Distribution of medical status and medications in elderly patients treated with dental implant surgery covered by national healthcare insurance in Korea

BACKGROUND: The purpose of this study was to investigate the distribution of systemic diseases and medications in patients older than 65 years of age who visited the hospital for implant treatment, as well as to investigate basic information about surgical complications that may occur after insured implant treatment. METHODS: A total of 126 patients over 65 years of age were treated for implant surgery from October 1, 2013 to October 30, 2016. Electronic chart review was conducted to obtain medical records, which included sex, age, systemic diseases, medication(s) being taken, and control of the medications. Five patients were excluded due to lack of medical records giving information about systemic disease. RESULTS: Of the 126 patients, 112 (88.9%) were taking medication due to systemic disease and 9 patients (7.1%) were not. The sex distribution was 71 women and 55 men and the highest proportion of patients were between 65 and 69 years old. The most common diseases were, from most to least frequent, hypertension, cardiovascular disease, diabetes, and osteoporosis. The drug groups that can cause major complications after dental treatment were classified as hemorrhagic, osteoporotic, and immunosuppressive agents, and were taken by 45 (35.7%), 22 (17.5%) and 4 (3.2%) patients, respectively. CONCLUSION: Given that 88.9% of the elderly patients who were eligible for insurance implant treatment had systemic disease, it is necessary to carefully evaluate patients' medical histories and their general conditions in order to prevent emergencies during implant surgery.ope

Improvement of accessibility to dental care due to expansion of national health insurance coverage for scaling in South Korea

Since 2013, adults aged over 20 can receive national health insurance scaling once a year in South Korea. In this study, we analyzed the usage status of national health insurance care service for periodontal disease in 2010-2018 by using Healthcare big data of the Health Insurance Review and Assessment Service. The increase rate of the dental care users was very high at 7.8 and 11.2% in 2013 and 2014, respectively. These are higher than the increase rate of all medical institution users, which is between -1.7 and 3.7%. In 2017, the rate of dental use was 44.4%, which has increased more than 10% compared to 2012. Percent receiver of national health insurance scaling was 19.5% in 2017. The 20s had the highest rate of 23.2%. The rate decreased with age. Based on these results, it can be evaluated that the expansion of national health insurance coverage for scaling improves accessibility to dental care. A more long-term assessment of the effect of periodic dental examination and scaling on reducing the prevalence of periodontal disease is needed. National health insurance coverage should be extended to oral hygiene education and supportive periodontal therapy in order to prevent periodontal disease.ope

Parathyroid Hormone (1-34) Might Not Improve Early Bone Healing after Sinus Augmentation in Healthy Rabbits

Purpose. This study evaluated the effect of administering intermittent parathyroid hormone [PTH (1-34), henceforth PTH] on the early-stage bone healing of maxillary sinus augmentation in healthy rabbits. Materials and Methods. Bovine bone mineral was grafted on the sinuses of 20 female New Zealand white rabbits. The animals were randomly divided into two groups, PTH (n = 10) or saline (n = 10), in which either PTH or saline was injected subcutaneously 5 days a week for 2 weeks. Half of the animals in each group were killed at 2 weeks postoperatively and the other half were killed at 4 weeks postoperatively. The dosage of PTH was 10 μg/kg/day. Radiographic and histomorphometric analyses were performed. Result. The new bone area (NBA) did not differ significantly between the PTH and saline groups. The NBA in the PTH group in the total augmented area and in the demarcated window, center, and Schneiderian membrane regions increased significantly from 2 to 4 weeks. The number of osteoclasts decreased significantly from 2 to 4 weeks in both groups, with no difference between the two groups. Conclusion. Intermittent PTH might not stimulate new bone formation in healthy rabbits during the first 4 weeks of healing.ope

The Necessity of Establishing a Specialist Program for Geriatric Dentistry for the Elderly of Korea Based on their General Health Status

Korea became an aged society as of 2018, and will have plunged into a super-aged society by 2025. For the dental treatment of elderly patients, their general conditions are to be considered to make appropriate treatment plans and strategies, based on advanced knowledge of geriatric dentistry and clinical experience. In this study, the social demand for geriatric dental specialists for the treatment of the elderly of Korea is investigated by looking at their general health conditions, ADL (Activities of Daily Living), and IADL (Instrumental Activities of Daily Living), along with the review of the advanced training programs of geriatric dentistry in other countries.ope

