ABSTRACT
Purpose@#For the dignity of patients nearing the end of their lives, it is essential to provide end-of-life (EoL) care in a separate, dedicated space. This study investigated the utilization of specialized rooms for dying patients within a hospice unit. @*Methods@#This retrospective study examined patients who died in a single hospice unit between January 1, 2017, and December 31, 2021. Utilizing medical records, we analyzed the circumstances surrounding death, the employment of specialized rooms for terminally ill patients, and the characteristics of those who received EoL care in a shared room. @*Results@#During the 1,825-day survey period, deaths occurred on 632 days, and 799 patients died. Of these patients, 496 (62.1%) received EoL care in a dedicated room. The average duration of using this dedicated space was 1.08 days. Meanwhile, 188 patients (23.5%) died in a shared room. Logistic regression analysis revealed that a longer stay in the hospice unit was associated with a lower risk of receiving EoL care in a shared room (odds ratio [OR]=0.98, 95% confidence interval [CI] 0.97~0.99; P=0.002). Furthermore, a higher number of deaths on the day a patient died was associated with a greater risk of receiving EoL care in a shared room (OR=1.66, 95% CI 1.33~2.08; P＜0.001). @*Conclusion@#To ensure that more patients receive EoL care for an adequate duration in a private setting, additional research is necessary to increase the number of dedicated rooms and incorporate them into the hospice unit at an early stage.
ABSTRACT
Background@#Sleep duration is associated with hearing loss, especially presbycusis, which is the most common type of hearing loss; however, there is limited evidence regarding this association among the Korean population. We aimed to determine the relationship between sleep duration and high-frequency hearing loss in Korean adults aged ≥40 years. @*Methods@#We examined 5,547 Korean adults aged ≥40 years who completed audiometric tests and questionnaires regarding sleep duration during the 2010–2012 cycle of the Korea National Health and Nutrition Examination Survey. Mild presbycusis was defined as >25 decibels (dB) and 40 dB pure tone averages at high frequencies (3,000, 4,000, and 6,000 Hz) for both ears. Additionally, the sleep duration was divided into quartiles. Odds ratios and 95% confidence intervals were estimated using multivariable logistic regression after adjusting for covariates. @*Results@#The prevalence of presbycusis in South Korean adults was 62.1%, of which 61.4% showed moderate to severe presbycusis. The incidence of moderate-to-severe, but not mild, presbycusis showed a significant positive correlation with sleep duration. @*Conclusion@#Our findings suggest that sleep duration is associated with the prevalence of presbycusis.
ABSTRACT
Background@#Folic acid is involved in inflammatory reactions; however, the association between folic acid and allergic diseases, particularly asthma, remains unclear. Thus, this study aimed to evaluate the association between serum folic acid levels and asthma in Koreans. @*Methods@#This study analyzed the serum folic acid levels of 6,615 individuals included in the 2016–2018 Korea National Health and Nutrition Examination Survey. The prevalence of asthma was determined using a questionnaire that identified cases of physician-diagnosed asthma. The relationship between serum folic acid levels and asthma was analyzed using logistic regression analysis. @*Results@#Multiple logistic regression analysis showed that a 1 ng/mL increase in serum folic acid level significantly reduced the risk of asthma after adjusting for confounding factors including sex, age, household income, current smoking, current alcohol use, and body mass index (odds ratio [OR], 0.930; 95% confidence interval [CI], 0.876– 0.987; P=0.017). The relationship between the adjusted odds of asthma and serum folic acid levels were consistently inverse (OR, 2.266; 95% CI, 1.126–4.420; P for trend=0.038). @*Conclusion@#Serum folic acid levels are inversely associated with physician-diagnosed asthma in the Korean population.
