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Purpose: Intraoperative cardiac arrest (IOCA) is rare, unpredictable, and may result in a poor outcome. The features of IOCA during cancer surgery and factors related to survival following an IOCA were examined.Methods: This was a retrospective study of patients who had cancer surgery under general anesthesia between March 2009 and March 2021 (n = 84,615) to determine the number of patients who had an IOCA. Patients’ clinical information, cause of IOCA, hypoxemia during anesthesia, and the duration of hypotension and CPR were analyzed.Results: A total of 22 cases of IOCA occurred during cancer surgery (overall incidence: 2.6 per 10,000 surgeries). Return of spontaneous circulation was achieved in 17 patients, but only 13 survived until discharge. There were statistically significant differences between the deceased and the survival cancer patient groups in; (1) duration of hypoxemia (survival group: 5 minutes, range: 2-18 minutes; deceased group: 60 minutes, range, 22.5-120 minutes; p = 0.019); (2) duration of hypotension (survival group: 35 minutes, range, 15-55 minutes; deceased group 160 minutes, range, 140-185 minutes; p = 0.007); and (3) total duration of CPR (survival group: 3 minutes, range: 1-15 minutes; deceased group: 40 minutes, range: 19-149 minutes; p = 0.005).Conclusion: The duration of hypoxemia and hypotension prior to the onset of IOCA, as well as the duration of CPR were associated with the prognosis of IOCA, highlighting the need to reduce multiorgan damage caused by hypoxemia and hypotension during surgery in high-risk patients.

Background/Objectives: This study is to confirm the accuracy of various blood pressure measurementmethods by 119 paramedics.Methods/Statistical analysis: This study evaluated the accuracy of blood pressure measurement andthe confidence of blood pressure measurement in stable, stable and noisy, driving, and driving noisesituations for 40 119 paramedics. The collected data were analysed with SPSS 22.0 using frequency,descriptive statistics, and paired t-test.Findings: The confidence of blood pressure measurement was significantly higher in four situationsafter education. In blood pressure measurement accuracy, there was the significant difference in thefollowing situations: Stable noisy and driving noisy in normal blood pressure(t=-2.823, p=.007).Stabledriving, stable noisy(t=-2.191, p=.034), and driving noisy(t=-2.421, p=.020)in hypertension. Stabledriving, stable noisy(t=-3.674, p=.001), and driving noisy(t=-2.095, p=.043) in hypotension. In theaccuracy of blood pressure measurement by palpation, there was the significant difference in stable anddriving situation under hypotension(t=-2.211, p=.033).Improvements/Applications: The education on blood pressure measurement in various environmentsis necessary to improve the measurement accuracy of 119 emergency personnel.

Little is known about the effects of parenchymal or vascular amyloid β peptide (Aβ) deposition in the brain. We hypothesized that Aβ strain-specific information defines whether Aβ deposits on the brain parenchyma or blood vessels. We investigated 12 autopsied patients with different severities of Aβ plaques and cerebral amyloid angiopathy (CAA), and performed a seeding study using an Alzheimer’s disease (AD) mouse model in which brain homogenates derived from the autopsied patients were injected intracerebrally. Based on the predominant pathological features, we classified the autopsied patients into four groups: AD, CAA, AD + CAA, and less Aβ. One year after the injection, the pathological and biochemical features of Aβ in the autopsied human brains were not preserved in the human brain extract-injected mice. The CAA counts in the mice injected with all four types of human brain extracts were significantly higher than those in mice injected with PBS. Interestingly, parenchymal and vascular Aβ depositions were observed in the mice that were injected with the human brain homogenate from the less Aβ group. The Aβ and CAA seeding activities, which had significant positive correlations with the Aβ oligomer ratio in the human brain extracts, were significantly higher in the human brain homogenate from the less Aβ group than in the other three groups. These results indicate that exogenous Aβ seeds from different Aβ pathologies induced Aβ deposition in the blood vessels rather than the brain parenchyma without being influenced by Aβ strain-specific information, which might be why CAA is a predominant feature of Aβ pathology in iatrogenic transmission cases. Furthermore, our results suggest that iatrogenic transmission of Aβ pathology might occur due to contamination of brain tissues from patients with little Aβ pathology, and the development of inactivation methods for Aβ seeding activity to prevent iatrogenic transmission is urgently required.

