This thesis is to reflect prevalently stereo-typed community ideas and find alternative ones that have interconnected, relational, and autonomous acting system for our lives. Probably community is the collective space in which 'I' as the subject in the world meet others and achieve the desirable objects each other. By the way the community spaces could be nation state, societies, and people of nation or ones that deal local problems, environments, and ecology and clubs ect, which are variable according to our concerns. In a sense community pay attention to not societies such as nations or people but lives of individuals, preparing for the territories where men feel convenient in their bodies and mentalities without artificial manipulation. In such a community the participant's vital energy can be stretched actively and relationally, and even if the leader be, there is the politics of doing nothingness not to be the obstacle in the way mens' will goes. In those communities they can live their lives at their nature and realize their dreams without barriers to their way. If we find these ideas of communities which are alternative for our period, we should gaze at Asiatic ones that may be scattered in classics of Confucianism, Daoim and ect. With these concepts and concerns, this paper was drawn up.
Objectives: This study aimed to identify factors affecting the duration of untreated psychosis (DUP) in patients with schizophrenia spectrum disorder. Methods: Six-hundred patients with schizophrenia spectrum disorder were recruited from mental health welfare centers in Gwangju Metropolitan City and Gyeonggi-do. Subjects were categorized into two groups according to median DUP. Demographic and clinical characteristics were compared between the two groups. Results: The mean DUP was 80.8 weeks, and the median DUP was 15.9 weeks. Patients with Medicaid, higher age, and longer duration of the schizophrenia prodrome were more likely to have a longer DUP. The DUP was shorter in patients who were consulted by family/relatives prior to treatment. Patients visiting university hospitals were more likely to have a shorter DUP compared with those visiting psychiatric clinics or small-sized mental hospitals, i.e., with less than 100 beds. A multivariate regression analysis showed that the duration of the prodrome was a factor that significantly affected DUP. Conclusion: The vulnerable group of patients with schizophrenia with a long DUP should be monitored closely. Moreover, it is necessary to develop a strategy to identify patients who have an insidious course of psychosis to reduce the DUP.
Journal of agricultural medicine and community health
/
v.35
no.4
/
pp.370-382
/
2010
Objectives: The purpose of this study was to investigate the level of health promoting behaviors and the significant factors in rural elderly(young-old vs old-old). Methods: The data was collected using structured questionnaires from June 22th to Sep. 18th, 2009. A total of 556 elderly aged 65 years or over were selected from 14 rural districts in C province, South Korea. Age was divided into two groups as below 65-74 and 75 or older. A structured questionnaire was used to obtain information on the demographic characteristics, their perceived health status, the difficulty of activities of daily living, quality of life, self-efficacy and health promoting behaviors. The health promoting behaviors included nutrition, stress management, interpersonal support, exercise, health responsibility and self-actualization. The scores for health promoting behaviors were used mean and standard deviation. The data was analyzed using SPSS Win 12.0. Results: Of the 556 subjects, we found that the young-old(65-74 aged) were 359 and the old-old elderly(over 75 aged) were 197. We found that the level of health promoting behavior was higher for young-old ($2.75{\pm}0.374$) compared to old-old elderly people ($2.67{\pm}0.399$). In multiple linear regression, quality of life, self-efficacy, living with spouse, and number of generation living together for the young-old, and quality of life for old-old elderly were significantly associated with health promoting behaviors. Conclusions: The study findings indicate that there are age differences in associated factor of health promoting behaviors. Therefore our findings may provide useful assistance in developing effective intervention programs to improve health promoting behavior of the elderly in rural areas according to their age differences.