ABSTRACT
Objective@#To identify the most favorable sites that optimize the initial stability and survival rate of orthodontic mini-implants, this study measured hard and soft tissue thicknesses in the median and paramedian regions of the palate using cone-beam computed tomography (CBCT) and determined possible sexand age-related differences in these thicknesses. @*Methods@#The study sample comprised CBCT images of 189 healthy subjects. The sample was divided into four groups according to age. A grid area was set for the measurement of hard and soft tissue thicknesses in the palate. Vertical lines were marked at intervals of 0, 1.5, and 3.0 mm lateral to the midpalatal suture, while horizontal lines were marked at 2-mm intervals up to 24 mm from the posterior margin of the incisive foramen. Measurements were made at 65 points of intersection between the horizontal and vertical lines. @*Results@#The palatal hard tissue thickness decreased from the anterior to the posterior region, with a decrease in the medial-to-lateral direction in the middle and posterior regions. While the soft tissue was rather thick around the lateral aspects of the palatal arch, it formed a constant layer that was only 1–2-mm thick throughout the palate. Statistically significant differences were observed according to sex and age. @*Conclusions@#The anterolateral palate as well as the midpalatal suture seem to be the most favorable sites for insertion of orthodontic mini-implants. The thickness of the palate differed by age and sex; these differences should be considered while planning the placement of orthodontic mini-implants.
ABSTRACT
Objectives@#Community Water Fluoridation (CWF) was suspended in Ansan city in 2018. The purpose of this study was to inspect the status of caries in the permanent teeth of adolescents and suggest the index as the baseline for cohort study in the CWF suspended area. @*Methods@#Oral examinations and questionnaire surveys were conducted on adolescents aged 12 years. Of 1,479 individuals, 890 (60.2%) consented to the examinations. Frequency and logistic regression analyses were used to investigate the status of permanent dental caries by demographic, sociological, and health behavioral characteristics. The study was conducted with approval from IRB Kyung Hee University. @*Results@#The findings reveal gaps in the prevalence of caries among the study sample according to demographic, sociological and health behavioral factors. Rates of untreated caries were higher among adolescents who stayed in the area for a lesser duration, had foreign parents, or had cariogenic drinks more often (p<0.05). @*Conclusions@#A gap in untreated caries was observed based on demographic, sociological, and health behavioral factors. The findings of the study suggest the need to monitor oral health following cessation of CWF, along with developing alternative programs in the near future.
ABSTRACT
Objectives@#Community Water Fluoridation (CWF) was suspended in Ansan city in 2018. The purpose of this study was to inspect the status of caries in the permanent teeth of adolescents and suggest the index as the baseline for cohort study in the CWF suspended area. @*Methods@#Oral examinations and questionnaire surveys were conducted on adolescents aged 12 years. Of 1,479 individuals, 890 (60.2%) consented to the examinations. Frequency and logistic regression analyses were used to investigate the status of permanent dental caries by demographic, sociological, and health behavioral characteristics. The study was conducted with approval from IRB Kyung Hee University. @*Results@#The findings reveal gaps in the prevalence of caries among the study sample according to demographic, sociological and health behavioral factors. Rates of untreated caries were higher among adolescents who stayed in the area for a lesser duration, had foreign parents, or had cariogenic drinks more often (p<0.05). @*Conclusions@#A gap in untreated caries was observed based on demographic, sociological, and health behavioral factors. The findings of the study suggest the need to monitor oral health following cessation of CWF, along with developing alternative programs in the near future.
ABSTRACT
Objective@#To identify the most favorable sites that optimize the initial stability and survival rate of orthodontic mini-implants, this study measured hard and soft tissue thicknesses in the median and paramedian regions of the palate using cone-beam computed tomography (CBCT) and determined possible sexand age-related differences in these thicknesses. @*Methods@#The study sample comprised CBCT images of 189 healthy subjects. The sample was divided into four groups according to age. A grid area was set for the measurement of hard and soft tissue thicknesses in the palate. Vertical lines were marked at intervals of 0, 1.5, and 3.0 mm lateral to the midpalatal suture, while horizontal lines were marked at 2-mm intervals up to 24 mm from the posterior margin of the incisive foramen. Measurements were made at 65 points of intersection between the horizontal and vertical lines. @*Results@#The palatal hard tissue thickness decreased from the anterior to the posterior region, with a decrease in the medial-to-lateral direction in the middle and posterior regions. While the soft tissue was rather thick around the lateral aspects of the palatal arch, it formed a constant layer that was only 1–2-mm thick throughout the palate. Statistically significant differences were observed according to sex and age. @*Conclusions@#The anterolateral palate as well as the midpalatal suture seem to be the most favorable sites for insertion of orthodontic mini-implants. The thickness of the palate differed by age and sex; these differences should be considered while planning the placement of orthodontic mini-implants.