Introduction: Early diagnosis of sepsis is paramount to effective management. The present study aimed to compare the prognostic accuracy of presepsin levels and other biomarkers in the assessment of septic shock and mortality risk in cancer patients. Materials and methods: A total of 74 cancer patients were evaluated for presepsin, lactic acid, C-reactive protein (CRP) levels, and white blood cell count (WBC). Specificity and sensitivity values for septic shock and death were compared between four biomarkers in all patients and those with and without acute kidney injury (AKI). Results: A total of 27 and 29 patients experienced septic shock and died, respectively. The area under the curve (AUC) and sensitivity and specificity estimated for presepsin levels for septic shock were 60%, 74%, and 51%, respectively. The corresponding values for mortality were 62%, 72%, and 49%, respectively. In patients without AKI, AUC of presepsin levels for septic shock and death were 62% and 65%, respectively, in those with AKI, these values were 44% and 58%, respectively. Presepsin levels showed higher sensitivity and specificity values than WBC and higher specificity than CRP but were similar to those of lactic acid levels. Conclusions: Presepsin levels are similar to lactic acid levels in the assessment of septic shock and mortality risk in cancer patients. In patients with AKI, presepsin levels should be considered carefully.

Background: Chronic smokers show differences in pain sensitivity compared to healthy non-smokers. Yet, no study to date has examined whether smoker status has an effect on postoperative pain. Objective: We aim to examine a possible correlation between preoperative smoking and postoperative opioid dose based on the hypothesis that smokers would use higher doses of opioids to manage increased postoperative pain. Study Design: A retrospective observational cohort study. Setting: The National Cancer Center in Korea. Methods: We examined medical record data for patients who had undergone curative resection for either lung or esophageal cancer (lobectomy or bilobectomy for lung cancer or an Ivor Lewis operation for esophageal cancer) between January 1, 2006 and December 31, 2010. We examined the correlation between the total preoperative average number of packs per day multiplied by years of cigarette smoking (pack-years) and morphine equivalent daily doses administered to patients after surgery, considering each type of cancer both individually and together. Partial correlation and regression analyses were performed to determine the causality of a possible relationship between pack-years of cigarette smoking and postoperative opioid dose. Results: A total of 1,129 patients (871 patients with lung cancer and 258 patients with esophageal cancer) were included in the final analysis. There was no significant correlation between total pack-years of cigarette smoking and postoperative opioid dose for lung cancer, esophageal cancer, or both cancer types combined (r = 0.042, -0.012, and 0.037, respectively). In the analysis of both cancer types combined, video-assisted thoracic surgery (VATS) was associated with an 11.1% decrease in opioid dose (β = -0.111, P = 0.003) and epidural analgesia was associated with a 7.2% increase in opioid dose (β = 0.072, P = 0.042). Limitations: The retrospective design of this study is a limitation. Conclusion: Our study did not observe a correlation between preoperative smoking and postoperative opioid dose in patients with lung or esophageal cancer. Key words: Smoking, postoperative pain, opioid, lung cancer, esophageal cancer, analgesia

The purpose of this study was to investigate the relationship between environment problem recognition, eco-friendly attitude, and eco-friendly nursing practice. A self-reported questionnaire was completed by 191 hospital nurses from October to November, 2012. The data were analyzed through t-test, one way ANOVA, Pearson correlation analysis, and multiple regression analysis. There was a positive correlation between environment problem recognition (r=.46, p

Opioids are commonly used for postoperative pain control in cancer patients. In addition to pain control, an association between opioid use and long-term oncologic outcomes, such as recurrence or overall survival, has been postulated. The aim of this study was to determine whether postoperative opioid use in patients with non-small cell lung cancer is associated with long-term oncologic outcomes, including recurrence and death. Data obtained from 1009 medical records of patients who underwent curative resection at the National Cancer Center, Korea between January 2006 and December 2010 were retrospectively analyzed. Seven-day opioid use was divided into four quartiles to analyze probability of recurrence and death. Multivariate regression analyses of recurrence and death was conducted, including the calculation of odds ratios. A total of 871 patients were analyzed. When opioid dosage was examined by quartiles, the probability of death and recurrence increased gradually with increasing opioid use. However, in the multivariate regression analysis, the amount of opioid usage did not affect the risk of recurrence or death of lung cancer (P = 0.520 for recurrence; P = 0.659 for death). Opioid use was correlated with outcome when stratified by lung cancer stage (P = 0.004 for recurrence; P = 0.049 for death); however, the odds ratios only slightly increased (1.001 for stage IA-IIIA) for both outcomes. In non-small cell lung cancer patients, the amount of opioid usage does not affect the risk of recurrence and death of lung cancer. There was an association with stage (IA-IIIA), but the effect was negligible. A well-designed prospective study is needed.

