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Radiation Therapy of Intracranial Germinomas : Optimum Radiation Dose and Treatment Volume (두개내 배아종의 방사선치료:적정 방사선량 및 치료용적)

  • Chang, Sei-Kyung;Suh, Chang-Ok;Kim, Gwi-Eon
    • Radiation Oncology Journal
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    • v.17 no.4
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    • pp.269-274
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    • 1999
  • Purpose : To evaluate the Possibility of decreasing the radiation dose and to determine optimum treatment volume in intracranial germinomas. Materials and Methods : Forty five patients with pathologically-verified or presumed germinomas by a radiosensitivity test who had been treated with radiotherapy (RT) alone between 1971 and 1992 were retrospectively analyzed. The average age was 17.2 years with 68.9$\%$ of the patients being between the ages of 10$\~$20. The male and female ratio was 2.2:1. The locations of the primary tumors were at the pineal regions in 14 patients; the suprasellar regions in 12 patients; and multiple sites in 12 patients. Treatment volumes varied from a small local field (10) to the whole brain (7) or entire neuroaxis irradiation(28). All the cases after 1982 received craniospinal irradiation (CSI). Radiation doses were 41-59 Gy (median 48.5 Gy) to the primary tumor site and 19.5$\~$36 Gy (median 24 Gy) to the neuroaxis. The median follow-up period was 82 months with a range of 2$\~$260 months. Results : All the patients showed complete response after RT. Four patients sufferred from recurrence 14, 65, 76, and 170 months after RT, respectively, and two patients died with intercurrent disease. One of four recurrent cases was salvaged by re-irradiation. Therefore, a 5 and 10 year overall suNival was 95.3$\%$ and 84.7 $\%$ respectively. Five and ten year disease-free survival was 97.6 $\%$ and 88.8 $\%$ respectively. All the recurrences occurred in the patients who received local RT (3/10) or whole brain RT (1/7) with a radiation dose of 48-50 Gy. None of the patients who received CSI suffered recurrence. There was no recurrence among the 15 patients who received $\leq$45 Gy to the primary site and the 18 patients who received $\leq$24 Gy (6 patients received 19.5 Gy) to the neuroaxis. Conclusion : CSI is recommended for the treatment of intracranial germinomas. The radiation dose can be safely decreased to $\leq$45 Gy on a primay tumor site and 19.5 Gy on the spine.

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A Study on the Consciousness of the Environment Pollution Problem in Pohang City (환경문제에 관한 시민의식 조사 - 통합후 포항시민을 대상으로 -)

  • Ha, Yeong-Gil;Park, Kyung-Min;Kwon, Young-Sook
    • Journal of agricultural medicine and community health
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    • v.21 no.1
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    • pp.61-73
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    • 1996
  • This study conducted to determine the attitude on environment pollution by Pohang city citizens. 1,059 Pohang city citizens in the age group 20 and over were chosen and surveyed by officials's interview at Up, Myun and Dong during the period 6 September to 20 September 1995. The issue problems to be solved in Pohang city were traffic control 47.3%, environment pollution 22.7%, cultural institutions 11.6%, water service 9.9%, education system 5.1% and community security 2.1%. The 55.1% of subjects responded that responsibility for environment pollution is every citizens duty. The trash from houses were 'garbage'(48.1%), 'waste of life'(21.8%), 'reuse trash'(15.6%) and 'one use thing'(14.5%) in order. The 66.9% of subjects responded that the trash's standard envelopes can be easily tear and its texture is not good. The respondents sometimes or often had experienced foreign bodies, sediment in the water service supply. The 45.9% of the respondents use natural water as drinking water, and the water service supply(26.7%), underground water(17.0%) and buying water(9.3%) were followed. Pertaining to the air pollution(by percent) was pollution of the steel industry complex 78.0%, combustive gas 16.6% and construction dust 1.7%. The respondents at southern district complained of respiratory tract by air pollution and the respondents at northern district complained of the visual disturbance and the offensive odor(P<0.05). Water pollution problem is factory's wastewater 56.2%, home wastewater 36.4% and livestock's wastewater 5.6% in order. The respondents at southern district complained of the noise pollution by airplanes and factories at the afternoon and the respondents at northern district complained of the noise pollution by vehicles(P<0.05).

