• Title/Summary/Keyword: 장애영향평가

Search Result 496, Processing Time 0.114 seconds

Difference in Right Ventricular Function between Post-tuberculosis Emphysema and Primary Emphysema (결핵후 폐기종과 원발성 폐기종에서 우심질 기능의 차이)

  • Kim, Myung-A;Kim, Sang-Hyun;Chung, Hee-Soon
    • Tuberculosis and Respiratory Diseases
    • /
    • v.51 no.2
    • /
    • pp.97-107
    • /
    • 2001
  • Background : Tuberculosis itself causes not only lung parenchymal destruction but also pulmonary vascular damage. Secondary emphysema also causes pulmonary vascular damage, which can develop as a late sequela of pulmonary tuberculosis. Therefore, pulmonary circulatory impairment tends to be more severe in post-tuberculosis emphysema than in primary emphysema. In post-tuberculosis emphysema, the right ventricular function may play an important role. However, little information regarding the right ventricular function is available. The purpose of this study was to evaluate and compare the right ventricular function between post-tuberculosis emphysema and primary emphysema. Method: Post-tuberculosis emphysema(PTE) or primary emphysema(PE) was diagnosed by history, HRCT finding and pulmonary function. Twenty patients with post-tuberculosis emphysema were matched with 20 patients with primary emphysema according to both $FEV-1$ and FVC. Arterial blood gas analysis and echocardiography were done at rest and immediately after symptom-limited exercise. The right ventricular function was evaluated with the right ventricular ejection fraction using a modification of Simpson's method. Results : There was no significant difference in the demographics and pulmonary function between the two groups. In post-tuberculosis emphysema, the $PaCO_2$ was higher ($42.9{\pm}4.7$ vs $38.8{\pm}3.1\;mmHg$ at rest; $47.9{\pm}7.0$ vs $41.1{\pm}5.9\;mmHg$ after exercise; p<0.01) and the right ventricular ejection fraction was lower ($57.6{\pm}6.5$ vs $61.4{\pm}4.7%$ at rest; $51.1{\pm}10.8$ vs $59.8{\pm}6.6%$ after exercise; p<0.01) both at rest and after exercise. The $PaCO_2$ after exercise was also lower ($65.7{\pm}12.6$ vs $80.2{\pm}14.4\;mmHg$, p<0.01), while the Pa02 at rest tended to be lower($82.9{\pm}12.0$ vs $87.8{\pm}7.5$, p>0.05). In both groups, right ventricular ejection fraction correlated with the $PaCO_2$ after exercise(PTE r=0.536, PE r=0.557), and the $PaCO_2$ at rest(PTE r=-0.576, PE r=-0.588) and after exercise(PTE r=-0.764, PE r=-0.619). Conclusion : Impairment of the right heart function and gas exchange were more serious in post-tuberculosis emphysema than in primary emphysema, and gas exchange may be influenced by the right ventricular function in post-tuberculosis emphysema.

  • PDF

The Relationship of between Anxiety Tendency and Recurrent Abdominal Pain in Elementary School Children (학동기 소아에서 반복성 재발성 복통과 불안 성향과의 관련성)

