ABSTRACT
Background@#This study analyzed the practice of dental medical dispute prevention rules of dental hygienists to present an improvement plan for improving perceived importance and practice and provide data for the development of effective medical dispute prevention programs. @*Methods@#A self-administered questionnaire survey was conducted targeting dental hygienists who were providing assistance at dental hospitals and dental clinics in Seoul and Gyeonggi-do regions from March 22 to April 28, 2022. The questionnaire collected from 273 dental hygienists consisted of eight questions on general characteristics, 30 questions on medical dispute experience, and 14 questions on medical dispute prevention. @*Results@#Complaints showed a high experience rate in ‘Consultation & reservation’, medical disputes in ‘Patient handling (unkind) related’, and ‘Prosthesis installation and cement removal’. In both the importance and practice of medical dispute prevention rules, Preservation of medical records and other medical-related data’ was high, and ‘Management of patients on standby for a long time’was low in terms of practice. ‘Lack of time’ and ‘Lack of manpower’ were cited as reasons for not resolving dental treatment disputes. The importance of dental dispute prevention rules was found to be significant according to age and position, and it was also found to affect the level of practice. @*Conclusion@#Seventy-six-point six percent of the respondents said that education on the prevention of medical disputes was necessary, although they lacked recognition of prevention rules compared to their perceptions and experiences. This study suggested specifying prevention rules in dental hygiene subjects and expanding education, improvement of dental treatment system, revise the law on the range of work to improve the recognition and practice of prevention rules.
ABSTRACT
Background@#Self-leadership, an action strategy that can maximize individual capabilities, can affect the organizational commitment of dental hygienists and ultimately improve the quality of medical services. This study aims to demonstrate the need for self-leadership and organizational commitment for dental hygienists and develop measures to improve the quality of medical services. @*Methods@#An online survey of dental hygienists working at dental hospitals and clinics in Seoul and Gyeonggi province, Republic of Korea was conducted from March 28 to May 1, 2022. A total of 341 questionnaires were returned and analyzed. The measurement tools were modified and supplemented based on the theories and models developed by Manz for self-leadership, Mowday for organizational commitment, and Cronin and Taylor for medical services. Descriptive statistics, independent t-tests, ANOVA, simple regression, and multiple regression analyses were performed using SPSS 25.0. @*Results@#In leadership education, self-leadership is based on participation experience, the number of participants, and when and where it is received. Organizational commitment comes from participation experience, and the quality of medical services has been found to affect participation experience and location. Self-leadership had an effect on the quality of medical services (β=0.497, t=10.551, p＜0.001; β =0.599, t=13.783, p＜0.001; β=0.353, t=7.601, p＜0.001) and organizational commitment was found to have a mediating effect. @*Conclusion@#Dental hygienists’ self-leadership has a positive effect on the quality of medical services through the formation of appropriate interrelationships within the organization. Therefore, self-leadership programs should be developed, participated in, and promoted to improve the self-leadership of dental hygienists. Moreover, hospitals should improve their environment to provide and improve self-leadership education.
ABSTRACT
BACKGROUND/OBJECTIVES@#The purpose of this study was to investigate the association between socioeconomic status and chewing discomfort and identify the role of food insecurity in the association's causal pathway in a representative sample of Korean elders.MATERIALS/METHODS: We conducted cross-sectional analyses of the Korea National Health and Nutrition Examination Survey (2013–2015) data for elders aged ≥ 65 years.Socioeconomic status indicators used included household income and education level.Chewing discomfort was assessed according to the self-reported presence of chewing problems. Food security was surveyed using a questionnaire based on the US Household Food Security Survey Module. @*RESULTS@#The odds ratios of chewing discomfort in the 1st and 2nd income quartiles were 1.55 (95% confidence interval [CI], 1.15–2.10) and 1.40 (95% CI, 1.03–1.90), respectively, compared to participants in the highest income quartile. Participants with the lowest education level were 1.89 (95% CI, 1.30–2.75) times more likely to have chewing discomfort than those without chewing discomfort. After including food security in the final model, the logistic coefficients were attenuated in the income and education quartiles. @*CONCLUSIONS@#Low socioeconomic status was associated with chewing discomfort. In addition, the results confirm that food insecurity can mediate the association between socioeconomic inequalities and chewing discomfort among the elderly.