Analysis of Various Influencing Factors Related to Patient-Dentist Interaction Score

Each college of dentistry in Korea is examining and reorganizing its own curriculum to prepare students for the practical examination of the National Dental Licensing Examination. Conducting an assessment of students’ compe - tency of communication skills with standardized patients is the first attempt for the examination. Yonsei University College of Dentistry carried out the evaluation of communication attitude, communication written exam, and commu - nication skills practice with standardized patients for Third year predoctoral students. The purpose of this study is a) to find out the relationship between the variables measured in communication skills education and b) to make a new basis for the application of communication education and evaluation in dentistry . Based on the results of the study, the following suggestions for the operation of a dental communication curriculum can be drawn: First, the communication classes and the practice with standardized patients should be based on the wide support of the school. In addition, the patient-dentist interaction (PDI) should be practiced in the same way as practically possible by predoctoral students. Moreover, a space is required to allow predoctoral students to practice PDI. Second, the communication score given by the standardized patients was the most influential on the total score of PDI. This indicates that the communication practice with the standardized patients for the practical examination of the National Dental Licensing Examination is a meaningful process in the course of its communication education.ope

Foreign body aspiration and ingestion in dental clinic: a seven-year retrospective study

Background: This retrospective study investigated the incidence rate of accidental foreign body aspiration and ingestion according to patient sex, age, and dental department. This study aimed to verify whether the incidence rate is higher in geriatric than in younger patients and whether it is different among dental departments. Methods: Accidental foreign body aspiration and ingestion cases were collected from electronic health records and the safety report system of Yonsei University Dental Hospital from January 2011 to December 2017. The collected data included patients' age, sex, medical conditions, treatment procedures, and foreign objects that were accidentally aspirated or ingested. The incidence rate was calculated as the number of accidental foreign body aspirations and ingestions relative to the total number of patient visits. Differences depending on the patients' sex, age, and dental department were statistically identified. Results: There were 2 aspiration and 37 ingestion cases during the 7-year analysis period. The male to female incidence ratio was 2.8:1. The incidence rate increased with age and increased rapidly among those aged 80 years or older. Seven of the 37 patients with accidental foreign body ingestion had intellectual disability, Lou Gehrig's disease, dystonia, or oral and maxillofacial cancer. The incidence rate was highest in the Predoctoral Student Clinic and the Department of Prosthodontics. The most frequently swallowed objects were fixed dental prostheses and dental implant components. Conclusion: The incidence rate of accidental foreign body aspiration and ingestion differed according to patient sex, age, and dental department. Dental practitioners must identify high-risk patients and apply various methods to prevent accidental foreign body aspiration and ingestion in dental clinics. Inexperienced practitioners should be particularly careful.ope

A study on moral education program using the example of value conflicts associated with real life for improvement in student's moral judgement

