• Journal of Hospice and Palliative Care
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• v.2 no.2
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• pp.109-113
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• 1999

Purpose : Because we don't have inappropriate health care system for the terminal cancer patients, there were abnormal behavior patterns of health care utilization. So, There were needs to develop the comprehensive care for terminal cancer patients. Increased attention is being paid to the futility of life-sustaining treatment and high cost of management of terminal cancer patients Materials and Methods : This study was performed on cancer patients, registered in 1996 Central Cancer Registry, who were as insured person of Korea Medical Insurance and died from January 1997 to June 1998. We studied the day of medical care and medical expenses of 151 cancer patients evaluable. Results : The mean day of inpatient care was 39 days, and the mean days of outpatient care was 14 days in study subjects. Mean expenses per day of medical care, day of inpatient, and day of outpatients care were 85,392 won, 105,908 won, and 40,173 won. 95% of medical expenses is paid to the general hospital, and 85% of medical expenses was paid for inpatient care. About half of all medical expenses in th last 6 months were incurred in the last 60 days of life, and about 30 percent were incurred in the last 30 days. Expenses of outpatients care increased between 6 month and 3 months, after which they decreased. Expenses of inpatients care increased during all last 6months Conclusion : The distribution or medical expenses during the last 6 months in our study is similar to the distribution of American Medicare costs. We need to study medical expenses during the last year of life with large scale and details in order to develop the plan about the management of terminal cancer patient.

• Biomolecules & Therapeutics
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• v.26 no.6
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• pp.546-552
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• 2018

A comprehensive collection of proteins senses local changes in intracellular $Ca^{2+}$ concentrations ($[Ca^{2+}]_i$) and transduces these signals into responses to agonists. In the present study, we examined the effect of sphingosine-1-phosphate (S1P) on modulation of intracellular $Ca^{2+}$ concentrations in cat esophageal smooth muscle cells. To measure $[Ca^{2+}]_i$ levels in cat esophageal smooth muscle cells, we used a fluorescence microscopy with the Fura-2 loading method. S1P produced a concentration-dependent increase in $[Ca^{2+}]_i$ in the cells. Pretreatment with EGTA, an extracellular $Ca^{2+}$ chelator, decreased the S1P-induced increase in $[Ca^{2+}]_i$, and an L-type $Ca^{2+}$-channel blocker, nimodipine, decreased the effect of S1P. This indicates that $Ca^{2+}$ influx may be required for muscle contraction by S1P. When stimulated with thapsigargin, an intracellular calcium chelator, or 2-Aminoethoxydiphenyl borate (2-APB), an $InsP_3$ receptor blocker, the S1P-evoked increase in $[Ca^{2+}]_i$ was significantly decreased. Treatment with pertussis toxin (PTX), an inhibitor of $G_i$-protein, suppressed the increase in $[Ca^{2+}]_i$ evoked by S1P. These results suggest that the S1P-induced increase in $[Ca^{2+}]_i$ in cat esophageal smooth muscle cells occurs upon the activation of phospholipase C and subsequent release of $Ca^{2+}$ from the $InsP_3$-sensitive $Ca^{2+}$ pool in the sarcoplasmic reticulum. These results suggest that S1P utilized extracellular $Ca^{2+}$ via the L type $Ca^{2+}$ channel, which was dependent on activation of the $S1P_4$ receptor coupled to PTX-sensitive $G_i$ protein, via phospholipase C-mediated $Ca^{2+}$ release from the $InsP_3$-sensitive $Ca^{2+}$ pool in cat esophageal smooth muscle cells.