ABSTRACT
Background@#The elderly have, a higher disease morbidity than other age groups due to a decrease in resistance to the diseaseand have complex diseases, so care should be taken. Accordingly, it is considered important to provide information for improving the health of the elderly. Health information plays an important role in individual health promotion and education, so the degree of exposure to information about oral health of the elderly is expected to have a significant impact on understanding and acquiring information on oral content videos on the importance, prevention, and management of oral health of the elderly in the future. @*Methods@#This study analyzed video content related to oral diseases of the elderly in a total of 150 videos uploaded on YouTubefrom January 1, 2012 to May 13, 2021, using a total of three books of dental hygiene for the elderly. @*Results@#Forty-nine broadcasters accounted for the most of this information. Among the information providers, there were twodental hygienists. They accounted for 1.3% of all the information providers. The highest number of dental hygienists who broadcasted information was 42 in 2019. The average number of views was 37,303 periodontal diseases, the highest. Among the videos, dry mouth was the most common with 34 oral diseases. @*Conclusion@#The number of images for each disease varies, so it seems that information should be provided in various ways. Dentalhygienists should widely improve oral health knowledge by providing various dental hygiene management images for each oral disease to improve the oral health of the general public. In addition, based on the information of the Health Insurance Review and Assessment Service, the development and provision of content should be actively carried out so that people can obtain the information they desire.
ABSTRACT
Background@#The purpose of this study is to investigate the effect of liquefied digestive medicines on the composite resin surface. @*Methods@#Three types of liquefied digestive medicines (Gashwalmyeongsu, Wicheongsu, and Saengrokcheon) were selected as experimental groups, Samdasoo and Chamisul as negative controls, and Trevi as positive controls were selected to measure pH and titratable acidity. The samples filled with resin at acrylic were made total 300, 50 per group. To evaluate the erosion risk of the composite resin, the specimens were immersed in a liquefied medicine for 1, 3, 5, 15, and 30 minutes, and then the surface microhardness was measured using the Vickers Hardness Number, and the surface change was observed with scanning electron microscope (SEM). @*Results@#The average pH of the three liquefied medicine was 3.75±0.30, the Saengrokcheon was the lowest at 3.45±0.01, and the Trevi was 4.66 and Samdasoo and Chamisul were 7.40 and 8.58, respectively. The amount of NaOH reaching pH 5.5 and 7.0 was the lowest in the order of Trevi, Gashwalmyeongsu, Wicheongsu, and Saengrokcheon. The largest surface hardness reduction value was shown in Gashwalmyeongsu (−11.85±3.73), followed by Saengrokcheon (−9.79±3.11) and Wicheongsu (−8.28±2.83), and Samdasoo (−0.84±1.56) and Chamisul (−6.24±0.42) had relatively low surface hardness reduction values. However, Trevi (−16.67±5.41), a positive control group containing carbonic acid, showed a higher decrease in surface hardness than the experimental group. As a result of observation with SEM, experimental group and positive control group, showed rough surfaces and irregular cracks, and negative control groups showed smooth patterns similar to before immersion. @*Conclusion@#The liquefied digestive medicine with low pH could weaken the composite resin surface, and the carbonic acid component could more effect on the physical properties of the composite resin than pH.
ABSTRACT
Background@#This study aimed to investigate the effect of selecting commercially available blending teas and applying them to bovine teeth on color change over time. @*Methods@#After selecting healthy bovine teeth, using a cutting-disc, 105 specimens with a dimension of 5×5×3 mm were prepared, and 15 specimens were distributed to each group. Black tea was used as a positive control, water was used as a negative control, and blended tea of five types was used as an experimental group. First, pH and buffering capacity were measured with a pH meter, and tooth color was determined using a spectrophotometer before immersion in the blending tea solution and 1, 5, 7, 14, and 21 days after immersion. Thereafter, the shape change of the enamel surface was observed using a scanning electron microscope, and SPSS ver.26 was used to analyze the color change. @*Results@#The average pH of the five blending teas in the experimental group was 3.78, and the pH of group 3 (strawberry rhubarb) was the lowest at 3.22. The pH levels of black tea and water were 5.19 and 7.30, respectively. The buffering capacity was the highest in group 3 at both pH levels of 5.5 and 7.0. The L*a*b* color change according to immersion time was the largest in group 4 (rooibos yellow flower), and the amount of color change was large in black tea and group 4. As a result of observing the enamel surface of bovine teeth, changes in the surface shape were noted in all groups immersed in the experimental solution for 21 days, except for water. @*Conclusion@#There was a significant difference between the experimental groups in terms of color change according to the immersion time, and color and enamel surface changes were observed in black tea and all experimental groups, except for water.
