• Journal of Oral Medicine and Pain
• /
• v.38 no.1
• /
• pp.19-28
• /
• 2013

With Korea's rapid entry to aged society, elderly population has become a major age group both in the whole society and medical field and its importance will be constantly stressed out. Elderly population is also important in the field of oral medicine which deals with chronic and recurrent diseases in the orofacial region of non-dental origin but there exist few studies indicating epidemiology of elderly patients in this regards. This study aimed to investigate change of age distribution of new patients in a university-based dental hospital and oral medicine clinic for last decade and to investigate clinical epidemiology of elderly patients (${\geq}$ 65 years) of oral medicine clinic. This study was performed retrospectively using medical records of the new patients in Dankook University Dental Hospital in 2001 and 2011. According to the study, percentage of elderly new patients increased in both dental hospital and oral medicine clinic and degree of the increase was greater in oral medicine clinic than in the whole hospital (p=0.000). 13.5% of adult patients ${\geq}$ 18 years of oral medicine clinic were elderly patients ${\geq}$ 65 years. 83% of elderly patients were suffering from one or more systemic diseases. Although TMD was the most common reason for elderly patients who visited oral medicine clinic, oral soft tissue diseases, dry mouth, burning mouth syndrome and oromandibular dystonia was more frequently diagnosed in elderly patients compared to adult patients aged 18 to 64 years. Pain severity and interference of Brief Pain Inventory and depression and anxiety scores of Hospital Anxiety Depression Scales were higher in elderly patients than in the adult patients (p<0.05). Increase of elderly patients with chronic oral diseases and pain needs more attention of dentists and specialists of oral medicine to improvement of assessment and development of tailored management because large portion of the elderly patients have systemic diseases, polypharmacy and impaired communication, possibly restricting treatment options.

• Journal of Radiation Protection and Research
• /
• v.38 no.4
• /
• pp.214-227
• /
• 2013

Computed tomographic scan as a screening procedures in asymptomatic individuals has seen a steady increase with the introduction of multiple-raw detector CT scanners. This report provides a brief review of the current controversy surrounding CT cancer screening, with a focus on the radiation induced cancer risks and clinical efficacy. 1. A large study of patients at high risk of lung cancer(the National Lung Screening Trial[NLST]) showed that CT screening reduced cancer deaths by 20%(1.33% in those screened compared with 1.67% in those not screened). The rate of positive screening tests was 24.2% and 96.4% of the positive screening results in the low-dose CT group were false-positive. Radiation induced lung cancer risk was estimated the most important in screening population because ERR of radiation induced lung cancer does not show the decrease with increasing age and synergistic connection between smoking and radiation risk. Therefore, the radiation risk may be on the same order of magnitude as the benefit observed in the NLST. Optimal screening strategy remain uncertain, CT lung cancer screening is not yet ready for implementation. 2. Computed tomographic colonography is as good as colonoscopy for detecting colon cancer and is almost as good as colonoscopy for detecting advanced adenomas, but significantly less sensitive and specific for smaller lesions and disadvantageous for subsequent therapeutic optical colonoscopy if polyps are detected. The average effective dose from CT colonography was estimated 8-10 $mS{\nu}$, which could be a significant dose if administered routinely within the population over many years. CT colonography should a) achieve at least 90% sensitivity and specificity in the size category from 6 and 10 mm, b) offer non-cathartic bowl preparation and c) be optimized and standardized CT parameters if it is to be used for mass screening. 3. There is little evidence that demonstrates, for whole-body scanning, the benefit outweighs the detriment. This test found large portion of patient(86~90.8%) had at least one abnormal finding, whereas only 2% were estimated to have clinically significant disease. Annual scans from ages 45 to 75 years would accrue an estimated lifetime cancer mortality risk of 1.9%. There is no group within the medical community that recommends whole-body CT. No good studies indicate the accuracy of screening CT, at this time. The benefit/risk balance for any of the commonly suggested CT screening techniques has yet to be established. These areas need further research. Therefore wild screening should be avoided.

