Purpose: The purpose of this study was to evaluate the current status of hospice palliative care facilities, and to identify problems and improve hospice palliative care in Korea. Methods: The questionnaire survey was implemented from October to December, 2007. It was consisted of general characteristics of organization, health manpower, facilities & equipments, service programs, and so on. Sixty two (79.5%) out of 78 hospice palliative care facilities returned the questionnaires. Results: They were 42 hospital-based hospice palliative care hospitals and 9 clinics, and most of them are located at central metropolitan areas (Seoul and Gyeonggi Province). more than 80% of hospitals met with the requirements (one doctor per 10 patients and one nurse per 1.5 patients), whereas 42.9% of clinics met the requirements. Approximately 22% of them met the requirement of sick room (4 patients for 1 room). Most of them provided various hospice palliative care programs. The proportion of giving regular education programs to hospice palliative care personnels were about half (41.9%). Thirty two (51.6%) facilities provided home visiting hospice palliative care service. Conclusion: There were lack of enough health manpower, rooms, and programmes and they varied among facilities. It is necessary to increase the number of hospice palliative care facilities with consideration of regional fair distribution and standardization of programmes.
Yang, Jeong Soo;Cho, Eun Young;Jung, Hae Sung;Hwang, Ji Young;Lee, Dong-Jin;No, Eun Suk;Choi, Myoung-Bum;Park, Chan-Hoo;Youn, Hee-Shang;Woo, Hyang-Ok
Clinical and Experimental Pediatrics
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v.45
no.7
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pp.896-901
/
2002
Purpose : The aim of this study was to determine the epidemiology of Kawasaki disease in the Kyung Nam area and to evaluate whether the results of this epidemiological study could support infectious etiology. Methods : We sent a questionnaire to three training hospitals in the Kyung Nam area and retrospectively reviewed their medical records of Kawasaki disease from Jun. 1995 to Dec. 1999. Results : The total number of patients was 717 cases, with little differences of annual prevalence during the five years. In all cases, the monthly prevalence of Kawasaki disease was high in Apr. and Jul. At the eastern of Kyung Nam, the monthly prevalence was high in Apr. and Jul. in 1995 and 1996, Jul. in 1997, Apr. in 1998 and Apr. and Jul. in 1999. In the central area of Kyung Nam, the monthly prevalence was high in Apr. in 1995 and 1996, Apr. and Jul. in 1997 and Jul. in 1998 and 1999. In the western Kyung Nam, the monthly prevalence was high in Nov. in 1995, Aug. in 1996, Oct. in 1997, Dec. in 1998 and Nov. in 1999. Conclusion : In the eastern and central areas of Kyung Nam, the monthly prevalence of Kawasaki disease was similarly high in Apr. and Jul. However, in the western district, the prevalence was high in late fall and winter. We could not prove the hypothesis that Kawasaki disease occurred with the spread of single infectious agent, but the a nnually similar prevalence in eastern and central Kyung Nam supported the infection theory for the etiology of the disease.
Chon, Gyu Rak;Choi, Ik Su;Lim, Chae-Man;Koh, Younsuck;Oh, Yeon-Mok;Shim, Tae Sun;Lee, Sang Do;Kim, Woo Sung;Kim, Dong-Soon;Kim, Won Dong;Hong, Sang-Bum
Tuberculosis and Respiratory Diseases
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v.62
no.5
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pp.398-405
/
2007
Background: There is little data on the 3 year prognosis and quality of life of patients on long-term (>72 hour) mechanical ventilation in a medical intensive care unit (MICU). Methods: Patients with long-term mechanical ventilation from May 2003 through July 2003 in MICU of Asan Medical Center, Seoul were enrolled in this studay. The survival rates were observed prospectively at 1, 3, 6, 12, 24, 36 months, and the quality of life of survivor was measured at 12 months by using Short Form 36 (SF-36). Results: The survival rate at 1, 3, 6, 12, 24 and 36 months was 54.8% (40/73), 39.7% (29/73), 30.1% (22/73), 20.5% (15/73), 18.3% (13/71) and 16.9% (12/71), respectively. There was a similar survival rate regardless of the diseases that required mechanical ventilation. A neoplasm or chronic liver disease had a worse survival rate than chronic lung or kidney disease (p<0.05). Each SF-36 domain except for the Role-emotional was inferior to the general population. Conclusions: The survival rate of patients with mechanical ventilation more than 72 hours is decreases continuously until 12 months but is relatively constant from 12 to 36 months. In these patients quality of life is also decrased.