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The Associations of Empowerment and Social Capital with Self-Rated Health in Communities with Poor Health (사망률이 높은 지역사회에서 임파워먼트 및 사회적 자본과 주관적 건강수준의 연관성)

  • Kim, Jang-Rak;Jeong, Baek-Geun;Park, Ki-Soo;Kang, Yune-Sik
    • Journal of agricultural medicine and community health
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    • v.37 no.3
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    • pp.131-144
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    • 2012
  • Objectives: This study was performed to identify the associations of empowerment and social capital (such as social participation and trust) with self-rated health in Korean communities with poor health. Methods: This study used the data from community health interviews conducted at 29 administrative sections (dong, eup, or myeon) with high mortality from August to October in both 2010 and 2011 as part of the Health Plus Happiness Plus Projects in Gyeongsangnam-do Province. The study subjects comprised 6,383 individuals composed of approximately 220 adults randomly sampled from each administrative section. The empowerment was measured with five-point Likert scale responses to seven perceived control questions (two at the individual level, five at the community level). The social participation was measured with 'participation in formal and/or informal group' and trust using responses to three questions about trust of others. Results: The high empowerment scores at both individual and community levels, social participation in informal groups, and high trust level had independent and significant associations with good self-rated health after adjusting for socio-demographic factors (sex, age, marital status, occupation, and food affordability) and health behaviors (smoking, alcohol drinking, and exercise) in the logistic regressions. There were weak but significant associations among empowerment, social participation, and trust levels. Conclusions: Empowerment, social participation, and trust were weakly inter-related and significantly associated with self-rated health. More studies are warranted for empowerment and other social capital indices in health promotion.

A Study of Electrolyte Excretion and Salt Intake in a Rural Community (일부 농촌지역 주민의 요중 전해질 측정을 통한 식염 섭취량 추정과 고혈압과의 관계 연구)

  • Moon, Joung-Joo;Ham, Sun-Hee;Choi, Kyoung-Ae;Yook, Mi-Ee;Chai, Young-Hee;Kim, Ki-Soon
    • Journal of Preventive Medicine and Public Health
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    • v.24 no.1 s.33
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    • pp.8-15
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    • 1991
  • This study was carried out in order to examine the urinary excretion of electrolytes (Na, K) and their relationship with blood pressure, and to estimate the amount of daily salt intake in a rural community. From January to March in 1987, a mobile screeing team visited 40 villages, and carried out health screening of 537 adult volunteers whose age were over 30 years and collected 12-hours overnight urine. To determine the completeness of collection, the urinary creatinine was measured. If the creatinine excretion was beyond the range given to the age group, the sample was excluded from the analysis as an incomplete collection : 345 samples were remained for analysis. This study revealed the following results. 1. The mean excretion amounts of urinary electrolytes for 12 hours were Na 193.5 mEq, K 20.8 mEq, creatinine 1.0 g. The mean ratio of electrolytes were Na/K 9.84, Na/creatinine 0.44, K/creatinine 0.046. 2. Both the mean excretion amount of K and the mean ratio of K/creatinine were less in hypertensives than in normotensives. K excretion also showed a tendency towards a decrease in inverse proportion to systolic blood pressure when it exceeded 120 mmHg. There was no significant difference between the hypertensives and normotensives in Na excretion. The sodium to potassium ratio increased in poportion to systolic blood pressure. 3. The mean daily salt excretion amount was 22.4 g. Assuming that 90% of the intake was excreted, the estimated amount of daily salt intake was 24.9 g.

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Survey of Sedation Practices by Pediatric Dentists (소아치과의사의 진정법 사용에 대한 실태조사)