ABSTRACT
Background/Aims@#Because gastrointestinal tract is not sterile, primary culture has contamination risk despite of massive washing with antimicrobial media. Microbial contamination can play a key role in initial failure during biopsy-derived primary tumor culture. @*Methods@#Tumor tissue was acquired from esophageal and gastric tumors using endoscopic biopsy. Three-dimensional cultures were performed, and separated spheroids were cultured in media for 7 to 10 days and then transferred to Matrigel (Corning Inc.). We investigated risk factors and patterns of initial fungal contamination. @*Results@#Initial tumor contamination was observed in 23% (7/30) of esophageal cancer and 20% (3/15) of gastric cancer samples. Two cases of bacterial contamination occurred during the establishment of culture protocol. Moderate to thick whitish plaques (p < 0.001) and food retention in lumen (p < 0.001) were risk factors for initial fungal contamination. After exclusion of high risk patients for contamination, no fungal contamination occurred in primary organoid cultures. Fungal contamination was usually detected within 3 days after tumor preparation. However, unusual fungal contamination (GC11 and EC29) was recognized after several passages. Growing spherical shapes resembled cancer organoids. Although they rapidly proliferated and multiple daughter spheroids appeared, the media were translucent. After several passages, yeasts and pseudohyphae were detected on the edges of the solid spherical structures and media. @*Conclusions@#Moderate to thick whitish plaques and food retention are clinical risk factors for initial fungal contamination during biopsy-derived cancer organoid culture. Most initial fungal contamination was detected within 3 days, but it could be unusually recognized after several passages.
ABSTRACT
Background/Aims@#Because gastrointestinal tract is not sterile, primary culture has contamination risk despite of massive washing with antimicrobial media. Microbial contamination can play a key role in initial failure during biopsy-derived primary tumor culture. @*Methods@#Tumor tissue was acquired from esophageal and gastric tumors using endoscopic biopsy. Three-dimensional cultures were performed, and separated spheroids were cultured in media for 7 to 10 days and then transferred to Matrigel (Corning Inc.). We investigated risk factors and patterns of initial fungal contamination. @*Results@#Initial tumor contamination was observed in 23% (7/30) of esophageal cancer and 20% (3/15) of gastric cancer samples. Two cases of bacterial contamination occurred during the establishment of culture protocol. Moderate to thick whitish plaques (p < 0.001) and food retention in lumen (p < 0.001) were risk factors for initial fungal contamination. After exclusion of high risk patients for contamination, no fungal contamination occurred in primary organoid cultures. Fungal contamination was usually detected within 3 days after tumor preparation. However, unusual fungal contamination (GC11 and EC29) was recognized after several passages. Growing spherical shapes resembled cancer organoids. Although they rapidly proliferated and multiple daughter spheroids appeared, the media were translucent. After several passages, yeasts and pseudohyphae were detected on the edges of the solid spherical structures and media. @*Conclusions@#Moderate to thick whitish plaques and food retention are clinical risk factors for initial fungal contamination during biopsy-derived cancer organoid culture. Most initial fungal contamination was detected within 3 days, but it could be unusually recognized after several passages.
ABSTRACT
Background@#To identify work–family balance and level of happiness among married women dental hygienists in Seoul and Gyeonggi Province. The goal of this study is to use the outcome as basic data to determine the compatibility of dental hygienists with work and family, systems, and improvement of happiness levels. @*Methods@#From July 3 to August 10, 2020, 250 dental hygienists in Seoul and Gyeonggi Province were targeted. The questionnaire comprised 65 questions, including general characteristics (perception of work–family balance, perception of work–family balance system, job satisfaction, parenting type, happiness level) whether or not they were implemented. The results were obtained through a self-control questionnaire. @*Results@#The perception of work–family balance was significantly different in job rank and average income, while that of the work– family balance system had significant differences in workplace type, total work experience, current job work experience, childcare system status, and parental leave period. Happiness level and job satisfaction were significantly different in job rank, average income, and childcare system status. Additionally, the perception of work–family balance and that of the work–family balance system showed a positive correlation with job satisfaction and happiness level. Finally, the perception of married women dental hygienists toward work–family compatibility was determined, where the higher the satisfaction with the job, the higher the level of happiness. @*Conclusion@#To improve the work–family balance and job satisfaction of dental hygienists and their levels of happiness, changes in social perception and improvement of the working environment such as proper staffing, flexible work systems, and incentive systems should be considered.