  • Moon, Ji-Young;Moon, Kyung-Rye
    • Pediatric Gastroenterology, Hepatology & Nutrition
    • /
    • v.10 no.2
    • /
    • pp.129-137
    • /
    • 2007
  • Purpose: It has been reported that children with chronic pain have higher levels of anxiety than age-matched controls. Therefore, this study was designed to determine the relationship between anxiety and recurrent abdominal pain in elementary school children. Methods: In 2005, we surveyed 1,254 elementary school children (592 boys and 662 girls) whose ages ranged from 7 to 12 years. The degree of trait and state anxiety was compared between agroup suffering from intermittent abdominal pain, a group suffering from recurrent abdominal pain and a normal control group following the Korean version of Spielberger's State-Trait Anxiety Inventory YZ form (STAI-YZ). Results: 709 (56.5%) and 69 (5.5%) of the patients reported intermittent abdominal pain and and recurrent abdominal pain, respectively, during the 12 month period before this study was conducted, and trait and state anxiety values for each of these groups was 116 (9.3%) and 63 (5.0%), respectively. In addition, the State-Trait Anxiety score was significantly higher in the group with intermittent abdominal pain and RAP than the anxiety score of the normal control group. Additionally, the STAI-YZ score increased in proportion to the severity of abdominal pain, but was not correlated with the duration, frequency, onset time or location of abdominal pain. Furthermore, the proportion of the group with abdominal pain in the group that had trait or state anxiety was significantly higher than the proportion of the group that did not have trait and state anxiety. Conclusion: Recurrent abdominal pain during childhood is correlated with state and trait anxiety, therefore, psychological factors, such as anxiety duringtreatment, must also be considered when determining the cause of recurrent abdominal pain.

  • PDF

Investigations of the Potential Fisheries Resources in the Southern Waters of Korea - Biological Composition of Demersal Trawl Catches - (한국 남해안의 잠재어업자원 조사연구 - 저층크롤 어획량의 생물학적 조성 -)

  • Lee, Dae-Jae;Kim, Jin-Kun;Shin, Hyong-Ho
    • Journal of the Korean Society of Fisheries and Ocean Technology
    • /
    • v.34 no.3
    • /
    • pp.241-258
    • /
    • 1998
  • The experimental demersal trawl surveys to provide the essential information for the assessment, management and utilization of commercially important fish stocks in the southern waters of Korea were carried out during five research cruises between October 1996 and October 1997 by the training ship “KAYA” of Pukyong National University. The biological sampling was conducted by using the trawl net with a cover net of 36 mm in mesh size at 64 planned trawl stations during daylight to identify the biological characteristics of fish. Each catch was standardized into catch per unit of time and the catches at each trawl station were sorted, weighed and counted by species. The changes in catches of each fish species and the shifts in dominant species by seasions and sampling regions in the research area were analyzed, and the abundance of fish was estimated from the relationship between the trawl catches and the volume of the water column sampled by demersal trawls. The results obtained can be summarized as follows : 1. During the 64 demersal trawls conducted in the southern waters of Korea, 129 species including 112 species of fishes, 8 species of Cephalopoda and 7 species of Crustacea, were identified Also, during the 1996 and 1997 trawl surveys in the reseach area, a large number of commercially important species with small differences in proportion was found. me proportion of Japanese horse mackerel which comprised 19.8% of the total catch by weight was highest, followed by chub mackerel(15.0%), swordtip squid(9.0%), redwing searobin(6.2%), konoshiro gizzard shad(6.1%), Japanese flying squid(5.8%), silver pomfet(5.1%), blackmouth goosefish(5.1%), etc. Swordtip squid, Japanese flying squid, blackmouth goosefish and blackthroat seaperch were among the dominant species in all seasons with a relatively high and stab1e proportion(3.6~9.0%), and were widely distributed in the entire southern water of Korea. 2. The catch rates by cover net varied at 0.7~91.9% by weight of the total trawl catch by codend and cover net at 64 planned trawl stations and the mean catch rate was 44.4%. Species comprising a major portion of the catches by cover net mainly were swordtip squid, konoshiro gizzard shad, the juveniles of Japanese horse mackerel, blackthroat seaperch and chub mackerel, etc. 3. The distribution density of fish in terms of biomass per unit volume which derived from the catch data by 63 bottom trawl hauls in the southern waters of Korea ranged from 17.9 $\times$ 10-6 to 1,440.9 $\times$ 10-6kg/m3 with the mean value of 153.8 $\times$ 10-6 kg/m3. These fish densities varied between seasons, location of sampling stations and sea conditions. From these results, it is worth noting that the catch composition of multispecies and the increased occurrence of small fish in the southern waters of Korea may also result in new problems in determining the total allowable catch(TAC) levels for economically important species.

