pulsed host dendritic cell combined with short-term immunosuppression prolong skin allograft survival and has potential therapeutic application for induction of donor antigen specific tolerance.
Animals ; Antigen-Presenting Cells ; Dendritic Cells ; Graft Survival ; Humans ; Immune Tolerance ; Immunosuppression ; Isoantigens ; Rats ; Rejection (Psychology) ; Skin ; Tacrolimus ; Tissue Donors ; Transplantation, Homologous ; Transplants ; Veins