Park, Moon-Hwan;Yun, Sang-Won;Kim, Kung-Ho;Lee, Mung-Sun;Cho, Dong-Ill;Rhu, Nam-Soo
Tuberculosis and Respiratory Diseases
/
v.41
no.4
/
pp.405-412
/
1994
Background: In Korea, the prevalence of tuberculosis and hepatitis is high, and combined therapy with rifampicin and pyrazinamide is used in tuberculosis, so drug induced hepatitis is not only problem of tuberculosis therapy but also cause of treatment failure. However most of recent reports on drug induced hepatitis during antituberculosis medication have dealt with its pathogenesis and have stressed the biochemical, and histopathological aspects of the disorder, whereas this study was designed primarily to provide information on the clinical features. Method: The subjects of study were 1414 patients treated with antituberculosis drugs on the department of chest medicine at National Medical Center during the 5-year 6-month period from January 1, 1988, to June 30, 1993. Retrospective analysis of clinical features for the 29 patients who developed drug induced hepatitis was done. Results: 1) The incidence of antituberculosis drug induced hepatitis was 2.1%. 2) Male to fema1e ratio of antituberculosis drug induced hepatitis was 2:1, but case rates among males and females were not significantly different. 3) Rates of drug induced hepatitis according to age distribution shows the most common incidence between 35 to 49 year old age group, but rates among groups of age were not significant1y different. 4) Drug induced hepatitis was most common in the case of moderate advanced pulmonary tuberculosis(rate is 2.78%), but rates among types of tuberculosis were not significant1y different. 5) 18 cases(62%) of antituberculosis drug induced hepatitis patients had no signs or symptoms. In remaining cases, they were nausea, vomiting, jaundice, hepatomegaly, icteric sclera, right upper quadrant tenderness in order. 6) 22 cases(76%) of antituberculosis drug induced hepatitis cases had occured within the first month. 7) The duration of abnormal liver function was $28{\pm}5$(Mean${\pm}$SD), ranged from 5 days to 180 days. 8) One case of antituberculosis drug induced hepatitis died. 9) The levels of abnormal GOT ranged from 64 to 1055U/L and GPT from 68 to 931U/L. Conclusion: There are no dicided predisposing factors of antituberculosis drug induced hepatitis, so it should be done biochemical monitoring as well as close monitoring for overt signs or symptoms of hepatitis to avoid the development of irreversible hepatic reaction, especially at the treatment of the first month.
You, Dong Kil;Lee, Soo Hyun;Yoo, Keon Hee;Sung, Ki Woong;Lim, Do Hoon;Shin, Hyung Jin;Koo, Hong Hoe
Clinical and Experimental Pediatrics
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v.48
no.2
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pp.186-190
/
2005
Purpose : The purpose of this study was to evaluate the responses and toxicities of risk-adapted chemotherapy in pediatric intracranial germ cell tumors(IC-GCT). Methods : Fourteen patients who were diagnosed as IC-GCT from October 2002 to December 2003 received chemotherapy as an initial treatment modality. The low risk(LR) group was defined as follows : Pure germinoma and normal AFP level. Beta-hCG level 50 mIU/mL or less. The others belonged to the high risk(HR) group. Chemotherapy was composed of cisplatin, cyclophosphamide, etoposide and vincristine. Double doses of cisplatin and cyclophosphamide was used in HR patients. Results : Pathologic confirmation was done in all but one. Median age at diagnosis was 11.6 yr (1.2-18.7 yr), and nine patients belonged to the HR group. Tumor markers were normalized after chemotherapy in all patients whose tumor markers had been elevated. Four LR patients(80 percent) and seven HR patients(77.8 percent) showed complete response(CR) at the end of chemotherapy. An additional two of the three patients with partial response(PR) achieved CR after radiation therapy (RT), and the remaining one relapsed before RT. Four LR and all HR patients experienced infectious episodes that required hospitalization. Four of the nine HR patients(44.4 percent) suffered from tinnitus, three of whom developed sensorineural hearing loss. All but one are surviving, event-free, with a median follow-up of 13.9 mo(8.1-22.3 mo). Conclusion : Risk-adapted cisplatin-based chemotherapy was effective even in HR patients, but regimen modification seems to be necessary to avoid an unacceptably high toxicity rate.
