• Journal of muscle and joint health
• /
• v.8 no.1
• /
• pp.86-108
• /
• 2001

This study was performed to examine the annual experience rate of musculoskeletal symptom and its related factors in rural farmers. Six-hundred and sixty one rural farmers were investigated by questionnaire survey through interview from July 1 to July 31 in 2000. The results were as follows; The rural farmers who had experienced musculoskeletal symptom during recent 1 year was 82.7% in male, 92.1% in female. The annual experience rate of musculoskeletal symptom by part of the body in male were turned out as back; 42.3% leg and knee; 36.4%, shoulder; 21.4%, arm and hand; 12.7%, elbow; 7.7%, hip; 6.8% neck; 6.4%, ankle and foot; 6.4% in order. The annual experience rate of musculoskeletal symptom by part of the body in female were turned out as back; 59.4%, leg and knee; 48.5%, shoulder; 20.2%, arm and hand; 13.8%, hip; 10.7%, neck; 6.8%, ankle and foot; 6.3%, elbow; 5.0% in order. The annual experience rate of musculoskeletal symptom, back pain, and pain on leg and knee were significantly higher in female. In male, the experience rate of musculoskeletal symptom was different significantly according to educational level, family size, economic status, status of smoking, duration of farming, type of major agricultural affairs. By the multiple logistic regression analysis for experience of musculoskeletal symptom, family size and economic status were the significant variables. It was higher in male with no or one family living together and low economic status. In female, the experience rate of musculoskeletal symptom was different significantly according to body mass index, perceived health status, type of agricultural affairs. By the multiple logistic regression analysis for experience of musculoskeletal symptom, body mass index, perceived health status, and type of major agricultural affairs were the significant variables. It was higher as female farmer's body mass index was increasing and when female farmer's perceived health status was not healthier, and it was lower when female farmer did livestock farming as major agricultural affair. The experience rate of musculoskeletal symptom was higher in the busy season for farmers and treatment methods for musculoskeletal symptom were physical therapy, medication, herb medical treatment, etc. In conclusion, because most of farmers experience musculoskeletal symptom, continuous systematic study on musculoskeletal symptom of farmers and active effort to prevent and manage musculoskeletal symptom of farmers are necessary.

• Radiation Oncology Journal
• /
• v.18 no.1
• /
• pp.32-39
• /
• 2000

Purpose :The incidence of adenocarcinoma of the uterine cervix is low. Traditionally, Low Dose Rate (LDR) brachytherapy has been used as a standard modality in the treatment for patients with carcinoma of the uterine cervix. The purpose of this report is to evaluate the effects of the High dose rate (HDR) brachytherapy in the patients with adenocarcinoma of the uterine cervix compared with the LDR. : From January 1971 to December 1992, 106 patients of adenocarcinoma of uterine cervix were treated with radiation therapy in the Department of Radiation Oncology, Yonsei University with curative intent. LDR brachytherapy was carried out on 35 patients and 71 patients were treated with HDR brachytherapy. In LDR Group, 8 patients were in stage I, 18 in stage II and 9 in stage III. External radiation therapy was delivered with 10 MV X-ray, daily 2 Gy fractionation, total dose 40$\~$46Gy (median 48 Gy). And LDR Radium intracavitary irradiation was peformed with Henschke applicator, 22$\~$59 Gy to point A (median 43 Gy). In HDR Group, there were 16 patients in stage 1, 38 in stage II and 17 in stage III. The total dose of external radiation was 40$\~$61 Gy(median 45 Gy), daily 1.8$\~$2.0 Gy. HDR Co-60 intracavitary irradiation was peformed with RALS (Remote Afterloading System), 30 $\~$ 57 Gy(median 39 Gy) to point A, 3 times a week, 3 Gy per fraction. Conclusion : The 5-year overall survival rate in LDR Group was 72.9$\%$, 61.9$\%$, 45.0$\%$ in stage I, II, III, respectively and corresponding figures for HDR were 87.1$\%$, 58.3$\%$, 41.2$\%$, respectively (p>0.05). There was no statistical difference in terms of the 5-year overall survival rate between HDR Group and LDR Group in adenocarcinoma of the uterine cervix. There was 11$\%$ of late complication rates in LDR Group and 27$\%$ in HDR Group. There were no prognostic factors compared HDR with LDR group. The incidence of the late complication rate in HDR Group stage II, III was higher than that in LDR Group(16.7$\%$ vs. 31.6$\%$ in stage II, 11.1$\%$ vs. 35.3$\%$ In stage III, p>0.05). Although the incidence of radiation induced late complication rate was higher in HDR Group stage II and III patients than that in the LDR Group, statistical significance was not detected and within acceptable level. Conclusion : There was no difference in terms of 5-year survival rate and failure pattern in the patients with adenocarcinoma of the uterine cervix treated with HDR and LDR brachytherapy. Even late complication rates were higher in the HDR group It was an acceptable range. This retrospective study suggests that HDR brachytherapy seems to replace the LDR brachytherapy in the adenocarcinoma of the uterine cervix. However, further studies will be required to refine the dose rate effects.