The High quality cardiopulmonary resuscitation (CPR), defibrillation, and drug administration have influence on the return of spontaneous circulation (ROSC) in cardiac arrest victim. In out-of-hospital environment, the influencing factors of quality of CPR include manpower, fatigue of the rescuers, space limitation of the ambulance, chest compression and ventilation within moving ambulance, CPR experience of the emergency medical technicians, and transport distance. The purpose of the study is to investigate the ventilation and chest compression within moving ambulance. The subjects were 763 firefighters in Gyeonggido. Male accounted for 87.8%. Emergency medical technician 1 (EMT-1) was 29.9%. and EMT-2 was 70.1%. One handed chest compression accounted for 14.0% and two handed chest compression accounted for 86.0%. Chest compression only accounted for 71.3% and the compression to ventilation ratio of 30:2 was performed in 28.7%. EMT-1 was more skillful than EMT-2, but there was no statistical significance between the compression to ventilation ratio of 30:2 CPR, chest compression only, one handed compression and two handed compression.

The purpose of this study is to investigate the CPR within ambulance. The Subjects were 890 emergency medical technicians in fire department in Gyeonggido. After continuing education program, the emergency medical technicians completed the questionnaires from January to February, 2012. Questionnaire consisted of demographic characteristics, method of chest compression (one handed or two handed), chest compression - ventilation ratio, and hands only CPR. Data were analyzed by frequency analysis and Chi-square test, t-test. One-way analysis of variance (ANOVA) was followed by Scheffe post-hoc test to analyze changes in all parameters between all groups. One handed chest compression accounted for 14.0% and two handed chest compression accounted for 86.0%. Hands only CPR accounted for 71.7% and standard CPR (30:2) accounted for 28.3%. In order to perform the high quality CPR, as least three persons must be dispatched in the ambulance. The flexible management of manpower may improve the survival from the cardiac arrest. A systemic approach for educating and training EMT`s in CPR is needed.

Received : 26 December, 2013 Revised : 6 February, 2014 Accepted : 10 February, 2014 ABSTRACT Objectives : The purpose of the study is to investigate satisfaction, awareness and utilization of dental telephone services in dental clinic patients. Methods : A self-reported questionnaire was filled out by 220 dental clinic patients in G metropolitan city from March 11 to September 27, 2013. The data were analyzed by a descriptive analyses, χ-test and relevant factors were determined using logistic regression analysis by SPSS 12.0. Corresponding Author Yun-Jeong Kim Department of Dental Hygiene, Kwangju Woman's University 201 Yeodai-gil, Gwangsan-gu, Gwangju 506-713, Korea. Tel : +82-62-950-3845 +82-10-3930-1069 Fax : +82-62-950-3840 E-mail : tokyj@kwu.ac.kr Results : The experience rate of scaling was 68.0% and the average number was 1.04±1.13. The experience rate of regular check-up was 41.0% and the average number was 1.01±1.29. Satisfaction and utilization rate of scaling and regular checkup was higher than that in those who did not receive the services. The major variables influencing the experience of scaling were woman, utilization of dental telephone service and regular check-up were awareness, utilization of dental telephone service and reason of utilization of dental telephone service(preventive). Conclusions : The dental telephone service in dental patients improved oral health. Accordingly, it is necessary to develop the professional dental hygiene program for oral health in dental patients.