Purpose: In the revascuarization of ischemic dysfunctional myocardium, stunned myocardium was reported to recover function earlier than hibernating myocardium. It was also suggested that stunning and hibernation could be discriminated by reversibility of perfusion impairment on myocardial SPECT. In this study, we investigated the time course of functional recover after CABG according to reversibility of perfusion impairment. Materials and Methods: In 92 patients with coronary artery disease, Tl-201 rest/dipyridamole stress Tc-99m-MIBI gated SPECT was performed before, 3 months after, and 17 months after CABG. Using a 20-segment model, segmental perfusion and systolic thickening were automatically quantified. Perfusion-impaired segments with abnormal thickening were classified by reversibility into reversible (REV) and irreversible (IRREV) groups. The proportions of function-recovered segments were compared between groups and also between 3 months and 17 months in each group. Results: A total of 129 segments were Included In the analysis, and 76 were REV and 53 were IRREV. At 3 months after CABG, 61 segments (80%) in REV group showed functional recovery while 28 segments (53%) in IRREV group did (p<0.001). However, at 17 months after CABG, 60 segments (79%) in REV group and 37 segments (70%) un IRREV group showed functional recovery (p=n.s.). When comparing 3 months and 17 months in each group, REV group showed no difference, while IRREV group showed significant further improvement (p<0.05). Conclusion: In viable myocardium with ischemic myocardial dysfunction, the segments with reversible perfusion impairment recover function earlier after revascularization than irreversible segments.
We evaluated diagnostic accuracy of diuretic renal scan with standardization in 45 childrens(107 hydronephrotic kidneys) with 91 diuretic assessments. Sensitivity was 100%, specificity was 78%, and accuracy was 84% in 49 hydronephrotic kidneys with standardization. Diuretic renal scan without standardization, sensitivity was 100%, specificity was 38%, and accuracy was 57 % in 58 hydronephrotic kidneys. The false-positive results were observed in 25 cases without standardization, and in 8 cases with standardization. In diuretic renal scans without standardization, the causes of false-positive results were 10 early injection of lasix before mixing of radioactivity in pelvocalyceal system, 4 full bladder, 2 markedly dilated pelvocalyceal systems postpyeloplsty, 6 extrarenal pelvis, and 3 immature kidneys of neonates. In diuretic renal scans with standardization the causes of false-positive results were 2 markedly dilated systems postpyeloplsty, 2 extrarenal pelvis, 1 immature kidney of neonate, and 2 severe venal dysfunction, 1 vesicoureteral reflux. In diuretic renal scan without standardization the false-positive results by inadequate study were common, but false-positive results by inadequate study were not found after standardization. The false-positive results by dilated pelvocalyceal systems postpyeloplsty, extrarenal pelvis, and immature kidneys of neonates were not dissolved after standardization. In conclusion, diagnostic accuracy of diuretic renal scan with standardization was useful in children with renal outflow tract obstruction by improving specificity significantly.
The purpose of this study is to evaluate the distribution of clusters and blood flow rate in ADHD SPECT brain blood flow images of children using statistical parametric mapping (SPM99). We studied 64 ADHD children (4-15 y, $8.03{\pm}2.57$ y. male/female:52/12) and compared them with a control group of 12 children (6-l7 y, $9.42{\pm}3.37$ y, male/female:8/4). We injected blood flow tracer $^{99m}Tc$-ethylcysteinate dimer (ECD) as a rCBF agent and took blood flow images after 30 min. by SPECT camera. In the case of hyperperfusion of rCBF in the ADHD group, we found 3 clusters clearly separated at the cingulate gyrus, Rt.cerebral occipital lobe and Lt.cerebellar post. lobe, on probability level 0.05 (P<0.05). Thirty-six ADHD patients with average hyperfusion rates between 18.72-19.30% in each cluster had more increase in blood flow than the average perfusion rate at the Rt. cerebral occipital lobe. These levels were influenced by P-value. In the case of hypoperfusion in the ADHD children, 4 decreased clusters on Lt. and Rt. cerebral frontal lobe, Lt. cerebral claustrum and Rt. cerebral, sup. temporal gyrus at P<0.01 can be seen. The average hypoperfusion rates for the ADHD children were 18.41-18.69% in each cluster, which showed more hypopefusion than the average perfusion rate at the Lt. Cerebrum inf. Frontal gyrus. The perfusion rates and the number of patients were not affected by P-value. The result of this study shows significant hyperpefusion clusters at the probability level of P:0.05 and hypoperfusion clusters at P:0.01. The number of ADHD patients in each clusters and the perfusion rate were not affected by P-value.