• Radiation Oncology Journal
• /
• v.13 no.4
• /
• pp.359-368
• /
• 1995

Purpose : This is a retrospective analysis for pattern of failure, survival rate and prognostic factors of 114 patients with histologically proven invasive cancer of the uterine cervix treated with definitive irradiation. Materials and Methods : One hundred fourteen patients with invasive carcinoma of the cervix were treated with a combination of intracavitary irradiation using Fletcher-Suit applicator and external beam irradiation by 6MV X-ray at the Ewha Womans University Hospital between March 1982 and Mar 1990. The median age was 53 years(range:30-77 years). FIGO stage distribution was 19 for IB, 23 for IIA, 42 for IIB, 12 for IIIA and 18 for IIIB. Summation dose of external beam and intracavitary irradiation to point A was 80-90 Gy(median:8580 cGy) in early stage(IB-IIA) and 85-100 Gy(median:8850 cGy) in advanced stage(IIB-IIIB). Kaplan-Meier method was used to estimate the survival rate and multivariate analysis for progrostic factors was performed using the Log likelihood for Weibull Results : The pelvic failure rates by stage were $10.5{\%}$ for IB. $8.7{\%}$ for IIA, $23.8{\%}$ for IIB, $50.0{\%}$ for IIIA and $38.9{\%}$ for IIIB. The rate of distant metastasis by stage were $0{\%}$ for IB, $8.7{\%}$ for IIA, $4.8{\%}$ for IIB. $0{\%}$ for IIIA and $11.1{\%}$ for IIIB. The time of failure was from 3 to 50 months and with median of 15 months after completion of radiation therapy. There was no significant coorelation between dose to point A($\leq$90 Gy vs >90 Gy) and pelvic tumor control(P>0.05). Incidence rates of grade 2 rectal and bladder complications were $3.5{\%}$(4/114) and $7{\%}$(8/114), respectively and 1 patient had sigmoid colon obstruction and 1 patient had severe cystitis. Overall 5-year survival rate was $70.5{\%}$ and disease-free survival rate was $53.6{\%}$. Overall 5-year survival rate by stage was $100{\%}$ for IB, $76.9{\%}$ for IIA, $77.6{\%}$ for IIB $87.5{\%}$ for IIIA and $69.1{\%}$ for IIIB. Five-rear disease-free survival rate by stage was $81.3{\%}$ for IB, $67.9{\%}$ for IIA, $46.8{\%}$ for IIB, $45.4{\%}$ for IIIA and $34.4{\%}$ for IIIB. The prognostic factors for disease-free survival rate by multivariate analysis was performance status(p= 0.0063) and response rate after completion of radiation therapy(p= 0.0026) but stage, age and radiation dose to point A were not siginificant. Conclusion : The result of radiation therapy for early stage of the uterine cervix cancer was relatively good but local control rate and survival rate in advanced stage were poor inspite of high dose irradiation to point A above 90 Gy. Prospective randomized studies are recommended to establish optimal tumor doses for various stages and volume of carcinoma of uterine cervix, And ajuvant chemotherapy or radiation-sensitizing agents must be considered to increase the pelvic control and survival rate in advanced cancer of uterine cervix.

• Radiation Oncology Journal
• /
• v.20 no.3
• /
• pp.221-227
• /
• 2002

Purpose : To evaluate the role of postoperative chemoradiotherapy in locally advanced rectal cancer, we retrospectively analyzed the treatment results of patients treated by curative surgical resection and postoperative chemoradiotherapy. Materials and Methods : From April 1989 through December 1998, 119 patients were treated with curative surgery and postoperative chemoradiotherapy for rectal carcinoma in Gyeongsang National University Hospital. Patient age ranged from 32 to 73 years, with a median age of 56 years. Low anterior resection was peformed in 59 patients, and abdominoperineal resection in 60. Forty-three patients were AJCC stage II and 76 were stage III. Radiation was delivered with 6 MV X rays using either AP-PA two fields, AP-PA both lateral four fields, or PA both lateral three fields. Total radiation dose ranged from 40 Gy to 56 Gy. In 73 patients, bolus infusions of 5-FU $(400\;mg/m^2)$ were given during the first and fourth weeks of radiotherapy. After completion of radiotherapy, an additional four to six cycles of 5-FU were given. Oral 5-FU (Furtulone) was given for nine months in 46 patients. Results : Forty $(33.7\%)$ of the 119 patients showed treatment failure. Local failure occurred in 16 $(13.5\%)$ patients, 1 $(2.3\%)$ of 43 stage II patients and 15 $(19.7\%)$ of 76 stage III patients. Distant failure occurred in 31 $(26.1\%)$ patients, among whom 5 $(11.6\%)$ were stage II and 26 $(34.2\%)$ were stage III. Five-year actuarial survival was $56.2\%$ overall, $71.1\%$ in stage II patients and $49.1\%$ in stage III patients (p=0.0008). Five-year disease free survival was $53.3\%$ overall, $68.1\%$ in stage II and $45.8\%$ in stage III (p=0.0006). Multivariate analysis showed that T stage and N stage were significant prognostic factors for five year survival, and that T stage, N stage, and preoperative CEA value were significant prognostic factors for five year disease free survival. Bowel complication occurred in 22 patients, and was treated surgically in 15 $(12.6\%)$, and conservatively in 7 $(5.9\%)$. Conclusion : Postoperative chemoradiotherapy was confirmed to be an effective modality for local control of rectal cancer, but the distant failure rate remained high. More effective modalities should be investigated to lower the distant failure rate.