ABSTRACT
Background@#This study was conducted to identify the level of gender sensitivity and gender equality consciousness among dental hygiene students and to confirm the necessity of gender equality programs in the curriculum. @*Methods@#A self-report questionnaire was conducted with some dental hygiene students using the Gender Sensitivity tool and Korean Gender Egalitarianism Scale for Adolescents (KGES-A). @*Results@#First, the gender equality consciousness of the students who took women’s studies was high in the areas of educational life and socio-cultural life, and that of the subjects of grandparent families and Catholic was found to be high in the domestic life area. Second, the gender sensitivity of the subjects who took women’s studies was found to be high in all sub-areas. In addition, the gender sensitivity of females was higher in the areas of sexual identity, non-violence, and self-reflection than that of males. That of 4-year college students was higher in the areas of sexual identity, openness to gender roles, and non-violence than that of 3-year college students. In addition, the gender sensitivity of Catholic students was high in the areas of sexual identity and openness to gender roles. Third, gender equality consciousness was found to have an effect depending on whether subjects took women’s studies, family type, family type, and religion, and gender sensitivity was found to have an effect depending on whether subjects took women’s studies or gender. @*Conclusion@#Since dental hygienist is a profession that targets humans, education that can instill equal awareness and values of humans is important. To inspire gender sensitivity and gender equality consciousness in a prospective professional, it is necessary to conduct programs and education related to gender intelligence within dental hygiene curriculum.
ABSTRACT
Background@#Various oral health management programs in Korea affect the oral health improvement in the elderly Several studies have been conducted to date; however, those studies have not shown uniform results due to the differences in research methods or designs. Hence, this study aimed to review the overall research trends of the reported oral health care programs for the elderly in Korea, verify their effects, and clarify them based on the systematic literature review. @*Methods@#The literature search selected intervention studies that applied the oral health care program for the elderly in Korea from 2001 to 2020. Following the COre, Standard, and Ideal (COSI) models presented by the US National Library of Medicine, we selected databases including Korean studies Information Service System (KISS), ScienceOn, Research Information Sharing Service (RISS), DBpia, PubMed, and Google Scholar. Of the 1,335 studies searched using keywords, titles, and abstracts, 21 were finally selected based on primary and secondary exclusion criteria. @*Results@#The most frequent intervention period was 4 weeks, and the number of interventions varied between 2 and 90 times. As for the type of intervention, 14 studies that conducted both theory and practice were the most frequent. Significant differences in the clinical indicators, such as calculus, halitosis, salivation rate, swallowing function, and dry mouth, were found in most oral health care programs. @*Conclusion@#Based on the results of this study, the intervention program needs further verification using multiple indicators in future studies. In addition, a study extending the intervention period and the number of samples is considered necessary for verifying continuous effectiveness of the intervention program.
ABSTRACT
Purpose@#Intensive IV insulin infusion therapy has been applied widely to critically ill patients. However, IV insulin protocols are complex, and require repeated calculations. The purpose of this study was to evaluate the safety and efficiency of a computerized insulin infusion (CII) protocol to replace manual insulin infusion protocols, for glucose control in critically ill patients. @*Methods@#This was an observational study (September 2016 to January 2017) of 43 patients in ICU whose blood glucose level was between 140-180 mg/mL and could not be controlled by the conventional manual insulin protocol. The CII protocol was integrated in to the electronic medical record order system, and automatically calculated the insulin infusion dose and blood sugar test (BST) interval. BSTs were taken 48 hours pre- and post-initiation of the CII protocol. The proportion of BSTs in the normal (70-180 mg/mL), hypoglycemic (70 mg/mL), and severe hyperglycemic (> 250 mg/mL) range were recorded. @*Results@#The mean number of BSTs performed before using the CII protocol was 10.3/person and 0.4/hour, and after implementing the protocol, increased to 21.7/person and 0.7/hour. The mean glucose level (281.4 mg/mL) decreased after using the CII protocol (195.5 mg/mL; p 250 mg/mL) decreased from 47.3% to 17.9% after protocol implementation (p = 0.020). @*Conclusion@#The CII protocol safely and successfully maintained a normal glucose range, and decreased severe hyperglycemia in intensive care patients.