이 연구는 병원 전 심정지 환자에게 심폐소생술과 후 72시간 이상 자발순환이 회복된 환자 8례를 대상으로 하였다.분석 결과 심정지 원인으로는 심장질환이 3례, 응급상황으로 인해 병력을 구하지 못한 경우가 5례를 보였다. 심정지 환자의 6례가 가정에서 발생하였고, 가족이나 동료에 의해 심정지가 목격된 경우가 8례였으며, 가족이나 동료 등 목격자의의해 시행된 심폐소생술은 5례였다. 구급대원 도착 후 임종 호흡을 보인 환자가 3례로 확인되었다. 심정지 환자의 최초초기리듬은 심실세동 7례, 무맥성전기활동 1례를 보였다. 출동에서 현장 도착까지 소요시간은 6.1분(±2.7), 출동에서 병원 도착까지 소요시간은 23.0분(±8.8), 자발순환이 회복되기까지 심폐소생술 지속 시간은 8.7분(±3.4)이 소요되었다. 출동한 구급대원의 자격은 1급응급구조사 6례, 2급응급구조사 2례였으며, 3명 출동이 7례를 보였다. 병원 전 심정지 환자의소생률 향상을 위해서는 무엇보다도 목격자에 의한 심폐소생술이 필요하며, 이를 위해서는 일반인 심폐소생술 교육을 지속적으로 진행하여야 한다.ABSTRACTThis study was to investigate the cardiopulmonary resuscitation (CPR) outcomes and the clinical characteristics of out-of-hospital cardiac arrest (OHCA) by analyzing date in one region. A total 8 patients, survived over 72 hours after ROSC.The cardiac arrest were caused by unknown (5 cases), cardiac disease (3 cases). The most common place of cardiac arrestwas in the home (6 cases), witnessed cardiac arrest (8 cases), cardiopulmonary resuscitation by bystander was performed(4 cases), agonal respiration (3 cases). The initial electrocardiogram (ECG) showed ventricular fibrillation (VF) in 7 cases,pulseless electrical activity (PEA) other rhythms in 1 cases. Average time from call to scene arrival 6.1 minutes, call tohospital arrival 23.0 minutes, duration of total CPR was 8.7 minutes. The certificate of them were level 1 emergency med-ical technician (EMT) 6 cases, level 2 EMT 3 cases, total 3 members 7 cases. To improve the rate of survival for out-of-hospital cardiac arrest victims, development of continuous CPR educational program for lay rescue.

Summary Purpose The purpose of this study was to evaluate the clinical usefulness of the Critical Patient Severity Classification System (CPSCS) and Glasgow Coma Scale (GCS) for critically ill neurological patients and to determine the applicability of CPSCS and GCS in predicting their mortality. Methods Data were collected from the medical records of 187 neurological patients who were admitted to the intensive care unit of C university hospital. The data were analyzed through chi-square test, t test, Mann-Whitney, Kruskal-Wallis, goodness-of-fit test, and receiver operating characteristic curve. Results In accordance with patients' general and clinical characteristics, patient mortality turned out to be significantly different depending on intensive care unit stay, endotracheal intubation, central venous catheter, and severity by CPSCS. Hosmer-Lemeshow goodness-of-fit tests were applied to CPSCS and GCS. The results of the discrimination test using the receiver operating characteristic curve were CPSCS 0 , .743, GCS 0 .583, CPSCS 24 , .734, GCS 24 .612, CPSCS 48 , .591, GCS 48 .646, CPSCS 72 , .622, and GCS 72 .623. Logistic regression analysis showed that each point on the CPSCS score signifies a 1.034 higher likelihood of dying. Conclusion Applied to neurologically ill patients, early CPSCS scores can be regarded as a useful tool.

Objectives: The purpose of the study is to compare the effect of traditional face-to-face Cardio-Pulmonary Resuscitation (CPR) training to the video self-instruction method and to improve layperson training and cost savings. Methods/Statistical analysis: In a randomized controlled study following the control group design, a self-led video training group received 30 minutes of video instruction while a traditional training group received 30 minutes of conventional classroom instruction. Data were drawn from pre- and posttest structured group interviews and posttest CRP performance scores using Laerdal Skill Reporter manikins. Analysis of covariance was employed to verify the effect of video and traditional training on the willingness to perform CPR. Findings: The video training group (131.6) exhibited a statistically significant (p < .001) acceleration in compression speed over the traditional group (117.1), with the video group showing a statistically significant lower compression correctness rate (38.6) compared to the traditional group (59.7). Further statistically significant differences (p = .008; .002; .006) between the video training group and the traditional face-to-face group includes lower scores in CPR willingness (1.9:2.8), knowledge (3.1:3.7) and performance (3.0:3.4) in the video group compared to the traditional group. Improvements/Applications: Under identical conditions, training using video self instruction has a smaller effect on the willingness to perform CPR compared to traditional classroom instruction.