The purpose of this study is to develop a education program for the students' improvement in moral judgement, by applying 'Value Conflicts' lesson dealing with the state of actual problems in the class. First, the pretest was carried out to examine the student's moral judgement. And the effect of this program was proved based on the result obtained through the observation and the analysis of the moral judgement changes with the model of moral value conflicts related to a real life. The moral judgement could be defined as the ability of thinking and judging what is right or wrong, what a person should do or not and understanding the reason for that. It is difficult to induce children's interest because some cases of the value conflicts presented in the traditional class is different from real life. To make up for this point, by converting into the examples reflecting the problems which children undergo actually in their school life, this program was designed and developed so that they could sympathize with their lesson and understand easily. The general procedure in this education program is as follows : Preparing ▷ Presenting the situation of value conflicts and identifying a problem ▷ Thinking one's position and choosing ▷ Discussion ▷ Role play ▷ Evaluation and conclusion. In the study, 20 students aged twelve, who show their problem behaviors in an elementary school S located in Mapo-gu in Seoul, were examined by the pretest to know their moral judgement. And the value conflicts model lesson program associated with real life applied to them, then the obtained data was collected and the post-test was conducted with the instrument used for the moral judgement examination. Statistics of the collected data were gained by SPSS/WIN program and T-test was operated to analyze the difference of the results from pretest and those from post-test. Based on the result gained through the procedures of this program, it could affect positively in improving children's moral judgement. Meanwhile, there are some limited things in conducting the value conflicts model lesson program. First, it has a limitation in generalizing the result of the examination for only 20 students aged twelve who have problem behaviors. Second, the example of value conflicts presented for this education program in this study was taken based on demands survey of teachers and students showing their problem doings. Therefore, the example contents are limited. Third, as the value conflicts model lesson program has been operated for relatively short term of 4 weeks in this study, there could be somewhat insufficient parts. It is necessary to extend the conducting time of the program effectively to get more information about the aspect of moral judgement changes.;본 연구는 학생들의 도덕판단력의 향상을 위하여 도덕수업에서 실제 문제사태를 활용한 가치갈등 수업모형을 적용한 도덕교육 프로그램을 개발하는데 그 목적이 있다. 이를 위해 먼저 연구 집단에게 사전검사를 실시하여 도덕판단력을 살펴보고 실생활과 관련된 가치갈등 수업모형 프로그램을 투입한 후, 도덕판단력이 어떻게 변화되었는지를 관찰하고 분석하여 프로그램에 대한 효과를 검정하였다. 도덕판단력이라 함은 무엇이 옳고 그른지, 무엇을 마땅히 해야 하거나 하지 말아야 하는지, 그리고 그러한 이유와 정당한 근거가 무엇인지를 사고 · 판단하는 능력이라고 정의할 수 있다. 이러한 도덕판단력을 기르기 위한 방법 중의 하나로 도덕과의 가치갈등 수업모형이 있는데, 이 모형은 Kohlberg의 도덕성 발달 이론에 근거하여 제시된 도덕적 갈등 상황을 이해하고, 토론을 통하여 자신의 입장을 진술, 그 근거를 설명하는 과정의 수업모형을 의미한다. 본 연구에서는 기존의 가치갈등 수업에서 제시된 가치갈등 사례가 아동들의 실제생활과는 차이가 있어 아동들의 흥미를 유발하기 어렵고, 가치갈등 상황에 쉽게 공감하지 못하는 문제점을 극복하고자 아동들이 학교생활에서 실제로 겪고 있는 문제 장면을 가치갈등 사례로 전환하여 프로그램을 고안 · 개발하였다. 본 프로그램의 실생활과 관련된 가치갈등 수업모형 프로그램의 일반적인 절차는 ‘준비하기 ▷ 가치갈등 사태의 제시와 문제 확인 ▷ 자신의 입장의 탐색 및 선택 ▷ 토론을 통한 다양한 입장되기 ▷ 공감을 위한 역할극 하기 ▷ 정리 및 평가'의 과정을 거치도록 하였다. 본 연구는 서울특별시 마포구에 위치하고 있는 S초등학교의 문제행동을 보이는 5학년 학생 20명을 대상으로 사전검사를 통해 도덕판단력을 검사하였으며, 실생활과 관련된 가치갈등 수업모형 프로그램을 투입한 후 자료를 수집하고 사후 검사를 실시하였으며, 이때의 사전 · 사후 검사도구는 기존 개발되어 사용되는 Rest의 도덕판단력 검사(한국의 문용린이 2003년, KDIT로 재구성)이다. 수집된 결과는 SPSS/WIN 프로그램( Ver 12.0)을 이용하여 통계 처리하였으며, 도덕 판단력 사전 · 사후 비교 검증의 차이를 t검증을 통하여 실시하여 투입된 실생활과 관련된 가치갈등 사레를 활용한 프로그램의 효과를 검증하였다. 프로그램 적용의 결과, 실생활과 관련된 가치갈등사례 프로그램은 전체적인 도덕판단능력에 대해 살펴보았을 때 아동의 도덕판단능력 향상에 긍정적인 영향을 주었으므로 유의미한 결과를 얻었다고 볼 수 있다. 한편 본 연구는 문제행동을 보이는 아동의 도덕판단력 향상을 위해 실생활과 관련된 가치갈등 수업모형 프로그램을 실시함에 있어 몇 가지 제한점이 있다. 첫째, 본 연구는 초등학교 5학년의 문제행동을 보이는 학생 20명을 대상으로 하였기 때문에 그 결과를 일반화하는데 제한이 있다. 따라서 더욱 많은 아동을 대상으로 한 연구를 통해 종합적이고 일반적인 결론을 얻어내는 연구가 필요하다. 둘째, 본 연구의 프로그램에서 사용된 가치갈등 사례를 문제행동을 보이는 아동들과 교사들의 요구조사 설문지에 근거하여 추출하였기 때문에 문제행동의 범위와 내용이 한정되어 있다. 셋째, 본 연구는 4주간의 단기간에 걸쳐 프로그램이 비교적 짧게 실행된 관계로 유의미한 결론을 얻지 못한 부분도 있다. 따라서 좀 더 장기간의 탄력적인 프로그램 적용을 통해 도덕판단능력의 변화양상을 자세히 알아보는 과정이 필요하다.Ⅰ. 서론 = 1 A. 연구의 필요성 및 목적 = 1 B. 연구문제 = 4 C. 연구의 한계 = 4 D. 용어의 정의 = 4 Ⅱ. 이론적 배경 = 6 A. 도덕판단력 = 6 B. 가치갈등 수업모형 = 16 Ⅲ. 연구방법 = 26 A. 연구의 대상 = 26 B. 연구 설계 = 28 C. 연구도구 = 31 D. 자료처리 = 44 Ⅳ. 프로그램의 실제 및 결과 = 45 A. 프로그램의 실제 = 45 B. 프로그램의 결과 = 57 Ⅴ. 결론 및 제언 = 61 A. 결론 = 61 B. 제언 = 63 참고문헌 = 65 부록 = 69 ABSTRACT = 10

