Satisfaction Survey of Telemedicine Services for the Patients With Dementia in the Vulnerable Area for Medical Service / 신경정신의학

Objectives@#To assess the satisfaction of dementia patients with telemedicine services. Underlying factors were extracted from a satisfaction dataset, and possible associations among factors were investigated to determine their statistical relevances. @*Methods@#A survey was conducted using a questionnaire to determine satisfaction with telemedicine services of patients with dementia in 9 public health centers and 5 designated hospitals in 8 provinces in Gangwon-do from 20 July 2020 to 31 October 2020. Four hundred and ninety-seven users responded to the survey. Factor analysis was performed on survey data and multiple linear regression was used to extract relevant factors. @*Results@#The percentage of subjects satisfied with telemedicine services was 78.8%. Thirty-five items of the satisfaction survey indicated that the five factors, that is, necessity (Cronbach’s α 0.952), satisfaction (Cronbach’s α 0.929), medical system reliability (Cronbach’s α 0.924), medical staff reliability (Cronbach’s α 0.924), and geographic vulnerability (Cronbach’s α 0.922), were related to satisfaction with telemedicine services, and that of these, geographic vulnerability was most associated with the need for telemedicine services. @*Conclusion@#This study shows that dementia patients with experience of telemedicine services were generally satisfied with treatment. Despite its limitations, the satisfaction survey was found to provide a reliable and valid scale for assessing user satisfaction.

The Effect of Cognitive Intervention on Cognitive Improvement in Patients with Dementia

BACKGROUND AND PURPOSE: The effect of cognitive intervention in patients with dementia is inconsistent. This study sought to find out the effect of cognitive intervention by measuring interval change between before and after intervention. METHODS: We evaluated cognitive changes according to clinical diagnostic group across Gangwon province for 940 patients with dementia diagnosed at hospital clinics and 2,975 subjects without dementia. All subjects were treated with cognitive intervention. They underwent a cognitive and mood assessment before and after intervention. We used interval change of Mini-Mental State Examination (MMSE) scores as a primary measure of interventional outcome. RESULTS: Changes in mean MMSE score were significantly different between the non-dementia group and the dementia group (p=0.016), with changes of 0.7±2.4 and 1.0±3.7 points (±standard deviation), respectively. Cognitive improvement regarding completion of session was significantly higher in the dementia group (p=0.001), with changes of 0.41±4.51 for uncompleted group and 1.30±3.22 points for completed ones. Lower initial MMSE scores, lower age, and type of intervention were found to be independent predictive factors of subsequent cognitive changes as indicated by mean MMSE scores. CONCLUSIONS: These findings suggest that cognitive intervention might be useful for patients with dementia. Their response to treatment might be related to the type of intervention.

Similarity Analysis of Korean Medical Literature and Its Association with Efforts to Improve Research and Publication Ethics

In the present study, the frequency of research misconduct in Korean medical papers was analyzed using the similarity check software iThenticate®. All Korean papers written in English that were published in 2009 and 2014 in KoreaMed Synapse were identified. In total, 23,848 papers were extracted. 4,050 original articles of them were randomly selected for similarity analysis. The average Similarity Index of the 4,050 papers decreased over time, particularly in 2013: in 2009 and 2014, it was 10.15% and 5.62%, respectively. And 357 (8.8%) had a Similarity Index of ≥ 20%. Authors considered a Similarity Index of ≥ 20% as suspected research misconduct. It was found that iThenticate® cannot functionally process citations without double quotation marks. Papers with a Similarity Index of ≥ 20% were thus individually checked for detecting such text-matching errors to accurately identify papers with suspected research misconduct. After correcting text-matching errors, 142 (3.5% of the 4,050 papers) were suspected of research misconduct. The annual frequency of these papers decreased over time, particularly in 2013: in 2009 and 2014, it was 5.2% and 1.7%, respectively. The decrease was associated with the introduction of CrossCheck by KoreaMed and the frequent use of similarity check software. The majority (81%) had Similarity Indices between 20% and 40%. The fact suggested that low Similarity index does not necessarily mean low possibility of research misconduct. It should be noted that, although iThenticate® provides a fundamental basis for detecting research misconduct, the final judgment should be made by experts.

Cavitary Lung Lesion in a Patient with Systemic Lupus Erythematosus: An Unusual Manifestation of Cytomegalovirus Pneumonia

Cytomegalovirus (CMV), a member of the human herpesvirus group, causes severe disease in immunocompromised patients. In particular, CMV pneumonia can be a life-threatening disease to patients taking immunosuppressive drugs. The radiographic manifestations of CMV are variable and may consist of reticular or reticulonodular patterns, ground-glass opacities, air-space consolidations, or mixed patterns. A cavitary lesion in pneumonia associated with CMV infection is extremely rare. Herein we report on a case of CMV pneumonia which presented with a cavitary lesion and was treated successfully in a systemic lupus erythematosus patient who was taking immunosuppressive drugs.