  • PDF

Results of Coventional Radiotherapy for Carcinomas of the Tonsillar Region (편도암의 방사선 치료 성적)

  • Nah Byung Sik;Nam Taek Keun;Ahn Sung Ja;Chung Woong Ki
    • Radiation Oncology Journal
    • /
    • v.15 no.2
    • /
    • pp.97-104
    • /
    • 1997
  • of $PLC-\gamma$ 1 activity. Results : In the immunohistochemistry, the expression of $PLC-\beta$ was negative for all grnups. The expression of $PLC-\gamma$ 1 was highest in the group III followed by group II in the proliferative zone of mucosa. The expression of PKC-01 was strong1y positive in group I followed by group II in the damaged surface epithelium. The above findings were also confirmed in the immunoblotting study. In the irnrnunoblotting study, the expressions of $PLC-\beta,\;PLC-\gamma\;1,\;and\;PLC-\delta$ were the same as the results of immunohistochemistry The expression of ras oncoprotein was weakly Positive in groups II, III and IV. The of EGFR was the highest in the group II, III, followed by group W and the expression of PKC was weakly positive in the group II and III. Conclusion : $PLC-\gamma$ 1 mediated signal transduction including ras oncoprotein, EGFR, and PKC play a significant role irL mucosal regeneration after irradiation. $PLC-\delta$ 1 mediated signal transduction might have an important role in mucosal damage after irradiation. Further studies will be necessary to confirm the signal transduction mediating the $PLC-\delta$ 1.

  • PDF

Influence of Delayed Gastric Emptying in Radiotherapy after a Subtotal Gastrectomy (위부분절제술 후 방사선치료에서 음식물 배출지연에 따른 영향)

  • Kim, Dong-Hyun;Kim, Won-Taek;Lee, Mi-Ran;Ki, Yong-Gan;Nam, Ji-Ho;Park, Dal;Jeon, Ho-Sang;Jeon, Kye-Rok;Kim, Dong-Won
    • Radiation Oncology Journal
    • /
    • v.27 no.4
    • /
    • pp.194-200
    • /
    • 2009
  • Purpose: This aim of this study was to evaluate changes in gastric volume and organ position as a result of delayed gastric emptying after a subtotal gastrectomy performed as part of the treatment of stomach cancer. Materials and Methods: The medical records of 32 patients who underwent concurrent chemoradiotherapy after a subtotal gastrectomy from March 2005 to December 2008 were reviewed. Of these, 5 patients that had more than 50 cc of residual gastric food detected at computed tomography (CT) simulation, were retrospectively enrolled in this study. Gastric volume and organ location was measured from CT images obtained before radiotherapy, twice weekly. In addition, authors evaluated the change of radiation dose distribution to planning the target volume and normal organ in a constant radiation therapy plan regardless of gastric volume variation. Results: A variation in the gastric volume was observed during the radiotherapy period (64.2~340.8 cc; mean, 188.2 cc). According to the change in gastric volume, the location of the left kidney was shifted up to 0.7 - 2.2 cm (mean, 1.2 cm) in the z-axis. Under-dose to planning target volume (V43, 79.5${\pm}$10.4%) and over-dose to left kidney (V20, 34.1${\pm}$12.1%; Mean dose, 23.5${\pm}$8.3 Gy) was expected, given that gastric volume change due to delayed gastric emptying wasn't taken into account. Conclusion: This study has shown that a great change in gastric volume and left kidney location may occur during the radiation therapy period following a subtotal gastrectomy, as a result of delayed gastric emptying. Detection of patients who experienced delayed gastric emptying and the application of gastric volume variation to radiation therapy planning will be very important.