• Radiation Oncology Journal
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• v.28 no.1
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• pp.39-49
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• 2010

Purpose: This aim of this study is to analyze the dosimetric difference between intensity-modulated radiation therapy (IMRT) using 3 or 5 beams and MSF in the radiotherapy of the left breast. Materials and Methods: We performed a comparative analysis of two radiotherapy modalities that can achieve improved dose homogeneity. First is the multistatic fields technique that simultaneously uses both major and minor irradiation fields. The other is IMRT, which employs 3 or 5 beams using a fixed multileaf collimator. We designed treatment plans for 16 early left breast cancer patients who had taken breast conservation surgery and radiotherapy, and analyzed them from a dosimetric standpoint. Results: For the mean values of $V_{95}$ and dose homogeneity index, no statistically significant difference was observed among the three therapies. Extreme hot spots receiving over 110% of the prescribed dose were not found in any of the three methods. A Tukey test performed on IMRT showed a significantly larger increase in exposure dose to the ipsilateral lung and heart than multistatic fields technique (MSF) in the low-dose area, but in the high-dose area, MSF showed a slight increase. Conclusion: In order to improve dose homogeneity, the application of MSF, which can be easily planned and applied more widely, is considered an optimal alternative to IMRT for radiotherapy of early left breast cancer.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.6
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• pp.504-508
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• 2004

Surgical process of oral and maxillofacial area as well as dental treatment are stressful situations to the patients. It is well known that serum level of stress hormones including adrenocorticotropic hormone(ACTH) and cortisol increase when the body is exposed to stress. However, there have been few studies on demographic and clinical factors related with stress. Therefore, the purpose of this study was to supply data to cope with stress more comprehensively and efficiently by analyzing the effect of factors related with stress in addition to surgical procedure. Prospective cohort study method was selected. Serum levels of ACTH and cortisol were measured by sampling bloods pre-operatively and post-operatively from 45 patients who had been operated at the Bundang Jesaeng Hospital department of oral and maxillofacial surgery. To evaluate factors associated with stress, patients were classified according to gender, age, method of payment(insurance or self), experiences of operation, kind of operations(expected operations or unexpected operations). Relative risk was calculated to assess relationships between changes of serum level of ACTH and cortisol and factors related with stress, whereas Chi-square analysis was executed to evaluate statistical significance. With regard to serum level of ACTH, relative risk was 1.3 in the group of the patients who were less than 40 years old. With regard to serum level of cortisol, relative risk was 1.8 for women compared with men, 1.4 in the group of the patients who were less than 40 years old and 1.6 in the group of the patients who had not experienced any other operations. In addition to surgical procedure, factors related with stress included gender, age, method of payments, experiences of operation and kind of operations. Therefore, we should provide comprehensive schemes to reduce stress of the patients going through oral and maxillofacial surgery.

• Journal of Conservation Science
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• v.32 no.3
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• pp.353-364
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• 2016

The materials of sculptured stone property around the Hyeonleung Royal Tomb in Guri consist mainly of high weathered of granitic rocks with magnetite-series. Deterioration characteristics occurred highly with microorganism, soil inflow and black contaminants at the burial mound zone. As a result of deterioration evaluation, stone surface around the burial mound zone show serious comprehensive damage of soil inflow (50.5%) and lichen coverage (47.6%) which are the major damaging factors, and there are about 8.6% of biological growth noticeably in the north side. Surface contaminants and the discoloration had the complex causes. Gypsum occurred between joints of stones and the major contaminant type, darkening which was analyzed organic bodies caused discoloration. From result of ultrasonic velocity measurements, there are mean value of 2,195 m/s with highly weathered (HW) grade. Most of the stone properties showed 4 to 5 weathered grade. Therefore, it turned out that sculpture stone properties require conservation treatments. To remove soil accelerating damage factors and lichen occupying high percents, the cleaning process is necessary and consolidation, rejoining and filling are needed as well. Also, consideration on removing conservation materials containing Ca and e fflorescence is required and retreatments need to be considered.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.5
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• pp.327-336
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• 2020

This study was undertaken to identify ways that enable a successful comeback to everyday life and improvement in the quality of life, by understanding the experiences of cancer survivors in returning to everyday life. Totally, 19 people diagnosed with complete cure after 5 years of cancer treatment, were recruited for the study. Data was collected through in-depth interviews from January 18 to February 25, 2017. One-time interviews took 90 to 120 minutes, and data analysis was achieved by applying the grounded theory. The central phenomenon of 'reality that cannot be escaped' and 'uncertain reality that cannot know tomorrow' was attributed to the causal conditions 'hard reality', 'physical exhaustion', 'psychological exhaustion' and 'economic exhaustion'. Depending on context conditions such as 'lack of family support', 'shift to a vulnerable working class', 'insufficient support system', 'hope for the societal support system', 'daunted gender', 'prejudice against cancer/cancer patients', 'information on life after rare full healing'. The strategy for a successful return was influenced by intervention conditions such as 'robust family fence' and 'effective cancer insurance', which resulted in 'building a new life' or 'enduring'. We conclude that for a successful return to daily lives, cancer survivors require comprehensive information, health and social-welfare interventions.

