• Title/Summary/Keyword: Korean guidelines

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Clinical Value of a Desktop Spirometer (HI-801) for Spirometry Screening (선별 검사를 위한 탁상용 폐활량기 (HI-801)의 임상적 유용성에 관한 고찰)

  • Choi, Hye Sook;Choi, Cheon Woong;Park, Myung Jae;Kang, Hong Mo;Yoo, Hong Ji
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.4
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    • pp.276-283
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    • 2007
  • Background: A national health care initiative recommends routine spirometry screening of all smokers over age 45 or patients with respiratory symptoms. In response to the recommendation, new, simple, and inexpensive desktop spirometers for the purpose of promoting widespread spirometric screening were marketed. The performance of these spirometers was evaluated in vivo testing with healthy subjects. However, the clinical setting allows spirometric assessment of various pathologic combinations of flow and volume. Objective: The aim of this study was to compare the accuracy of a desktop spirometer to a standard laboratory spirometer, in a clinical setting with pathologic pulmonary function. Method: In a health check-up center, where screening pulmonary funct test was performed using the HI-801 spirometer. Subjects who revealed the ventilation defect in screening spirometry, performed the spirometry again using the standard Vmax spectra 22d spirometer in a tertiary care hospital pulmonary function laboratory. Pulmonary function test with both spirometer was performed according to the guidelines of the American Thoracic Society. Results: 109 patients were enrolled. Pulmonary function measurements (FVC, $FEV_1$, PEFR, FEF25%-75%) from the HI-801 correlated closely (r=0.94, 0.93, 0.81, 0.84, respectively) with those performed with the Vmax spectra 22d and showed the good limits of agreement and differences between the 2 devices; FVC +0.35 L, $FEV_1$ +0.16 L, PEFR +1.85 L/s, FEF25%-75%-0.13 L/s. With the exception of $FEV_1$, FEF25%-75%, these differences were significant(p<0.05) but small. Conclusion: The HI-801 spirometer is comparable to the standard laboratory spirometer, Vmax spectra 22d, with high accurary for $FEV_1$ and FVC and acceptable differences for clinical use.

Effects of a Self-Help Program including Stretching Exercise on Reduction of Symptom in Patients with Fibromyalgia (신장운동을 포함한 자조관리프로그램이 섬유조직염환자의 증상완화에 미치는 효과)