ABSTRACT
Purpose@#Intensive IV insulin infusion therapy has been applied widely to critically ill patients. However, IV insulin protocols are complex, and require repeated calculations. The purpose of this study was to evaluate the safety and efficiency of a computerized insulin infusion (CII) protocol to replace manual insulin infusion protocols, for glucose control in critically ill patients. @*Methods@#This was an observational study (September 2016 to January 2017) of 43 patients in ICU whose blood glucose level was between 140-180 mg/mL and could not be controlled by the conventional manual insulin protocol. The CII protocol was integrated in to the electronic medical record order system, and automatically calculated the insulin infusion dose and blood sugar test (BST) interval. BSTs were taken 48 hours pre- and post-initiation of the CII protocol. The proportion of BSTs in the normal (70-180 mg/mL), hypoglycemic (70 mg/mL), and severe hyperglycemic (> 250 mg/mL) range were recorded. @*Results@#The mean number of BSTs performed before using the CII protocol was 10.3/person and 0.4/hour, and after implementing the protocol, increased to 21.7/person and 0.7/hour. The mean glucose level (281.4 mg/mL) decreased after using the CII protocol (195.5 mg/mL; p 250 mg/mL) decreased from 47.3% to 17.9% after protocol implementation (p = 0.020). @*Conclusion@#The CII protocol safely and successfully maintained a normal glucose range, and decreased severe hyperglycemia in intensive care patients.
ABSTRACT
Background@#In this study, the bleaching effect and surface damage of two types of over-the-counter home tooth bleaching agents were explored using an in vitro study of bleaching agents applied to bovine teeth specimens for 14 days. @*Methods@#Domestic over-the-counter home tooth bleaching agents of gel and patch form that shared common active ingredients and manufacturers were selected and tested. The experiment specimens were made using composite resin with bovine tooth samples and then measured the initial microhardness. Specimens were then divided into a Gel group and a Patch group and underwent bleaching treatment once a day for two weeks for 30 to 60 minutes (recommended) or 7 hours. All specimens were coffee-stained prior to bleaching. The bleaching effect was measured using a spectrophotometer and surface damage was measured using a microhardness meter. @*Results@#The difference in color following the bleaching procedure was positive in both the Gel and Patch group, although there were no statistically significant differences in bleaching effect between groups. There was no significant difference in bleaching effect based on duration. The microhardness test revealed that both the Gel group and the Patch group had surface damage after bleaching. The greatest surface damage was found in the Patch group that had undergone a 7-hour bleaching treatment, although the differences were not statistically significant. @*Conclusion@#The bleaching effect of the home tooth bleaching agent was visible to the naked eye. However, longer applications than recommended did not result in greater bleaching, unlike consumers’ expectations, and instead increased the chance of enamel damage. As such, there is a need for consumers to be alert and adhere to recommendations provided by each company.
ABSTRACT
Background@#A comprehensive history taking at the first visit could be an important start of treatment. This study investigated the current status of the initial history taking for dental patients in S area, and the implementation and importance of the initial history taking process. Based on this, we intend to provide basic data for the development of organized and standardized questionnaires in dental clinics. @*Methods@#In April 2019, 303 dental clinics in S area were targeted and special dental clinics (orthodontics, children, and disabled) were excluded. The questionnaire consisted of 29 items, including general characteristics, systemic disease history, dental history, oral health behaviors, and the data were obtained through self-administered questionnaire. @*Results@#Initial history taking was mostly implemented using oral and questionnaire at the time of the first visit. Systemic disease history, dental history, and oral health behaviors differed in the work experience of the dental clinic staff. As a result of analyzing the importance according to implementation, there were significant differences in all questions except drug-related items. The importance of the questionnaire was highly recognized, but the reason it was not actually implemented was because of existing the questionnaire in the clinic and lack of time. @*Conclusion@#Considering that the initial history taking implementation rate showed low, it is necessary to develop standardize a practical questionnaire and interview skills for dental clinics in the future. In addition, training programs should be provided to dental staff that can recognize the importance of initial history taking questionnaires and contribute to active implementation.