This is the study of actual condition and improvement on emergency medical treatment by 119 emergency medical service personnel. The subjects in this study were 299 emergency medical service personnel. Data were collected from May 1 to August 31 of 2010, and analyzed by SPSS 12.0 program. The major area of study of them were study of emergency medical services 41.5%, study of nursing 10.0%, fire fighting related studies 15.4%, health related studies 1.0%, and others 32.1%. The certificate of them were 1st class emergency medical technician(EMT) 38.1%, 2nd class EMT 33.8%, nurse 9.4%, first aid education 14.0%, and others 4.7%. Frequency of Prehospital emergency care, oxygen supply(274), splint apply(229), spinal immobilization(229), external bleeding control(223), medication(7), intravenous(4). Professionally trained EMT makes possible to secure high quality emergency medical treatment in the prehospital phase. Therefore, it is essential for the quality improvement of prehospital emergency care that well trained EMT ride on the ambulance together and take the responsibility for the treatment and transferring of emergency patients. In order to improve the proficiency of 119 emergency medical services personnel, it is also necessary to provide continuous job training programs for the prehospital emergency medical treatment.

목적 : 이 연구는 국가예방접종률 산출 및 조사방법론 개발을 위한 기반을 조성하기 위하여 예방접종률 파악을 위한 자료원 중 영유아 예방접종 수첩기록의 정확도를 평가하기 위하여 수행되었다. 대상 및 방법 : 연구대상은 2005년 1월 31일을 기준으로 충청남도 논산시에 주민등록상 거주하는 생후 12-35개월 영유아 전체로 하였다. 연구대상자가 거주하는 가구를 2005년 2-4월까지 방문하여 보호자의 동의를 얻어 예방접종 수첩기록을 조사하였다. 예방접종 수첩기록의 정확도를 평가하기 위하여 2005년 5-7월까지 예방접종을 시행한 의료기관 및 보건소의 접종관련 기록을 확보하여 예방접종 접종 여부 및 접종 일자의 기록 일치 여부를 확인하였다. 비교 대상 예방접종은 결핵(BCG), B형간염, 디프테리아/파상풍/백일해(DTaP), 홍역/유행성이하선염/풍진(MMR), 폴리오, 일본뇌염, 수두, 인플루엔자, B형 헤모필루스 인플루엔자 뇌수막염(Hib), A형간염, 폐구균으로 총 11종을 대상으로 하였다. 결과 : 예방접종 수첩의 예방접종 여부 및 접종 일시 기록의 정확도는 BCG는 69.5% 및 80.1%였으며, B형 간염은 1차 41.3% 및 89.7%, 2차 76.6% 및 82.1%, 3차 79.7% 및 79.0%였으며, DTaP는 1차 79.9% 및 87.5%, 2차 80.8% 및 87.3%, 3차 82.5% 및 85.1%, 4차 79.9% 및 83.5%였으며, 폴리오는 1차 79.5% 및 88.1%, 2차 79.8% 및 86.2%, 3차 82.1% 및 84.8%였으며, MMR은 83.2% 및 84.0%였으며, 일본뇌염 1차는 80.7% 및 83.1%였으며, 수두는 74.9% 및 83.7%였으며, 인플루엔자는 74.1% 및 55.3%였으며, Hib 1차는 72.7% 및 90.7%였으며, A형 간염 1차는 79.5% 및 88.4%였으며, 폐렴구균 1차는 73.2% 및 90.3%로 나타났다. 결론 : 여러 가지 연구의 제한점에도 불구하고, 예방접종 수첩의 상당한 수준의 신뢰도를 확인하였으나 수첩의 예방접종력 정확도 및 타당도에 대한 추가 연구가 필요할 것으로 판단된다.