• Journal of Food Hygiene and Safety
• /
• v.27 no.4
• /
• pp.375-387
• /
• 2012

The objective of this study is investigation of contamination levels and assessment of health risk effects of heavy metals in herbal pills. 31 Items and 93 samples were obtained for this investigation from major herbal medicine producing areas, herbal markets and on-line supermarkets from Jan to Jun in 2010. Inductively coupled plasma mass spectrometer method was conducted for the quantitative analysis of Pb, Cd and As. In addition, the mercury analyzer system was conducted for that of Hg without sample digestion. The average contents of heavy metals in samples were as follows : 0.87 mg/kg for Pb, 0.08 mg/kg for Cd, 2.87 mg/kg for As and 0.16 mg/kg for Hg, respectively. In addition, the average contents of heavy metals in different parts of plants, including cortex, fructus, herba, radix, seed, algae and others were 0.63 mg/kg, 3.94 mg/kg, 1.42 mg/kg, 1.05 mg/kg, 0.16 mg/kg, 22.31 mg/kg and 10.17 mg/kg, respectively. After the estimations of dietary exposure, the acceptable daily intake (ADI), the average daily dose (ADD), the provisional tolerable weekly intake (PTWI) and the relative hazard of heavy metals were evaluated. As the results, the relative hazards compared to PTWI in samples were below the recommended standard of JECFA as Pb 3.1%, Cd 0.9%, Hg 0.5%. Cancer risks through slope factor (SF) by Ministry of Environment Republic Korea and Environmental Protection Agency was $4.24{\times}10^{-7}$ for Pb and $3.38{\times}10^{-4}$ for As (assuming that the total arsenic content was equal to the inorganic arsenic). Based on our results, possible Pb-induced cancer risks in herbal pills according to parts used including cortex, fructus, herba, radix, seed, algae and others were $1.95{\times}10^{-7}$, $1.45{\times}10^{-6}$, $2.14{\times}10^{-7}$, $6.27{\times}10^{-7}$, $1.99{\times}10^{-8}$, $3.61{\times}10^{-7}$ and $9.64{\times}10^{-8}$, respectively. Possible As-induced cancer risks in herbal pills by parts used including cortex, fructus, herba, radix, seed, algae and others were $1.54{\times}10^{-5}$, $7.24{\times}10^{-5}$, $1.23{\times}10^{-4}$, $2.02{\times}10^{-5}$, $3.25{\times}10^{-6}$, $2.18{\times}10^{-3}$ and $5.67{\times}10^{-6}$ respectively. Taken together, these results indicate that the majority of samples except for some samples with relative high contents of heavy metals were safe.

• Journal of Nutrition and Health
• /
• v.9 no.2
• /
• pp.68-86
• /
• 1976

The primary purpose of this study is to evaluate the correct nutritional status on pre-school children in Korea. Furthermore, it made an attempt to find and define nutrional problems, and assist in establishment on their nutritional improvement plan. For this, food intake and health condition (physical, clinical, biochemical and parasitological) survey on 109 Pre-school children in both sexes, randomly selected from Yang-Gu area in Gang-Won province and Rea-ju area in Kyong-gy Province, were conducted by means of three-day records, during the two periods of Spring and Fall season in 1975. The results obtained are summerized as follows: 1. The food intake; Average food intake of the subjects per day were $508{\sim}647g$ ($83{\sim}91%$ in vegetable foods and $5.5{\sim}11.7%$ in animal foods) in Yang-gu area, and $587{\sim}698g$ ($88{\sim}89%$ in vegetable foods and $6.3{\sim}7.6%$ in animal foods) in Rea-ju area. 2. The intake of energy and nutrients; a) Calory intake. Average energy intake of subjects per day in Yang-gu area$(1120{\sim}1415kcal)$ were all lower than the Korean Recommended Dietary Allowances (RDA) in either Spring and Fall survey, whereas the subjects in Rea-ju area were lower intake $(1213{\sim}1418kcal)$ than the RDA in the Spring but higher intake$(1516{\sim}1755kcal)$ than the RDA in the Fall, and the average intake were similar level with that of RDA. b) Protein intake. Average protein intake of the subjects per day in Yang-gu area $(33{\sim}43g)$ girl subjects in Rea-ju area $(35{\sim}39g)$ were lower than the RDA in either Spring and Fall survey, whereas the boy subjects in Rea-ju area$(36{\sim}38g)$ were lower in Spring and higher $(49{\sim}57g)$ in the Fall than that of the RDA, but the average $(43{\sim}47g)$ were similar level with the RDA. The protein intake from animal sources in all subjects were much lower $(5.5{\sim}11.7\;of\;total\;protein)$ than the RDA. c) Fat intake. Average fat intake were very lower in all subjects of both area $(14{\sim}24g\;in\;Yang-gu,\;10{\sim}12g\;in\;Rea-ju)$ than that of RDA which is recommended $12{\sim}14%$ of total energy to be supplied from fat. d) Calcium intake. Average calcium intake were very low in all subjects of both area $(264{\sim}355mg\;in\;Yang-gu\;and\;283{\sim}429mg\;in\;Rea-ju)$, especially, these in Spring were about a half level of the RDA, and it was much increased in the Fall due to increased intake of milk, but it was still not enough than the RDA. e) Vitamin A intake. Average intake of V.A ($703{\sim}1465\;IU$ in Ynag-gu and $750{\sim}1521\;IU$ in Rea-ju) were also lower than the RDA, moreover their V-A sources were mainly vegetable, so that the V-A supply might be critical one for the subjected. f) Riboflavin intake. Average riboflavin intake on all subjects in both area except boys in Rea-ju area in Fall, were very lower than the RDA. 3. The physical status; a) Average weight and height of boys aged 4 and 5 in Yang-gu area and girls of aged 5 in Rea-ju area were lower than those of Korean Standard of 1967 report, but those by age of girls in Yang-gu area and boys in Rea-ju area were a little heigher than the Korean Standard. It is, hower, present Korean standard of physical status might be somehow heigher than the 1967, since the socio-economical situation has been much improved during past a decade. So that, if one considered on this sense, the physical status of the subjects on this survey might be somehow lower than those of present Korean standard. b) Average upper arm circumference in both area were no difference each other, and their mean values of age 4, 5 and 6 in boy and girl were 15.6, 16.5, 16.4 and 15.5, 16.5, 16.4cm respectively. c) Average chest girth of boys were similar to those of Korean standard whereas the girls were smaller than the Korea standard. The average head circumference also showed similar tendency with the chest girth. 4. The clinical findings; The most popular clinical signs were angular stomatitis and dental caries, and boys had more heigher incidence then the girls. 5. The biochemical findings; a) Hemoglobin and anemia Average Hb value of boys and girls were 11.4 and 10.9g per 100 ml of blood respectively. The incidence of anemia (Hb value below 11 g/100 ml, by WHO) was increased by age, and girls had more heigher incidence than the boy (34% : 48%). The incidence of anemia in age of 4,5, and 6 in boys and girls were 28%, 41% 34%, and 33%, 50%, 49% respectively. The degree of the anemia was not severe, and the anemia of there subjects may be caused mainly low intake of better quality protein and low iron intake as well. b) Hematocrit. Average Ht value of whole subject were $39.9{\sim}41.6%$. c) Blood plasma protein. Average blood plasma protein contents of whole subjects were $6.6{\sim}7.4gm$ per 100 ml. The incidence of deficient range (<6.0g%, by ICNND) was only one girl of age 4 in yang Gu area. 6. Parasitological findgs; The most popular parasitism were asicris lumbicoides and trichocephalus trichiura, and about 2/3 of the whole subjects were suffering one or more of these parasitism.