Arrhythmia Surgery in Fontan Operation (폰탄 수술에서의 부정맥수술)

  • 임홍국;한국남;김웅한;이정렬;노준량;김용진
    • Journal of Chest Surgery
    • /
    • v.37 no.8
    • /
    • pp.644-651
    • /
    • 2004
  • Background: Refractory atrial arrhythmias in patients late after the Fontan operation result in significant morbidity and mortality. We reviewed our experience with arrhythmia surgery in patients who had Fontan operation. Material and Method: Between July 1986 and December 2003, 275 early survivors after Fontan operation were reviewed. Fourteen patients underwent. arrhythmia surgery at reoperation after Fontan operation, and mean age at reoperation was 16.8$\pm$7.1 (range: 4.5 ∼ 30.6) years. Mechanisms of arrhythmia included atrial flutter in 8 patients, and atrial fibrillation in 2. Arrhythmia surgery has evolved from isthmus cryoablation in 12 patients to right-sided maze in 2 patients. Thirty-two patients. underwent prophylactic isthmus cryoablation concomitantly at initial Fontan operation. Result: Postoperative arrhythmias occurred in 68 patients (24.7%) among 275. There was no early and late mortality after the arrhythmia surgery. After redo Fontan operation, all patients maintained normal sinus rhythm. Atrial flutter recurred in 3 patients who had sinus conversion with medication and 7 required permanent pacemakers with a mean follow-up of 26.5$\pm$29.1 (range: 2 ∼ 73) months. All patients have improved to NYHA class I or II. After prophylactic cryoablation at initial Fontan operation, 29 patients (90.6%) had sinus rhythm, 1 patient had junctional tachycardia, 1 patient had sinus nodal dysfunction, and 1 patient had AV block with a mean follow-up of 51.3$\pm$19.8 (range: 4∼80) months. Conclusion: Redo Fontan operation, and concomitant arrhythmia surgery reduced atrial arrhythmias and improved NYHA functional classification.

Temporal Patterns of Pesticide Residues in the Keum, Mangyung and Dongjin Rivers in 2002 (2002년 금강, 만경-동진강 하천수 중 잔류농약의 연간 검출 양상)

  • Kim, Chan-sub;Lee, Hee-Dong;Ihm, Yang-Bin;Son, Kyeong-Ae
    • Korean Journal of Environmental Agriculture
    • /
    • v.36 no.4
    • /
    • pp.230-240
    • /
    • 2017
  • BACKGROUND: To evaluate residues of environmentally concerned pesticides in water system, this monitoring was conducted over three rivers. The residual characteristics and discharging condition of these residues on water system was investigated. METHODS AND RESULTS: Total twenty nine sampling sites were selected through main streams and branch streams of Keum, Mangyung and Dongjin rivers, and the water samples from them were regularly collected one month interval, especially biweekly from May to August in 2002. Of the pesticides monitored, six fungicides which include hexaconazole, isoprothiolane and iprobenfos were detected with frequencies of 0.3-50.9% and in their residue level of $0.1-4.7{\mu}g/L$. Sixteen insecticides which include nine organophosphoruses, three carbamates, endosulfan, cypermethrin, buprofezin and fipronil were detected with frequencies of 0.3-32.5% and in their residue level of $0.01-2.8{\mu}g/L$. Nine herbicides which include alachlor molinate, anilofos, butachlor, dimepiperate, metolachlor, oxadiazon, pretilachlor and thiobencarb were detected with frequencies of 0.8-22.9% and in their residue level of $0.01-9.07{\mu}g/L$. CONCLUSION: Detection frequencies and residue levels of insecticides and herbicides were the highest in waters sampled in May and June. Almost pesticides detected were for the paddy rice and their residue levels were very low to compare with standard values.