In anatomical education, cyber class has been studied as a strong strategy coincided with academic characterestics. In the present study, we investigated the correlation between self-evaluation factors, use of cyber classroom and academic achievement of health allied undergraduate students according to application of cyber class in the anatomical education. The subjects of study were totally 231 students who were majored in nursing science (n=143) and sports science (n=88) in last 3 years (2007-2009). Based on frequency of log-in, survey and grade of score, we analyzed correlation of their factors and their scores using frequency analysis, T-test and analysis of variance.Regardless of their major, most of students gave high scores in all of self-evaluation factors, convinience of cyber classroom, suitability of assignment. The frequency of log-in correlated highly with academic achievement( r =0.246, p

[Purpose] The purpose of this study was to investigate whether ten weeks of aquatic therapy exercise would increase low back muscle strength and reduce low back pain in 19 elderly subjects. [Subjects] Nineteen low back disorder patients were randomly assigned to one of two groups: an aquatic therapy exercise group (n=9), and a control group (n=10). [Methods] The aquatic therapy group participated five times a week for ten weeks in an aquatic exercise designed to strengthen the low back muscles. Data collection was done using a Cybex-770 system. [Results] The results show that the aquatic exercise significantly reduced visual analog scale pain by 52.1%. Significant improvements in low back muscle strength were found in the aquatic therapy group on peak torque of flexor in 180/sec by 48.31% and on peak torque of extensor in 180/sec by 152.85% . [Conclusion] Based on the results, we conclude that the ten weeks of aquatic therapy exercise can enhance low back muscle strength and reduce low back pain in elderly women.

According to a research analysis of the factors which affect the medical utilization fee after an increase of health insurance benefits for patients with serious illnesses based on 225 patients over 6 months, both before and after the increase of benefits, from January, 1st, 2005 to June 30th, and also from January, 1st, 2006 to June 30th. In terms of genders, 67.8% of males were affected, whereas only 32.2% of females were effected, a much higher rate of men than women. Men also had higher rates before and after the increase of benefits. Out of 5 categories related to medication and treatment, radiation testing was the most expensive at about 5,300,000, operation fees were 590,000, and costs of other testing approximately 200,000 with the least expensive category being 120,000 for medication. By looking at the relationship between the fees and increase of benefits, medication was a hospital charge (p

This study examines the effect of video self-instruction (VSI) on cardiopulmonary resuscitation (CPR) performance and attitude. A five-minute video clip of adult CPR was shown once to a five-minute VSI group, twice to a ten-minute VSI group, and three times to a 15-minute VSI group. CPR self-assessment scores and manikin assessed performance were collected twice, one before and one after VSI. A paired t-test was used to compare self-assessment scores from before and after VSI; one-way ANOVA was used to compare CPR scores. When self-assessment scores from before and after VSI were compared, the five-minute VSI group showed a statistically significant difference (p=.03) in performances; the ten-minute VSI group showed a statistically significant difference (p=

Purpose: In spite of the rapidly expanding importance of the basic sciences, the number of professors teaching basic sciences in medicine has not changed in the last decade. Thus, the need for new methods of teaching and learning has increased. The purpose of this study was to develop and assess integrative lecturing in the basic sciences for undergraduate allied health sciences students. Methods: We developed an alternate form of lecturing in anatomy, physiology, microbiology, and pathology, focusing on the gastrointestinal system. We tested several teaching strategies including E-learning, face-to-face, and practice. Students majoring in nursing (n=43), sports science (n=26), and emergency medical technology (n=35) participated and were asked to complete an anonymous survey. Results: The majority of the students were satisfied with the new lecture style (86.6%). They preferred integrative lectures to traditional lectures. The degree of satisfaction with E-learning and practice were much higher than with face-to-face. Most of the students identified the knowledge of interdisciplinary relationship and participating in cadaveric dissections as the important effects of this lecture style. Conclusion: From this study, it can be suggested that integrative lecturing in basic sciences for public health- / medicine- related courses is effective in teaching and learning. Further studies for the development of integrative contents and system are needed.

The purpose of the study was to investigate the level of oral health and oral health related Activities of Daily Living (ADL) and the clinical factors influencing Oral Health Related Quality of Life (OHRQoL) in Korean elderly. Data were obtained from a cross-sectional survey of 256 elderly people (mean age = 78.9±5.36). Participants were recruited when they attended the public health center in Chungnam. Data were collected by means of oral examination and personal interview from September 19 through to October 20, 2012. Oral health related ADL, OHRQoL and dry mouth were measured by a total 24 item. The data were analyzed with t-test, one-way Analysis of Variance (ANOVA), and stepwise multiple regression using the Statistical Package for the Social Sciences (SPSS) program. Participants had a mean of 12.0 remaining natural teeth, which was significant with age and perceived oral health. Decayed-Missing-Filled Teeth (DMFT) index achieved a mean of 15.8. Powerful predictors of OHRQoL were masticatory difficulty, oral pain, residential type, perceived oral health, frequency of brushing and perceived health in elderly. Based on the findings, OHRQoL has a significantly impact on oral health related ADL. These results suggest that elderly oral health promotion should be developed according to assessment index which measured predictors related to oral health in the elderly.