• Korean Journal of Veterinary Research
• /
• v.35 no.2
• /
• pp.337-345
• /
• 1995

To evaluate the pathogenicity and immunogenicity of Eimeria tenella to the chicken treated with dexamethasone(DEX) and testosterone propionate (TES), we administered 0.1ml/chicken of dexamethasone and 40mg/chicken of testosterone propionate at 1-, 2-, and 7-days old, respectively. We also immunized with ND oil-emulsion vaccine at 2 weeks old. After that, we immunized and challenged with 100 and $1{\times}10^5$ oocysts/chicken of E tenella at 2 and 4 weeks old, respectively. And then we investigated the HI titers for ND virus, survival rate, body weight gain, lesion score and the weight of the bursa of Fabricius and thymus. The titers for ND virus in the groups treated with TES were higher than those in the groups treated with DEX and CON during 3 to 6 weeks. After challenge, the survival rate of testosterone propionate treated-challenged(TES-CHA) and TES-immunized and challenged(TES-V&C) groups were 61.5 and 83.3% and those of the other groups were all 100%. At 1 week after challenge, the lesion scores of TES-CHA group(4.0) was the highest of all experimental groups. Those of DEX and controlchallenged( CON-CHA) groups were 2.8, and those of all V&C groups were 2.4. During 1 and 2 weeks after immunization, the body weight gains of TES groups were severe low(61.6-82.2g and 189.6-260.4g). During 1 and 2 weeks after challenge, the body weight gains of all CHA groups were lower than those of not challenged groups. But, those of all V AC groups were not different from those of not immunized groups. At 4- and 6-weeks old, the weight of the bursa of Fabricius and thymus in the chicken of all TES groups were lower than those of all control (CON) and DEX groups. Therefore, testosterone propionate acted as immunosuppressive drug. Also, it was thought that the chicken affected a little humoral immunity to E tenella.

• Korean Journal of Veterinary Research
• /
• v.36 no.3
• /
• pp.577-598
• /
• 1996

