• Korean Journal of Hospice Care
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• v.1 no.1
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• pp.46-69
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• 2001

Hospice Care is the best way to care for terminally ill patients and their family members. However most of them can not receive the appropriate hospice service because the Korean health delivery system is mainly be focussed on acutly ill patients. This study was carried out to clarify the situation of hospice in Korea and to develop a hospice care delivery system model which is appropriate in the Korean context. The theoretical framework of this study that hospice care delivery system is composed of hospice resources with personnel, facilities, etc., government and non-government hospice organization, hospice finances, hospice management and hospice delivery, was taken from the Health Delivery System of WHO(1984). Data was obtained through data analysis of litreature, interview, questionairs, visiting and Delphi Technique, from October 1998 to April 1999 involving 56 hospices, 1 hospice research center, 3 non-government hospice organizations, 20 experts who have had hospice experience for more than 3 years(mean is 9 years and 5 months) and officials or members of 3 non-government hospice organizations. There are 61 hospices in Korea. Even though hospice personnel have tried to study and to provide qualified hospice serices, there is nor any formal hospice linkage or network in Korea. This is the result of this survey made to clarify the situation of Korean hospice. Results of the study by Delphi Technique were as follows: 1.Hospice Resources: Key hospice personnel were found to be hospice coordinator, doctor, nurse, clergy, social worker, volunteers. Necessary qualifications for all personnel was that they conditions were resulted as have good health, receive hospice education and have communication skills. Education for hospice personnel is divided into (i)basic training and (ii)special education, e.g. palliative medicine course for hospice specialist or palliative care course in master degree for hospice nurse specialist. Hospice facilities could be developed by adding a living room, a space for family members, a prayer room, a church, an interview room, a kitchen, a dining room, a bath facility, a hall for music, art or work therapy, volunteers' room, garden, etc. to hospital facilities. 2.Hospice Organization: Whilst there are three non-government hospice organizations active at present, in the near future an hospice officer in the Health&Welfare Ministry plus a government Hospice body are necessary. However a non-government council to further integrate hospice development is also strongly recommended. 3.Hospice Finances: A New insurance standards, I.e. the charge for hospice care services, public information and tax reduction for donations were found suggested as methods to rise the hospice budget. 4.Hospice Management: Two divisions of hospice management/care were considered to be necessary in future. The role of the hospice officer in the Health & Welfare Ministry would be quality control of hospice teams and facilities involved/associated with hospice insurance standards. New non-government integrating councils role supporting the development of hospice care, not insurance covered. 5.Hospice delivery: Linkage&networking between hospice facilities and first, second, third level medical institutions are needed in order to provide varied and continous hospice care. Hospice Acts need to be established within the limits of medical law with regards to standards for professional staff members, educational programs, etc. The results of this study could be utilizes towards the development to two hospice care delivery system models, A and B. Model A is based on the hospital, especially the hospice unit, because in this setting is more easily available the new medical insurance for hospice care. Therefore a hospice team is organized in the hospital and may operate in the hospice unit and in the home hospice care service. After Model A is set up and operating, Model B will be the next stage, in which medical insurance cover will be extended to home hospice care service. This model(B) is also based on the hospital, but the focus of the hospital hospice unit will be moved to home hospice care which is connected by local physicians, national public health centers, community parties as like churches or volunteer groups. Model B will contribute to the care of terminally ill patients and their family members and also assist hospital administrators in cost-effectiveness.

• The korean journal of orthodontics
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• v.32 no.6 s.95
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• pp.401-411
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• 2002