In Korea BCG vaccination has been employed as the main control measure for tuberculosis since 1962. Recently, the protective efficacy of BCG against tuberculosis has been controversial worldwide. A case-control study was conducted to evaluate the efficacy of BCG in Korea which has a high prevalence of tuberculosis(2.5%). The study subjects were children under the age of 14 years who were hospitalized and diagnosed as tuberculosis in three general hospitals in Taegu City during last 6 years ($1975{\sim}1980$). Among 416 hospitalized tuberculous patients, 314 cases were confirmed as to the presence or absence of the BCG scar. A control group was selected from the same hospital patients of the same period as the cases. The control group was other than tuberculous patients whose distribution of age, sex and residence were the same as the cases. The results obtained are as follows: For all forms of tuberculosis, the relative risk and the protective efficacy of BCG were 3.5 and 71.8%. The efficacy was higher among female than among male (78.6% vs. 65.8%). The efficacy was higher among the one year and above than among less than 1 year of age. For tuberculous meningitis, the relative risk and the protective efficacy of BCG were 3.9 and 74.3 %. The efficacy was statistically significantly higher among female than among male (p<0.05). The relative risk and the protective efficacyt of BCG for uberculous meningitis combined with miliary tuberculosis and combined with pulmonary tuberculosis represented 6.9, 85.6%, and 7.4, 86.5%, respectively. On the other hand, the relative risk and the protective efficacy of BCG for miliary tuberculosis were 2.1 and 51.6%, and for pulmonary tuberculosis, 2.3 and 54.7%, respectively. From these results, it appears that BCG vaccination is an efficient preventive measure in Korea where tubercluosis is prevalent. Thus the routine BCG vaccination should be continued.
With the development of the 4th industrial, research is being conducted to prevent diseases and reduce damage in various fields of science and technology such as medicine, health, and bio. As a result, artificial intelligence technology has been introduced and researched for image analysis of radiological examinations. In this paper, we will directly apply a deep learning model for classification and detection of pneumonia using chest X-ray images, and evaluate whether the deep learning model of the Inception series is a useful model for detecting pneumonia. As the experimental material, a chest X-ray image data set provided and shared free of charge by Kaggle was used, and out of the total 3,470 chest X-ray image data, it was classified into 1,870 training data sets, 1,100 validation data sets, and 500 test data sets. I did. As a result of the experiment, the result of metric evaluation of the Inception V3 deep learning model was 94.80% for accuracy, 97.24% for precision, 94.00% for recall, and 95.59 for F1 score. In addition, the accuracy of the final epoch for Inception V3 deep learning modeling was 94.91% for learning modeling and 89.68% for verification modeling for pneumonia detection and classification of chest X-ray images. For the evaluation of the loss function value, the learning modeling was 1.127% and the validation modeling was 4.603%. As a result, it was evaluated that the Inception V3 deep learning model is a very excellent deep learning model in extracting and classifying features of chest image data, and its learning state is also very good. As a result of matrix accuracy evaluation for test modeling, the accuracy of 96% for normal chest X-ray image data and 97% for pneumonia chest X-ray image data was proven. The deep learning model of the Inception series is considered to be a useful deep learning model for classification of chest diseases, and it is expected that it can also play an auxiliary role of human resources, so it is considered that it will be a solution to the problem of insufficient medical personnel. In the future, this study is expected to be presented as basic data for similar studies in the case of similar studies on the diagnosis of pneumonia using deep learning.