This study was conducted to identify the effects of caffeine or combinations of caffeine and iron or vitamin E on the lipid and protein components or blood chemistry levels of the serum as well as the total homogenate, mitochondrial and microsomal fraction of the rat(Sprague-Dawley, female) liver. Chronic test were conducted to determine those effects. The chronic test was conducted by dividing rats into 5 groups according to the type of drugs and dosages administrated as follows; the control(group A), and group B was given 25mg/kg caffeine orally once daily for 30 days, group C was given 50mg/kg caffeine orally once daily for 30 days, group D was given 25mg/kg caffeine and orally ferric chloride once daily for 30 days and group E was given 25mg/kg caffeine and 25mg/kg vitamin E once daily for 30 days. The concentrations of glucose, urea nitrogen, uric acid, creatinine, total protein, albumin, A/G ratio, triglyceride, total cholesterol, HDL-cholesterol, free fatty acid, phospholipid as well as the activities of alanine aminotransferase(ALT), aspartate aminotransferase(AST) and alkaline phosphatase(ALP) were measured in the serum of each experimental groups. The concentrations of the carbonyl group and malondiaidehyde(MDA) and the patterns of the SDS-PAGE(Sodium Dodecyl Sulfate - Polyacrylamide Gel Electrophoresis) and fatty acid compositions in free fatty acids and phospholipids were analyzed to determine the oxidative damages and metabolic changes on the lipid and protein components in the serum, and total homogenate, mitochondrial and microsomal fractions of the rat liver. The results obtained from this study were summarized as follows; 1. Body weights of groups B, C, D and E were significantly decreased(p < 0.01) in comparison with that of the control in the chronic test. 2. The concentrations of serum glucose in groups B(124.5mg/dl), C(130.1mg/dl), D(122.1mg/dl), E(119.3mg/dl) were significantly higher(p < 0.01) in comparison to that of the control(101.5mg/dl). But, there were no significant differences in the concentrations of urea nitrogen, uric acid, creatinine, total protein, albumin and A/G ratio in comparison to that of the control. 3. The concentrations of total cholesterol and HDL-cholesterol in serum of groups B(69.6, 53.4mg/dl), C(73.0, 56.3mg/dl), D(68.9, 51.1mg/dl) and E(68.2, 51.3mg/dl) were significantly higher(p < 0.01) in comparison to that of the control(52.6, 38.8mg/dl). On the other hand, the concentrations of triglyceride in serum of groups B(45.0mg/dl), C(40.4mg/dl), D(33.8mg/dl) and E(47.2mg/dl) were significantly lower(p < 0.01) in comparison to that of the control(66.2mg/dl). There were no significant differences in the activities of ALT, AST and ALP in comparison to that of the control. 4. The concentrations of free fatty acid and phospholipid in serum of groups B(45.7, 154.4mg/dl), C(50.0, 167.2mg/dl), D(52.5, 148.4mg/dl) and E(41.1, 159.2mg/dl) were higher(p < 0.01) in comparison to that of the control(35.2, 125.3mg/dl). And the concentrations of the carbonyl group and malondialdehyde in serum of group D(1.82, 0.52nM/mg protein) were significantly higher(p < 0.01) in comparison to the control(1.53nM/mg protein). 5. The concentrations of carbonyl group in total homogenate, mitochondrial and microsomal fraction of group D(1.45, 0.94, 1.67nM/mg protein) were significantly higher (p < 0.01) in comparison to the control(1.16, 0.66, 1.27nM/mg protein). And the concentrations of malondialdehyde in the total homogenate, mitochondrial and microsomal fraction of group D(6.70, 6.10, 1.36nM/mg protein) were significantly higher(p < 0.01) in comparison to the control(5.17, 3.64, 0.68nM/mg protein). 6. As the analytical results of the fatty acid compositions of free fatty acid in serum, the proportions of stearic acid and arachidonic acid of groups B(16.52, 12.62%), C(17.52, 15.18%), D(19.73, 13.47%) and E(17.62, 13.28%) were significantly higher(p < 0.01) in comparison to the control(14.75, 7.88%), but the proportions of oleic acid and linoleic acid of groups B(12.97, 32.59%), C(10.88, 31.23%), D(12.37, 30.66%) and E(11.95, 32.41%) were significantly lower(p < 0.01) in comparison to the control(16.44, 35.12%). Otherwise, as the results of the fatty acid compositions of phospholipid in serum, the proportions of stearic acid and arachidonic acid of groups B(39.37, 16.39%), C(40.63, 17.83%), D(42.73, 15.39%) and E(39.16, 15.70%) were significantly higher(p < 0.01) in comparison to the control(37.74, 14.24%), but the proportions of oleic acid and linoleic acid of groups B(4.03, 14.38%), C(3.54, 12.38%), D(4.52, 11.68%) and E(4.29, 13.64%) were significantly lower(p < 0.01) in comparison to the control(5.53, 16.14%). 7. As the analytical results of the fatty acid compositions of free fatty acid in total homogenate, mitochondrial and microsomal fraction of liver, the proportions of oleic acid of groups B(7.8**, 8.73**, 6.88%) and C(6.89**, 7.75**, 6.58%) were lower(**:p < 0.01) in comparison to the control(8.67, 10.08, 7.81%), but the proportions of arachidonic acid of group C(22.62, 19.79, 23.71%) were significantly higher(p < 0.01) in comparison to the control(20.93, 18.47, 22.24%). And the proportions of palmitic acid of group D(25.95**, 26.16, 26.34**%) were significantly higher(**:p < 0.01) in comparison to the control(24.43, 25.42, 23.34%). In addition, the proportions of linoleic acid of group D(23.43, 25.02, 23.95%) were also significantly higher(p < 0.01) in comparison to the control(22.17, 23.75, 21.26%). The proportions of stearic acid of group D(19.87, 19.76**%) in mitochondrial and microsomal fraction were lower(**:p < 0.01) in comparison to the control(21.01, 24.18%), and the proportions of stearic acid of group E(16.71*, 19.65**%) in mitochondrial and microsomal fraction were significantly lower(**:p < 0.01, *:p < 0.05) in comparison to the control(21.01, 24.18%), and the proportions of linoleic acid of group E(25.04, 29.20, 26.48%) in total homogenate, mitochondria and microsome were significantly higher(p < 0.01) in comparison to the control(22.17, 23.75, 21.26%). 8. As the results of the fatty acid compositions of phospholipid in total homogenate, mitochondrial and microsomal fraction of liver, the proportions of palmitic acid of group D(17.58**, 18.78*, 18.23%**) were significantly higher(**:p < 0.01, *:p < 0.05) in comparison to the control(16.28, 17.22, 16.38%), and the proportions of stearic acid of group D(36.41, 37.23, 39.53%) were also significantly higher(p < 0.01) in comparison to the control(34.18, 34.16, 36.04%). But the proportions of oleic acid(3.41*, 3.11**, 3.12**%) and linoleic acid (18.03**, 15.79**, 14.74**%) of group D were significantly lower(**:p < 0.01, *:p < 0.05) in comparison to the control(oleic : 3.63, 3.72, 3.79%, linoleic : 20.03, 18.71, 18.48%). 9. In order to determine the oxidative damages to the protein in serum, mitochondrial and microsomal fraction of the rat liver, the patterns of the SDS-PAGE were identified, but the results of SDS-PAGE were not significantly different between the control and experimental groups.