  • Han, Sang-Sook
    • Journal of muscle and joint health
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    • v.5 no.1
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    • pp.39-56
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    • 1998
  • This study was an quasi-experimental study, done to identify factors Influencing the reduction of symptoms in patients with fibromyalgia. The primary purpose of the study was to develop a Self-Help Program suitable for patients with fibromyalgia in Korea. The secondary purpose was to identify the effects of a Self-Help Program which included stretching exercise. This study was carried out between Feb. 24 and July 8, 1997 and patients in the study Included out patient diagnosed with fibromyalgia based on the criteria developed by the American College of Rheumatology(1990) and H, University which is a tertiary patient care clinic for Rheumatism. The experimental group included 38 patients who were residents of Seoul or Kyungi province, and a control group of 38 patients who were residents of other areas. The control patients were matched to the experimental group patients and they were selected considering the number of tender points on the Fibromyalgia Impact Questionnaire score and a score of self-efficacy. The experimental group participated in a Self-Help Program based on the American Arthritis Foundation(1995) guidelines. The program participants participated in a small group which consisted of 12-15 members attending the program once a week, for 6 weeks with each program lasted two to two and a half hours. The stretching exercise was carried out in each patient's home every day following the video tape exercise provided by the researcher, and the researcher provided encouragement and concern to the patients by calling them once a week. The number times the exercise was performed was divided by the number of participants to calculate the percentage of performance and determine the amount of exercise. Self-efficacy was measured by the Self-Efficacy Scale developed by Lorig et al. (1989) for arthritis patients. The degree of pain was converted to scores based on the Visual Analog Scale, the number of tender points was converted to scores based on the criteria of the ACR(1990) and of Yunus. Depression was measured by CES-D and physical disability, sleep disturbance, fatigue, and anxiety of patients with fibromyalgia were measured by the Fibromyalgia Impact Questionnaire. The level of the exercise performance was converted to scores using the number of times the exercise was performed following the video tape prepared by Association of Rheumatology Health Professionals. Data were analyzed by SPSS windows and the results ire described below. 1. The experimental group which participated in the Self-Help Program showed higher efficacy scores than the control group when both groups were analyzed for depression and the number of tender points as common variables(F=9.146, p=.003). 2. The experimental group which participated in the Self-Help Program showed lower scores than the control group, for pain, the number of tender points, depression, physical disability, fatigue, sleep disturbance and anxiety. These symptoms of fibromyalgia can all be seen to have subsided(F=9.483, p=.003 : F=32.680, p=.001 ; F=11.104, p=.001, F=5.344 : p=.024, F=7.630 : P=.007, F=15.6512, p=.003 : F= 7.5412, p=.008). 3. In the experimental group, the self-efficacy score for the first three weeks showed a positive correlation with the exercise-performance score for four to six weeks (r=.387, p=.043). 4. In the experimental group, the relationship between the level of exercise-performance and the reduction of symptoms showed a significant correlation only to physical disability(r= -.500, p=.001). 5. In the experimental group, the relationship between the self-efficacy score and pain, the number of tender points, depression, physical disability, fatigue, sleep disturbance and anxiety score showed inverse correlations and thus, a reduction of symptoms occured when the self-efficacy score increased(r=-.325, p=.004 ; r= -.253, p=.027, r=-.452, p=.001 : r=-.434, p=.001 ; r=-.316, p=.005 ; r=-.460, p=.001 ; r=-.397, p=.014). Therefore, self-efficacy improved following the Self-Help Program including the stretching exercise. It was also found that physical symptoms (pain, number of tender points, level physical disability) and psychological symptoms (depression, fatigue, sleep disturbance, anxiety) were reduced. Moreover, It was found that the higher the self-efficacy, the the higher the degree of achievement of goals set for the stretching exercises. In addition, the level of exercise-performance influenced the level of physical disability, one of the symptoms of fibromyalgia. Accordingly, the conclusions from this study are that exercise-performance and the reduction of symptoms is achieved through promotion of self-efficacy. Therefore, it is proposed that are the Self-Help Program including stretching exercises is an appropriate nursing intervention for the reduction of symptoms of fibromyalgia.

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Analysis of Image Distortion on Magnetic Resonance Diffusion Weighted Imaging

  • Cho, Ah Rang;Lee, Hae Kag;Yoo, Heung Joon;Park, Cheol-Soo
    • Journal of Magnetics
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    • v.20 no.4
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    • pp.381-386
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    • 2015
  • The purpose of this study is to improve diagnostic efficiency of clinical study by setting up guidelines for more precise examination with a comparative analysis of signal intensity and image distortion depending on the location of X axial of object when performing magnetic resonance diffusion weighted imaging (MR DWI) examination. We arranged the self-produced phantom with a 45 mm of interval from the core of 44 regent bottles that have a 16 mm of external diameter and 55 mm of height, and were placed in 4 rows and 11 columns in an acrylic box. We also filled up water and margarine to portrait the fat. We used 3T Skyra and 18 Channel Body array coil. We also obtained the coronal image with the direction of RL (right to left) by using scan slice thinkness 3 mm, slice gap: 0mm, field of view (FOV): $450{\times}450mm^2$, repetition time (TR): 5000 ms, echo time (TE): 73/118 ms, Matrix: $126{\times}126$, slice number: 15, scan time: 9 min 45sec, number of excitations (NEX): 3, phase encoding as a diffusion-weighted imaging parameter. In order to scan, we set b-value to $0s/mm^2$, $400s/mm^2$, and $1,400s/mm^2$, and obtained T2 fat saturation image. Then we did a comparative analysis on the differences between image distortion and signal intensity depending on the location of X axial based on iso-center of patient's table. We used "Image J" as a comparative analysis programme, and used SPSS v18.0 as a statistic programme. There was not much difference between image distortion and signal intensity on fat and water from T2 fat saturation image. But, the average value depends on the location of X axial was statistically significant (p < 0.05). From DWI image, when b-value was 0 and 400, there was no significant difference up to $2^{nd}$ columns right to left from the core of patient's table, however, there was a decline in signal intensity and image distortion from the $3^{rd}$ columns and they started to decrease rapidly at the $4^{th}$ columns. When b-value was 1,400, there was not much difference between the $1^{st}$ row right to left from the core of patient's table, however, image distortion started to appear from the $2^{nd}$ columns with no change in signal intensity, the signal was getting decreased from the $3^{rd}$ columns, and both signal intensity and image distortion started to get decreased rapidly. At this moment, the reagent bottles from outside out of 11 reagent bottles were not verified from the image, and only 9 reagent bottles were verified. However, it was not possible to verify anything from the $5^{th}$ columns. But, the average value depends on the location of X axial was statistically significant. On T2 FS image, there was a significant decline in image distortion and signal intensity over 180mm from the core of patient's table. On diffusion-weighted image, there was a significant decline in image distortion and signal intensity over 90 mm, and they became unverifiable over 180 mm. Therefore, we should make an image that has a diagnostic value from examinations that are hard to locate patient's position.

