• Tuberculosis and Respiratory Diseases
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• v.56 no.1
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• pp.40-50
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• 2004

Background : Radiation pneumonitis(RP) is the major serious complication of thoracic irradiation treatment. In this study, we attempted to retrospectively evaluate the long-term prognosis of patients who experienced acute RP and to identify factor that might allow prediction of RP. Methods : Of the 114 lung cancer patients who underwent thoracic radiotherapy between December 2000 and December 2002, We performed analysis using a database of 90 patients who were capable of being evaluated. Results : Of the 44 patients(48.9%) who experienced clinical RP in this study, the RP was mild in 33(36.6%) and severe in 11(12.3%). All of severe RP were treated with corticosteroids. The median starting corticosteroids dose was 34 mg(30~40) and median treatment duration was 68 days(8~97). The median survival time of the 11 patients who experienced severe RP was significantly poorer than the mild RP group. (p=0.046) The higher total radiation dose(${\geq}60Gy$) was significantly associated with developing in RP.(p=0.001) The incidence of RP did not correlate with any of the ECOG performance, pulmonary function test, age, cell type, history of smoking, radiotherapy combined with chemotherapy, once-daily radiotherapy dose fraction. Also, serum albumin level, uric acid level at onset of RP did not influence the risk of severe RP in our study. Conclusion : Only the higher total radiation dose(${\geq}60Gy$) was a significant risk factor predictive of RP. Also severe RP was an adverse prognostic factor.

• The Journal of Korean Institute of Communications and Information Sciences
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• v.38C no.9
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• pp.822-829
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• 2013

Hypertension is one of the most common clinical diseases, with an increasing prevalence globally. Hypertension triggers various harmful consequences and affects multiple organs. Life-long care may be required in some cases. According to the Korea Center for Disease Control and Prevention, the prevalence of hypertension is gradually increasing. A 2011 survey revealed that 28.9% of Korean adults had hypertension. The prevalence rates were slightly higher among men than women. Accurate measurement of blood pressure(BP) is crucial to classify patients, to identify BP-related risks, and to inform correct treatment. For accurate blood pressure measurement, the use of a cuff bladder size appropriate for the mid-upper arm circumference(MUAC) is essential. Incorrect sized cuff bladder is one of the main causes of equipment error affecting sphygmomanometer accuracy. When commercial sphygmomanometers were examined, the cuff bladders differed from the dimensions specified in the ISO 81060-1:2007 standards. Undercuffing is responsible for a spurious overestimation of BP in patients with large arms leading to overdiagnosis of hypertension, whereas overcuffing (that is, use of relatively large cuffs with small arms), may be responsible for an opposite problem, leading to erroneous underestimation of BP levels. The cuff bladder sizes recommended by the American Heart Association(AHA) are an arm circumference(AC) of 17-25 cm for small-sized adults, AC of 24-32 cm for adults, AC of 32-42 cm for normal-sized adults, and AC of 42-50 cm for obese adults. In contrast, the AC of Korean adults ranges from 23-31 cm, belonging to a single type of adult bladder. Three types of bladders are necessary for Korean adults with an AC of 23-31cm. Hospitals often use one or two differently-sized Western cuffs for adult patients, which can yield inaccurate BP determinations. Cuff bladders with dimensions based on anthropometric reference data obtained from Koreans will aid hospitals to measure BP more accurately.

• Journal of Gastric Cancer
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• v.6 no.4
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• pp.257-262
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• 2006

Purpose: We analyzed the clinicopathologic features, including treatment and outcome, and the survival rates between young and elderly patients with gastric cancer. Materials and Methods: Clinical information was reviewed for 1086 patients who had undergone a gastrectomy for gastric cancer during a 10-year period from 1990 to 1999, and the patients were assigned to one of two groups: the A group (<40 years of age, 91 patients) and the B group (${\geq}70\;years\;of\;age,\;85\;patients)$). Results: Compared to the B group, the A group had more females (47.3% vs 32.9%), a greater frequency of family history of cancer (15.4% vs 3.5%), and greater proportions of histologically poorly differentiated tumors (84.5% vs 40.2%) and Lauren diffuse-type tumors (69.1% vs 35.1%)(P<0.05). There was no difference in TNM stage. Cardiopulmonary co-morbidities were more in the B group, respectively, 1.1% (A group) and 11.8% (B group)(P<0.01), but the morbidity and the mortality were similar. Although there was no difference in curability, the B group underwent less aggressive operations in lymph-node dissection above D3 and had a shorter operation time, a smaller number of retrieved lymph nodes, and less adjuvant chemotherapy (P<0.001). However, there were no differences in the disease-specific 5-year survival rates, 67.6% and 67.0% respectively. Conclusion: Young and elderly patients with gastric cancer had different clinicopathological features. Especially, elderly patients underwent relatively less aggressive treatment. In spite of these facts, the outcome of treatment and the disease-specific survival rates were not different.