  • Yang, Yeonmi;Shin, Teojeon;Yoo, Seunghoon;Choi, Seongchul;Kim, Jiyeon;Jeong, Taesung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.41 no.3
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    • pp.257-265
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    • 2014
  • The aim of this study was to establish the appropriate guidelines in the sedation techniques and to organize the continuing education programs for the sedation in future under the direction of Committee on Sedation, Education and Research under the Korean Academy of Pediatric Dentistry(KAPD). The surveys on the sedation technique were performed on 111 organizations which practices the sedation and responded to the survey via online and e-mail by February 2014. The collected survey were analyzed. The purpose of sedation was mainly to manage the children's behavior and its uses were primarily on 3~4 years old children. The most frequent duration of treatment was 1~2 hours to treat both maxillary and mandible. The preferred dosages of sedative drugs were chloral hydrate(CH) 50~70 mg/kg, hydorxyzine(Hx) 1~2 mg/kg, and intramuscular midazolam(Mida IM) 0.1~0.2 mg/kg. The preferred combination of the sedative drugs were CH + Hx + $N_2O/O_2$(67.6%), CH + Hx + Mida submucosal administration (SM) + $N_2O/O_2$(29.7%), and Mida IM + $N_2O/O_2$(23.4%). The administration of additional sedatives was carried out at 48%, mainly using Midazolam. 87.5% of the respondents experienced the adverse effects of the sedation such as vomiting/retching, agitation during recovery, subclinical respiratory depression, staggering, and etc. Among them, only 20% periodically retrain the emergency management protocol. About the discharge criteria for patients after the sedation, the respondents either showed a lack of clear criteria or did not follow the recommended discharge criteria. 86% of the respondents expressed the interests in taking a course on the sedation and they wanted to learn mostly about the sedation-related emergency management, the safe dosage of the sedative drugs, and etc. The use of sedation in pediatric dentistry must be consider a patient's safety as top priority and each dentist must show the evidence of sound practices for the prevention of any possible medical errors. Therefore, KAPD must establish the proper sedation guidelines and it needs to provide the systematic technical training program of sedation-related emergency management for pediatric dentists.

The Effect of Corticosteroid on the Treatment of Endobronchial Tuberculosis (기관지 결핵 환자에서 부산피질 스테로이드 투여가 기관지 협착의 완화에 미치는 영향)

  • Mo, Eun-Kyung;Kim, Ho-Joong;Kim, Dong-Gyn;Choi, Jung-Eun;Park, Myung-Jae;Hyun, In-Gyu;Lee, Myung-Koo;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.409-418
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    • 1997
  • Objective : Appropriate antituberculosis chemotherapy may not prevent occurrence or progression of tracheobronchial stenosis and obstruction in the patients with endobronchial tuberculosis. The effect of corticosteroid treatment combined with antituberculosis chemotherapy was inconclusive. We evaluated prospectively the effect of corticosteroid treatment. Methods : We diagnosed endobronchial tuberculosis by bronchoscopic examination and bronchial biopsy in the patients of tuberculosis within one month of antituberculosis chemotherapy. After randomization, we prescribed isoniazid, rifampin, ethambutol, and pyrazinamide with or without prednisolone 40 mg for 4 weeks. We carried out bronchoscopy in second month and ninth month of treatment. Results : Edematous endobronchial tuberculosis showed significant improvement of bronchial stenosis after corticosteroid treatment(p < 0.05). Corticosteroid treatment did not have advantage of improvement of bronchial stenosis in the patients with infiltrative endobronchial tuberculosis. Conclusion : Corticosteroid is effective in the treatment of bronchial stenosis when endobronchial tuberculosis is edematous type, in the early period of antituberculosis chemotherapy.

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초등학생 아침 안 거르기를 위한 보건소 건강증진프로그램 개발 및 효과에 관한 연구

