The purpose of this study was to address the current status of hospital-based home care(HBHC). We analyzed the data on HBHC from national electronic data information of Health Insurance Review Agency. Beside, we surveyed 75 hospital-based home care agency. In 2006, 20,343 elderly(64.0% from all HBHC user) used 333,889 visits(76.8%from all visits). Medical diagnosis was composed of circulatory disease including cerebrovascular diseases 41.3%, endocrine system disease including Diabetes mellitus 10.4%, neoplasm 9.7%. Some of subjects used HBHC in excess of maximum covered 8 visits a month by National Health Insurance, decubitus 7.0%, the cancer 5.4%, the diabetes 2.5%, the hypertension 1.1%, and the stroke 0.9%. This results will contribute to expand the coverage of hospital-based home care by National Health Insurance. There was distribution difference in medical diagnosis and nursing intervention between HBHC and Public health center-based home care(PBHC) subjects. Therefore, HBHC subjects had more severe medical diagnosis, and were intervened more injections, examinations, than PBHC subjects. These differences must be considered to set up functional role among the three types of home visit care.
This study observed elderly women's adaptation process on separation by death in rural areas through grounded theory approach and developed its entity theory. Participants for this study were 14 elderly women who have lost their husbands in the last 12 months. The study was conducted for 8 months starting January 2010. Each interview per session took 40 to 90 minutes, study notes were taken on site, and recorded contents were transcribed by the researcher which was myself. The research data were collected by in-depth interview and with help of local community's nurses who were in charge of taking care of the participants. The collected data were analyzed by applying Strauss & Corbin's grounded theory (1998). As a result of study, 80 concepts, 28 subcategories, and 12 categories were deducted during open coding process. Adaptation process on separation by death was process of 'finding a way to live alone' which used strategy of 'attempting a make changes in life', and 'embracing the situation' which were influenced by conciliatory conditions of 'degree on economic condition', 'change in health', and 'supporting system' which focuses on phenomenon of 'bearing life alone' which is influenced by context condition of 'marital chemistry of couples during lifetime', and 'the couple's leadership during lifetime' together with casual conditions of 'the fall of wall'. The adaptation process accordance to time flow were divided into 4 steps which were step of 'shock and release of emotions', step of 'longing and resentment', step of 'resignation and acceptance', and step of 'life's restructure'. Above results suggest right directions for welfare for the aged and process of 'finding a way to live alone' for participants by controlling several factors and using intervention strategy, and provided basic data required for developing and applying practical welfare mediation.
Objectives : This article aims to describe the development of smartphone application for the case management of patients with schizophrenia. Methods : Gwangju Bukgu-Community Mental Health Center developed and launched a smartphone application (HYM) for cognitive-behavioral case management and symptom monitoring. The development of the application involved psychiatrists, nurses, social workers, psychologists, and software technicians from a software development company (Goosl Corp.). Results : The HYM application for clients includes six main modules including Thought record, Symptom record, Daily life record, Official notices, Communication, and Scales. The key module is the 'Thought Record' for self-directed cognitive-behavioral treatment (CBT). When the client writes and sends the self-CBT sheet to the case manager, the latter receives a notification and can provide feedback in real time. 'Communication' and 'Official notices' are useful for promoting communication between case managers and clients with schizophrenia. Ratings in 'Symptom record', 'Daily life record', and 'Scales' modules are stored in graphic or table form representing changes in them and shared with case managers. Conclusion : The interactive function of this application is the key characteristics that distinguishes it from other mobile self-treatment tools. This smartphone application may contribute to the development of a youth- and customer-friendly case management system for individuals with early psychosis.
The purpose of this study was to identify the persistent and dynamic association between bullying and victimization. Gender differences in patterns of school bullying was hypothesized based on the literature. Analysis were based on waves 3-6 of the Korea Children and Youth Panel Survey, a nationally representative data of primary and secondary school students in South Korea (N = 1,881). Autoregressive cross-lagged model was employed to identify the reciprocal association between bullying and victimization in longitudinal data. As hypothesized, regardless of gender, lagged effects were statistically significant between each time points such that current bullying caused future bullying and current victimization led to future victimization. However, there was no cross-lagged effects of current victimization on future bullying nor current perpetration on future victimization for both male and female youth. Findings from this study may have implications for designing policies against school bulling. Not only is short-term intervention for handling immediate psycho-social maladjustment important, but so are long-term plans that prevent youth from falling into continued perpetration and victimization in the system of school bullying.