Kim, Ja Kyoung;Ko, Eun Young;Lee, Yu Jin;Jun, Yong Hun;Kim, Soon Ki
Clinical and Experimental Pediatrics
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v.46
no.1
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pp.11-16
/
2003
Purpose : Iron deficiency is still the most common nutrient deficient disorder despite the improvement in general health and nutrition. This study is designed to evaluate the dietary history of infants and young children with iron deficiency anemia(IDA) and the effects of nutritional counseling. Methods : This study was conducted on 120 children from 6 to 36 months of age with IDA. Their parents completed a questionnaire and took counsel for nutrition. IDA was defined as Hb <11.0 g/dL, ferritin <10 ng.mL or transferrin saturation <15%, or Hb increase >1 g/dL after iron preparation. The questionnaire consisted of their feeding patterns, weaning time and kinds of food. Results : In the 120 infants and young children aged from 6 to 36 months, the parents of 82 cases was counseled about nutrition. Fifty six infants among 82 cases have started weaning and the main foods of weaning were rice and/or rice gruel. Nutritional problems in weaning were that some children over one year of age were using a bottle, and parents restricted weaning food at will because of allergic disease or chronic disease. Most parents were satisfied with the nutritional counseling given from a clinical dietitian and showed good compliance. Conclusion : Many infants and young children with IDA were provided with non iron-fortified foods and made an inadequate wean. Most parents were satisfied with the nutritional counseling and showed good compliance. The need of dietary counseling was required for prevention and treatment of iron deficiency anemia because of inadequate weaning.
Purpose: Childhood obesity can be complicated by hypertension, hyperlipidemia, non-alcoholic fatty liver disease, and diabetes mellitus. The aim of this study was to evaluate the prevalence of obesity and metabolic complications of children and adolescents based on the degree of obesity. Methods: We analyzed the records of 8,880 students who received student health examinations between May 2006 and October 2008 at the Eulji General Hospital. The prevalence of obesity was evaluated by the body mass index and obesity index. A total of 1,076 obese students had blood tests. We analyzed aspartate aminotransferase (AST), alanine aminotransferase (ALT), fasting glucose, total cholesterol, and blood pressure according to the degree of obesity. Results: According to the body mass index, the overall prevalence of obesity was 7.2% (7.8% of male and 6.5% of female students). Based on the obesity index, 12.3% of students (mild: 6.3%, moderate: 5.0%, and severe: 1.0%) were obese. The prevalence of hypercholesterolemia, ALT elevation, and hypertension were increased as a function of the degree of obesity (p<0.05), but hyperglycemia showed no significant differences (p=0.298). The overall prevalence of ALT elevation was 17.7% (mild obese group, 10.4%; moderate obese group, 20.5%; and severe obese group, 46.8%). The prevalence of hypercholesterolemia, hypertension, and hyperglycemia were significantly higher in the elevated ALT group (24.7%, 42.6%, and 5.2%, respectively) compared to the normal ALT group (11.1%, 29.8%, and 2.0%, respectively; p<0.05). Conclusion: Hypercholesterolemia, liver function test abnormalities, and hypertension were associated with the degree of obesity. We should focus our attention on managing obese children and adolescents to prevent metabolic complications.
As people prefer to use right or left hand, some have preferred chewing side while others do not. Totally, 82 volunteers composed of students and staffs from Dental Hospital College of Dentistry Yonsei University participated in this study for the investigation of influence of preferred chewing habit, that has lasted for more than a year, on electromyographic(EMG) activity of masticatory muscles and bite force. Among the 82 volunteers, 46 had preferred chewing habit while the other 36 did not. Prior to the investigation, those with factors that could affect the study, such as, general disease, irregular dentition and malocclusion, were screened and excluded by questionnaire and clinical examination. The results were as follows: 1. There was no significant difference in EMG activities between chewing side and non-chewing side of preferred chewing subjects at rest as well as maximal voluntary contraction(MCV)(p>0.05). 2. Asymmetrical coefficient of temporal and masseter muscle EMG activities between preferred chewing subjects and non-preferred chewing subjects at rest was not significantly different(p>0.05). 3. Asymmetrical coefficient of masseter EMG activity was significantly higher(p<0.05) than that of non-preferred chewing subjects at MCV, whereas that of anterior temporal muscle showed no difference(p<0.05). 4. In preferred chewing subjects, there was no significant difference in average bite force and occlusal contact area between chewing side and non-chewing side(p>0.05). 5. There was no significant difference in Asymmetrical coefficients of average bite force and occlusal contact area between preferred chewing subjects and non-preferred chewing subjects (p>0.05). Consequently, preferred chewing habit can be considered as physiological asymmetry with normal function rather than to have influence on EMG muscle activity of masticatory muscles, average bite force and occlusal contact area. Objective standardization to differentiate preferred chewing subjects and non-preferred chewing subjects should be established in the further study.