• Quality Improvement in Health Care
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• v.20 no.1
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• pp.28-40
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• 2014

Objectives: Prescriptions for Parkinson's can be dispensed at the outpatient pharmacy. In general, the treatment of Parkinson's disease requires a multitude of drugs, sometimes taken 4 to 6 times a day at specific times as prescribed by the medical practitioner. Said "time-specific therapy" is one of the major reasons of dispensing delay observed at the outpatient pharmacy. Because our establishment lacked a computerized system to support time-specific prescriptions, they were not recognized electronically. They had to be issued and dispensed manually, which required a greater amount of time than the automated process. To solve the problem, a new sig code was developed to handle time-specific prescriptions with a comprehensive automated dispensing system to support it. This study aims to create electronic programs and streamline the process to increase dispensing performance. And thus, ensure greater patient safety and dispensing accuracy within a shorter dispensing time and also increase employee satisfaction through a decreased workload. Methods: After identifying the problems caused by non-electronic prescriptions an automated system that allowed the issuance of time-specific prescriptions was developed. A new sig code was created that could be recognized by the Pharmacy electronic medical program, the label printer to group medications by administration times and the Automatic Tablet Counter(ATC) to count the grouped drugs accordingly. Result: With the new sig code, the practitioner became able to electronically select the times of drug administration while issuing the prescription. This 'time-specific prescription' can now be recognized by the pharmacy electronic medical program, the label printer and the ATC like any other prescription. Conclusion: The developed program started operating on September 2013. Although not all Parkinson's patients have been issued with the new electronic 'time-specific prescription', the overall dispensing process has become more streamlined and accurate. As the medical team continues to integrate the new system in their practice an additional decrease of the dispensing time is predicted. Future program upgrades and other new time-saving approaches are scheduled, which are expected to further increase the service quality of our outpatient pharmacy.

• Strategy21
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• s.42
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• pp.53-82
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• 2017

Samuel Eliot Morison (1887-1976) was one of the pre-eminent historians of his generation. He was not only a famous historian at that time, but also was promoted to the rank of Admiral in U.S. Navy Reserve. Fifteen volume History of United States Naval Operations in World War II was published between 1947 and 1962, was not only a comprehensive report on the Navy's projection of power over two oceans, but a classic of historical literature that stands as the definitive treatment of it subject. Although he was fifty-five when war come to America in December 1941. Samuel Eliot Morison was determined to play a role. A professor at Harvard at the time, he joined volunteering for duty in the Navy. An experienced sailor, Professor Morison had earlier sailed that same routes taken by Christopher Columbus while researching his biography, Admiral of the Ocean Sea, which appeared in January 1942 th much acclaim and later got a Pulitzer Prize. Thus Morison plunged into the war, crossing the Atlantic aboard a destroyer. He assumed himself as "Parkman on the sea", tried to follow Parkman's historiographic method, not only participatory history but also literary style. And during writing History of United States Naval Operations in World War II, He emphasized two principles, publicity and objectivity. In terms of publicity, he always worried about who read history and why. In his pamphlet, "History as a Literary Art", he asserted it is useless if readers do not read a history which historians wrote. So he thought historians have forgotten that there is an art of writing of history. Therefore, he built his narratives around brightly rendered visuals and used the present tense to describe actions he witnessed firsthand, he wrote of the U.S. combat in very vividly. But strongly driven by publicity, he sometimes lost his balance in writing the naval history. For instance, the naval history became the focus of criticism for its prejudiced comments about the commanders. Also some reviewers asserted he did not secure the objectivity on writing the naval history. Although he sometimes deliberately torpedoed the objectivity of his work for strengthening publicity, by writing an extensive U.S. naval history, he introduced maritime history and naval history to the public widely. Until in early twentieth century, U.S. historians usually had been focusing their effort to the traditional areas, for example politic, economy, and etc. His intensive effort on the operations of U.S. Navy in World War II aroused a public interest in maritime and naval history. In conclusion, through using literary style and realistic narratives, historian Morison wrote a naval history for all the people which could appealed to the public.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.5
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• pp.382-390
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• 2017