• Sleep Medicine and Psychophysiology
• /
• v.3 no.1
• /
• pp.68-78
• /
• 1996

Objective : The Mini-Mental State Examination(MMSE) and Brief Cognitive Rating Scale(BCRS) are frequently using screening tests fur evaluating the cognitive function in clinical practice and research. The authors tried to evaluate the clinical usefulness of these tests for the patients with non-traumatic subcortical cerebrovascular disease. Method : We administered the MMSE and BCRS to 85 patients and 195 normal control group. In order to compare the test results according to the lesion site, we divided patients into left sided lesion group(21 patients), right sided lesion group(31 patients) and both sided lesion group(13 patients). Their cognitive function was evaluated by the BNA and daily living functional activity was examined by the IADLs(Instrumental Activities of Daily Living Scale)and GERRI(Geriatric Evaluation by Relative's Rating Instrument). Results : The results are as follows : 1) In the BNA, the patients scored significantly lower than control group at all items(except Right-Left Orientation and Motor Impersistence), but there were no difference in the MMSE(total score and all 5 items), and only 2 items(recent memory and self-care) were significantly different between two groups in the BCRS. 2) In the comparison by lateralization, there were significant differences among three groups at 3 items(Left Tactile Form Perception, Left Finger Localization and Right Finger Localization) in the BNA. But, there were no difference in the MMSE and BCRS. 3) In the correlation between daily living functioning and the MMSE/BCRS, control group showed no relation(except item of cognitive functioning), but patient group was significantly correlated with 3 items(social functioning, instrumental activities of daily living and cognitive functioning). Conclusions : These findings suggest that MMSE and BCRS are not useful as the test for cognitive function and discrimination of lateralization in patients with non-traumatic subcortical cerebrovascular disease. However, scores of these tests may be related with the functional level(such as daily living function) of patients.

• The Korean Journal of Rehabilitation Nursing
• /
• v.3 no.1
• /
• pp.43-58
• /
• 2000

Pain management is a major issue in caring of cancer patients. Patients' concerns for reporting pain and taking analgesics are patient-related barriers to the management of cancer pain. Since such study has not been done at all in Korea, it is clearly needed to study on these problems. The purpose of this study is to attain basic data in order to improve cancer pain management in Korea. This is done by: 1) examining the extent of patients' concerns that might be barriers to the optimal pain management, and the extent of related factors (pain management hesitancy, adequacy of using analgesics, pain severity and pain interference); 2) identifying the relationship between patients' concerns and the related factors. The data has been collected from 180 cancer patients who were hospitalized in medical wards of one university hospital in Seoul, Korea during the period from November 1, 1997 to February 28, 1998. The data has been collected through interviews with (1) Barriers Questionnaire - Korean Version (BQ-K); (2) Hesitancy Experience Questionnaires (HQ); (3) Pain Management Index (PMI); (4) Brief Pain Inventory (BPI); and (5) Demographic Data. The data were analyzed by descriptive statistics and by t-test, One-way ANOVA, Pearson correlation using SPSSWIN program. The Results are as following: 1) The mean scores of Pain Management Concerns (PMC) by BQ-K were toward the moderate with a little high points(2.59). Most of the patients (99.4%) had some extent of concerns (over lout of maximum 5 points). Among the eight subscales of BQ-K, the Pain Management Concerns (PMC) about 'Fear of tolerance' was the highest (3.80) and 'Worry about side effects' was the least (1.40). 2) The extent of Pain Management Hesitancy (PMH) by HQ of wnom had pain on the day of the interview was a little higher than moderate score(5.53 out of maximum 10 points). 6.7% of the patients with experiencing pain used less adequate analgesics for the severity of pain than they were expected. 27.8% of them never used any analgesics at all. The mean score of pain severity by BPI was 16.59 (maximum: 40), and that of the interference with daily life by BPI was 32.03 (maximum: 70). 3) The patients who were older, less educated, and in low socio-economic status were likely to have more concerns. Pain Management Concerns (PMC) was positively correlated with Pain Management Hesitancy (PMH) (r=.75), pain severity (r=.44) and pain interference (r=.50). Those who were not using adequate analgesics had higher Pain Management Concerns (PMC) than did those who were using adequate analgesics (t=-5.42). The patients who had more Pain Management Concerns (PMC) tended to hesitate more to report pain and to use analgesics. They used more inadequate analgesics for the severity of pain and also had experienced more pain severity and interference with daily life. In conclusion, the patients' concerns for reporting pain and for using analgesics are major patient-related barriers to cancer pain management in Korea. The patients' concerns were correlated significantly with the level of the hesitancy experience, inadequate use of analgesics, the pain severity and the interference with daily life. Considering this, an educational program for cancer patients under the treatment with analgesics should be developed in order to solve these problems.