• Journal of Chest Surgery
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• v.42 no.6
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• pp.696-703
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• 2009

Background: A Comprehensive Aortic Root and Valve Reconstruction (CARVAR) procedure is comprised of aortic root wall reconstruction and corrections of the leaflets for treating various aortic valve diseases. We evaluated our recent early clinical experience with the CARVAR procedure. Material and Method: From October 2007 to September 2008, 114 cases (66 males) of CARVAR procedures were performed, The mean patient age was 53 years (range: 14~84) The patients were divided into 4 groups: 1) the AAR group: aortic regurgitation with aortic root wall deformity such as annulo-aortic ectasia or ascending aortic aneurysm (n=18), 2) the IAR group: isolated AR with leaflet abnormality (n=42), 3) the IAS group: isolated aortic stenosis (n=51) and 4) the PAVR group: previous aortic valve replacement (n=3). Sinotubular junction (STJ) reduction was done in all the patients, leaflet correction was done in 10 of the AAR group patients and in all the patients of the other groups, annulus reduction was done in 14 of the MR group patients and in 6 of the IAR group patients. Aortic dissection was excluded from this analysis. Result: There was no mortality or follow-up death. The diameter of the aortic sinus decreased from $54.6{\pm}8.4$ mm to $38.3{\pm}3.8$ mm in the AAR group, the mean AR grade decreased from 3.2 to 0.2 in the IAR group, the mean aortic valve pressure gradient decreased from $47.1{\pm}24.4$ mmHg to $15.1{\pm}11.7$ mmHg in the IAS group and the mean AR grade decreased to 0 in the PAVR group. Balloon type coronary perfusion cannula-related coronary ostial stenosis developed in 4 patients and this was treated with OPCAB in three patients and with PTCA in one patient. Two patients developed postoperative infectious endocarditis. All the patients were discharged and followed up in a stable condition. Conclusion: The CARVAR procedure showed excellent short term results, but a good further follow up result is required to apply this procedure to most kinds of aortic valve diseases.

• Journal of Korean Ophthalmic Optics Society
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• v.16 no.3
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• pp.273-281
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• 2011

Purpose: In order to provide the fundamental information for the design development of RGP lenses and its clinical prescription, the corneal types of Korean twenties were analyzed according to corneal shapes, astigmatic degree, and the certain distance from the corneal apex. Methods: Corneal types of total 252 eyes in 20s were firstly classified, then their corneal radii from the certain distance from the corneal apex were measured by corneal topography and further analyzed based on the astigmatic degree. Results: Korean 20s' corneal types were classified as 14.3%(36 eyes) of round, 31.3%(79 eyes) of oval, 28.6%(72 eyes) of symmetric bow tie, 17.5%(44 eyes) of asymmetric bow tie, 8.3%(21 eyes) of irregular shapes. The round and oval typed corneas had mild astigmatic degree whereas the higher astigmatic degree in symmetric and asymmetric bow tie typed corneas were shown. The relative corneal radii of round and oval typed corneas at each distance from corneal apex were shown to consistently increase regardless of astigmatic degrees when they measured at certain distances from the corneal apex. However, the relative corneal radii of symmetric and asymmetric bow tie typed corneas within 1.0-1.5mm from the corneal apex were decreased, which showed steeper slope than it within 1.0 mm and somewhat different based on astigmatic degrees. Bigger change of corneal radii outer 3.5 mm from the corneal apex in symmetric bow tie typed corneas with astigmatism of 1.50-2.00 D and 2.25-2.75 D appeared. Conclusions: The consideration of radial change from the central cornea to peripheral cornea is necessary for manufacturing RGP lens and its prescription since they showed different change in corneal radii by corneal patterns and astigmatic degrees.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.5 no.2
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• pp.158-165
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• 2002