Precise bracket positioning is essential in modem orthodontics. However, there can be alterations in the vertical position of a bracket due to several reasons. The purpose of this study was to evaluate the effect of variations in the vertical bracket position on the crown inclination in Korean patients with normal occlusion. From a larger group of what was considered to be normal occlusions obtained from the Department of Orthodontics, College of Dentistry, Seoul National University, each of the final 10 subjects (6 males and 4 females, with an average age of 22.3 yews) was selected. The dental models of each of the subjects were scanned three-dimensionally by a laser scanner, and measurements drawn from these were made on the scanned dental casts of the subjects were input into the computer program. From this the occlusal plane and the bracket plane were determined. The tooth plane was then constructed to measure the crown inclination on the bracket plane of each tooth. From a practical standpoint, information was obtained on the extent to which the torque of a tooth would be changed as the bracket position was to be moved vertically (in ${\pm}0.5mm,\;{\pm}1.0mm,\;{\pm}1.5mm$) from its ideal position. A one way analysis of the variance (ANOVA) was used to compare each group of the different vertical distances from the bracket plane on a specific tooth. Duncan's multiple comparison test was then performed. There were statistically significant differences in the crown inclination among the groups of different vertical distances for the upper central incisor, upper lateral incisor, upper canine, upper first and second molars, lower first and second premolars, and lower first and second molars (p<0.05). On the upper anterior teeth, upper molars, lower premolars and lower molars, the resultant torque values due to the vertical displacement of the bracket were different depending on the direction of the displacement, occlusal or gingival. This study implies that the torque of these teeth should be handled carefully during the orthodontic treatment. In circumstances in which the bracket must be positioned more gingivally or occlusally due to various reasons, it would be useful to provide the chart of torque alteration of each tooth referred to in this study with its specified bracket prescription.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.11
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• pp.5469-5475
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• 2012

Background and Objectives: Acute lymphoblastic leukemia (ALL) is a complex genetic disease involving many fusion oncogenes (FO) having prognostic significance. The frequency of various FO can vary in different ethnic groups, with important implications for prognosis, drug selection and treatment outcome. Method: We studied fusion oncogenes in 101 pediatric ALL patients using interphase FISH and RT-PCR, and their associations with clinical features and treatment outcome. Results: Five most common fusion genes i.e. BCR-ABL t (22; 9), TCF3-PBX1 (t 1; 19), ETV6-RUNX1 (t 12; 21), MLL-AF4 (t 4; 11) and SIL-TAL1 (del 1p32) were found in 89/101 (88.1%) patients. Frequency of BCR-ABL was 44.5% (45/101). BCR-ABL positive patients had a significantly lower survival ($43.7{\pm}4.24$ weeks) and higher white cell count as compared to others, except patients with MLL-AF4. The highest relapse-free survival was documented with ETV6-RUNX1 (14.2 months) followed closely by those cases in which no gene was detected (13.100). RFS with BCR-ABL, MLL-AF4, TCF3-PBX1 and SIL-TAL1 was less than 10 months (8.0, 3.6, 5.5 and 8.1 months, respectively). Conclusions: This is the first study from Pakistan correlating molecular markers with disease biology and treatment outcome in pediatric ALL. It revealed the highest reported frequency of BCR-ABL FO in pediatric ALL, associated with poor overall survival. Our data indicate an immediate need for incorporation of tyrosine kinase inhibitors in the treatment of BCR-ABL+ pediatric ALL in this population and the development of facilities for stem cell transplantation.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.11 no.2
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• pp.252-261
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• 2000

Objectivity：This study was conducted to examine the depression, self-concept, perception of stress & coping strategy in children with chronic physical illness. Methods：Two groups of participants were recruited for this study, 13 children with chronic illness in outpatient or inpatient treatment at Seoul National University Children's Hospital, and 13 nonpatient children. They were assessed using Korean form of the Piers-Harris Self-Concept Scale (PHSCS), Kovacs' Children's Depression Inventory(CDI) and three subscaleds('color how you feel' 'color how others make you feel' 'A children in the rain' of Children's Self-Report and Projective Inventory(CSRPI). Result：There were significant differences between the chronic ill children and the healthy children in scores of depression and self-concept. The chronicity ill children were more depressive and had very negative self-concept, and obtained significantly lower scores than the healthy children in the subscales of PHSCS, 'intellectual/school status' and 'popularity' Among three scales of CSRPI, there was no difference in 'color how you feel' and 'color how others make you feel' But there were significant differences in all items of 'A child in the rain'(quantity of raining, duration of raining, tool, and effectiveness). 'Duration of raining' correlated most negatively with PHSCS scores, and correlated positively with CDI scores. Conclusion：The children with chronic illness are more depressive and have very negative selfconcept. And they feel that the stresses are more permanent, but have no appropriate coping strategy. The results suggest that the chronic illness strongly affects the psychological and emotional adjustment of children(i.e. depression, peer relation, stress coping strategy).

