• 보건행정학회지
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• 제9권1호
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• pp.30-71
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• 1999

There has been a dramatic increase in public awareness regarding dementia during recent years. However, dementia remains a family affair and patients do not receive adequate care in Korea. This study aims to assist patients and their caregivers by establishing Home and Community based Long-Term Care in a city. The data collected for analysis include five main categories: dementia prevalence, limitations of daily activities of patients, burden of caregivers, the services that patient's family want to utilize, the resources that handle dementia in the community. Major findings can be summarized as follows: 1)The prevalence rate of dementia for elderly people is 13.1 per 100 persons. Alzheimer's disease amount to 38.9% of dementia patients and vascular dementia account for 36.7% of them 2)Eight out of ten patients have mild dementia. Almost all patients have normal ADL. IADL, however, shows different picture. In every items of IADL, about 60% of patients reveals some limitations. 3)The proportion of patients who had medical diagnosis is as low as 20%. Families of patients think dementia as normal aging process and medical doctors in the community do not give special concern to dementia patients. 4)Caregivers does not have proper social support. They suffer from long care time, experience large obstacles in respect of health, daily living, and social activity. 5)Health center and Community welfare center have launched some programs-consultation, home-visiting nursing, day care center, voluntary force mobilization and so on-for dementia patients. But they do not perform expected roles and functions because of lack of skilled personnels and inadequate coordination of relevant organizations for dementia care. 6)Families of dementia patients prefer home helper and home-visiting nurse to hospitalization. For the future, however, demand for institution-based long-term services will increase. We develope community dementia care model based on above findings as follows: 1)Health center execute community cardiovascular control program for the prevention of vascular dementia. 2)Refer to epidemiologic characteristics of patients and preference of family, the most urgent task for dementia care in this city is to expand and organize Home and Community based Long-Term Care. 3)For the continuous and comprehensive care, care plan for a patient must be prepared. Case management team should be builded to prepare this plan and coordinate relevant resources. 4)Special long-term care unit for dementia will be needed in a near future. This unit should have multiple functions, such as day-care center, short stay facility, training center for relevant personnels, besides long-term nursing home considering effective care of dementia and efficient operation of the facility. 5)Voluntary workers deserve their due efforts. Incentive mechanisms must be developed to activate voluntary activities.

• 한국주거학회논문집
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• 제19권6호
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• pp.105-114
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• 2008

The purpose of this study is to classify playground types according to the physical characteristics of playgrounds in child care facilities, to analyze the needs of care-givers and to evaluate the adequacy of playgrounds according to playground types. The specific areas discussed in this study were the evaluation of the adequacy in the physical characteristics of playgrounds for children's outdoor play activities by the care-givers, who assist in the outdoor play activities of children and manage safety in the playground, and a report on playground requirements of them. Data was collected from field survey carried out to investigate the physical characteristics of playgrounds of 21 child care facilities. This survey incorporated a structured-questionnaire for the purpose of evaluating the adequacy of the physical characteristics of playgrounds (location and size of the playground, play equipments, the composition of play areas, ground covers, and location of sidewalk in the playground) by the 181 care-givers from the facilities and investigating the needs of them. The major results showed the following. 1) In field survey, it was observed that while the location and the size of the playgrounds varied widely, ground cover, play equipments, and the composition of play area turned out to be identical, regardless of the location and the size of the playgrounds. 2) The playgrounds were classified into five types according to the number of children and the size of the playground. The five types include A-type as a large-scale facility/smallsize playground, B-type as a small-scale facility/large-size playground, C-type as a small-scale facility/small-size playground, D-type as a middle-scale facility/large-size playground, and E-type as a large-scale facility/large-size playground. 3) The adequacy of the physical characteristics of playground in the D-type was evaluated to be higher than that of the other types. The adequacy of the C-type playground was evaluated to be lower than that of the other types in terms of size and the composition of play areas within the playground. 4) The care-givers of the D-type and the E-type playground expressed a desire to install various play equipments, while the care-givers of the C-type playground did not wish to install play equipment. 5) Various outdoor play areas were needed in the D-type playground.