• Radiation Oncology Journal
• /
• v.22 no.2
• /
• pp.77-90
• /
• 2004

Purpose: The purpose of this review Is to provide an update on novel radiation treatments for head and neck cancer Recent Findings: Despite the remarkable advances In chemotherapy and radiotherapy techniques, the management of advanced head and neck cancer remains challenging. Epidermal growth factor receptor (EGFR) Is an appealing target for novel therapies In head and neck cancer because not only EGFR activation stimulates many important signaling pathways associated with cancer development and progression, and importantly, resistance to radiation. Furthermore, EGFR overexpression Is known to be portended for a worse outcome in patients with advanced head and neck cancer. Two categories of compounds designed to abrogate EGFR signaling, such as monoclonal antibodies (Cetuxlmab) and tyrosine kinase inhibitors (ZD1839 and 051-774) have been assessed and have been most extensively studied In preclinical models and clinical trials. Additional TKIs In clinical trials include a reversible agent, Cl-1033, which blocks activation of all erbB receptors. Encouraging preclinical data for head and neck cancers resulted In rapid translation Into the clinic. Results from Initial clinical trials show rather surprisingly that only minority of patients benefited from EGFR inhibition as monotherapy or In combination with chemotherapy. In this review, we begin with a brief summary of erbB- mediated signal transduction. Subsequently, we present data on prognostic-predictive value of erbB receptor expression in HNC followed by preclinlcal and clinical data on the role of EGFR antagonists alone or in combination with radiation In the treatment of HNC. Finally, we discuss the emerging thoughts on resistance to EGFR biockade and efforts In the development of multiple-targeted therapy for combination with chemotherapy or radiation. Current challenges for investigators are to determine (1 ) who will benefit from targeted agents and which agents are most appropriate to combine with radiation and/or chemotherapy, (2) how to sequence these agents with radiation and/or cytotoxlc compounds, (3) reliable markers for patient selection and verification of effective blockade of signaling in vivo, and (4) mechanisms behind intrinsic or acquired resistance to targeted agents to facilitate rational development of multi-targeted therapy, Other molecuiar-targeted approaches In head and neck cancer were briefly described, Including angloenesis Inhibitors, farnesyl transferase inhibitors, cell cycle regulators, and gene therapy Summary: Novel targeted theraples are highly appealing in advanced head and neck cancer, and the most premising strategy to use them Is a matter of intense Investigation.

• Journal of Korea Port Economic Association
• /
• v.32 no.4
• /
• pp.73-87
• /
• 2016

The purpose of this study is to investigate the empirical results of Analytic Hierarchy Process/Data Envelopment Analysis-Assurance Region(AHP/DEA-AR) by using multiple regression analysis during the period of 2009-2012 with 5 inputs (number of gantry cranes, number of berth, berth length, terminal yard, and mean depth) and 2 outputs (container TEU, and number of direct calling shipping companies). Assurance Region(AR) is the most important tool to measure the efficiency of seaports, because individual seaports are characterized in terms of inputs and outputs. Traditional AHP and multiple regression analysis techniques have been used for measuring the AR. However, few previous studies exist in the field of seaport efficiency measurement. The main empirical results of this study are as follows. First, the efficiency ranking comparison between the two models (AHP/DEA-AR and multiple regression) using the Wilcoxon signed-rank test and Mann-Whitney signed-rank sum test were matched with the average level of 84.5 % and 96.3% respectively. When data for four years are used, the ratios of the significant probability are decreased to 61.4% and 92.5%. The policy implication of this study is that the policy planners of Korean port should introduce AHP/DEA-AR and multiple regression analysis when they measure the seaport efficiency and consider the port investment for enhancing the efficiency of inputs and outputs. The next study will deal with the subjects introducing the Fuzzy method, non-radial DEA, and the mixed analysis between AHP/DEA-AR and multiple regression analysis.