The Results of Various Vestibular Function Tests in Young Male Adult (장정에 시행한 몇가지 평가기능 검사성적에 대한 고찰)

  • 박찬일;추광철;노관택
    • Proceedings of the KOR-BRONCHOESO Conference
    • /
    • 1972.03a
    • /
    • pp.2.3-2
    • /
    • 1972
  • The vestibular function test reveals the objective findings of the impairment of the vestibular labyrinth. It's purpose is based on the analysis of the findings and detect the location and etiology of the labyrinthine impairment. In the vestibular function test, the vestibulo-spinal reflex has the clinical significance upon the tonus of the striated muscles by the labyrithine stimulation and contribute to regulating the posture and the position, at rest as well as in motion. The vestibulo-spinal reflex must performe as one of the routine vestivular function test because it can be evoked in man by such weak stimuli to the labyrinth as cannot induce vestibulo-ocular reflex. Authors performed the vestibular function test such as one leg test, gait test, stepping test and vertical writing test to one hundred of healthy and young male adult and received the following results. Results 1. One leg test: In 30 seconds, the frequency of dropping the leg on the ground was between 0 to 3 times in Rt., and 0 to 5 times in Lt. The mean frequency was 0.48 times in Rt., and 0.68 times in Lt. 2. Gait test: In forward gait; the range of the deviation was distributed 0 to 100 cm and mean range was 22.5cm to the Rt., 26.1cm to the Lt. In backward gait; the range deviation was distributed 0 to 140cm and mean range was 35.4cm to the Rt., 33.0cm to the Lt. 3. Stepping test: In normal head position; forward movement war 93% and backward 5%. The angle of displacement deviated to the Rt. side in 36%, and Lt. in 50%. The angle of rotation deviated to the Rt. side in 53 %, and Lt. in 36%. The mean values: angle of displacement was 22.05 degrees, angle of rotation was 24.40 degrees, distance of displacement was 48.95cm. In backward head position; Forward movement was 94% and backward was 3%. The angle of displacement deviated in 34%, and Rt. in 55%, to the Rt. side The angle of rotation deviated to the Rt. side in 50%, and Lt. in 42%. The mean values; angle of displacement was 29.72 degrees, angle of rotation was 39.53 degrees, distance of displacement was 44.17cm. 44.17cm. 4. Vertical writing test: The angle of deviation was between 0 to 16 degrees in all cases, and was between 0 to 12 degrees in the cases of normal head position. The mean angle of deviation was between 4.15 to 5.76 degrees on each side. The direction of deviation to the Rt. side was 54~69%, Lt. was 25~40% and 3~7% was vertical without deviation.

  • PDF

Effects of Private Insurance on Medical Expenditure (민간의료보험 가입이 의료이용에 미치는 영향)

  • Yun, Hee Suk
    • KDI Journal of Economic Policy
    • /
    • v.30 no.2
    • /
    • pp.99-128
    • /
    • 2008
  • Nearly all Koreans are insured through National Health Insurance(NHI). While NHI coverage is nearly universal, it is not complete. Coverage is largely limited to minimal level of hospital and physician expenses, and copayments are required in each case. As a result, Korea's public insurance system covers roughly 50% of overall individual health expenditures, and the remaining 50% consists of copayments for basic services, spending on services that are either not covered or poorly covered by the public system. In response to these gaps in the public system, 64% of the Korean population has supplemental private health insurance. Expansion of private health insurance raises negative externality issue. Like public financing schemes in other countries, the Korean system imposes cost-sharing on patients as a strategy for controlling utilization. Because most insurance policies reimburse patients for their out-of-pocket payments, supplemental insurance is likely to negate the impact of the policy, raising both total and public sector health spending. So far, most empirical analysis of supplemental health insurance to date has focused on the US Medigap programme. It is found that those with supplements apparently consume more health care. Two reasons for higher health care consumption by those with supplements suggest themselves. One is the moral hazard effect: by eliminating copayments and deductibles, supplements reduce the marginal price of care and induce additional consumption. The other explanation is that supplements are purchased by those who anticipate high health expenditures - adverse effect. The main issue addressed has been the separation of the moral hazard effect from the adverse selection one. The general conclusion is that the evidence on adverse selection based on observable variables is mixed. This article investigates the extent to which private supplementary insurance affect use of health care services by public health insurance enrollees, using Korean administrative data and private supplements related data collected through all relevant private insurance companies. I applied a multivariate two-part model to analyze the effects of various types of supplements on the likelihood and level of public health insurance spending and estimated marginal effects of supplements. Separate models were estimated for inpatients and outpatients in public insurance spending. The first part of the model estimated the likelihood of positive spending using probit regression, and the second part estimated the log of spending for those with positive spending. Use of a detailed information of individuals' public health insurance from administration data and of private insurance status from insurance companies made it possible to control for health status, the types of supplemental insurance owned by theses individuals, and other factors that explain spending variations across supplemental insurance categories in isolating the effects of supplemental insurance. Data from 2004 to 2006 were used, and this study found that private insurance increased the probability of a physician visit by less than 1 percent and a hospital admission by about 1 percent. However, supplemental insurance was not found to be associated with a bigger health care service utilization. Two-part models of health care utilization and expenditures showed that those without supplemental insurance had higher inpatient and outpatient expenditures than those with supplements, even after controlling for observable differences.