• 한국의료질향상학회지
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• 제3권2호
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• pp.36-51
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• 1997

Background : Clinical practice guidelines define "systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances" and help to improve patient care. The purpose of this study is to develop a clinical practice guideline for the most effective diagnoses and treatments of benign prostatic hyperplasia based on patient preference and clinical need. Methods : For this research project, extensive literature searches (208 articles) were conducted. As well, critical reviews and syntheses (meta-analysis) were used to evaluate empirical evidence and significant outcomes of the BPH literature. Questionnaires about clinical practice for BPH patients were distributed and consensus meetings were undertaken to grasp variations in clinical practice and to reach agreement on the guideline's development. The guideline was promoted under the sponsorship of the Korean Medical Association and the Korean urological Cancer. Society. For the task, the Benign Prostatic Hyperplasia Guideline Panel was composed of multidisciplinary experts in the field. Results : BPH is a disease that affects a patient's quality of life. This Clinical Practice Guideline was developed for the typical man over age 50 with symptoms of prostatism, but with no significant medical morbidities such as diabetes or other known causes of voiding dysfunction, such as urethral stricture or neurogenic bladder. The guidelines detail the relative benefits and obstacles associated with all diagnostic and treatment approaches, including watchful waiting. Conclusion : This guideline provides a cornerstone for our medical association. It represents the most current scientific knowledge regarding the development, diagnosis, and treatment of BPH. It will be revised and updated as needed.

• Asian Pacific Journal of Cancer Prevention
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• 제16권18호
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• pp.8579-8587
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• 2016

Background: The molecular mechanisms linking breast cancer progression and inflammation still remain obscure. The aim of the present study was to investigate the possible association of angiopoeitin like protein 4 (ANGPTL4) and its regulatory factor, hypoxia inducible factor-$1{\alpha}$ (HIF-$1{\alpha}$), with the inflammatory markers nuclear factor kappa B/p65 (NF-${\kappa}B$/P65) and interleukin-1 beta (IL-$1{\beta}$) in order to evaluate their role in inflammation associated breast cancer progression. Materials and Methods: Angiopoietin-like protein 4 (ANGPTL4) mRNA expressions were evaluated using quantitative real time PCR and its protein expression by immunohistochemistry. DNA binding activity of NF-${\kappa}B$/P65 was evaluated by transcription factor binding immunoassay. Serum levels of ANGPTL4, HIF-$1{\alpha}$ and IL-$1{\beta}$ were immunoassayed. Tumor clinico-pathological features were investigated. Results: ANGPTL4 mRNA expressions and serum levels were significantly higher in high grade breast carcinoma ($1.47{\pm}0.31$ and $184.98{\pm}18.18$, respectively) compared to low grade carcinoma ($1.21{\pm}0.32$ and $171.76{\pm}7.58$, respectively) and controls ($0.70{\pm}0.02$ and $65.34{\pm}6.41$, respectively), (p<0.05). Also, ANGPTL4 high/moderate protein expression was positively correlated with tumor clinico-pathological features. In addition, serum levels of HIF-$1{\alpha}$ and IL-$1{\beta}$ as well as NF-${\kappa}B$/P65 DNA binding activity were significantly higher in high grade breast carcinoma ($148.54{\pm}14.20$, $0.79{\pm}0.03$ and $247.13{\pm}44.35$ respectively) than their values in low grade carcinoma ( $139.14{\pm}5.83$, $0.34{\pm}0.02$ and $184.23{\pm}37.75$, respectively) and controls ($33.95{\pm}3.11$, $0.11{\pm}0.02$ and $7.83{\pm}0.92$, respectively), (p<0.001). Conclusion: ANGPTL4 high serum levels and tissue expressions in advanced grade breast cancer, in addition to its positive correlation with tumor clinico-pathological features and HIF-$1{\alpha}$ could highlight its role as one of the signaling factors involved in breast cancer progression. Moreover, novel correlations were found between ANGPTL4 and the inflammatory markers, IL-$1{\beta}$ and NF-${\kappa}B$/p65, in breast cancer, which may emphasize the utility of these markers as potential tools for understanding interactions for axes of carcinogenesis and inflammation contributed for cancer progression. It is thus hoped that the findings reported here would assist in the development of new breast cancer management strategies that would promote patients' quality of life and ultimately improve clinical outcomes. However, large-scale studies are needed to verify these results.

• Journal of Periodontal and Implant Science
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• 제34권4호
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• pp.819-836
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• 2004

Nowdays, the awareness of implant treatment has grown rapidly among dentists and patients alike in Korea, as it becomes a widely accepted treatment. The reason is that unlike crown and bridge or denture treatment, implant treatment helps preserve existing bone and improve masticatory functions. So, It is needed understanding about the type, distribution of implant patient. The following results on patient type and implant distribution were compiled from 4433 implant cases of 1596 patients treated at the periodontal dept. of Y University Hospital during 1992 to 2004. 1. There are no dissimilarities between men and women, with patients in their 40, 50s accounting for 52.5% of patients and 57.5% of implant treatments; the largest share of patients and implant treatments. 2. Mn. posterior area accounted for 54.9% of implant treatments followed by Mx. posterior area(27.6%), Mx anterior area(11.9%) and Mn anterior area(5.6%). 3. Partial edentulous patients treated by single crown and bridge-type prosthesis accounted for 97.5% and fully edentulous patient accounted for the remaining 2.5%. 4. The major cause of tooth loss is periodontal disease, followed by dental caries, trauma and congenital missing. Also, older people are more likely to suffer from tooth loss due to periodontal disease rather than dental caries. 5. In the distribution of bone quality for maxillae, type III was most, followed by type II, r type IV and r type I. As for mandible, type II was most, followed by type III, type IV and for type I. 6. In the distribution of bone quantity for maxillae, type C was most, followed by type B, type D, type A, and for type E. As for mandible, type B was 52% most, followed by type C, type D, type A and type E. 7. The majority of implants were those of 1O-14mm in length (85.2%) and regular diameter in width (64%). The results provided us with basic data on patient type, implant distribution, bone condition, etc. We wish that our results coupled with other research data helps assist in the further study for better implant success/survival rates, etc.