Effects of titanium surface coating on ceramic adhesion / 대한치과보철학회지

STATEMENT OF PROBLEM: The adhesion between titanium and ceramic is less optimal than conventional metal-ceramic bonding, due to reaction layer form on cast titanium surface during porcelain firing. PURPOSE: This study characterized the effect of titanium-ceramic adhesion after gold and TiN coating on cast and wrought titanium substrates. MATERIAL AND METHOD: Six groups of ASTM grade II commercially pure titanium and cast titanium specimens(13mm x 13mm x 1mm) were prepared(n=8). The conventional Au-Pd-In alloy served as the control. All specimens were sandblasted with 110micrometer Al2O3 particles and ultrasonically cleaned for 5min in deionized water, and dried in air before porcelain firing. An ultra-low-fusing dental porcelain(Vita Titankeramik) was fused on titanium surfaces. Porcelain was debonded by a biaxial flexure test at a cross head speed of 0.25mm/min. The excellent titanium-ceramic adherence was exhibited by the presence of a dentin porcelain layer on the specimen surface after the biaxial flexure test. Area fraction of adherent porcelain(AFAP) was determined by SEM/EDS. Numerical results were statistically analyzed by one-way ANOVA and Student- Newman-Keuls test at alpha=0.05. RESULTS: The AFAP value of cast titanium was greatest in the group 2 with TiN coating, followed by group 1 with Au coating and the group 3 with Al2O3 sandblasting. Significant statistical difference was found between the group 1, 2 and the group 3 (p.05). The AFAP values of the cast titanium and the wrought titanium were similar. However the group treated with Al2O3 sandblasting showed significantly lower value (p<.05).

Study on Pain, Efficacy, and Comfort during First Stage of Laboring Women / 여성건강간호학회지

PURPOSE: This study was purposed to survey pain, efficacy, and comfort during the first stage of labor and to identify correlations among them. METHOD: The subjects were 116 laboring women who were admitted to a baby-friendly hospital recommended by UNICEF for breast feeding. Data were collected using a structured questionnaire composed of labor pain, labor efficacy, and labor comfort with 10 cm visual analog scale respectively. The data were analyzed by frequency, Pearson's correlation, and ANOVA. RESULT: Labor pain, labor efficacy, and labor comfort in latent phase were positive correlation with them in active phase. The more pain, the less labor efficacy and the less comfort in latent phase. and the more pain, the less comfort in active phase. Labor efficacy was positively correlated with labor comfort in both phase. Lastly, women supported by their husbands had significantly higher labor pain than women supported by their mothers. CONCLUSION: The results suggest that nurses develop a labor efficacy program for pregnant women and their mothers or spouses.

THE STUDY ON THE PHYSICAL PROPERTY OF THE PERMANENT SOFT DENTURE LINERS / 대한치과보철학회지

This study was performed to evaluate the tensile bond strength and modulus of elasticity of three permanent soft denture liners (Molloplast B , Ufi Gel C , Tokuyama ) before and after thermocycling. And their water sorption were also evaluated. Each soft denture liner was bonded to PMMA denture base resin blocks and the tensile bond strength and modulus of elasticity were measured by using universal testing machine. For the water sorption, weight measured after immersion of soft denture liners in 37+/-1degrees C water bath for 4 weeks. The results were as follows : 1. Molloplast B had the highest tensile bond strength, while Tokuyama had the lowest tensile bond strength, There was no significant difference between Tokuyama and Molloplast B in the both nonthermocycling and thermocycling. There was significant difference in tensile strength of Tokuyama before and after thermocycling(p<0.05). 2. For the modulus of elasticity, there was no significant difference between Ufi Gel C and Tokuyama in the both nonthermocycling and thermocycling. There was significant difference in modulus of elasticity of Tokuyama before and after thermocycling(p<0.05). 3. The failure modes of Molloplast B and Ufi Gel C were nainley adhesive type and that of Tokuyama was mainly mixed type in case of nonthermocycling and cohesive type after thermocycling. 4. The water sorption of each soft liners was within+/-2% in times (p<0.05) but, there was no significant difference among the soft liners in times.

The Reversibility of Cerebral Artery Contraction and Pathologic Change in the Rabbit Vasospasm Model

Although it is well known that cerebral vasospasm is caused by the breakdown of blood products extravasated during subarachnoid hemorrhage(SAH), it is still controversial whether its persistence is caused by the continuing contraction of the smooth muscle of vessels or by morphologic change in the vessel wall. The purpose of this study is to evaluate the reversibility of vasospasm induced by intra-arterial papaverine injection and to evaluate morphological change in the vessel wall in SAH induced in rabbits. In each of 18 rabbits, vertebral angiography was performed 7 days before the induction of artificial SAH was made by injection of autologous arterial blood around the basilar artery through a silicone catheter placed in the prepontine cistern. Before and after the injection of papaverine, further vertebral angiograms were obtained on days 1(n=1), 2(n=2), 3(n=1), 4(n=2), 5(n=4), 6(n=1), 7(n=2), 8(n=1), 14(n=1), 16(n=1) and 30(n=1) after the creation of SAH. Immediately after this further angiography, the rabbits were sacrificed and portions of the basilar artery were prepared for electron microscopic(EM) study and immunohistochemical staining. Vasospasm of the basilar artery was most severe in the rabbit sacrificed one day after SAH(54.1% of pre-SAH diameter) and maintained until 30 days thereafter(61.0% of the pre-SAH diameter). Five days after SAH, the diameter of the basilar artery following papaverine injection was 78.6% of its pre-SAH diameter, suggesting a decrease in the reversibility of papaverine-induced effects. The ultrastructural changes seen on EM study were most remarkable on post-SAH days 1 and 2 and tended to be gradually milder on later days. Immunohistochemical staining showed diffuse strong positive reactivity for smooth muscle actin in the media at 1, 5, 7, and 14 days after SAH, and strong positive reactivity for vimentin in the intima and media at 2, 5, and 30 days after SAH. When the reversibility of papaverine-induced arterial contraction decreased, findings of increased immunoreactivity to the cytoskeletal protein of smooth muscle of the basilar artery suggested that morphological changes in the artery wall had contributed to the maintenance of vasospasm.