• The Korean Nurse
• /
• v.20 no.4 s.112
• /
• pp.27-38
• /
• 1981

오늘 저희에게 주어진 주제, 내일에 타당한 간호사업 및 간호교육의 향방을 어떻게 정하여야 하는가의 논의는 오늘날 간호계 주변에 일어나고 있는 변화의 실상을 이해하는 데서 비롯되어져야 한다고 생각하는 입장에서 먼저 세계적으로 건강관리사업이 당면한 딜레마가 어떠한 것이며 이러한 문제해결을 위해 어떠한 새로운 제안들이 나오고 있는가를 개관 하므로서 그 교육적 의미를 정의해 보고 장래 간호교육이 지향해야할 바를 생각해 보려 합니다. 오늘의 사회의 하나의 특징은 세계 모든 나라들이 각기 어떻게 전체 국민에게 고루 미칠 수 있는 건강관리체계를 이룩할 수 있느냐에 관심을 모으고 있는 사실이라고 봅니다. 부강한 나라에 있어서나 가장 빈궁한 나라에 있어서나 그 관심은 마찬가지로 나타나고 있읍니다. 보건진료 문제의 제기는 발달된 현대의학의 지식과 기술이 지닌 건강관리의 방대한 가능성과 건강 관리의 요구를 지닌 사람들에게 미치는 실질적인 혜택간에 점점 더 크게 벌어지는 격차에서 발생한다고 봅니다. David Rogers는 1960년대 초반까지 갖고 있던 의료지식의 축적과 민간인의 구매력 향상이 자동적으로 국민 건강의 향상을 초래할 것이라고 믿었던 순진한 꿈은 이루어지지 않았고 오히려 의료사업의 위기는 의료지식과 의료봉사간에 벌어지는 격차와 의료에 대한 막대한 투자와 그에서 얻는 건강의 혜택간의 격차에서 온다고 말하고 있읍니다. 균등 분배의 견지에서 보면 의료지식과 기술의 향상은 그 단위 투자에 대한 생산성을 낮춤으로서 오히려 장애적 요인으로 작용해온 것도 사실이고 의료의 발달에 따른 일반인의 기대 상승과 더불어 의료를 태성의 권리로 규명하는 의료보호사업의 확대로 야기되는 의료수요의 급증은 모두 기존 시설 자원에 압박을 초래하여 전래적 의료공급체제에 도전을 가해 왔으며 의료의 발달에 건 기대와는 달리 인류의 건강 문제 해결은 더욱 요원한 과제로 남게 되었읍니다. 현시점에서 세계인구의 건강문제는 기아, 영양실조, 안전한 식수 공급 및 위생적 생활환경조성의 문제에서부터 가장 정밀한 의료기술발달에 수반되는 의료사회문제에 이르는 다양한 문제를 지니고 있으며 주로 각개 국가의 경제 사회적 여건이 이 문제의 성격을 결정짓고 있다고 볼수 있읍니다. 그러나 건강 관리에 대한 요구는 영구히, 완전히 충족될 수 없는 요구에 속한다는 의미에서 경제 사회적 발달 수준에 상관없이 모든 국가가 공히 요구에 미치지 못하는 제한된 자원문제로 고심하고 있는 실정입니다. 또 하나의 공통된 관점은 각기 문제의 상황은 달라도 오늘날의 건강 문제는 주로 의료권 밖의 유전적 소인, 사회경제적, 정치문화적인 환경여건과 각기 선택하는 삶의 스타일에 깊이 관련되어 있다는 사실입니다. 따라서 오늘과 내일의 건강관리 문제는 의학적 견지에서 뿐 아니라 널리 경제, 사회, 정치, 문화적 관점에서 포괄적인 접근이 시도되어야 한다는 점과 의료의 고급화, 전문화, 일변도의 과정에서 소외되었던 기본건강관리체계 강화에 역점을 둔 다양하고 탄력성 있는 사업전개가 요구되고 있다는 점입니다. 다양한 건강관리요구에 적절히 대처할 수 있기 위한 그간 세계 각처에서 시도된 새로운 건강관리 접근과 그 제안을 살펴보면 대체로 4가지의 뚜렷한 성격들로 집약할 수 있을 것 같습니다. 그 첫째는 건강관리사업계획 및 그 수행에 있어 지역 사회의 적극적 참여를 유도하는 일, 둘째는 지역단위의 일차보건의료에서 부터 도심지 신예 종합병원, 시설 의료에 이르기까지 건강관리사업을 합리적으로 체계화하는 일. 셋째로 의료인력이용의 효율화 및 비의료인의 훈련과 협조 유발을 포함하는 효과적인 인력관리에 대한 제안과 넷째로 의료보험 및 각양 집단 의료유형을 포함하는 대체 의료재정 운영관리에 관련된 제안들을 들 수 있읍니다. 건강관리사업에 있어 지역사회 참여의 의의는 첫째로 사회 경제적인 제약이 모든 사람에게 가능한 최대한의 의료를 모두 고루 공급하기 어렵게 하고 있다는 점에서 제한된 정부재정과 지역사회가용자원을 보다 효율적으로 이용할 수 있게 하는 자조적이고 자율적인 지역사회건강관리체제의 구현에 있다고 볼 수 있으며 둘때로는 개인과 가족 및 지역민의 건강에 영향하는 많은 요인들은 실질적으로 의료권 외적 요인들로서 위생적인 생활양식, 식사습관, 의료시설이용 등 깊이 지역사회특성과 관련되어 국민보건의 실질적 향상을 위하여는 지역 주민의 자발적인 참여가 필수여건이 된다는 점 입니다. 지역 단위별 체계적인 의료사업의 전개는 제한된 의료자원의 보다 합리적이고 효율적인 이용을 가능하게 하며 요구가 있을때 언제나 가까운 거리에서 경제 사회적 제약을 받지 않고 이용할 수 있는 일차건강관리망을 통하여 건강에 관련된 정보를 얻으며 질병예방, 건강증진 및 기초적인 진료의 도움을 얻을 수 있고 의뢰에 대한 제2차, 제3차 진료에의 길은 건강관리사업의 질과 폭을 동시에 높고 넓게 해 줄 수 있는 길이 된다는 것입니다. 인력 관리에 관련된 두가지 기본 방향으로서는 첫째로 기존보건의료인력의 적정배치 유도이고 둘째는 기존인력의 역할확대, 조정 및 비의료인의 교육훈련과 부분적 업무대체를 들수 있으며 이러한 인력관리의 기본 방향은 부족되는 의료인력의 생산성을 높이고 주민들의 자조적 능력을 강화시킨다는 데에 두고 있음니다. 