ABSTRACT
This study aims to contribute to managing the human resource of dental hygienists and qualitatively enhancing dental medical services by examining factors that affect their turnover intention. Therefore, it attempted to examine their degrees of emotional labor, job satisfaction, and social support and the effects of each variable on turnover intention. This study administered self-reporting questionnaires to dental hygienists working in dental hospitals, dental clinics, and general or university hospitals in Seoul Metropolis and Gyeonggi-do by conducting convenience sampling, from May 18, 2017 to August 4, 2017. Among a total of 224 copies that were distributed, a total of 223 copies, excluding 1 copy with poor responses, were used in the data analysis. The research tools comprised 12 questions on general characteristics, 24 questions on emotional labor (4-point Likert scale), 16 questions on job satisfaction (5-point Likert scale), 8 questions on social support (4-point Likert scale), and 4 questions on turnover (5-point Likert scale). The scores of dental hygienists were as follows: emotional labor, 2.49 out of 4; job satisfaction, 3.14 out of 5; social support, 3.04 out of 4; and turnover intention, 3.07 out of 5. Their turnover intention has a positive correlation with emotional labor, but a negative correlation with job satisfaction and social support. It was found that some factors that significantly influence turnover intention included the amount of overtime work and job satisfaction. Thus, dental medical institutes should search for measures, including improvement of the working environment, to reduce the amount of overtime work and enhance job satisfaction.
Subject(s)
Humans , Academies and Institutes , Dental Clinics , Dental Hygienists , Hospitals, University , Intention , Job Satisfaction , Seoul , Statistics as TopicABSTRACT
The aim of this study was to analyze in depth the standardized Clinical dental hygiene curriculum of the Fones School in the United States. We investigated the clinical dental hygiene curriculum in 2015~2016 including title, credit, hours, contents, goals, competencies, and evaluation. We obtained the course syllabus and data related to each subject, for each grade, from the professors and students at the university. The goals and competencies, of the clinical dental hygiene program, which were based on the goals of the Fones School and the mission of the University of Bridgeport, were developed in accordance with the dental hygienist practice standards proposed by the American Dental Hygienists Association. The curriculum consisted of theory to teach proper dental hygiene care procedures and incorporated practical exercises that modeled an actual clinical setting. The students had to document the procedures performed for each client/patient and improve their clinical competency through discussion with the professors. Dental hygiene care should be provided for children, adolescents, adults, elderly, and patients, which includes patients with moderate or severe periodontal status. Students were evaluated by a paper test or case study presentation and their clinical evaluation was based on their clinical competency. In particular, professors evaluated students on a rotational basis, so they could evaluate the level of achievement of clinical competency of all students and find ways to improve any weaknesses. Therefore, the current study suggested that clinical dental hygiene program in Korea could be improved if based on the curriculum of Fones School in the United States.
Subject(s)
Adolescent , Adult , Aged , Child , Humans , Clinical Competence , Curriculum , Dental Hygienists , Exercise , Korea , Oral Hygiene , United StatesABSTRACT
The purpose of this study was to provide basic data to standardize the clinical dental hygiene curriculum, based on analysis of current clinical dental hygiene curricula in Korea. We emailed questionnaires to 12 schools to investigate clinical dental hygiene curricula, from February to March, 2017. We analyzed the clinical dental hygiene curricula in 5 schools with a 3-year program and in 7 schools with a 4-year program. The questionnaire comprised nine items on topics relating to clinical dental hygiene, and four items relating to the dental hygiene process and oral prophylaxis. The questionnaire included details regarding the subject name, the grade/semester/credit system, course content and class hours, the number of senior professors, and the number of patients available for dental hygiene clinical training purposes. In total, there were 96 topics listed in the curricula relating to clinical dental hygiene training, and topics varied between the schools. There was an average of 20.4 topic credits, and more credits and hours were allocated to the 4-year program than to the 3-year program. On average, the ratio of students to professors was 21.4:1. Course content included infection control, concepts for dental hygiene processes, dental hygiene assessment, intervention and evaluation, case studies, and periodontal instrumentation. An average of 2 hours per patient was spent on dental hygiene practice, with an average of 1.9 visits. On average, student clinical training involved 19 patients and 26.6 patients in the 3-year and 4-year programs, respectively. The average participation time per student per topic was 38.0 hours and 53.1 hours, in the 3-year and 4-year programs, respectively. Standardizing the clinical dental hygiene curricula in Korea will require consensus guidelines on topics, the number of classes required to achieve core competencies as a dental hygienist, and theory and practice time.