This study was conducted to identify the factors affecting the quality of life of cancer patients based on demographic characteristics, health status, and mental health using the results of the 6th National Health and Nutrition Survey. The research tool used the demographic characteristics, health status, mental health, and quality of life of the KNHANES VI-2. Data analysis was conducted using SAS 9.3 version. There were significant differences in the quality of life in the study results by age, gender, economic activity, individual income quartile, subjective health status, mental health status, activity limitation, stress perception, and experience of depression symptoms. Factors influencing the quality of life of cancer patients included age, sex, income quintiles(individual), subjective health status, activity limitation, and experience of depression symptoms, which together explained 39.1% of the quality of life. To improve the quality of life of cancer patients, comprehensive management is required from diagnosis to treatment to return to society. It is also necessary to develop and apply long-term programs including multidimensional approaches and improvement of quality of life, early screening of cancer and cancer prevention education, management of depression symptoms, and social support.

• Korean Security Journal
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• no.7
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• pp.233-285
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• 2004

‘Defined legally as a violation of law' (Sutherland, E. H. Principles of Criminology, Lippincott, Chicago, 1939) Crime within the group is essentially and primarily antisocial in that the criminal who is welfare of his group acts instead against it and breaks the principles of social solidarity not merely by not doing what these principles prescribe, but by doing something exactly opposites. Any program set up to attack crime and delinquent behavior at their sources. A program of his nature needs the constant and comprehensive collaboration of psychiatrists, social works, educations, lawmakers, and public officials, since crime is a social problem and it should be treated as such. Some crime preventives which should be mentioned are as follows, (1) The insurance that every child will be decently born and that his home life be socially and economically adequate; without socially mature parents the chid is handicapped at the start; thus parental education, integrated with the public school system, should be developed now. (2) A more meaningful educational program which would emphasize ideals of citizenship, moral integrity, and respect for the law and the police. (3) A periodic check made for potential delinquents throughout the public schools and treatment provided if possible; and if not, proper segregation in institutions. (4) Careful attention paid to press, movies, and radio so that crime may no longer appear to be glamorous. This can be done by women's clubs, civic bodies, and other educational groups exerting pressure on the movie syndicates and broadcasting companies to free their productions of the tawdry and lurid characteristics of crime and criminals. Aggression associated with the phallic stage of development, The child ordinarily comprehends sexual intercourse as an aggressive and sadistic act on the part of the male, and specifically on the part of the penis. Evidence that the penis is phantasied as a weapon of violence and destruction come from unconscious productions of normal adults. Limerick, for instance, often refer to the penis as square, or too large, etc., so that intercourse is dangerous and painful for the partner, This may wall be a projection of the male's own fear of coitus. A certain portion of the death-instinct always remains within the person; it is called 'primal sadism' and according to Freud is identical with masochism. 'After the chief part of it(the death instinct) has been directed outwards towards objects, there remains as a residuum within the organism the true erotogenic masochism, which on the one hand becomes a component of the libido and on the other still has the subject itself for a object.' Criminalism, compulsive-neurotic frequent repetition of criminal acts in a compulsive manner. Like most symptoms of the compulsive-neurotic, such antisocial act are closely rated to feelings of hostility and aggression, often against the father. Because these acts are symptomatic, they afford only temporary relief and are therefore repeated. One patient with compulsive-neurotic criminalism was apprehended after breaking into hardware store and stealing money. He later confessed to many similar incidents over the preceding two years. At the same time it was apparent that he stole only for the sake of stealing. He did not need the money he thus obtained and had no special plans for using it.