Purpose: We designed this retrospective study to establish the incidence of diagnosic delay in children diagnosed with acute appendicitis and to identify associated factors with delayed diagnosis and its impact on the clinical course. Methods: All cases of children under 15 years of age who underwent appendectomy from 1996 to 2001 at Gangneung Asan Hospital were reviewed. We reviewed signs and symptoms, type of health professional first contacted, the advice given by the health professional and a history of appendicitis in first degree relatives. Diagnostic period is the time elapsed between first complaints and definitive diagnosis. Delay was defined as diagnostic period exceeded the 48 hours. Postoperative course and complications were also reviewed. Results: Incidence of diagnostic delay differed by whether diarrhea and fecalith on X-ray were present. Also children whose parents were advised to observe them at home were more likely to have a diagnostic delay. In almost half of the cases in delayed group, initial diagnosis was not acute appendicitis but gastroenteritis. The perforation rate in non-delayed group was 22%, whereas 87% in delayed group. The delayed group showed a higher number of postoperative complication and a longer hospitalization period. Conclusions: Diarrhea with abdominal pain and fever in children should not be dismissed as gastroenteritis, respiratory infections or other common disorders. Our study suggests that physicians have a responsibility to prevent diagnostic delay and resultant perforation of acute appendicitis in children by having a high index of suspicion about acute appendicitis.

• Korean Journal of Hospice Care
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• v.8 no.1
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• pp.29-48
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• 2008

Purpose: The purpose of this study was to provide the basic information on the improvement plan by identifying the role accomplishment and job satisfaction of the hospice nurses and analyzing the factors that impact such role accomplishment and job satisfaction. Methods: The data was collected of 189 hospice nurses who have been working more than 6 months in 56 hospice programs registered in Korea Hospice Association and Korean Catholic Hospice Association from October to November, 2007 by structured questionnaire which was developed by Ryu(1979), based on the Riehl's nursing role and the research of Choe(2005) on the role of hospice nurse. Results: The role accomplishment and job satisfaction of the study subject were 3.53 point and 3.39 point, respectively. The roles of hospice nurses were accomplished by the order of advocator, nursing care provider, coordinator (cooperation), educator, quality manager, counsellor, administrator, and researcher. The job satisfaction of the hospice nurses was shown highest in the satisfaction of professional status, followed by the satisfaction of the interaction, satisfaction of the task itself, satisfaction of the administrative aspect, satisfaction of the autonomous, and the lowest in the satisfaction of the pay. The role accomplishment of the subjects according to their socio-demographic and job characteristics was found to have a significant difference by their age, marriage status, academic background, and position. It also has a significant difference by whether they play role of coordinator, whether they took whole responsibility as hospice, working experience as hospice/palliative nurse, and the level of hospice/palliative nursing training(p<.05). In the study of job satisfaction of the subjects according to their socio-demographic and job characteristics, the job satisfaction was found to have a significant difference by the increase of age, the number of duties consisting the hospice team, whether they play role of coordinator, whether they take whole responsibility as hospice, the level of hospice/palliative nursing training, and whether they wish to work for as long as possible(p<.05). The role accomplishment and the job satisfaction of the subjects showed a statistically significant positive correlation. (r=.541, p<.01) Conclusion: Raised saiary will be increased hospice nurse's job satisfaction. And we suggest a repetitive study using the identical tool to the equally extracted subjects with same representativeness of each hospice/palliative institute type. For the expanded role and enhanced professional standard of hospice nurses, we also suggest a study on the improvement plan to enhance the roles of researcher and administrator.

• The Journal of Korean society of community based occupational therapy
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• v.10 no.2
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• pp.11-24
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• 2020