• 의료커뮤니케이션
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• 제13권2호
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• pp.205-216
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• 2018

Background: The purpose of the study was to analyze the contents and importance of clinical practicum education in adult health nursing. Methods: This is a descriptive study using content analysis for identifying the items of clinical nursing checklists gathered from 13 university nursing programs accredited by Korean Accreditation Board of Nursing Education. Items in the checklist were standardized in accordance with the Nursing Intervention Classification (NIC) and categorized into simple-technical skill, complex-technical skill, and disease-specific care. The perceived significance of each item was examined by surveying nurses who in charge of nurse education from various clinical setting. Results: A total of 182 items in the clinical practicum contents were analyzed, and the terminologies of each item were variously described among nursing schools. Fifty percent of the total items were categorized into simple-technical skill. In terms of clinical importance, expert validity results showed that nurses considered infection control, infection protection, and fall prevention as the most significant items, which was not the same as the most common items in the clinical nursing checklist. Conclusion: These findings suggest that standardized nursing terminologies are needed to describe a nursing practicum checklist. Clinical importance of each item in the checklist should be taken into consideration in developing a clinical nursing checklist to assist the students in achieving the competencies as a clinical nurse.

• 한국어병학회지
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• 제34권1호
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• pp.81-98
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• 2021

As Korea declared that the entire country is free from ISA (Infectious salmon anaemia) based on the OIE aquatic code in 2019, it is necessary to improve the import quarantine system that meets the level of ISA management in Korea. Currently, Korea imports Atlantic salmon and rainbow trout from countries which have history of ISA outbreak such as Norway and the United States, so there is a constant possibility that trade with these countries will bring ISAV (Infectious salmon anaemia virus) into Korea. Therefore, some amendments to the Aquatic Life Diseases Control Act (ALDCA) are needed to prevent the entry of ISAV into the Korea through international trade. The amendment to the ALDCA should contain a list of countries, zones or compartments that the Korean competent authority has allowed or banned imports of ISA-susceptible fish. In addition, the subordinate statutes or administrative rules of the ALDCA need to be revised so that on-site inspections/audit can be conducted for the evaluation of the ISA management system in exporting countries. After the revision of the subordinate statutes or administrative rules, it is necessary to strengthen the present import conditions in line with those that meet the level of ISA management in Korea. As for the strengthened import conditions, the competent authorities of exporting countries must export only salmonid fish produced in zones or compartments declared freedom of ISA to Korea, and must prove through lab-testing that ISAV should not be detected in the fish exporting to Korea. In addition, official veterinarians/fish health professionals of the exporting country should check the health status of the fish within 72 hours prior to export. Also, competent authorities of the exporting countries must attest that fish storage containers and water, ice and other equipment used for transportation should be cleaned and disinfected to avoid contamination with pathogens, including ISA. Therefore, the proposed measures presented here will further improve the current import condition for salmonid fish and assist decision-making on strategies to reduce the risk of ISA introduction into Korea. Also, it is expected to contribute to maintain the status of ISA-free country.

• 한국방사선학회논문지
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• 제7권1호
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• pp.9-15
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• 2013

본 연구는 전산화단층촬영에서 간 질환의 자동 인식으로 질감특징분석(texture feature analysis. TFA) 알고리즘을 제안하고자 하였으며, 간세포암(Hepatocellular carcinoma. HCC)에 대한 컴퓨터보조진단(computer-aided diagnosis. CAD) 시스템을 설계하고, 제안하는 각 알고리즘의 성능을 평가하고자 하였다. HCC 영상에서 분석영역($40{\times}40$ 픽셀)을 설정하고 각 부분영상에 통계적 특징을 이용한 6가지 TFA 파라메터(평균 밝기, 평균 대조도, 평탄도, 왜곡도, 균일도, 엔트로피)비교하여 간세포암 인식률(recognition rate)을 구하였다. 결과적으로 TFA는 간세포암 인식률을 나타내는 척도로 유의함을 알 수 있었으며 6가지 파라메터에서 균일도가 가장 인식률이 높았으며 평균 대조도, 평탄도, 왜곡도가 비교적 높았고 평균 밝기와 엔트로피는 상대적으로 낮은 인식률을 나타내었다. 이와 관련하여 높은 인식률을 보인 알고리즘(최대 97.14%, 최소 82.86%)을 간세포암 영상의 병변을 판별하여 임상의 조기 진단을 보조하여 치료를 시행한다면 진단의 효율성이 높아 질 것으로 판단되었으며, 향후 효율적이고 정량적인 분석을 추가함으로써 질병인식의 일반화에 대한 기준 연구가 필요 할 것으로 사료되었다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권6호
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• pp.481-489
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• 2010