Tumor suppressor genes (TSGs) play a crucial role in maintaining cellular homeostasis. When the function of these genes is lost, it can lead to cellular plasticity that drives the development of various cancers, including small-cell lung cancer (SCLC), which is known for its aggressive nature. SCLC is primarily driven by numerous loss-of-function mutations in TSGs, often involving genes that encode epigenetic regulators. These mutations pose a significant therapeutic challenge as they are not directly targetable. However, understanding the molecular changes resulting from these mutations might provide insights for developing tumor intervention strategies. We propose that despite the heterogeneous genomic landscape of SCLC, the effects of mutations in patient tumors converge on a few critical pathways that drive malignancy. Specifically, alterations in epigenetic regulators lead to transcriptional dysregulation, pushing mutant cells toward a highly plastic state that makes them immune evasive and highly metastatic. This review will highlight studies showing how an imbalance of epigenetic regulators with opposing functions leads to the loss of immune recognition markers, effectively hiding tumor cells from the immune system. Additionally, we will discuss the role of epigenetic regulators in maintaining neuroendocrine features and how aberrant transcriptional control promotes epithelial-to-mesenchymal transition during tumor development. Although these pathways seem distinct, we emphasize that they often share common molecular drivers and mediators. Understanding the connection among frequently altered epigenetic regulators will provide valuable insights into the molecular mechanisms underlying SCLC development, potentially revealing preventive and therapeutic vulnerabilities for SCLC and other cancers with similar mutations.
Li-Jen Wang;Masahiro Jinzaki;Cher Heng Tan;Young Taik Oh;Hiroshi Shinmoto;Chau Hung Lee;Nayana U. Patel;Silvia D. Chang;Antonio C. Westphalen;Chan Kyo Kim
Korean Journal of Radiology
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v.24
no.11
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pp.1102-1113
/
2023
Objective: To elucidate the use of radiological studies, including nuclear medicine, and biopsy for the diagnosis and staging of prostate cancer (PCA) in clinical practice and understand the current status of PCA in Asian countries via an international survey. Materials and Methods: The Asian Prostate Imaging Working Group designed a survey questionnaire with four domains focused on prostate magnetic resonance imaging (MRI), other prostate imaging, prostate biopsy, and PCA backgrounds. The questionnaire was sent to 111 members of professional affiliations in Korea, Japan, Singapore, and Taiwan who were representatives of their working hospitals, and their responses were analyzed. Results: This survey had a response rate of 97.3% (108/111). The rates of using 3T scanners, antispasmodic agents, laxative drugs, and prostate imaging-reporting and data system reporting for prostate MRI were 21.6%-78.9%, 22.2%-84.2%, 2.3%-26.3%, and 59.5%-100%, respectively. Respondents reported using the highest b-values of 800-2000 sec/mm2 and fields of view of 9-30 cm. The prostate MRI examinations per month ranged from 1 to 600, and they were most commonly indicated for biopsy-naïve patients suspected of PCA in Japan and Singapore and staging of proven PCA in Korea and Taiwan. The most commonly used radiotracers for prostate positron emission tomography are prostate-specific membrane antigen in Singapore and fluorodeoxyglucose in three other countries. The most common timing for prostate MRI was before biopsy (29.9%). Prostate-targeted biopsies were performed in 63.8% of hospitals, usually by MRI-ultrasound fusion approach. The most common presentation was localized PCA in all four countries, and it was usually treated with radical prostatectomy. Conclusion: This survey showed the diverse technical details and the availability of imaging and biopsy in the evaluation of PCA. This suggests the need for an educational program for Asian radiologists to promote standardized evidence-based imaging approaches for the diagnosis and staging of PCA.
This review discusses the pivotal role of vascular endothelial growth factors (VEGF) in angiogenesis and lymphangiogenesis, vital processes influencing vascular permeability, endothelial cell recruitment, and the maintenance of tumor-associated blood and lymphatic vessels. VEGF exerts its effects through tyrosine-kinase receptors, VEGFR-1, VEGFR-2, and VEGFR-3. This VEGF-VEGFR system is central not only to cancer but also to diseases arising from abnormal blood vessel and lymphatic vessel formation. In the context of cancer, VEGF and its receptors are essential for the development of tumor-associated vessels, making them attractive targets for therapeutic intervention. Various approaches, such as anti-VEGF antibodies, receptor antagonists, and VEGF receptor function inhibitors, are being explored to interfere with tumor growth. However, the clinical efficacy of anti-angiogenic agents remains uncertain and necessitates further refinement. The article also highlights the physiological role of VEGFs, emphasizing their involvement in endothelial cell functions, survival, and vascular permeability. The identification of five distinct VEGFs in humans (VEGF-A, VEGF-B, VEGF-C, VEGF-D, and PLGF) is discussed, along with the classification of VEGFRs as typical receptor tyrosine kinases with distinct signaling systems. The family includes VEGFR-1 and VEGFR-2, crucial in tumor biology and angiogenesis, and VEGFR-3, specifically involved in lymphangiogenesis. Overall, this review has provided a comprehensive overview of VEGF and VEGFR, detailing their roles in various diseases, including cancer. This is expected to further facilitate the utilization of VEGF and VEGFR as therapeutic targets.