Objective : The Human Rights constitute one of the basic pillars of every work where persons are involved, such is the case of the occupational therapy field. Methods : In this study we investigate the human rights sensitivity and the advocacy activities of occupational therapists. The differences according to their characteristics, the relationship and the impact of the human rights sensitivity are examined and presented. Making use of online surveys 116 subjects participated in the study. Results : The measured average of human right sensitivity is 69.00 ± 17.67 point, being them distributed according to the following subcategories: to the perception of the situation corresponds 23.25±5.62 points, to the perception of the consequences 22.75±6.54 points and for the perception of the responsibility 23±6.54 points. In all the cases have been taken in account the equal rights, the right to education in disables, the right to pursue the happiness of the elderly, the right of the disables to have personal freedom, the privacy rights and the privacy rights for mental illness people. According to the working area the Human Right sensitiveness is higher in Seoul than in the Gyeongsang province meanwhile the advocacy activities is higher in Seoul and in Gyeonggi province than in Gyeongsang province. Depending of the type of service, general hospitals and rehabilitation/nursing hospitals showed higher human rights sensitivity than other service organizations According to the working field, occupational therapy group focused in elderly showed higher Human Right sensitivity than other fields. Professionals belonging groups of clinical experience from 3 to 5 years and from 6 to 10 years showed higher advocacy activities than professionals with more than 11 years of experience. A positive correlation was showed between the human rights sensitivity and the advocacy activities. For this situation, the human rights sensitiveness was divided in sub-categories in perception of the situation, perception of the consequences and perception of the responsibility. As showed by the result of multiple regression analyses the advocacy activities of human would grow up in accordance with the increase of the human rights sensitiveness of responsibility perception. Conclusion : Due to the actual lack of information, the collection and study of basic data is fundamental for the development of practical human rights educational programs and to emphasize the role of the defense of the human rights.

• Journal of the Society of Cosmetic Scientists of Korea
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• v.41 no.4
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• pp.325-331
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• 2015

Skin is exposed to sunlight or artificial indoor light on a daily. The reached solar light on the earth surface consist of 50% visible light and 45% infrared (IR) except for ultra violet (UV). The negative effects of UV including UVB and UVA have been steadily investigated within the last decades. However, little is known about the effects of visible or IR light. In this study, we irradiated human dermal fibroblasts using light emitting diode (LED) to investigate the optimal parameter for enhancing cell growth and collagen synthesis. We found that red of 630 nm and green of 520 nm enhance the cell proliferation, but irradiation with purple and blue light exerts toxic effects. To examine the response of irradiation time and light intensity on the fibroblasts, cells were exposed to red or green light with intensities from 0.05 to $0.75mW/cm^2$. Procollagen secretion was increased of 1.4 fold by 10 min irradiation, while 30 min treatment decreased the collagen synthesis of dermal fibroblasts. Treatment with red of $0.3mW/cm^2$ and green of 0.15 and $0.3mW/cm^2$ resulted in enhancement of collagen mRNA. Lastly, we investigated the combinatorial effect of red and green light on dermal fibroblasts. The sequential irradiation of red and green light is an efficient way for the purpose of the increase in the number of fibroblasts than single light treatment. On the other hand, the exposure of red light alone was more effective method for enhancing of collagen secretion. Our study showed that specific light parameters accelerated cell proliferation, gene expression and collagen secretion on human dermal fibroblasts. In conclusion, we demonstrate that light exposure with specific parameter has beneficial effects on the function of dermal fibroblasts, and suggests the possibility of its cosmetically and clinical application.

• Korean Journal of Psychosomatic Medicine
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• v.24 no.1
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• pp.74-82
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• 2016

Objectives : Suicide attempters have impaired decision making and are at high risk of reattempt. Therefore it is important to refer them to psychiatric treatment. Especially, People with medical comorbidity are at higher risk of suicidal attempt and mortality. The aim of this study was to investigate the characteristics of suicidal attempters and to analyze the influence of the medical comorbidity on decision to receive psychiatric treatment after visit to an emergency department. Methods : One hundred and thirty two patients, who visited the emergency room of a general hospital in Gyeonggi-do between January, 2012 and December, 2012 were enrolled as the subjects of this study. After reviewing each subject's medical records retrospectively, demographic and clinical factors were analyzed. Results : Regardless of the engagement type, either via admission or outpatient clinic, the determinant factors of psychiatric treatment engagement were psychiatric diagnosis, employment status, previous psychiatric treatment history, and previous attempt history. Comparison of severity of medical comorbidity(Charlson Comorbidity Index) showed that suicide attempters who received psychiatric treatment via admission or refused the treatment tended to have higher level of medical comorbidity than who received psychiatric treatment via outpatient department. Conclusions : Our findings showed that medical comorbidity of suicide attempters affected the decision to accept psychiatric treatment. All psychiatrists should evaluate the presence and the severity of medical comorbidity of the suicide attempters and consider implementing more intervention for the medically ill attempters who are willing to discharge against advice.