  • Lee, Hae-Yeon;Moon, Hyun-Gyung;Cho, Sung-Eok;Lee, In-Young;Choi, Hye-Ryun;Jang, Young-Ju;Park, Young
    • Proceedings of the KSCN Conference
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    • 2003.11a
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    • pp.1058-1059
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    • 2003
  • 학동기(만 6-12세)에 좋은 영양 공급은 일생의 성장 발육의 기초를 조성하여 지적, 사회적, 정서적 능력을 향상시킬 수 있다. 이에 초등학생의 영양문제와 식습관을 해결하는 방안의 하나로 최근 대두되고 있는 아침결식률을 낮추기 위한 ‘아침 안 거르기’ 사업을 학교와 연계 개발하여 프로그램을 진행하고 그 효과를 평가하였다. 이 연구는 서울시 강북구 관내에 위치한 4개 초등학교 5학년 학생 1026명(실험군 451명, 대조군 675명)을 대상으로 4∼9월까지 6개월간 5단계로 실시되었다. 프로그램의 효과평가를 위해 사전(실험군-학생 428명, 부모 416명, 대조군-학생 656명, 부모 589명), 사후(실험군-학생 427명, 부모 368명, 대조군-학생 608명, 부모 558명) 설문조사를 2회 실시하여 행동과 인식률 변화를 측정하였다. 프로그램은 매월 1회 담임교사가 진행하였고, 교육자료 및 홍보물은 아침먹기 캐릭터 가방걸이와 학부모의 참여를 높이고자 가정통신문과 교육내용을 함께 삽입하여 제작한 알림장, 아침먹기와 일찍자기를 실천할 실천스티커를 배포하였고 프로그램 종료 후 아침 먹기 실천달력을 제공하였다. 또 아동들 자신의 식생활을 바르게 꾸려 나갈 수 있도록 가공식품의 ‘영양표시’에 관한 교육을 함께 교육하였고, 설문조사를 통해 영양표시제에 관한 인식변화와 행동변화율을 측정하였다. 학생들의 아침식사 실천율은 매일 먹는 그룹이 실험군은 62.9%에서 69.6%로 7% 상승하였고, 전혀 먹지 않는 그룹은 11.2%에서 6.4%로 4.8% 감소하였다(p<0.001) 대조군의 경우 매일 먹는 그룹은 70.4%에서 70.2%로, 전혀 먹지 않는 그룹은 6.9%에서 6.5%로 나타났다(p<0.001). 아침식사가 건강에 미치는 영향에 대한 인식률 변화는 큰 영향이 있다고 답한 그룹이 실험군은 60.1%에서 64.8% (p<0.001)로, 대조군은 64.8%에서 57.2% (p<0.001)로 각각 변화하였다. 일찍 자기가 건강에 미치는 영향에 대한 인식률은 큰 영향이 있다고 답한 그룹이 실험군은 52.5%에서 70.7%(p<0.001), 대조군은 55.3%에서 60.2%로(p<0.001), 일찍 자기 실천에 대한 의지 변화는 11시 이전에 잘 계획이라는 그룹이 실험군은 31.9%에서 43.9%(p<0.001), 대조군은 35.5%에서 36.8%로 나타났다(p<0.001). 영양 표시에 관한 문항에서는 식품구매시 영양표시를 보고 구매한 경험이 없다는 군이 실험군에서는 58.2%에서 40.4%로 감소하였고(p<0.001), 대조군은 64%에서 53.6% (P<0.001)로 감소하였다. 영양소에 관한 지식 평가에서 짜지 않은 간식을 선택할 때 유의할 성분을 나트륨이라고 답한 그룹은 실험군은 31.7%에서 56.3%로, 대조군은 15.9%에서 23.0%로 나타나 그룹간 큰 차이를 보였다. 아침식사로 좋아하는 음식은 김치, 김치찌개, 밥, 피자, 고기, 빵, 된장찌개, 김, 햄, 계란후라이 순이었으며 싫어하는 아침음식은 피망, 고추, 양파, 김치, 시금치, 마늘, 콩, 파, 피자, 나물순으로 나타났다. 아침식사로 혼자서도 준비할 수 있는 음식은 밥, 라면, 계란후라이, 김치, 반찬, 볶음밥, 계란, 국, 햄, 씨리얼 순으로 나타났다. 부모의 인식률 변화는 가정내에 컴퓨터 설치장소로 적합하다고 생각되는 장소로 실험군의 경우 학생 방은 28.0%에서 21.6%로 6.4%감소하였고, 마루나 거실은 61.3%에서 66.0%로 5%증가하였다(p<0.001). 반면 대조군의 경우 학생 방은 28.8%에서 24.9%로 3.9% 감소, 마루나 거실은 63.4%에서 65.9%로 2.5%증가하여 실험군과 큰 차이를 보였다(p<0.001) 자녀의 늦은 취침시간과 아침식사에 관한 인식률 변화는 아침식사에 영향이 있다는 군은 실험군의 경우 78.1%에서 82.7%로 4.2% 증가하였고(p<0.05), 대조군의 경우 82.2%에서 80.5%로 감소하여 나타났다.(P<0.001) 연구결과 실험군의 경우 일주일 동안 아침을 전혀 먹지 않는 학생이 감소하고 매일 아침을 먹는 학생이 유의적으로 증가하여 아동의 아침식사 행동변화와 인식률 변화에 도움이 된 것으로 나타났다.

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Some Biologic Correlates of Perinatal Mortality (주산기사망(周産期死亡)과 생물학적요인(生物學的要因))

  • Ahn, Yoon-Ok
    • Journal of Preventive Medicine and Public Health
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    • v.9 no.1
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    • pp.129-138
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    • 1976
  • The causes and problems underlying deaths in perinatal period are often similar and might be expected to yield to same type of preventive measures. This is one of the reasons for attempting to develop a reporting of perinatal mortality and its related matters. This study aims at figuring out the biologic risk factors onto the perinatal death. Considering stillbirth and early neonatal mortality separately, considerable associations between stillbirth and reproductive history of women, are observed, ana it is found that prematurity is the the far most important factor in the early neonatal mortality.