The Journal of Korean Academy of Sensory Integration
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v.21
no.1
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pp.47-58
/
2023
Objective : This study aimed to investigate the current status and actual use of assessment tools by institutions in the field of occupational therapy with children in Korea. Methods : The study was conducted with 67 occupational therapists working with children in Korea. To investigate the use of evaluation tools by area, knowledge of the evaluation tools, and desire to participate in further education, the questionnaires used in studies by Lee, Hong, and Park (2018) and Kim (2015) were modified and supplemented according to the child evaluation tools currently in usein institutions in Korea. For data collection, we distributed Google questionnaires to child occupational therapists for 3 weeks using convenience sampling. Excel was used to analyze the use of the evaluation tools according to institution. Technical statistics and frequency analyses were used to verify the general characteristics, evaluation-related information, status of evaluation tool use, knowledge levels relating to evaluation tools, and desire to participate in education. A t-test was used for the evaluation tool status. Results : Welfare centers used the most evaluation tools, with an average of 11.1, followed by university hospitals, rehabilitation hospitals, clinics, and daycare centers. There were differences in the choice of tools used, hospital with the Jebsen-Taylor hand function test and the Wee-FIM (Functional Independence Measure) being the most frequently applied. Centers, daycare centers, and welfare center the Sensory Profile test and clinical observation were also used often. Regarding the level of knowledge of evaluation tools and the desire to participate further in education, 30 (44.8%) of the respondents had not completed their education, and 42 (62.7%) rated their knowledge level as generally low. When asked about the importance of using a manual to guide them in their use of evaluation tools, 66 (98.6%) answered positively, and 66 (98.6%) answered that they needed specialized training in the use of evaluation tools. Conclusion : This study makes it possible to understand the use and status of evaluation tools as used by different institutions in Korea in the field of child occupational therapy It is anticipated that it will provide the basis for introducing existing evaluation tools and preparing new evaluation tools to be used in this field in Korea.
Background: The decision of staging of esophageal cancer have great effect on the resectability of the lesion and estimation of the patient's prognosis. Today, CT is one of the most popular modality for staging of esophageal cancer. However, it has some limitations because of false-positive or false-negative findings on cancer staging. The purpose of this study was to analyze the efficacy of CT in preoperative staging of esophageal cancer. Material and Method: We retrospectively analysed the difference of staging of esophageal cancer between CT and histopathological findings for the 114 patients with histologically proven esophageal cancer who underwent operation at the department of thoracic and cardiovascular surgery, Chonnam national university hospital, between January 1999 and June 2003. We evaluated the efficacy of chest CT in the staging of esophageal cancer compared to postoperative histopathologic findings by calculating sensitivity, specificity, accuracy, and reproducibility of chest CT to detect abnormality. Result: The reproducibilities between chest CT and histopathologic findings were 0.32 (p<0.01) for primary tumor (T), 0.36 (p<0.01) for lymph node invasion (N), and 0.62 (p<0.01) for distant metastasis (M). The reproducibilities between chest CT and histopathologic findings for lymph node invasion (N) and distant metastasis (M) were superior to that of primary tumor (T). The accuracy of primary tumor (T) was 65.8% and 98.2% in group III and IV, which was significantly higher than that of group I and II (78.9% and 62.3%). In general, specificity of chest CT for TNM staging was superior to sensitivity. Conclusion: In conclusion, preoperative CT scanning can provide important information on lymph node invasion and metastasis of lesion than primary tumor invasion.
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