ABSTRACT
Several recent studies have reported that reactive oxygen species (ROS), superoxide anion and hydrogen peroxide (H2O2), play important roles in various cellular signaling networks. NADPH oxidase (Nox) isozymes have been shown to mediate receptor-mediated ROS generation for physiological signaling processes involved in cell growth, differentiation, apoptosis, and fibrosis. Detectable intracellular levels of ROS can be induced by the electron leakage from mitochondrial respiratory chain as well as by activation of cytochrome p450, glucose oxidase and xanthine oxidase, leading to oxidative stress. The up-regulation and the hyper-activation of NADPH oxidases (Nox) also likely contribute to oxidative stress in pathophysiologic stages. Elevation of the renal ROS level through hyperglycemia-mediated Nox activation results in the oxidative stress which induces a damage to kidney tissues, causing to diabetic nephropathy (DN). Nox inhibitors are currently being developed as the therapeutics of DN. In this review, we summarize Nox-mediated ROS generation and development of Nox inhibitors for therapeutics of DN treatment.
ABSTRACT
OBJECTIVES: This study aimed to estimate the financial budget of fluoride application in the National Health Insurance.METHODS: The amount of fluoride application was calculated by using the sealant rate (utilization rate 1), dental examination rate (utilization rate 2), and the average rate of these two (utilization rate 3) in children and adolescents. For the next five years, 100% of the existing fees were applied to estimate the financial budget.RESULTS: The total budget for children and adolescents was estimated to be 22.0 billion won minimum and 83.5 billion won maximum in the first year, and 104.8 billion won minimum and 398.5 billion won maximum up to the next five years. Moreover, in high risk groups, the total budget was estimated to be 4.2 billion won minimum and 16.1 billion won maximum in the first year, and 18.6 billion won minimum and 70.8 billion won maximum up to the next five years.CONCLUSIONS: The financial budget of fluoride application coverage for children and adolescents was similar or lower than that of the current dental sealants. It needs to implement promptly with the reason of financial saving over the long-term point of view. Based on this evidence, it is affordable and necessary to begin to promote oral health for children and adolescents.
Subject(s)
Adolescent , Child , Humans , Budgets , Fees and Charges , Fluorides , Insurance, Health , National Health Programs , Oral Health , Pit and Fissure SealantsABSTRACT
OBJECTIVES: Studies on oral health care in North Korea are being pursued in South Korea. However, the covertness of North Korea offers substantial resistance to the access of information from the country, including in the field of oral health care. In this study, we explored North Korea's oral health care policy and its status in the Kim Jong-Un Era.METHODS: We used existing information from Internet searches and also interviewed three health care professionals who had recently contact with North Korea.RESULTS: At present, there are four development policies of oral health care in North Korea: expansion of dental institutions and resource support, strengthening the prevention and treatment of dental diseases, improvement of dental prosthetics, and increasing the responsibility and role of the dental workforce. In addition, there has been an increasing interest in children's oral health with the development of a few programs.CONCLUSIONS: In order to improve overall oral health care, cooperation is required from North Korea in accessing relevant information in the field of children's oral health, dental prosthetics, and dental materials. For this to occur, there should be a preliminary trust building process between North Korea and South Korea as well as access to information from reliable sources.