• Journal of the Korean Institute of Traditional Landscape Architecture
• /
• v.37 no.3
• /
• pp.93-107
• /
• 2019

The purpose of this paper is to explore the application of Chinese traditional garden space construction principle studied by predecessors in modern park landscape, and to find more methods of traditional garden space construction inheritance and innovation through research. Tian Chaoyang's book "Fifteen Lectures on Chinese Classical Gardens and Modern Translation" mentions that Chinese traditional gardens are combining time and space, so he draws a brief pattern diagram containing the principle of the space construction. According to this principle of space construction, the researchers chose Qujiang Pool Heritage Park, which combines modern and traditional, then analyzed its spatial structure and and space elements. The results are as follows. The complex spatial structure of the park is composed of spatial boundary lines and spatial routes. The complex boundary space is composed of bridges, squares, plants, rows of buildings and other elements. The water space in the center of the park is designed in accordance with the traces of the historical water system, and its natural zigzag shoreline expands the water space. The central water space is divided into the big pool and the small pool, the Yanbo island and Bird island are created respectively. The building at the park boundary connects the park's interior and exterior. Most of the buildings in the park are located in the convex corner of the route or space. Through this research, it can be concluded that Qujiang park also applies the space construction principle combining time and space. And then, the garden elements of Qujiang park are recreating the history and culture of Qin, Han, Sui and Tang dynasties with modern methods, thus creating a park with Chinese regional characteristics. Since the Tang dynasty was the most prosperous period in Qujiang, the park was dominated by Tang culture. Through the research of this paper, we can see that the space construction principle of Qujiang Pool Heritage Park is the inheritance of the space construction principle of Chinese traditional garden. And the landscape element of Qujiang park is the landscape created by combining traditional history and culture, which is the innovative part of modern garden. Through this study, the creation of modern landscape with Chinese characteristics can provide some hints on the direction of inheritance and innovation.

• Proceedings of the Korean Biophysical Society Conference
• /
• 2003.06a
• /
• pp.37-37
• /
• 2003

We have shown the $Ca^{2+}$-activated chloride current is present in cardiac myocyte in rabbit pulmonary vein (Kim et al., 2002). This current amplitude was increased as [N $a^{+}$]$_{i}$ was increased and we suggested this chloride current may be involve in the spontaneous action potential frequency change. Since this current is activated by the increase of intracellular $Ca^{2+}$, we would like to test what is the inducer of the increase of [C $a^{2+}$]$_{i}$ between a L-type $Ca^{2+}$-current or a reverse mode of N $a^{+}$-C $a^{2+}$ exchange current. White rabbit (1.5 kg) was used and anesthetized with Ketamin (100 mg/kg). Pulmonary vein (PV) was isolated and sleeve area between left atrium and PV was dissected. Using collagenase (Worthington 0.7 mg/cc), single cardiac myocytes were isolated. In the presence of 15 mM of N $a^{＋}$, three steps of voltage pulses were applied (holding potential : -40 ㎷, -80 ㎷ for 50 msec, 30 ㎷ for 5 msec, 10 ㎷ steps from -70 ㎷ to 60 ㎷). The inward and outward tail current was activated after brief 5 msec prepulse. The outward tail current was blocked by the removal of extracellular chloride substituted by glucuronic acid or by a chloride channel blocker, 5 mM 9-AC. But the inward tail current was still remained even though the amplitude was decreased. The reversal potentials were changed to the direction of the change of chloride equilibrium potential ( $E_{Cl}$ ) but the shift of equilibrium potential was not enough to match to the theoretical equilibrium potential shift. In the presence of L-type $Ca^{2+}$ channel blocker, nifedipine 1 uM, inward tail currents were greatly reduced but the outward current tail currents were still remained. In the presence of N $a^{+}$-C $a^{2+}$ exchange current blocker, 10 uM KB-R7943, the inward and outward tail currents were blocked almost completely. We tried to test the $Ca^{2+}$sensitivity of the chloride current with various [C $a^{2+}$]$_{i}$ in pipette solution from 100 nM to 1 uM but we failed to activate $Ca^{2＋}$-activated chloride currents even though the cell became contracted in the presence of 1 uM $Ca^{2+}$. From these results, we could conclude that the increase of [C $a^{2+}$]$_{i}$ to activate the outward $Ca^{2+}$-activated chloride current was mainly induced by the activation of the reverse mode of N $a^{+}$-C $a^{2+}$ exchanger, But for the increase of [C $a^{2+}$]$_{i}$ to activate the inward tail current, L-type $Ca^{2+}$ current may be the major provoking current. Since the cytosolic increase of [C $a^{2+}$]$_{i}$ through pipette solution have failed to activate $Ca^{2+}$-activated chloride current, this chloride current may have very low $Ca^{2+}$ sensitivity or a comparmental increase $Ca^{2+}$ such as in subsarcolemmal space may activate the chloride current. Since there are several reports and models that the increase of $Ca^{2+}$ in subsarcolemmal space would be over several to tens of uM, both possibility may be valid together.uM, both possibility may be valid together.