• Journal of Acupuncture Research
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• v.19 no.3
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• pp.107-114
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• 2002

Objective : This study was designed to find the most effective and safest way to overcome Lumbago due to blood stasis and sprain involved in a few Meridian Tendino-musculatures by evaluating the effect of two kinds of Dong-gi(Dong-qi) Acupuncture(DGA) and by reporting their side effects. Material : 97 patients of out and admission patients were selected, who were diagnosed with lumbar sprain caused by repetitive bending, heavy weight lifting, unsuitable posture, concussion and falling down and whose Lumbago due to blood stasis and sprain in the concept of oriental medicine. Methods : 97 patients were divided into three groups. One is exclusive DGA group to which DGA and the method retaining needles on the acupoints for about 20 minutes were applied, the other is DGA combined active exercise group in which patients stretched their Meridian Tendino-muscuIatures with their hips moving up and downward repeatedly during DGA, the third is DGA combined passive exercise group in which patients were made to flex or extend their bodies on the auto flexion-distraction table in a prone position, from 10 to 20 degree, during DGA. In each group, bed rest, physical therapy and herbal medicine were used according to symptoms, in addition to DGA. In DGA method, "Su(Shu)" points of the meridian related to the involved Meridian Tendino-musculature were mainly chosen, that is, Sokkol(Shugu, B65), Hugye(Houxi, SI3), ChungJo(Zhongzhu, TE3) were used, for most LBP belonged to Bladder and Gallbladder Meridian Tendino-musculature disorders. Pyong-Bo-Pyong-Sa(Ping-Bu-Ping-Xie) such as Dong-Gi and Yeom-Jeon(Nian-Zhuan) was applied as Bo-Sa method. For evaluation of effectiveness, new score system was devised by severity of pain and range of movement. the score was given twice at patients' first and last visit and the difference between first and last score was regarded as a evaluation scale, the effectiveness was classified into four grade by evaluation scale.(scale : 12-15; excellent, 8-11; good, 4-7; fair, 0-3; bad) Results : 1. Exclusive DGA, DGA combined active exercise and DGA combined passive exercise group showed 97, 87 and 89% in effectiveness. 2. Exclusive DGA, DGA combined active exercise and DGA combined passive exercise group showed no aggravation of pain, range of movement. 3. In blood test of 34 patients, only one patient showed abnormal rise of sGOT, sGPT and $\gamma$-GTP at his first visit and the others didn't show any detrimental change. DGA had no bad influence upon BUN and creatinine of patients. Conclusion : For complex theraphy combining DGA, exercise, physical therapy and Herbal medicine proved to be highly effective on treating lumbago due to blood stasis and sprain, this is expected to be available for clinical use.

• Korean Journal of Environment and Ecology
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• v.30 no.3
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• pp.353-368
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• 2016

This study surveyed the diversity and distributional characteristics of benthic macroinvertebrates and freshwater fish during the period from April to October, 2015 in Seonun Mountain Provincial Park. As a result, a total of 78 species of benthic macroinvertebrates belonging to 50 families, 16 orders, and four phyla were observed in Seonun stream; additionally, 25 species of freshwater fish belonging to six families were identified in all the investigated sites. Among benthic macroinvertebrates, Ephemeroptera(13 spp.: 22.81%) was the largest group in terms of species richness. In the FFGs, gathering-collectors(30 spp.: 36.14%) were relatively larger as represented by Ephemeroptera that usually inhabit fast flowing streams. In the HOGs, clingers(23 spp.: 29.49%) and burrowers(17 spp.: 21.79%) were the dominant groups. For both EPT ratio and ESB index, site 8 appeared to be the highest with 44.44% and 72 marks respectively, while the sites 4 and 9 showed relatively lower rates and indices. According to the results of evaluation, site 8 needs to be designated as the highest protection area while the sites 4 and 9 may be designated as target areas for preferential improvement. According to the analysis of fish community, the dominant species was Zacco teminchkii(333 inds.: 36.80%), and the dominant index was the lowest(0.24) and diversity index was the highest(1.81) at site 8, which therefore represents a stable freshwater fish community. In this survey, six Korean endemic species were identified: Ephemera separigata, Neoperla coreensis, Rhodeus uyekii, Squalidus gracilis majimae, Microphysogobio yaluensis, and Iksookimia koreensis. Also, three species belonging to the management of exportable group(Davidius lunatus, E. separigara, N. coreenis) were observed. Two habitat specific species: Thraulus grandis and Anguilla marmorata, were found for the first time in Gochang area and marked on the Korean distribution map through discussion.