Subject(s)
Access to Information , Delivery of Health Care , Democratic People's Republic of Korea , Dental Materials , Internet , Korea , Oral Health , Stomatognathic DiseasesABSTRACT
OBJECTIVES: This study aimed to estimate the financial budget of light-curing composite resin fillings based on the expanded coverage of the National Health Insurance Service (NHIS), called “Moon Care.” METHODS: The estimated population with dental caries and the amount of light-curing composite resins used were determined. The fees for the resin fillings per tooth were considered for the calculations. The expected budget for the next five years for children and adolescents aged 5–12 and 5–19 years were calculated. RESULTS: During the first year of the coverage, the budget for children and adolescents aged <19 years was estimated to be 201.8 billion South Korean won (5–9 years, 17.9 billion South Korean won; 10–14 years, 76.6 billion South Korean won; and 15–19 years, 107.3 billion South Korean won). The total budget for the next five years for children and adolescents aged <19 years was estimated at 946.4 billion South Korean won. Likewise, the budget for children aged <12 years during the first year of the coverage was estimated at 63.9 billion South Korean won (5–9 years, 17.9 billion South Korean won and 10–12 years, 46 billion South Korean won), and the total budget for the next five years was estimated at 315.9 billion South Korean won. CONCLUSIONS: Government healthcare plans should be established based on treatment needs and financial estimations. All the items in the NHIS, including the light-curing composite resin filling, should be considered based on their contribution to oral health promotion. Furthermore, in the long term, the coverage for preventive health services should be included in the health insurance.
Subject(s)
Adolescent , Child , Humans , Budgets , Composite Resins , Delivery of Health Care , Dental Caries , Fees and Charges , Insurance, Health , National Health Programs , Oral Health , Preventive Health Services , ToothABSTRACT
Central odontogenic fibroma (COF) is defined as a fibroblastic odontogenic tumor characterized by varying density of the tooth epithelium. It is an extremely rare benign neoplasm that occurs in the maxilla and the mandible; only a few reports of COF are available in the literature. Diagnosis of the lesion based only on the radiological features of COF is difficult due to variation in the findings regarding this condition. This report describes 2 clinical cases of middle-aged women with COF. Clinical examination revealed palatal mucosal depression; additionally, oral examination, as well as panoramic radiographs, intraoral radiographs, and computed tomography scans, revealed severe root resorption. This report highlights the clinical and radiological imaging features of COF, with the goal of enabling straightforward differential diagnosis of the lesion by the clinician and thereby appropriate treatment of the patient.
Subject(s)
Female , Humans , Depression , Diagnosis , Diagnosis, Differential , Diagnosis, Oral , Epithelium , Fibroblasts , Fibroma , Mandible , Maxilla , Odontogenic Tumors , Root Resorption , ToothABSTRACT
PURPOSE: This study was conducted to evaluate the accuracy of linear measurements of 3-dimensional (3D) images generated by cone-beam computed tomography (CBCT) and facial scanning systems, and to assess the effect of scanning parameters, such as CBCT exposure settings, on image quality. MATERIALS AND METHODS: CBCT and facial scanning images of an anthropomorphic phantom showing 13 soft-tissue anatomical landmarks were used in the study. The distances between the anatomical landmarks on the phantom were measured to obtain a reference for evaluating the accuracy of the 3D facial soft-tissue images. The distances between the 3D image landmarks were measured using a 3D distance measurement tool. The effect of scanning parameters on CBCT image quality was evaluated by visually comparing images acquired under different exposure conditions, but at a constant threshold. RESULTS: Comparison of the repeated direct phantom and image-based measurements revealed good reproducibility. There were no significant differences between the direct phantom and image-based measurements of the CBCT surface volume-rendered images. Five of the 15 measurements of the 3D facial scans were found to be significantly different from their corresponding direct phantom measurements (P < .05). The quality of the CBCT surface volume-rendered images acquired at a constant threshold varied across different exposure conditions. CONCLUSION: These results proved that existing 3D imaging techniques were satisfactorily accurate for clinical applications, and that optimizing the variables that affected image quality, such as the exposure parameters, was critical for image acquisition.
Subject(s)
Anthropometry , Cone-Beam Computed Tomography , Dimensional Measurement Accuracy , Imaging, Three-DimensionalABSTRACT
Osseointegrated implants are now commonplace in contemporary dentistry. However, a number of complications can occur around dental implants, including peri-implantitis, maxillary sinusitis, osteomyelitis, and neoplasms. There have been several reports of a malignant neoplasm occurring adjacent to a dental implant. In this report, we describe 2 such cases. One case was that of a 75-year-old man with no previous history of malignant disease who developed a solitary plasmacytoma around a dental implant in the left posterior mandible, and the other was that of a 43-year-old man who was diagnosed with squamous cell carcinoma adjacent to a dental implant in the right posterior mandible. Our experiences with these 2 cases suggest the possibility of a relationship between implant treatment and an inflammatory cofactor that might increase the risk of development of a malignant neoplasm.
