Development of Nutritional Biochemistry Learning Goals and Core Competencies in the Dental Hygiene Curriculum / 치위생과학회지

Background@#In the dental hygiene curriculum, efforts are being made to introduce an integrated curriculum based on the competency of a dental hygienist. Because there is a connection and overlap in learning contents between Dental Nutrition and Oral Biochemistry, which are basic dental hygiene subjects, it is possible to integrate these two subjects. This study aims to derive Nutritional Biochemistry as an integrated curriculum for Dental Nutrition and Oral Biochemistry, and to develop learning goals and competencies for Dental Nutritional Biochemistry. @*Methods@#The learning contents of the integrated curriculum were composed by referring to the contents of the Dental Nutrition and Oral Biochemistry textbooks, and learning goals were derived from the learning contents. Moreover, competency was developed by analyzing the duties of a dental hygienist that can be performed through the learning goals. The Delphi survey was conducted twice to verify the content validity ratio (CVR) of the competence and the learning goal of the integrated curriculum. @*Results@#In the first Delphi survey, the CVR for two competencies was 0.56 or higher. Moreover, it was revised based on expert’s opinions, and as a result of the second Delphi survey after the revision, the CVR was either increased or maintained. Eighty-five learning goals were derived by referring to the textbook. According to CVR and expert opinions, after the first Delphi survey, the number of learning goals was reduced to 69. After the second Delphi survey, 68 learning goals were finally derived. @*Conclusion@#The development process of the integrated curriculum conducted in this study can be utilized for integration between subjects in basic dental hygiene.

Adhesion and Biofilm Formation Abilities of Bacteria Isolated from Dental Unit Waterlines / 치위생과학회지

The purpose of our study is to compare the adhesion and biofilm formation abilities of isolates from water discharged from dental unit waterlines (DUWLs). Bacteria were isolated from a total of 15 DUWLs. Twelve isolates were selected for the experiment. To confirm the adhesion ability of the isolates, each isolate was attached to a glass coverslip using a 12-well plate. Plates were incubated at 26℃ for 7 days, and the degree of adhesion of each isolate was scored. To verify the biofilm formation ability of each isolate, biofilms were allowed to form on a 96-well polystyrene flat-bottom microtiter plate. The biofilm accumulations of all isolates formed at 26℃ for 7 days were identified and compared. A total of 56 strains were isolated from 15 water samples including 12 genera and 31 species. Of the 56 isolates, 12 isolates were selected according to the genus and used in the experiment. Sphingomonas echinoides, Methylobacterium aquaticum, and Cupriavidus pauculus had the highest adhesion ability scores of +3 among 12 isolates. Among these three isolates, the biofilm accumulation of C. pauculus was the highest and that of S. echinoides was the third-most abundant. The lowest biofilm accumulations were identified in Microbacterium testaceum and M. aquaticum. Most isolates with high adhesion ability also exhibited high biofilm formation ability. Analysis of adhesion and biofilm formation of the isolates from DUWLs can provide useful information to understand the mechanism of DUWL biofilm formation and development.

Establishment of a Dental Unit Biofilm Model Using Well-Plate / 치위생과학회지

The water discharged from dental unit waterlines (DUWLs) is heavily contaminated with bacteria. The development of efficient disinfectants is required to maintain good quality DUWL water. The purpose of this study was to establish a DUWL biofilm model using well-plates to confirm the effectiveness of disinfectants in the laboratory. Bacteria were obtained from the water discharged from DUWLs and incubated in R2A liquid medium for 10 days. The bacterial solution cultured for 10 days was made into stock and these stocks were incubated in R2A broth and batch mode for 5 days. Batch-cultured bacterial culture solution and polyurethane tubing sections were incubated in 12-well plates for 4 days. Biofilm accumulation was confirmed through plating on R2A solid medium. In addition, the thickness of the biofilm and the shape and distribution of the constituent bacteria were confirmed using confocal laser microscopy and scanning electron microscopy. The average accumulation of the cultured biofilm over 4 days amounted to 1.15×10⁷ CFU/cm². The biofilm was widely distributed on the inner surface of the polyurethane tubing and consisted of cocci, short-length rods and medium-length rods. The biofilm thickness ranged from 2 µm to 7 µm. The DUWL biofilm model produced in this study can be used to develop disinfectants and study DUWL biofilm-forming bacteria.