• Strategy21
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• s.34
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• pp.58-92
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• 2014

Even after S. Korea took 5.24 Measure(24 May 2014), N. Korea has not stopped raising provocations such as the shelling of Yeonpyeong Island, electronic and cyber attacks. To make matters worse, the communist country lunched long-range missiles(twice) and conducted 3rd nuclear test, escalating tensions which could possibly lead to an all-out war. Korean Government failed to respond properly. However, escalation into an all-out war was deterred by the CFC immediately carrying out its peacetime duty(CODA). The US made a rapid dispatch of its augmentation forces(Aircraft carrier, nuclear-powered submarine, strategic bomber, F-22) to the Korean Peninsula. In recognition of the importance of the Combined Forces Command, since May 2013 the Park Geun-Hye Administration has been pushing ahead with re-postponement of Wartime Operational Control Transfer(which initially meant the disassembling of the CFC as of 1 December 2015) More recently, there has been a series of unusual indicators from the North. Judging from its inventory of 20 nuclear weapons, 1,000 ballistic missiles and biochemical weapons, it is safe to say that N. Korea has gained at least war deterrence against S. Korea. Normally a nation with nuclear weapons shrink its size of conventional forces, but the North is pursuing the opposite, rather increasing them. In addition, there was a change of war plan by N. Korea in 2010, changing 'Conquering the Korean Peninsula' to 'Negotiation after the seizure of the Greater Seoul Metropolitan Area(GSMA)' and establishing detailed plans for wartime projects. The change reflects the chain reaction in which requests from pro-north groups within the South will lead to the proclamation of war. Kim, Jeong-Un, leader of N. Korean regime, sent threatening messages using words such as 'exercising a nuclear preemptive strike right' and 'burning of Seoul'. Nam, Jae-June, Director of National Intelligence Service, stated that Kim, Jung-Un is throwing big talks, saying communization of the entire Korean Peninsula will come within the time frame of 3 years. Kim, Gwan-Jin, Defense Minister, shared an alarming message that there is a high possibility that the North will raise local provocations or a full-fledged war whenever while putting much emphasis on defense posture. As for the response concept of the Korean Government, it has been decided that 'ROK·US Combined Local Provocation Counter-Measure' will be adopted to act against local provocations from the North. Major provocation types include ▲ violation of the Northern Limit Line(NLL) with mobilization of military ships ▲ artillery provocations on Northwestern Islands ▲ low altitude airborne intrusion ▲ rear infiltration of SOF ▲ local conflicts within the Military Demarcation Line(MDL) ▲ attacking friendly ships by submarines. Counter-measures currently established by the US involves the support from USFK and USFJ. In order to keep the sworn promise, the US is reinforcing both USFK and USFJ. An all-out war situation will be met by 'CFC OPLAN5027' and 'Tailored Expansion Deterrence Forces' with the CFC playing a central role. The US augmentation forces stands at 690,000 troops, some 160 ships, 2,000 aircraft and this comprise 50% of US total forces, which is estimated to be ninefold of Korean forces. The CFC needs to be in center in handling both local provocations and an all-out war situation. However, the combat power of S. Korean conventional forces is approximately around 80% of that of N. Korea, which has been confirmed from comments made by Kim, Gwan-Jin, Defense Minister, during an interpellation session at the National Assembly. This means that S. Korean forces are not much growing. In particular, asymmetric capabilities of the North is posing a serious threat to the South including WMD, cyber warfare forces, SOF, forces targeting 5 Northwestern Islands, sub-surface and amphibious assault forces. The presence of such threats urgently requires immediate complementary efforts. For complementary efforts, the Korean Government should consider ① reinforcement of Korean forces; putting a stoppage to shrinking military, acquisition of adequate defense budget, building a missile defense and military leadership structure validity review, ② implementation of military tasks against the North; disciplinary measures on the sinking of ROKS Cheon-an/shelling of Yeonpyeong Islands, arrangement of inter-Korean military agreements, drawing lessons from studies on the correlation between aid for N. Korea, execution of inter-Korean Summit and provocations from the North, and ③ bolstering the ROK·US alliance; disregarding wartime operational control transfer plan(disassembling of CFC) and creation of a combined division.