Subject(s)
Adult , Aged , Humans , Carcinoma, Squamous Cell , Dental Implants , Dentistry , Mandible , Maxillary Sinus , Maxillary Sinusitis , Mouth Neoplasms , Osteomyelitis , Peri-Implantitis , PlasmacytomaABSTRACT
PURPOSE: This study was performed to investigate the influence of object shape and distance from the center of the image on the volumetric accuracy of cone-beam computed tomography (CBCT) scans, according to different parameters of tube voltage and current. MATERIALS AND METHODS: Four geometric objects (cylinder, cube, pyramid, and hexagon) with predefined dimensions were fabricated. The objects consisted of Teflon-perfluoroalkoxy embedded in a hydrocolloid matrix (Dupli-Coe-Loid TM; GC America Inc., Alsip, IL, USA), encased in an acrylic resin cylinder assembly. An Alphard Vega Dental CT system (Asahi Roentgen Ind. Co., Ltd, Kyoto, Japan) was used to acquire CBCT images. OnDemand 3D (CyberMed Inc., Seoul, Korea) software was used for object segmentation and image analysis. The accuracy was expressed by the volume error (VE). The VE was calculated under 3 different exposure settings. The measured volumes of the objects were compared to the true volumes for statistical analysis. RESULTS: The mean VE ranged from −4.47% to 2.35%. There was no significant relationship between an object's shape and the VE. A significant correlation was found between the distance of the object to the center of the image and the VE. Tube voltage affected the volume measurements and the VE, but tube current did not. CONCLUSION: The evaluated CBCT device provided satisfactory volume measurements. To assess volume measurements, it might be sufficient to use serial scans with a high resolution, but a low dose. This information may provide useful guidance for assessing volume measurements.
Subject(s)
Americas , Colloids , Cone-Beam Computed Tomography , Imaging, Three-Dimensional , SeoulABSTRACT
PURPOSE: The aim of this study was to develop the nursing management core task and competency matrix for hospital unit managers. The perceived level of importance and performance of identified core competencies by unit managers were also investigated. METHODS: Literature review and expert survey identified nursing management core task and competencies. Subsequently, the core task and competency matrix was developed and validated by expert panel. A survey of 196 nurse managers from 3 cities identified perceived importance and performance of core competiences. RESULTS: Thirty-eight nursing management core task and thirty-seven nursing management core competencies were identified comprising five categories; Clinical practice knowledge, Evidence-based practice, Employee development, Strategic planning and Initiative. Based on the core task and competencies, the task and competency matrix for unit managers was developed. In the analysis of importance and performance of core competencies, the mean score of importance (3.50±0.30) was higher than the mean score of performance (3.03±0.34). CONCLUSION: The development of core task and competencies for unit managers in hospitals provides a guide for the development and evaluation of programs designed to increase competence of unit managers.
Subject(s)
Humans , Evidence-Based Practice , Hospital Units , Mental Competency , Nurse Administrators , NursingABSTRACT
There is little evidence on the effects of environmental tobacco smoke (ETS) on prevalence of periodontal disease. The aims of this study were to explore the trends of prevalence of periodontal disease and types of exposure to smoke, including ETS according to the survey year, identify factors affecting periodontal disease, and compare the effect size of periodontal disease between active smokers and secondhand smokers. Data on 11,643 individuals were obtained from the fourth and fifth Korean National Health and Nutritional Examination Surveys. Information on exposure to ETS at home and work was self-reported. Severity of periodontal disease was evaluated using the community periodontal index. A multivariate logistic regression analysis was performed to model periodontal disease using types of smoking and the survey year. Overall, the prevalence of periodontal disease was 26.0% (n=3,029) and about 9% of the study population were secondhand smokers. The prevalence of periodontal disease among smokers was significantly increased according to smoking types by year. Active smokers showed a statistically significant adjusted odds ratio (aOR) for having periodontal disease except in the year 2007, whereas secondhand smokers had significant associations only in 2010 (aOR, 1.68; 95% confidence interval, 1.05 to 2.70) compared to non-smokers. For secondhand smokers, the statistical relationship of predicting periodontal disease was weaker than that of active smokers. However, ETS should separately be considered as an important risk factor for periodontal disease. This study suggested the need for further investigation of the impact of ETS on prevalence of periodontal disease using in-depth research designs and objective measurements for assessing periodontal disease and ETS.