Developing a Dental Unit Waterline Model Using General Laboratory Equipments / 치위생과학회지

Water supplied through dental unit waterlines (DUWLs) has been shown to contain high number of bacteria. To reduce the contamination of DUWLs, it is essential to develop effective disinfectants. It is, however, difficulty to obtain proper DUWL samples for studies. The purpose of this study was to establish a simple laboratory model for reproducing DUWL biofilms. The bacteria obtained from DUWLs were cultured in R2A liquid medium for 10 days, and then stored at −70℃. This stock was inoculated into R2A liquid medium and incubated in batch mode. After 5 days of culturing, it was inoculated into the biofilm formation model developed in this study. Our biofilm formation model comprised of a beaker containing R2A liquid medium and five glass rods attached to DUWL polyurethane tubing. Biofilm was allowed to form on the stir plate and the medium was replaced every 2 days. After 4 days of biofilm formation in the laboratory model, biofilm thickness, morphological characteristics and distribution of the composing bacteria were examined by confocal laser microscopy and scanning electron microscopy. The mean of biofilm accumulation was 4.68×10⁴ colony forming unit/cm² and its thickness was 10~14 µm. In our laboratory model, thick bacterial lumps were observed in some parts of the tubing. To test the suitability of this biofilm model system, the effectiveness of disinfectants such as sodium hypochlorite, hydrogen peroxide, and chlorhexidine, was examined by their application to the biofilm formed in our model. Lower concentrations of disinfectants were less effective in reducing the count of bacteria constituting the biofilm. These results showed that our DUWL biofilm laboratory model was appropriate for comparison of disinfectant effects. Our laboratory model is expected to be useful for various other purposes in further studies.

Open Repair of Ruptured Abdominal Aortic Aneurysm: The Suitability of Endovascular Aneurysm Repair Does Not Influence Operative Mortality

PURPOSE: We analyze the outcomes of open repair (OR) in patients with ruptured abdominal aortic aneurysm (RAAA) according to the anatomic suitability for endovascular aneurysm repair (EVAR). MATERIALS AND METHODS: We reviewed retrospectively all consecutive RAAA patients who underwent OR from January 2005 to March 2014. All suspected patients underwent preoperative computed tomography (CT). Outcomes were major morbidities and mortality. Multivariate analysis was performed by using logistic regression adjusted by controlled variables; gender, Hardman index, maximal aneurysmal diameter, rupture type, perioperative transfusion requirement, and perioperative urinary output. RESULTS: Among 54 consecutive patients with RAAA who underwent OR, 45 patients were included after exclusion of 9 patients (7, suprarenal; 1, infected; 1, inflammatory). Preoperative CT showed 27% (12/45) EVAR-suitable patients. Hostile neck anatomy was found in 88% (29/33) among unsuitable anatomy (UA) (n=33). The maximal aneurysmal diameter was statistically larger (83.1+/-21.0 mm vs. 68.8+/-12.3 mm, P=0.032) in the UA group. The 30-day mortality was 28.9% (13/45; 33% vs. 17% in UA group vs. suitable anatomy [SA] group, P=0.460; adjusted P=0.445). UA group had more patients with cardiac morbidity (55% vs. 25%, P=0.079; adjusted P=0.032; odds ratio, 12.914; 95% confidence interval, 1.238-134.675). There was no statistical difference in survival rate between SA and UA groups (74.1%, 74.1%, and 74.1% vs. 60.6%, 55.6%, and 32.4% at 1-, 3- and 5-year, respectively; P=0.145). CONCLUSION: In this study, relatively unfavorable outcomes were found in the EVAR-unsuitable group after OR in RAAA patients. However, unsuitable anatomy did not influence patient survival after OR by multivariate analysis.

Clinical Characteristics and Heart Rate Variability in Patients with Comorbid Panic Disorder and Major Depressive Disorder / 수면정신생리

OBJECTIVES: This study was designed to evaluate the differences in clinical characteristics and severity of symptoms between panic patients with and without comorbid major depressive disorder, and to ascertain the differences in the function of the autonomic nerve system measured by heart rate variability (HRV). METHODS: The subjects were 60 patients who have panic disorder without major depressive disorder and 19 patients who met DSM-IV criteria for both panic disorder and major depressive disorder. First, they drew up symptom checklists and self-rating scales, and were measured by Anxiety Disorder Inventory Schedule-Panic Attack & Agoraphobia (ADIS-P& A), Clinical Global Impression (CGI), Hamilton Rating Scale for Depression (HAM-D), Panic Disorder Severity Scale (PDSS) and Heart Rate Variability (HRV). For statistical analysis, we performed t-test to compare the scores of self reported scales and clinician's rating scales in panic patients with comorbid major depressive disorder and those without major depressive disorder. ANCOVA was used to compare the variables of HRV, considering age as a covariate. RESULTS: The subjective severities of depression and anxiety that comorbid patients complained of were higher than those of patients with only panic disorder. Futhermore, comorbid patients were more sensitive to anxiety and physical sensations, and they tend to be more negative in their thinking. The scores of clinician-rating scales such as CGI and PDSS were also higher in the comorbid patients. However, there were no significant differences in HRV variables between both groups, despite a tendency to low heart rate variability in the comorbid group. CONCLUSION: This study suggests that patients with panic disorder and comorbid major depressive disorder tend to complain of more symptoms and to be more sensitive to various symptoms than those with panic disorder without comorbid depression. However, in this study comorbid major depressive disorder did not have a significant impact on the HRV variables of patients with panic disorder.