Subject(s)
Humans , Consensus , Curriculum , Dental Hygienists , Electronic Mail , Infection Control , Korea , Oral HygieneABSTRACT
PURPOSE: Urinary N-acetyl-beta-D-glucosaminidase (NAG) has been known to reflect the damage of proximal tubular cells in the early stages of renal disease. Recent studies have demonstrated that tubular grade predicted renal outcome better than did other histological parameters in IgA nephropathy. We evaluated the meaning of urinary NAG in relation with initial histological features and renal outcomes in early subclinical IgA nephropathy. METHODS: Among the firstly diagnosed IgA nephropathy patients from Jan 2001 to Dec 2002, 43 subjects were selected with the criteria of normal renal function and 24-h urinary protein excretion <3.5 g/day. The subjects were followed for 2 years. Pathologic lesion was graded according to HASS classification and semiquantitative scorings, from 0 to 3, were carried out for glomerular (GG), interstitial (IG), tubular (TG), and vascular (VG) lesion. RESULTS: The subjects consisted of 20 male and 23 female with mean age of 30+/-13 years, baseline blood pressure 116+/-15/74+/-10 mmHg, Cr 1.03+/-0.24 mg/dL, Ccr 88+/-19 mL/min, 24-h urinary protein excretion (UPER) 1, 790+/-1, 610 mg/24-h, urinary NAG 11.8+/-11.0 U/g cr at the time of biopsy. Hass subclass was correlated significantly with glomerular, tubular, and interstitial grades (all p<0.05). In comparison with clinical parameters, glomerular grade was significantly related with 24-h UPER (p<0.05) and tubular grade was significantly related with systolic blood pressure (p<0.05). Urinary NAG level at the time of biopsy show significant correlation with tubular grade (p<0.05). Progression of renal disease occurred in nine patients (20.9%). The patients with renal disease progression showed significantly low baseline Ccr, high 24-h UPER, and high NAG (all p<0.05). In pathological findings, tubular grade was significantly related with renal prognosis (p<0.05). In regression analysis, tubular grade was a independent predictor of renal prognosis among above four parameters showing significant differences. In survival analysis, tubular grade 0, 1 and grade 2, 3 showed significant difference in renal survival as compared to each other. The patients with baseline NAG urinary NAG above 10 U/g Cr showed significantly worse renal survival as compared with those below 10 U/g Cr (p<0.05). CONCLUSION: Tubular lesion is an independent factor associated with renal progression in these patients. Urinary NAG reflects well the degree of tubular lesion at the time of biopsy. We carefully suggest, therefore, that the measurement of urinary NAG level is helpful to estimate tubular lesion and predict renal prognosis in subclinical asymptomatic IgA nephropathy patients before they undergo renal biopsy.
Subject(s)
Female , Humans , Male , Acetylglucosaminidase , Biopsy , Blood Pressure , Classification , Disease Progression , Glomerulonephritis, IGA , Hexosaminidases , Immunoglobulin A , PrognosisABSTRACT
For developing race-specific anthropometry-based total body water (TBW) equations, we measured TBW using bioelectrical impedance analysis (TBW(BIA)) in 2,943 healthy Korean adults. Among them, 2,223 were used as a reference group. Two equations (TBW(K1) and TBW(K2)) were developed based on age, sex, height, and body weight. The adjusted R2 was 0.908 for TBW(K1) and 0.910 for TBW(K2). The remaining 720 subjects were used for the validation of our results. Watson (TBW(W)) and Hume-Weyers (TBW(H)) formulas were also used. In men, TBW(BIA) showed the highest correlation with TBW(H), followed by TBW(K1), TBW(K2) and TBW(W). TBW(K1) and TBW(K2) showed the lower root mean square errors (RMSE) and mean prediction errors (ME) than TBW(W) and TBW(H). On the Bland-Altman plot, the correlations between the differences and means were smaller for TBW(K2) than for TBW(K1). On the contrary, TBW(BIA) showed the highest correlation with TBW(W), followed by TBW(K2), TBW(K1), and TBW(H) in females. RMSE was smallest in TBW(W), followed by TBW(K2), TBW(K1) and TBW(H). ME was closest to zero for TBW(K2), followed by TBW(K1), TBW(W) and TBW(H). The correlation coefficients between the means and differences were highest in TBW(W), and lowest in TBW(K2). In conclusion, TBW(K2) provides better accuracy with a smaller bias than the TBW(W) or TBW(H) in males. TBW(K2) shows a similar accuracy, but with a smaller bias than TBW(W) in females.