• Tuberculosis and Respiratory Diseases
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• v.61 no.3
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• pp.227-232
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• 2006

Background: In the measurement of bronchodilator reversibility, the forced expiratory volume in one second($FEV_{1}$) and the forced vital capacity(FVC) are commonly used parameters and recommended criteria for the reversibility requiring an increase of more than 200ml and 12% above the baseline, respectively. However, aged patients do not often meet the criteria of an increase in volume(>200ml) even though the medical history of that patient is adequate for asthma. This study investigated the role of the forced expiratory volume in six seconds($FEV_{6}$) in the bronchodilator reversibility test in elderly patients. Methods: A total of 236 patients more than 65 years of age with a $FEV_{1}$/FVC ratio<80% were enrolled in this study. The bronchodilator revesibility tests were examined. With the setting $FEV_{1}$ as the baseline, the patients were divided into three groups; Group I : $$FEV_{1}{\geq_-}80%$$ of the predicted value, Group II : 60%<$FEV_{1}$<80% of the predicted value, Group III : $$FEV_{1}{\leq_-}60%$$ of the predicted value. Results: Positive reversibility in the $FEV_{1}$, $FEV_{6}$, and FVC was in 33(14.0%), 49(20.8%) and 55(23.3%). However, Group III presented with reversibility in the $FEV_{1}$, $FEV_{6}$, and FVC in 15(22.4%), 30(44.8%) and 32(47.8%) respectively. Conclusions: The $FEV_{6}$ might be used as a complementary parameter in bronchodilatror reversibility in elderly patients. However, more study will be needed to determine the usefulness of $FEV_{6}$ in bronchodilator reversibility test.

• The korean journal of orthodontics
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• v.37 no.6
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• pp.421-431
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• 2007

The objective of this study was to provide guidelines for the diagnosis and successful treatment of orthodontic treatment with upper premolar extraction only Methods: The sample group consisted of 40 patients (20 with upper premolar extraction only, 20 with both upper and lower premolar extractions) who showed an overjet of more than 7 mm and were finished successfully. Lateral cephalographs were taken before and after orthodontic treatment. Landmarks showing the position of the upper and lower incisors and the position of the upper and lower lip were determined and angular measurement of these values were obtained for statistical analysis (Mann-Whitney test). Results: At pre-treatment, the position of the lower incisor was less labially inclined and the convexity of the lower lip was smaller in the upper premolar extraction only group than in the upper/lower premolar extraction group. At post-treatment, there was no difference in all measurements except for the position of the lower incisor. A comparison of changes between pre- and post-treatment showed that the retraction of upper & lower incisors and the decrease in convexity of the lower lip were greater in the upper/lower premolar extraction group. Conclusions: Treatment by upper premolar extraction can be of benefit for patients whose lower incisor proclination and lower lip protrusion are not excessive.

• Investigative Magnetic Resonance Imaging
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• v.13 no.2
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• pp.146-151
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• 2009

Purpose : To evaluate magnetic resonance (MR) imaging features of non-surgically treated tuberculous spondylitis and to evaluate the relationships between these features and clinical outcomes. Materials and Methods : Data from ten patients (male:female=6:4, mean age=45 years) with clinically proven tuberculous spondylitis who were treated nonsurgically over three months were analyzed retrospectively from 2000 to 2007. MRI was performed at least three times for each patient, at baseline, every three or six months, and at the end of treatment. All images were analyzed by two radiologists. Results : The mean follow-up period for the MR examination was 10.1 months (range, 4-17 months). Six patients had clinically complete resolution of tuberculous spondylitis with medication treatment only. Four patients were treated with surgical management alongside medication. All ten patients were divided into two groups by clinical outcome; six patients with complete treatment and four patients with incomplete treatment. In the complete treatment group, follow-up MR findings showed a loss of subligamentous spread of abscesses, decreased size of abscesses, no interval changes in vertebral body heights, and fatty changes in spinal lesions. MR findings in the incomplete treatment group showed bone marrow edema extension to adjacent vertebra, extension of the abscesses, and decreased height of the vertebral bodies. Conclusion : During the nonsurgical management of tuberculous spondylitis, MR imaging may play a role in predicting patient response to antituberculous drug treatment.