Subject(s)
Health Surveys , Korea , Logistic Models , Nutrition Surveys , Odds Ratio , Periodontal Diseases , Periodontal Index , Prevalence , Research Design , Risk Factors , Smoke , Smoking , Tobacco , Tobacco Smoke PollutionABSTRACT
PURPOSE: This study was performed to evaluate the feasibility of visualizing soft tissue lesions and vascular structures using contrast-enhanced cone-beam computed tomography (CE-CBCT) after the intravenous administration of a contrast medium in an animal model. MATERIALS AND METHODS: CBCT was performed on six rabbits after a contrast medium was administered using an injection dose of 2 mL/kg body weight and an injection rate of 1 mL/s via the ear vein or femoral vein under general anesthesia. Artificial soft tissue lesions were created through the transplantation of autologous fatty tissue into the salivary gland. Volume rendering reconstruction, maximum intensity projection, and multiplanar reconstruction images were reconstructed and evaluated in order to visualize soft tissue contrast and vascular structures. RESULTS: The contrast enhancement of soft tissue was possible using all contrast medium injection parameters. An adequate contrast medium injection parameter for facilitating effective CE-CBCT was a 5-mL injection before exposure combined with a continuous 5-mL injection during scanning. Artificial soft tissue lesions were successfully created in the animals. The CE-CBCT images demonstrated adequate opacification of the soft tissues and vascular structures. CONCLUSION: Despite limited soft tissue resolution, the opacification of vascular structures was observed and artificial soft tissue lesions were visualized with sufficient contrast to the surrounding structures. The vascular structures and soft tissue lesions appeared well delineated in the CE-CBCT images, which was probably due to the superior spatial resolution of CE-CBCT compared to other techniques, such as multislice computed tomography.
Subject(s)
Animals , Rabbits , Adipose Tissue , Administration, Intravenous , Anesthesia, General , Body Weight , Cone-Beam Computed Tomography , Contrast Media , Ear , Femoral Vein , Models, Animal , Multidetector Computed Tomography , Radiography , Salivary Glands , VeinsABSTRACT
PURPOSE: This study was performed to investigate the incidence and configuration of the bifid mandibular canal in a Korean population by using cone-beam computed tomography (CBCT) imaging. MATERIALS AND METHODS: CBCT images of 1933 patients (884 male and 1049 female) were evaluated using PSR-9000N and Alphard-Vega 3030 Dental CT units (Asahi Roentgen Ind. Co., Ltd, Kyoto, Japan). Image analysis was performed by using OnDemand3D software (CyberMed Inc., Seoul, Korea). The bifid mandibular canal was identified and classified into four types, namely, the forward canal, buccolingual canal, dental canal, and retromolar canal. Statistical analysis was performed by using the chi-squared test and one-way analysis of variance (ANOVA). RESULTS: Bifid mandibular canals were observed in 198 (10.2%) of 1933 patients. The most frequently observed type of bifid mandibular canal was the retromolar canal (n=104, rate: 52.5%) without any significant difference among the incidence of each age and gender. The mean diameter of the accessory canal was 1.27 mm (range: 0.27-3.29 mm) without any significant difference among the mean diameter of each type of the bifid mandibular canal. The mean length of the bifid mandibular canals was 14.97mm(range: 2.17-38.8 mm) with only a significant difference between the dental canal and the other types. CONCLUSION: The bifid mandibular canal is not uncommon in Koreans and has a prevalence of 10.2% as indicated in the present study. It is suggested that a CBCT examination be recommended for detecting a bifid canal.