We evaluated the diagnostic accuracy of $^{99m}Tc$-DISIDA scintigrauhy as a mean of differentiating biliary atresia from neonatal hepatitis. $^{99m}Tc$-DISIDA scintigraphy was visually interpreted by assessing the presence or absence of radioactivity in the intestine or gall bladder. In patients without intestinal radioactivity, we measured the hepatic retention index and the hepatic uptake index. The hepatic retention Index was expressed as the amount of change of liver activity from 5 minutes to 30 minutes postinjection. The hepatic uptake Index was graded visually with 5 minute images using the following scoring scheme : grade 0(normal hepatic uptake), grade 1(decreased hepatic uptake), grade 2(hepatic uptake equal to cardiac uptake), and grade 3(hepatic uptake less than cardiac uptake). Age, total bilirubin, and hepatic uptake index were compared between the biliary atresia and the neonatal hepatitis group, between neonatal hepatitis patients with and without intestinal radioactivity, and between the biliary atresia and neonatal hepatitis patients with absent intestinal radioactivity. The results were as follows ; 1) None of the 30 biliary atresia patients showed intestinal radioactivity, while 31/40 neonatal hepatitis patients showed intestinal radioactivity. The sensitivity, specificity, and accuracy of the presence of intestinal radioactivity ?or the diagnosis of biliary atresia was 100%, 78%, and 87%, respectively. 2) In patients with absent intestinal radioactivity the mean hepatic retention index was $1.5{\pm}0.6$ in the 16 biliary atresia patients, and $1.1{\pm}0.2$ in the 7 neonatal hepatitis patients(p<0.01). All 7 patients with hepatic retention index over 1.5 had biliary atresia. But there were 9 patients with biliary atresia below 1.5. 3) No significant differences were found in age, total bilirubin, or hepatic uptake Index between biliary atresia and neonatal hepatitis patients. However there were differences in age, total bilirubin, and hepatic uptake index between neonatal hepatitis patients with and without intestinal radioactivity. The hepatic uptake index was significantly lower, age was old, and total bilirubin was low in the group with intestinal radioactivity compared the group without intestinal radioactivity(p<0.05). Relation between total bilirubin and the hepatic uptake index was that total bilirubin was relatively low at normal hepatic uptake index in biliary atresia and neonatal hepatitis patients. 4) When hepatic uptake index and hepatic retention index were high it suggest that biliary atresia is more likely, considered relation between hepatic uptake Index and the hepatic retention index. Thus, we conclude that $^{99m}Tc$-DISIDA scintigraphy is accurate in the differential diagnosis of biliary atresia and neonatal hepatitis. In patients without intestinal radioactivity, the hepatic retention index and hepatic uptake index, along with the patient's age and total bilirubin level may supplement diagnosis and improve diagnostic accuracy.
Otitis media with effusion, described first by Politzer (1867), is closely related with the function of auditory tube, but its etiology and pathogenesis are not clearly defined yet. There are many theories about its pathogenesis including hydrops ex vacuo theory which was most reliable nowadays. In this paper, using cats in experimental animals, hydrops ex vacuo theory was proved and cytological study of the effusion and light microscopic observation of the middle ear mucosa in otitis media with effusion were done. The results were as follows: 1) The effusion was found in all experimental groups after eighteen hours of the auditory tube obstruction. 2) In the cytological study of effusion by smear technic, Polymorpholeukocytes were dominant in earlier days but monoculear cells were soon increased and no eosinophils were found. 3) In the culture of the effusion, no bacteria was cultured. 4) By opeating microscope, hypertrophy of the middle ear mucosa observed especially in the fourteen days after auditory tube obstruction and effusion was most remarkable in the fourteen days, also. 5) By light microscopy, there were epithelial hyperplasia, proliferation of goblet cells, capillaries and infiltration of inflammatory cells which showed same distribution as smear technic.
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