  • PDF

Sleep Patterns, Daytime Sleepiness and Personality Factors in Rotating Shiftworkers (순환제 교대근무자의 수면양상과 주간의 졸리움 및 성격요인과의 관련성)

  • Kim, Hyun;Kim, Leen;Suh, Kwang-Yoon
    • Sleep Medicine and Psychophysiology
    • /
    • v.5 no.1
    • /
    • pp.71-79
    • /
    • 1998
  • Objectives : This study was to evaluate sleep patterns and daytime sleepiness resulting from rotating shiftwork. The authors, also, tried to find out the relationship between the severity of daytime sleepiness and personality factors. Methods : The subjects consisted of 41 female rotating shiftwork nurses and the control group consisted of 39 female day timeworkers. All of them completed the Sleep questionnaire of Korea University Sleep Disorder Clinic, the Epworth Sleepiness Scale(ESS), the 16 Personality Factors(16PF), the Beck Depression Inventory(BDI) and the State Trait Anxiety Inventory(STAI). Multiple regression analysis of 16PF of the rotating shiftwork nurses was done to find out possible predictors of the severity of daytime sleepiness. Results : The mean duration of deprived sleep due to rotating shiftwork was $64.26\;{\pm}\;14.54\;min$. The frequency of sleep difficulty($1.24\;{\pm}\;1.17\;day/week$ vs $0.67\;{\pm}\;1.31\;day/week$, p < 0.05), time needed to fall asleep($103.05\;{\pm}\;73.48\;min$. vs $70.00\;{\pm}\;60.08\;min$, p < 0.05), sleep duration when having some difficulties in sleep ($204.25\;{\pm}\;79.90\;min$. vs $280.44\;{\pm}\;111.59\;min$., p < 0.001), recent changes in energy($x^2\;=\;4.16$, p < 0.05), worrying about sleep($x^2\;=\;11.08$, p < 0.05), and taking naps($x^2\;=\;4.98$, p < 0.05) showed significant differences between rotating shiftworkers and normal controls. The ESS socre of shiftworkers ($8.68\;{\pm}\;3.04$) was greater than that of normal controls ($6.86\;{\pm}\;3.04$)(p < 0.01). Personality factors such as C factor($R^2\;=0.283$), I factor($R^2\;=0.358$) and G factor($R^2\;=0.470$) were related with the severity of the daytime sleepiness(p < 0.001). Conclusions : The rotating shiftwork nurses had more difficulties in sleep such as having difficulties in falling asleep and in maintaining sleep, and showed lowered energy, decreased senses of well-being and so on. The rotating shiftwork nurses experienced more severe daytime sleepiness than controls did. Personality factors, such as C factor, I factor, and G factor of 16PF were suggested to be useful for predicting the severity of daytime sleepiness resulting from rotating shiftwork.

  • PDF