An Analysis of Smartphone Market and Social Welfare Effect of Smartphone Subsidies

학위논문 (석사)-- 서울대학교 대학원 : 경제학부, 2014. 8. 조성진.본 연구는 각 제품 특성에 따른 스마트폰 시장의 수요를 분석하고, 이를 통해 단말기 보조금의 사회후생 효과를 추정하였다. 자료로는 2013년 5월부터 2014년 2월까지 모 대리점의 실제 개통자료를 이용하였다. 또한 조건부 로짓 모형을 이용하여 판매된 스마트폰의 제품별 출고가, 할부원금, 판매량, 제원 등이 선택확률에 미치는 영향을 추정하고, 이를 통해 스마트폰 수요의 가격탄력성을 구하였다. 그리고 제조사의 이윤극대화 조건을 기반으로 하여 마크업을 계산하고, 이를 바탕으로 단말기 보조금으로 인한 소비자잉여와 생산자잉여의 변화분을 추정하였다. 그 결과 단말기 보조금의 지급으로 인한 소비자잉여와 생산자잉여의 증가폭이 총 보조금 액수보다 약 4조 4901억원만큼 큰 것으로 나타났다. 통신사 역시 이러한 보조금 지출을 부담할 유인을 가지고 있으며, 이러한 보조금의 원천이 이동통신 요금 인상으로 인한 소비자 잉여 감소분으로 볼 수도 있으나 실제 보조금으로 인해 가장 이득을 보는 것은 제조사인만큼 제조사로부터 더 많은 보조금이 지급되고 있을 가능성이 크다. 또한 현행 요금체계 하에서 보조금의 금지가 요금인하로 이어질 경로가 불확실하다는 점까지 고려하면 단말기 보조금 규제가 소비자에게 이익이 될 가능성은 미지수이다. 즉, 단말기 보조금의 실부담이 소비자에게 전가되는 것은 아니며, 정부의 보조금 정책은 역효과를 불러올 여지가 크다.This paper analyzes the demand of smartphone market and the effect of smartphone subsidies on the social welfare using an retailers data from May 2013 to Feb 2014. For this purpose, this paper uses conditional logit model to estimate the parameters of each models specification. The price elasticity and mark-ups of manufacturers are also estimated by this parameters. By employing these estimates and other assumptions, social welfare effect in the smartphone market is estimated. According to the estimation, the increase of social welfare due to smartphone subsidies is greater than the total subsidies, leading the social welfare surplus of 4,490 billion won. The telecommunication companies have incentive to spend this subsidies, and because the manufacturers benefit most, it can be inffered that there is greater subsidies from them. And there is no basis that the regulation of smartphone subsidies leads to reduction of communication fee, comsumers will not benefit from the regulation.제 1 장 서 론 ……………………………………… 1 제 1 절 연구의 배경 …………………………………… 1 제 2 절 본 연구의 기여와 구성 ……………………… 5 제 2 장 선 행 연 구 ……………………………… 6 제 3 장 분 석 ……………………………………… 9 제 1 절 자료 ……………………………………………… 9 제 2 절 모형 …………………………………………… 13 제 3 절 모형 추정 결과 ……………………………… 16 제 4 절 후생분석 ……………………………………… 22 제 4 장 논의 및 결론 …………………………… 28 참 고 문 헌 ……………………………………… 32 Abstract …………………………………………… 34 부록 ………………………………………………… 36Maste