• Journal of Arbitration Studies
• /
• v.14 no.1
• /
• pp.273-314
• /
• 2004

There is a belief in the construction industry that the traditional court system may not be an ideal forum to effectively and efficiently resolve construction disputes due to the protracted proceedings and the three tier appeal system resulting in a long delay in the final and conclusive settlement of the dispute, relatively high costs involved, the lack of requisite knowledge and experience in the relevant industry, etc. Hence, they assert that certain alternative dispute resolution ('ADR') methods, such as mediation, conciliation, arbitration or a new system for dispute settlement in the form of any combination thereof should be developed and employed for construction disputes so as to resolve them more promptly and efficiently to the satisfaction of all the disputants concerned. This paper discusses certain merits of such assertions and the need for additional considerations for effective resolution of the construction disputes in light of the complexity of the case, importance of expert witnesses, parties' relationship and non-level playing field of the construction industry and so on. At the same time, however, given the inherent nature of disputes rendering the parties involved in an adversarial position, it would rather be difficult, if not practically impossible, to satisfy all the parties concerned in the dispute. Accordingly, in this study, it is also purported to address the demerits of such assertions by studying the situation from a more balanced perspective, in particular, in relation to the operation of such ADRs. In fact, most of such ADRs as stipulated by special acts, such as the Construction Industry Basic Act of Korea, in the form of mediation or conciliation, have failed to get support from the industry, and as a result, such ADRs are seldom used in practice. Tn contrast, the court system has been greatly improved by implementing a new concentrated review system and establishing several tribunals designed to specialize in the review and resolution of specific types of disputes, including the construction disputes. These improvements of the court system have been warmly received by the industry. Arbitration is another forum for settlement of construction disputes, which has grown and is expected to grow as the most effective ADR with the support from the construction industry. In this regard, the Korean Commercial Arbitration Board ('KCAB') has established a set of internal rules end procedures in operation to efficiently handle construction disputes. Considering the foregoing, this paper addresses the most important elements of the arbitration, i.e., arbitration agreement and arbitral award, primarily focusing on the domestic arbitrations before the KCAB. However, since this parer is prepared for presentation at the construction disputes seminar for the public audience, it is not intended for academic purposes, nor does it delve into any specific acadcmic issues. Likewise, although this paper addresses certain controversial issues by way of introduction, it mainly purports to facilitate the understanding of the general public, including the prospective arbitrators on the KCAB roster without the relevant legal education and background, concerning the importance of the integrity of the arbitration agreement and the arbitral award. In sum, what is purported in this study is simply to note that there are still many outstanding issues with mediation, conciliation and arbitration, as a matter of system, institutional operation or otherwise, for further study and consideration so as to enhance them as effective means for settlement of construction disputes, in replacement of or in conjunction with the court proceeding. For this purpose, it is essential for all the relevant parties, including lawyers, engineers, owners, contractors and social activists aiming to protect consumers' and subcontractors' interests, to conduct joint efforts to study the complicated nature of construction works and to develop effective means for examination and handling of the disputes of a technical nature, including the accumulation of the relevant industrial data. Based on the foregoing, the parties may be in a better position to select the appropriate dispute resolution mechanism, a court proceeding or in its stead, an effective ADR, considering the relevant factors of the subject construction works or the contract structure, such as the bargaining position of the parties, their financial status, confidentiality requirements, technical or commercial complexity of the case at hand, urgency for settlements, etc.

• Journal of Acupuncture Research
• /
• v.22 no.3
• /
• pp.93-104
• /
• 2005

Objective : Because the cause and etiology of chronic headache are not yet fully explained, the treatment of this symptom is not simple. In order to study the effectiveness of East-West pain treatment on chronic headache, we evaluated its effect of pain alleviation and quality of life improvement on chronic headache patients who were treated with nerve block and acupuncture, and only acupuncture for eight weeks. Methods : 92 clinical experiment participants were gathered and through a questionnaire patients who experienced headache for more than 4 hours a day and more than 15 days per month were qualified as chronic headache patients. The qualified patients were classified into two groups, nerve block and acupuncture group(EW group, n=49) and acupuncture group(E group, n=43). Treatment was applied 2 times a weeks for 8 weeks. The acupoints, GV20, HN23, ST8, HN46, TE17, GB20, LI20O, LI11, LI14, ST36, and LR3 were stimulated for 20 minutes. The effects of two groups were analyzed using VAS scores and BPI(Brief Pain Inventory).