대체적 의료재정운영안은 대체로 의료공급과 재정관리를 이원화하여 주민의 경제능력이 의료수혜의 장애요소로 작용함을 막고 의료인의 경제적 동기에 의한 과잉치료처치에 의한 낭비를 줄임으로써 의료재정의 투자의 효과를 증대하는 데(cost-effectiveness) 그 기본방향을 두고 있다고 봅니다. 이러한 주변의료 사회적인 동향이 간호교육의 미래상에 끼치는 영향은 지대한 것이라 봅니다. 첫째로 장래 세계인구의 건강문제는 정치, 사회, 경제, 환경적인 의료권 밖의 요인들에 의해 더욱 크게 영향 받는다고 전제한다면 건강문제해결에 있어서도 전통적인 의료사업의 접근에서 더나아가 문제발생의 근원이 되는 생활개선이라는 차원에서 포괄적 접근을 생각하여야 하고 이를 위해선 정치, 경제, 사회전반에 걸친 깊이있는 이해과 주민의 생활환경에 직접 영향하는 교통수단, 통신망 mass media, 전력문제, 농업경영방법 및 조직적 사회활동 등 폭넓은 이해가 요구된다고 봅니다. 둘째로, 지역사회참여의 의의를 인정한다면 지역민의 자발적 참여를 효과적으로 유발시킬수 있고 의료집단과 각종 주민조직과 일반주민들 사이에서 협조적으로 일할수 있는 역량을 기르기위한 교육적 준비가 요구된다고 봅니다. 셋째로, 지역주민의 건강관리 자조능력 강화를 하나의 목표로 삼는다면 치료자에서 교육자로, 지도자에서 촉진자로, 제공자에서 지원자료의 역할의 변화 내지 다양화를 요구하게 될 것이므로 그에 대처할 수 있는 준비가 필요하다고 봅니다. 넷째로, 생각되어야 할 점은 지역중심건강관리사업을 지향하는 보건의료의 이념적 방향과 그에 상응하는 구체적 접근방법을 효율적으로 적용하기 위해서는 종횡으로 연결되는 의사소통체계의 정립과 민활한 정보교환이 이루어질 수 있어야 한다는 점에서 의사소통의 구심체로서 역할할 수 있는 역량을 함양해야 할 교육적 과제가 있다고 봅니다. 마지막으로 생각되어야 할 점은 지역중심으로 전개될 건강관리사업은 건강증진 및 질병예방적 측면과 질병진료 및 회복과 재활에 이르는 종합적이고 포괄적인 사업이어야 한다는 점에서 종래 공공 의료부문과 사설의료기관 사이에 나누어져 있던 예방의학과 치료의학의 통합 뿐 아니라 정부주축으로 이루어 지고 있는 지역사회개발사업 및 농촌지도사업과 종교 및 각종 민간인 집단이 벌이고있는 사업들과의 전체적인 통합적 접근이 이루어져야 한다고 생각하는 입장에서 종래 간호교육이 강조하지 않던 진료의 의무와 대외적 조직활동에 대한 보완적인 교육조치가 요구된다고 봅니다. 간호의 학문체계로서의 입장은 오랜 역사를 두고 논의의 대상이 되어왔으나 아직까지 뚜렷이 어떤 것이 간호 특유의 지식체계이며 건강문제에 관련하여 무엇이 간호특유의 결정영역이며 이 결정과 그 결과를 어떠한 방법으로 치료적 행위로 옮길 수 있는가에 대한 확실한 답을 얻지 못하고 있는 실정이라고 봅니다. 다만 근래에 제시된 여러 간호이론들 속에서 공통적으로 이야기되어지고 있는 개념들로선 우선 간호학문을 건강과 질병에 관련된 인간의 전인적이고 전체적인 상황을 다루는 학제적 과학으로서보는 입장이 있고 따라서 생물신체적인 면 외에 정신심리적, 사회경제적, 정치문화적 환경과의 상호작용 속에서 인간의 건강과 질병문제를 생각한다는 지향을 갖고 있다고 말할 수 있겠읍니다. 간호교육은 간호계 내적인 학문적, 이론적 체계화의 요구에 못지않게 대민봉사하는 전문직으로서의 사회적 책임을 감당해야하는 중요과제를 안고있어 변화하는 사회요구에 효과적으로 대처해 나가야 할 당면문제를 안고 있읍니다. 간효역할 확대, 보건진료원훈련 등 이러한 사회적 요구에 대응하려는 조치가 되겠읍니다. 이러한 시점에서 간호계가 분명히 짚고 넘어가야 할 사실은 이러한 움직임들이 종래의 의사들의 외업무공급을 연장 확대하는 입장에 서서 간호의 특수전문직 명목을 흐리게 할수있는 위험을 감수할 것인지 아니면 가능한 대체방안을 갖고 간호전문직의 독자적인 진로를 개척하면서 다각적인 도전을 받아들일 준비를 갖추든지 그 방향을 뚜렷이 해야할 일이라 생각합니다. 저로서는 이미 잘 훈련된 간호원들과 조산원들의 교육적, 경험적 배경을 기반으로 지역사회 최일선 건강관리요원으로 사회적 효능을 다 할수 있는 일차건강관리간호조직의 구현을 대체방안으로 제시하고 싶습니다. 간호원과 조산원들의 훈련된 역량과 건강관리체제의 구조적 변화를 효과적으로 조화시킨다면 대부분의 세계인구의 건강문제는 해결가능하다고 보는 입장입니다. 물론 정책과 의료와 행정적지원이 활성화되어지는 환경속에서만 그 기대하는 결과가 확대되리라는 점 부언하는 바입니다. 마지막으로 언급하고 싶은 점은 바로 오늘의 주제 ''교육의 동역자-선생과 학생''이라는 개념입니다. 특히 상회정의적 입장에서 보는 의료사업전개에 지역민 내지 의료소비자의 참여를 강조하는 현시점에 있어 교육자와 학생이 교육의 현장에서 서로 동역자로서 학습의 책임을 나누는 경험은 아주 시기적으로 적합하여 교육적으로 지대한 의미를 갖는 것이라고 생각합니다. 이에 수반되어져야 할 역할의 변화에 수용적인 자세를 갖고 적극 실제적용하려 노력하는 선생앞에서 자주적 결정을 행사해본 학생이야말로 건강관리대상자로 하여금 같은 결정권을 행사할수 있도록 촉구하여 주민의 자조적 역량을 기르고 의료사업의 민주화, 인간화를 이룩할 수 있는 길잡이가 될 수 있으리라 믿는 바입니다.