(The) effect of safflower seed fraction extract on periodontal ligament fibroblast and MC3T3-E1 cell in vitro.

치의학과/석사[한글] 최근 치주 영역에서 생약제제에 대한 관심이 증가되고 있으며 특히 홍화씨, 후박, 황금, 대조, 황백, 죽염, 황련, 은행엽, 옥수수 추출물 등이 치주염에 효과적인 생약제제로 알려져 있다. 이 중 홍화(safflower, Carthamus tinctorius L.)의 씨는 골절, 골다공증 등의 골질환 치료제로 쓰여 오면서 경험적으로 그 효능을 입증받은 제제로 수 년 전부터 치주 영역에서도 국내산 홍화씨에 대한 연구가 활발히 진행되어 홍화씨 추출물이 치주인대 섬유아세포와 조골세포의 활성도 증가, alkaline phosphatase(ALP) 활성도 증가, 골광물화 작용 증진에 효과적임이 보고되었으며 동물 실험에서도 홍화씨 추출물을 경구 투여했을 때 신생골 형성이 촉진됨을 보였다. 기존의 홍화씨 추출 방법은 한두 개의 용매를 이용하여 홍화씨의 전체 성분을 추출한 것이었으며 골조직 재생 효과를 극대화하기 위해서는 골조직 재생에 효과적인 성분만을 고농도로 추출하는 방법이 필요하였다. 이에 홍화씨 성분 중 골형성능 증진에 가장 효과적 인 성분을 찾기 위한 노력으로 다양한 용매를 이용하여 홍화씨 성분을 다단계 추출하여 여러 홍화씨 분획 추출물을 얻었으며 이 중 methanol과 물로 차례로 추출한 saf-M-W 분획이 조골세포의 골형성능 증진에 가장 효과적이었다. 이에 본 연구에서는 홍화씨 분획 추출물 saf-M-W를 이용하여 이것이 치주인대 섬유아세포와 조골세포 전구세포주인 MC3T3-E1 세포의 성장 및 분화에 미치는 영향을 알아보았다. 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide(MTT) test로 두 가지 세포에 대한 독성을 측정하였으며 치주인대 섬유아세포에서 발색 반응을 이용한 ALP 활성도 검사를 시행하였다. 또한 MC3T3-E1 세포에서는 Northern blot 분석을 통해 ALP 및 bone sialoprotein (BSP) mRNA 발현을, von Kossa 염색과 위상차 현미경으로 석회화 결절 형성을 관찰하여 다음과 같은 결과를 얻었다. 1. saf-M-W 농도 10㎍/㎖ 이하에서는 치주인대 섬유아세포와 MC3T3-E1 세포 모두에서 세포독성은 나타나지 않았다. 2. 치주인대 섬유아세포에서 saf-M-W 농도 변화에 따른 ALP 활성도 차이는 없었다. 3. MC3T3-E1 세포에서 10㎍/㎖ 농도의 saf-M-W 처리군의 ALP 및 BSP mRNA 발현이 대조군에 비해 현저히 증가하였다. 4. MC3T3-E1 세포에서 대조군에서는 석회화 결절이 형성되지 않은 반면 10㎍/㎖ 농도의 saf-M-W 처리군에서는 다량의 석회화 결절이 형성되었다. 이상의 결과는 홍화씨 분획 추출물 saf-M-W가 10㎍/㎖ 이하의 농도에서 치주인대 섬유아세포와 MC3T3-E1 세포에 대해 독성을 나타내지 않으며 MC3T3-E1 세포의 분화 및 골형성을 효과적으로 촉진할 수 있음을 시사한다. [영문] Recently, use of natural medicine is getting more attention, and some of them are believed to be effective in the treatment of periodontitis. Among them, the seeds of safflower(Carthamus tinctorius L.) have been proven to be effective through its use in bone diseases such as fracture and osteoporosis. During the last few years, studies using the seeds of safflower grown in Korea have been active, and it has been reported that safflower seed extract increase the proliferation and the alkaline phosphatase(ALP) activity of human periodontal ligament fibroblast(hPDLF), osteoblast, and that they promote the mineralization process. In animal studies, when safflower seed extract were administered orally new bone formation was promoted. Recently, in an effort to find out the most effective osteogenic components, among many components of the safflower seed, various safflower seed fraction extracts were obtained by multistep extraction of the safflower components using various solvents. Among these, saf-M-W fraction extracted by methanol and water was most effective in increasing osteogenic potential of osteoblasts. In this study, the effect of safflower seed fraction extract, saf-M-W, on the growth and differentiation of hPDLF and MC3T3-E1 cell was investigated. The toxicity of saf-M-W on both cells was measured using MTT test, and ALP activity was measured using the colorimetric assay of hPDLF. In addition, in MC3T3-E1 cells, the expression of ALP, bone sialoprotein(BSP) mRNA was observed using Northern blot, and the mineralized nodule formation was observed using von Kossa stain and phase-contrast microscope. 1. In concentrations below 10㎍/㎖, saf-M-W didn't show any toxicity on hPDLF and MC3T3-E1 cell. 2. The change in saf-M-W concentration had no effect on the ALP activity of hPDLF. 3. In MC3T3-E1 cells, mRNA expressions of ALP and BSP were greater in the experimental group treated with 10㎍/㎖ concentration of saf-M-W compared with the control group. 4. In MC3T3-E1 cells, abundance of mineralized nodules were formed in the experimental group treated with 10㎍/㎖ concentration of saf-M-W, while no mineralized nodule was formed in the control group. These results suggest that safflower seed fraction extract, saf-M-W, didn't show any toxicity on hPDLF and MC3T3-E1 cell at concentrations below 10㎍/㎖ and effectively enhanced the differentiation and osteogenic potential of MC3T3-E1 cell.ope