Purpose: Coronavirus disease 2019 (COVID-19) has posed a significant burden to infant and toddler's care globally, while the disease severity is generally mild in this age group. In this study, we aimed to assess epidemiological and clinical aspects of COVID-19 in infants and toddlers in Seoul, South Korea. Methods: We used Seoul Metropolitan Government's epidemiological investigation database to describe the epidemiological and clinical characteristics of COVID-19 in infants and toddlers, between March 2020 to December 2021. Results: A total of 5,025 infants and toddlers aged <5 years was diagnosed between the observed period. 2,720 (54.1%) had symptoms, and fever was the most common symptom in 1,941 (74.1%). Of the diagnosed cases, 96.4% did not have underlying diseases. In a district level, extended opening of childcare facility was associated with increased risk of COVID-19 in infants and toddlers. Conclusions: An efficient monitoring system, resembling routine clinical care, is crucial, considering the low rates of severe progression and fatality among infants and toddlers. Moreover, a well-grounded intervention based on scientific evidence, rather than unconditional closures, is necessary to establish a suitable childcare policy that ensures safety from infectious diseases while not overlooking the developmental aspects of social skills.
Min Jung Ko;Dong A Park;Sung Hyun Kim;Eun Sook Ko;Kyung Hwan Shin;Woosung Lim;Beom Seok Kwak;Jung Min Chang
Korean Journal of Radiology
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v.22
no.8
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pp.1240-1252
/
2021
Objective: To compare the accuracy for detecting breast cancer in the diagnostic setting between the use of digital breast tomosynthesis (DBT), defined as DBT alone or combined DBT and digital mammography (DM), and the use of DM alone through a systematic review and meta-analysis. Materials and Methods: Ovid-MEDLINE, Ovid-Embase, Cochrane Library and five Korean local databases were searched for articles published until March 25, 2020. We selected studies that reported diagnostic accuracy in women who were recalled after screening or symptomatic. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. A bivariate random effects model was used to estimate pooled sensitivity and specificity. We compared the diagnostic accuracy between DBT and DM alone using meta-regression and subgroup analyses by modality of intervention, country, existence of calcifications, breast density, Breast Imaging Reporting and Data System category threshold, study design, protocol for participant sampling, sample size, reason for diagnostic examination, and number of readers who interpreted the studies. Results: Twenty studies (n = 44513) that compared DBT and DM alone were included. The pooled sensitivity and specificity were 0.90 (95% confidence interval [CI] 0.86-0.93) and 0.90 (95% CI 0.84-0.94), respectively, for DBT, which were higher than 0.76 (95% CI 0.68-0.83) and 0.83 (95% CI 0.73-0.89), respectively, for DM alone (p < 0.001). The area under the summary receiver operating characteristics curve was 0.95 (95% CI 0.93-0.97) for DBT and 0.86 (95% CI 0.82-0.88) for DM alone. The higher sensitivity and specificity of DBT than DM alone were consistently noted in most subgroup and meta-regression analyses. Conclusion: Use of DBT was more accurate than DM alone for the diagnosis of breast cancer. Women with clinical symptoms or abnormal screening findings could be more effectively evaluated for breast cancer using DBT, which has a superior diagnostic performance compared to DM alone.
Background: Ginsenoside Rg1 (Rg1) is one of the main active components in Chinese medicines, Panax ginseng and Panax notoginseng. Research has shown that Rg1 has a protective effect on the cardiovascular system, including anti-myocardial ischemia-reperfusion injury, anti-apoptosis, and promotion of myocardial angiogenesis, suggesting it a potential cardiovascular agent. However, the protective mechanism involved is still not fully understood. Methods: Based on network pharmacology, ligand-based protein docking, proteomics, Western blot, protein recombination and spectroscopic analysis (UV-Vis and fluorescence spectra) techniques, potential targets and pathways for Rg1 against myocardial ischemia (MI) were screened and explored. Results: An important target set containing 19 proteins was constructed. Two target proteins with more favorable binding activity for Rg1 against MI were further identified by molecular docking, including mitogen-activated protein kinase 1 (MAPK1) and adenosine kinase (ADK). Meanwhile, Rg1 intervention on H9c2 cells injured by H2O2 showed an inhibitory oxidative phosphorylation (OXPHOS) pathway. The inhibition of Rg1 on MAPK1 and OXPHOS pathway was confirmed by Western blot assay. By protein recombination and spectroscopic analysis, the binding reaction between ADK and Rg1 was also evaluated. Conclusion: Rg1 can effectively alleviate cardiomyocytes oxidative stress injury via targeting MAPK1 and ADK, and inhibiting oxidative phosphorylation (OXPHOS) pathway. The present study provides scientific basis for the clinical application of the natural active ingredient, Rg1, and also gives rise to a methodological reference to the searching of action targets and pathways of other natural active ingredients.
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