Patients undergoing pulmonary resection are thought to be at high risk for the development of postoperative pulmonary complications (PPCs), and these complications may lead to serious morbidity. The purpose of this study was to identify the factors associated with postoperative pulmonary complications in patients undergoing lung cancer resection and to determine the effect of PPCs on survival.The study involved a retrospective review of 635 patients who had undergone curative resection for lung cancer. The patient group included 504 males (79.4%), and the overall mean age was 61.3 years. Patients were classified as those who had experienced PPCs (PPCs group, n = 105, 16.5%) or those who had not (no-PPCs group, n = 530, 83.5%).The surgical procedures performed were 101 pneumonectomies (15.9%), 505 lobectomies (79.5%), and 29 lesser resections (4.6%). Cancer types comprised 330 squamous cell carcinomas (52.0%), 255 adenocarcinomas (40.2%) and 50 others (7.8%). Univariate analysis showed that the following factors were predictors for PPCs: male sex, erythrocyte sedimentation rate, preoperative serum fibrinogen level, pulmonary function, chronic obstructive pulmonary disease, smoking, double primary cancer, and surgical duration. Multivariate logistic regression showed that preoperative serum fibrinogen level (p0.001), surgical duration (p0.0001) and being male (p = 0.02) were significant predictors of PPCs. Overall survival 3 years after surgery was 68.2% in no-PPCs group and 38.8% in PPCs group (p0.0001). Regardless of tumor staging, overall survival differed significantly between PPCs and no-PPCs groups, whereas disease-free survival did not.Higher preoperative serum fibrinogen levels, longer surgical duration, and being male were the predictive factors for PPCs in surgical candidates. The development of PPCs was linked to a shortened overall survival.

This study aimed to identify what impact the thickness differences between the leftside and rightside transversus abdominis (TrA), internal obliquus (IO) and external obliquus (EO) have on balance ability in the abdominal drawing-in maneuver (ADIM) and resting postures. [Subjects and Methods] In this study, 41 young adults were asked to adopt a resting posture and to perform ADIM. The thicknesses of the abdominal muscles (TrA, IO, EO) were measured using ultrasound imaging, Then balance ability was measured, so that a comparative analysis could be carried out. [Results] According to the results, the thicknesses of TrA and IO very significantly increased when ADIM was performed. The changes in thickness of the muscles on the left and right sides showed no significant correlations with balance ability. [Conclusion] According to the study results, the difference in thickness between the left and right side muscles in a normal person is small (symmetric), and the differences in the thickness of TrA and IO on the left and right side reduced when the ADIM, which is a re-education method for abdominal muscles was performed. Therefore, we consider that the ADIM should be used in future clinical trials to induce symmetric contraction of the abdominal muscles. Also, the correlation results of muscle balance and body balance can be used as empirical data.

[Purpose] The purpose of this study was to determine how an exercise program focusing on muscular strength could aid firefighters with chronic lower back pain. [Subjects] The research subjects were randomly assigned to two groups, the experimental group (n=8) and the control (n=8). [Methods] The experimental group performed two types of exercise programs four times per week for 8 weeks under supervision. Tests were performed before and after the 8 weeks of exercise in accordance with the Korea Occupational Safety and Health Agency’s program. [Results] At the end of the 8 weeks of the rehabilitation program, abdominal muscular strength were significantly increased in the experimental group, and this indicates that the exercise therapy was effective for improvement of muscular strength. [Conclusion] We found that exercise therapy is an effective intervention that can reduce the pain of patients with chronic lower back pain. The firefighters with chronic lower back pain who participated in this study exhibited enhanced lower back muscular strength and obtained some additional benefits. They need regular exercise.