부갑상선 호르몬 (1-34)가 건강한 토끼에서 상악동 증강술 후 초기 골 치유에 미치는 영향

Purpose: This study evaluated effect of administering intermittent parathyroid hormone [PTH (1-34), henceforth PTH] on early-stage bone healing of maxillary sinus augmentation and compared two different schedules of PTH administration in healthy rabbit. Materials and Methods: Bovine bone mineral was grafted on sinuses of 25 female New Zealand white rabbits. The animals were randomly divided into three groups: PTH (n =10); PTH was injected subcutaneously 5 days a week for 2 weeks and killed at 2 weeks (n=5) or 4 weeks (n=5) postoperatively, Saline (n=10); saline was injected and killed as same amount and schedule as the PTH group, PTH_mod (PTH modified interval, n=5); PTH was injected 2 days a week for 4 weeks and killed at 4 weeks postoperatively. The dosage of PTH was 10 µg/kg/day. Radiographic and histomorphometric analyses were performed. Result: The new bone area (NBA) did not differ significantly among the saline, PTH and PTH_mod groups. The NBA in the PTH group in the total augmented area and in the demarcated window, center, and Schneiderian membrane regions increased significantly from 2 to 4 weeks. The number of osteoclasts decreased significantly from 2 to 4 weeks in the saline and PTH groups, with no difference between the two groups. The PTH_mod group had larger number of osteoclasts than the saline and PTH groups in the Schneiderian membrane region. Osteocalcin was expressed in the PTH and PTH_mod groups and not in the saline group. Conclusion: Intermittent PTH might not stimulate new bone formation in healthy rabbits during the first 4 weeks of healing. In the PTH group, the consistency of NBA was increased at 4 weeks.open박