Evaluation of a Community-Based Cancer Patient Management Program: Collaboration between a Hospice Center and Public Health Centers (병원 호스피스센터-보건소 연계를 통한 지역사회 재가암환자 관리 프로그램 평가)

  • Lee, Hae-Sook;Park, Sun-Hee;Chung, Young-Soon;Lee, Boo-Kyung;Kwon, So-Hi
    • Journal of Hospice and Palliative Care
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    • v.13 no.4
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    • pp.216-224
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    • 2010
  • Purpose: The purpose of this study was to evaluate a community-based cancer patient management program (CBPCMP) which was collaborated between a hospice center and public health centers. Methods: The CBPCMP proceeded on four steps; 1) Signing agreements with three public health centers, 2) Enrolling the domiciliary terminal cancer patients, 3) Providing home hospice service, and 4) Inquiring patient's level of satisfaction. From February 1 to December 31 in 2009, 43 terminal cancer patients were referred and provided with home hospice service. The hospice team made a total of 605 visits. Medical records for each visit and data from satisfaction surveys were analyzed. Results: 76.7% of patients were older than 60 years, and 90.7% of the patients were alert. The level of functional status for 76.7% of patients rated as lower than ECOG grade 1. 62.8% of the patients or their caregivers signed hospice service agreements. On the initial evaluation, the most frequent reasons for referral were general weakness (86.0%), followed by anorexia (72.1%). Nurses visited the patients' most frequently (371 visits), followed by volunteers (216 visits). Nurses provided emotional support and health promotion counseling on 95.1% and 22.9% of visits, respectively. The mean satisfaction score rated by patients and their family was 4.45 out of 5. Conclusion: This study tested CBPCMP in collaboration with hospice centers and public health centers. CBPCMP showed a possibility to improve the quality of end of life care. To insure the quality care, however, the guidelines for home hospice service should be developed.

Perceptions of Caregivers and Medical Staff toward DNR and AD (Do Not Resuscitate (DNR)와 Advance Directives (AD)에 대한 환자 보호자와 의료인의 인식)

  • Lee, Sun Ra;Shin, Dong-Soo;Choi, Yong-Jun
    • Journal of Hospice and Palliative Care
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    • v.17 no.2
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    • pp.66-74
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    • 2014
  • Purpose: This study is aimed to investigate perceptions of caregivers and medical staff toward do not resuscitate (DNR) and advance directives (AD). Methods: Participants were 141 caregivers and 272 medical staff members from five general hospitals. A questionnaire used for the study consisted of 20 items: 14 about DNR perceptions, three about AD, one each for age, gender and employment. Results: Both medical staff and caregivers strongly recognized the need for DNR and AD, and the level of recognition was higher with medical staff than caregivers (DNR ${\chi}^2=44.56$, P=0.001; AD ${\chi}^2=16.23$, P=0.001). The main reason for the recognition was to alleviate sufferings of patients in the terminal phase. In most cases, DNR and AD were filled out when patients with terminal conditions were admitted, and patients made the decisions by consulting with their guardians. Medical staff better recognized the need and for growing demand for guidelines for the DNR and AD decision making process than caregivers (${\chi}^2=7.41$, P=0.0025). Conclusion: This study showed that patients highly rely on their caregivers when making decisions for DNR and AD. Thus, it is important that patients and caregivers are provided with objective information about the decisions. Since participants' strong support for DNR and AD was mainly aimed at alleviating patients' suffering, further study is needed in the association with hospice care. Medical staff also needs to understand the different views held by caregivers and fully consider the disparity when informing patients/caregivers to make the DNR and AD decisions.