[Purpose] The aim of this study was to determine the effects of a 12-week walking program on increasing an individual’s self-management and decreasing the risk factors of metabolic syndrome in the older adult population. [Subjects] A total of 31 older adults participated in this study. Eighteen participants in the experimental group and 13 controls completed the pretest and posttest measures. A walking exercise and health education were provided for the experimental group. Data were analyzed by ANCOVAs to examine group differences. [Results] At the end of the 12-week study period, the experimental group showed a significant improvement in individuals’ ability to self-manage their health compared to the control group. Also, there were significant differences between the two groups in the total numbers of risk factors of metabolic syndrome, systolic blood pressure and BMI. No significant difference in blood sugar levels, HDL-C, waist circumference, and triglyceride levels were found between the experimental and control group. [Conclusion] This study revealed that a combination of health education and for walking exercise can lead to improved lifestyle management and reduce risk factors of metabolic syndrome for the elderly population of Korea.

Angiotensin II (Ang II), one of the main vasoactive hormones of the renin-angiotensin system, contributes to the development and progression of atherosclerosis by inducing vascular smooth muscle cells (VSMCs) migration. Although previous studies have shown that Ang II upregulates low density lipoprotein receptor-related protein 1 (LRP1) expression in VSMCs and increases VSMCs migration, the role of LRP1 in Ang II-induced VSMCs migration remains unclear. Here, we reveal a novel mechanism by which LRP1 induces the expression of matrix metalloproteinase 2 (MMP2) and thereby promotes the migration of rat aortic SMCs (RAoSMCs). Knockdown of LRP1 expression greatly decreased RAoSMCs migration, which was rescued by forced expression of a functional LRP1 minireceptor, suggesting that LRP1 is a key regulator of Ang II-induced RAoSMCs migration. Inhibition of ligand binding to LRP1 by the specific antagonist receptor-associated protein (RAP) also led to reduced RAoSMCs migration. Because MMPs play critical roles in RAoSMCs migration, we examined the expression of several MMPs and found that the expression of functional MMP2 was selectively increased by Ang II treatment and decreased in LRP1-knockdown RAoSMCs. More interestingly, reduced MMP2 expression in LRP1-knockdown cells was completely rescued by exogenous expression of mLRP4, suggesting that MMP2 is a downstream regulator of LRP1 in Ang II-induced RAoSMCs migration. Together, our data strongly suggest that LRP1 promotes the migration of RAoSMCs by regulating the expression and function of MMP2.

Background: This study was designed to identify overtransfusion- triggering clinical factors in patients undergoing total hip replacement surgery. Methods: The discharge hematocrit was chosen for evaluation. Estimated red cell loss for each patient during the admission was calculated by the differences between admission and discharge hematocrit, multiplied by patient whole blood volume. Total RBC lost was then determined by the sum of RBC volume lost plus the RBC volume transfused. RBC transfusion was considered appropriate if given to replace RBC volume lost in excess of 15% of the RBC volume in each patient at admission. Comparison of transfusion practice was done on the basis of sex, age, preoperative hematocrit, surgical procedure and anesthetic method. Results: Forty-six (37.7%) of 122 patients were identified to have been transfused with red cell volumes in excess of red cell volumes lost. Significant differences for patients transfused in excess of needs were found by sex (52.4% of women vs. 22.0% of men, P = 0.001) and by preoperative hematocrit (71.4% of patients with lower hematocrit vs. 24.1 % of patients with higher hematocrit, P = 0.001). Conclusions: Preoperative hematocrit and sex can be a overtransfusion-triggering index.

Background: The radial artery pressure is known to differ from central arterial pressure in normal patients (distal pulse amplification) and in the early postcardiopulmonary bypass period. We assumed that there may be a change in the normal relationship between central and peripheral arterial pressure in patients with hepatic failure due to an arterio-venous shunt caused by vasodilation and a complex surgical procedure with major vessel clamping. This study was done to examine the adequacy of the radial artery as a site for blood pressure monitoring in liver transplantation (TPL). Methods: We investigated when the pressure gradient developed and what mechanism could be responsible by comparing femoral to radial artery pressure in 11 patients undergoing liver transplantation. Radial and femoral artery pressures, systemic vascular resistance, cardiac output and temperature were compared during surgery in all 11 patients. Additionally measurements included pH, /kg, /kg, central venous pressure, puhnonary artery pressure and mixed venous oxygen saturation. Results: The femoral artery systolic pressure was higher than the corresponding radial artery pressures during the operation. Although not statistically significant, the radial mean and diastolic artery pressures were lower than corresponding the femoral artery pressure. Conclusions: Radial artery systolic pressures underestimate the femoral artery pressure when undergoing a liver TPL. Failure to recognize these effects on pressure recordings can lead to inappropriate patient management decisions.