• Journal of radiological science and technology
• /
• v.31 no.1
• /
• pp.17-23
• /
• 2008

Purpose : Because there is a difference depending on the environment as for an inspection equipment the important part of bone density scan and the precision/accuracy of a tester, the management of quality must be made systematically. The equipment failure caused by overload effect due to the aged equipment and the increase of a patient was made frequently. Thus, the replacement of equipment and additional purchases of new bonedensity equipment caused a compatibility problem in tracking patients. This study wants to know whether the clinical changes of patient's bonedensity can be accurately and precisely reflected when used it compatiblly like the existing equipment after equipment replacement and expansion. Materials and methods : Two equipments of GE Lunar Prodigy Advance(P1 and P2) and the Phantom HOLOGIC Spine Road(HSP) were used to measure equipment precision. Each device scans 20 times so that precision data was acquired from the phantom(Group 1). The precision of a tester was measured by shooting twice the same patient, every 15 members from each of the target equipment in 120 women(average age 48.78, 20-60 years old)(Group 2). In addition, the measurement of the precision of a tester and the cross-calibration data were made by scanning 20 times in each of the equipment using HSP, based on the data obtained from the management of quality using phantom(ASP) every morning (Group 3). The same patient was shot only once in one equipment alternately to make the measurement of the precision of a tester and the cross-calibration data in 120 women(average age 48.78, 20-60 years old)(Group 4). Results : It is steady equipment according to daily Q.C Data with $0.996\;g/cm^2$, change value(%CV) 0.08. The mean${\pm}$SD and a %CV price are ALP in Group 1(P1 : $1.064{\pm}0.002\;g/cm^2$, $%CV=0.190\;g/cm^2$, P2 : $1.061{\pm}0.003\;g/cm^2$, %CV=0.192). The mean${\pm}$SD and a %CV price are P1 : $1.187{\pm}0.002\;g/cm^2$, $%CV=0.164\;g/cm^2$, P2 : $1.198{\pm}0.002\;g/cm^2$, %CV=0.163 in Group 2. The average error${\pm}$2SD and %CV are P1 - (spine: $0.001{\pm}0.03\;g/cm^2$, %CV=0.94, Femur: $0.001{\pm}0.019\;g/cm^2$, %CV=0.96), P2 - (spine: $0.002{\pm}0.018\;g/cm^2$, %CV=0.55, Femur: $0.001{\pm}0.013\;g/cm^2$, %CV=0.48) in Group 3. The average error${\pm}2SD$, %CV, and r value was spine : $0.006{\pm}0.024\;g/cm^2$, %CV=0.86, r=0.995, Femur: $0{\pm}0.014\;g/cm^2$, %CV=0.54, r=0.998 in Group 4. Conclusion: Both LUNAR ASP CV% and HOLOGIC Spine Phantom are included in the normal range of error of ${\pm}2%$ defined in ISCD. BMD measurement keeps a relatively constant value, so showing excellent repeatability. The Phantom has homogeneous characteristics, but it has limitations to reflect the clinical part including variations in patient's body weight or body fat. As a result, it is believed that quality control using Phantom will be useful to check mis-calibration of the equipment used. A value measured a patient two times with one equipment, and that of double-crossed two equipment are all included within 2SD Value in the Bland - Altman Graph compared results of Group 3 with Group 4. The r value of 0.99 or higher in Linear regression analysis(Regression Analysis) indicated high precision and correlation. Therefore, it revealed that two compatible equipment did not affect in tracking the patients. Regular testing equipment and capabilities of a tester, then appropriate calibration will have to be achieved in order to calculate confidential BMD.