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Nutritional Status of Mentally Retarded Children by Residence and by Degree of Handicap (정신지체아동의 거주형태별 및 장애등급별 영양상태 비교)

  • 김창임;박기순;박영숙
    • Korean Journal of Community Nutrition
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    • v.8 no.1
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    • pp.112-119
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    • 2003
  • We studied the nutritional status of on mentally handicapped children living at home or in institutions since early teenage years are nutritionally important. The subjects of 7 to 12 year old mentally retarded children attenending a special education school in Seoul were surveyed with questionnaires as well as 2-day dietary recall records, with the help of persons of their care-giver when needed. Among the 64 children,54.7% are living in institutions and the rest of them are living at home. They were ranged from the trainable (64.1%) , the educable (26.6%) , and the non-trainable (9.4%) . Their average daily intake of energy intakes (%RDA) was 2,070.1 kcal (94.1%) , Ca 603.9 mg (75.5%) , Fe 11.1 mg (92.5%), Vt.A 507.5 RE (84.6%) , Vt. B$_2$.1g (88.2%), niacin 14.1 g (93.6%) and Vt. C 58.2 g (83.1%) . Their average intakes of these nutrients were significantly higher in subjects of institutions than at home. The nutrients consumed at a much higher level than the RDh of the normal children were Vt. B, (1.6 g,146.8%) and protein (75.3g, 136.9%) . The higher percentage of children at home were under consumed of several nutrients (< 75% RDA) than ones in institutions. When comparing the degree of handicap, energy and nutrient intakes except Vt. C were highest in educable children than trainable ones or Dawn's children. MAR of the diets of the subjects was 0.84. Children at home showed lower MAR as well as NAR of each nutrients, whereas children belonged to INQ < 1 were less at home. Handicapped children at home were snacking higher amount relative to their calorie intake and too frequently, that may lead to their poor nutrition. There was positive correlations between factors of nutrition and physical and dietary behaviors, but there were no correlations between factors of nutrition and health-related habits. Nutritional caring mentally handicapped children in institutions seemed to be more effectively managed.

An Exploratory Study on Domestic Mobile Games and In-app Payment Fees (국내 모바일 게임 및 인앱 결제 수수료 적정성에 대한 탐색적 연구)

  • Lee, Taehee;Jeon, Seongmin
    • The Journal of Society for e-Business Studies
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    • v.26 no.3
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    • pp.55-66
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    • 2021
  • The mobile application (APP) market is growing at an unprecedented speed. Amid such growth, the global platform providers are mandating exclusive in-app payments and charging 30% for platform commission fees. A serious tension has arisen between mobile global platform providers and local content providers. The present study attempts to analyze the domestic mobile game market and in-app payment commission fees. This study estimates the size of the domestic mobile game market and platform commission fees by directly using publicly available financial statements and footnote information of some representative listed mobile game firms. Also, the study analyzes the cost structures of the same sample firms and attempts to draw some implications on sustainable growths of the mobile game ecosystem. We estimated that, in 2019, the domestic mobile game market is around 4.9 trillion Won and the ensuing in-app payment commission fees market was 1.5 trillion Won. High market share firms display a proportional increase in in-app payment commission fees in relation to sales growth. This, in turn, makes the in-app payment commission fees a primary cost item far exceeding employee salaries and R&D expenses. During the same period, low market share firms generated a mere profit or experienced net loss. Analysis of the cost structure reveals that these firms are even more liable to higher in-app payment commission fee cost structure than high market share. Most constituents of the mobile game ecosystem are small business entrepreneurs. By employing a micro-level analysis, the study estimates that, in 2019, a representative median firm generates 530 million Won in sales. At the same time, it spends 190 million Won in employee salaries, 50 Won million in R&D and 190 million Won in in-app payment commission fees, respectively. In the absence of other cost items, these three cost items alone account for 73.8% of sales revenue. The results imply that a sustainable growth of the local mobile game market heavily depends upon the cost structure of such representative median firm, the in-app payment commission fees being the primary cost item of such firm.