Introduction: TLR-5, a member of the toll-like receptor (TLR) family, is a element of the type I transmembrane receptors, which are characterized by an intracellular signaling domain homolog to the interleukin-1 receptor. These receptors recognize microbial components, particularly bacterial flagellin. All-trans retinoic acid (atRA, tretinoin), a natural metabolite of vitamin A, acts as a growth and differentiation factor in many tissues, and is also needed for immune functions. In this study, THP-1 human macrophage-monocytes were used to examine the mechanisms by which atRA regulated the expression of TLR-5. Because the molecular mechanism underlying this regulation at the transcriptional level is also unclear, this study examined which putative transcription factors are responsible for TLR-5 expression by atRA in immune cells. Materials and Methods: This study examined whether atRA induces the expression of TLR-5 in THP-1 cells using reverse transcription-polymerase chain reaction (RT-PCR), and which transcription factors are involved in regulating the TLR-5 promoter in RAW264.7 cells using a reporter assay system. Western blot analysis was used to determine which signal pathway is involved in the expression of TLR-5 in atRA-treated THP-1 cells. Results: atRA at a concentration of 10 nM greatly induced the expression of TLR-5 in THP-1 cells. Human TLR-5 promoter contains three Sp-1/GC binding sites around -50 bp and two NF-kB binding sites at -380 bp and -160 bp from the transcriptional start site of the TLR-5 gene. Sp-1/GC is primarily responsible for the constitutive TLR-5 expression, and may also contribute to NF-kB at -160 bp to induce TLR-5 after atRA stimulation in THP-1 cells. The role of NF-kB in TLR-5 expression was further confirmed by inhibitor pyrrolidine dithiocarbamate (PDTC) experiments, which greatly reduced the TLR-5 transcription by 70-80%. Conclusion: atRA induces the expression of the human TLR-5 gene and NF-kB is a critical transcription factor for the atRA-induced expression of TLR-5. Accordingly, it is conceivable that retinoids are required for adequate innate and adaptive immune responses to agents of infectious diseases. atRA and various synthetic retinoids have been used therapeutically in human diseases, such as leukemia and other cancers due to the antiproliferative and apoptosis inducing effects of retinoids. Therefore, understanding the molecular regulatory mechanism of TLR-5 may assist in the design of alternative strategies for the treatment of infectious diseases, leukemia and cancers.

• Journal of Korean Neurosurgical Society
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• 제29권7호
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• pp.935-939
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• 2000

Objective : Traumatic disc lesion is a lesion with tremendous controversies. The causal relationships of this lesion are not established along with pathogenesis, diagnostic criteria, methods of treatment and the outcome. However, a significant number of patients with back pain after a trauma underwent spinal operations under the diagnosis of traumatic disc lesions. Such an ill-directed operation eventually produce a person with an iatrogenic disability. We present two illustrative cases, and tried to make a preventive method. Methods : We examined the path from mild trauma after a road traffic accident into the iatrogenic disability in two illustrative cases, who requested disability assessment and medical appraisement. We evaluated the reason and background for such an unwanted outcome and tried to find a method to reduce or prevent it by a literature review. Results : These two patients were admitted to the hospital with the diagnosis of lumbar sprain after a road traffic accidents. They eventually underwent spinal surgery under another diagnosis such as traumatic disc herniation or internal disc disruption. They stayed at the hospital for more than six months and finally lost their jobs. They became the disabled at last. Although they complained back pain, they never insisted by themselves that their symptoms were due to the traumatic disc lesion. To prevent such an iatrogenic disability, the doctors should assist them to go-back to the workplace promptly instead of a reckless extension of the treatment period. It may be necessary to evaluate the certificates to extend the treatment period with an additional diagnosis by a medical expert. To reduce the unnecessary long-term admission, a new billing system such as a partial share for the high cost of the treatment by the patients may be needed. Conclusion : It is not the patient but the doctors, who has the responsibility to avoid the unnecessary operations. All treating doctors should try to reduce or prevent such an iatrogenic complication caused by ourselves before we are forced to do so.