The Relation between Heart Rate Variability and Pharmacotherapy in Patients with Panic Disorder / 신경정신의학

OBJECTIVES: This study was designed to evaluate relation between 6 weeks pharmacotherapy and the alteration of autonomic nervous system in patient with panic disorder. METHODS: The subjects were patients (n=44) who met DSM-IV criteria for panic disorder with or without agoraphobia. They were measured Anxiety Disorder Inventory Schedule-Panic attack & agoraphobia (ADIS-P & A), Clinical Global Impression (CGI) Hamilton Rating Scale for depression (HAM-D), Panic Disorder Severity Scale (PDSS) and heart rate variability (HRV) before and after 6 weeks pharmacotherapy. We prescribed paroxetine primarily and benzodiazepine (clonazepam, alprazolam) in case needed. For analysis, we performed paired sample t-test, partial correlation, stepwise multiple regression. RESULTS: After 6 weeks pharmacotherapy, a assessed clinical inventories significant improved. In HRV, patients showed stabilized sympathetic activity (LF, Normalized LF, log_LF), increased parasympathetic activity (Normalized HF). There were significant correlation between symptom improvement with parasympathetic components and symptom aggravation with sympathetic components. Multiple regression analysis showed that Normalized HF and TP were best explanatory variables of symptom improvement. CONCLUSION: This study suggests that 6 weeks pharmacotherapy is related to the alteration of autonomic nervous system and clinical improvement.

The Effects of Cognitive Behavioral Therapy for Discontinuation of Medication in Panic Disorder / 대한정신약물학회지

OBJECTIVE: The purpose of this study is to determine whether CBT is effective in tapering or discontinuing medication regardless of the type of medication and its maintenance effects after long-term follow up. METHOD: 224 patients meet DSM-IV criteria for panic disorder with or without agoraphobia completed 12 weekly sessions of Panic Control Therapy (PCT;Barlow et al.). 80 patients who were using benzodiazepines alone and 144 patients who were using benzodiazepines and Antidepressants were measured with several screening scales at the pre- and post-treatment. The scales were Beck Depression Inventory (BDI), Spielberg State Anxiety Inventory (STAI-State), Spielberg Trait Anxiety Inventory (STAI-Trait), Body Sensation Questionnaire (BSQ), Agoraphobic Cognition Questionnaire (ACQ), Anxiety Sensitivity Index (ASI), Panic Belief Questionnaire (PBQ). These patients were assessed at 3 months, 6 months, 12 months of follow up and they were also assessed for their medications, panic frequency, and End-State Functioning. RESULTS: After the completion of PCP, both benzodiazepines alone group and benzodiazepines and antidepressants combination group showed significant improvement (p<0.001) in all the results of 7-self reported questionnaires. 54% of patients discontinued their medication and 90.9% of patients were in HES at post-treatment. 70 % of patients were in HES at 3 month, 6 month, and 12 month follow up. The patients who could not discontinue medication also tapered their medication afterwards. The rate of discontinuing medication was significantly higher for the patients using benzodiazepines alone (86.3%) than patients using combination of benzodiazepines and antidepressants (56.3%). CONCLUSION: These findings support cognitive behavioral therapy can replace medication and these effects seem to last long.

Nutritional and Health Status of Korean Elderly from Low-income, Urban Area and Improving Effect of Meal Service on Nutritional and Health Status - V. The Effect of Meal Service for One Year on Nutritional and Health Status / 대한지역사회영양학회지

This study was performed to assess the effect of one year's of meal service for home-staying urban elderly with low incole on their nutritional status. One hundred and eighty three subjects, who had already completed the first nutritional survey, were assigned to two group : meal served(served) and non-meal served(non-served). A meal containing approximately on half of the RDA for energy, protein, calcium and iron was served as lunch everyday to served group. After on year of meal service, follow-up-nutritional survey was done and changes of parameters were analyzed with paired t-test. Served female showed signficantly increased intake of riboflavin and calcium, while non-served female showed significantly decreased intake of calcium. Serum total protein, serum albumin and serum cholesterol were significantly increased in female regardless of meal service. Served remale was observed with significantly elevated LDL-cholesterol, whereas non-served female showed singnificantly lowered HDL-cholesterol. Significantly decreased serum iron, serum transferrin saturaion and significantly increased TIBC were observed for female regardless of meal service. But the proportion of anemic elderly according to Hb or serum iron was decreased more in served group. Female showed significantly increased serum zinc and copper regardless of meal service, whereas only served male showed significantly increased serum copper.

Nutritional Status and Indicators of Immune Function of Elderly Residing in Low Income Urban Area / 대한지역사회영양학회지

No abstract available.