Annual Increase in Carbon and Nitrogen Stocks of Trees and Soils in a 'Niitaka' Pear Orchard Following Standard Fertilization Recommendations (표준 시비에 따른 '신고'배 수체 및 재배지 토양의 탄소 및 질소 저장량 변화)

  • Ro, Hee-Myong;Choi, Jin-Ho;Lee, Seo-Yeon;Lee, Tae-Kyu;Kim, Jong-Sung;Park, Ji-Suk;Choi, Jang-Jeon;Lee, Min-Jin
    • Horticultural Science & Technology
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    • v.33 no.4
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    • pp.591-597
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    • 2015
  • We determined the total C and N stocks in trees and soils after 1 year of fertilization in an experimental orchard with 16-year-old 'Niitaka' pear (Pyrus pyrifolia Nakai cv. Niitaka) trees planted at $5.0m{\times}3.0m$ spacing on a Tatura trellis system. Pear trees were fertilized at the rate of 200 kg N, 130 kg P and $180kg\;K\;ha^{-1}$. At the sampling time (August 2013), trees were uprooted, separated into six fractions [trunk, main branches, lateral branches (including shoots), leaves, fruit, and roots] and analyzed for their total C and N concentrations and dry masses. Soil samples were collected from 0 to 0.6 m in 0.1 m intervals at 0.5 m from the trunk, air-dried, passed through a 2-mm sieve, and analyzed for total C and N concentrations. Undisturbed soil core samples were also taken to determine the bulk density. Dry mass per tree was 5.6 kg for trunk, 12.0 kg f or m ain branches, 15.7 kg for lateral branches, 5.7 kg for leaves, 9.8 kg for fruits, and 10.5 kg for roots. Total amounts of C and N per tree were respectively 2.6 and 0.02 kg for trunk, 5.5 and 0.04 kg for main branches, 7.2 and 0.07 kg for lateral branches, 2.6 and 0.11 kg for leaves, 4.0 and 0.03 kg for fruit, and 4.8 and 0.05 kg for roots. Carbon and N stocks stored in the soil per hectare were 155.7 and 14.0 Mg, respectively, while those contained in pear trees were 17.8 and $0.2Mg{\cdot}ha^{-1}$ based on a tree density of 667 trees/ha. Overall, C and N stocks per hectare stored in the pear orchard were 173.6 and 14.2 Mg, respectively. Compared with results obtained in 2012, the amounts of C stocks have increased by $17.7Mg{\cdot}ha^{-1}$, while those of N stocks remained virtually unchanged ($0.66Mg{\cdot}ha^{-1}$).

A Research on the Development Initiative for Public Practices of Local Governmentsin Korea - Focused on the Local Adaptation Planning in Ecosystem Sector - (지자체 기후변화 적응실무 발전방향 연구 - 생태계 분야 기후변화 적응 시행계획 수립 및 이행을 중심으로 -)

  • Yeo, Inae;Hong, Seungbum
    • Journal of Environmental Impact Assessment
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    • v.29 no.2
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    • pp.79-92
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    • 2020
  • This study aimed at analyzing the current status and further needs of ecological information which is provided with the civil servants in the process of climate change adaptation planning in ecosystem sector and at providing suggestions for future development of ecological knowledge on climate change. Therefore, we conducted a questionary survey titled as "the knowledge-base and information needs for climate change adaptation in ecosystem sector" with the civil servants who are engaged with adaptation practices in the ecology related divisions in 17 regional local governments (RLG) and the affiliated basic local governments (BLG) in Korea. As a result, the characteristics of ecological information which is applied in public practices was analyzed and strategies for improved utilization was suggested. 75% of the respondents (RLG 85% and BLG 72%) were aware of the relativeness between the existence and utilization of ecological information and the execution of climate adaptation practices in ecosystem sector. They were agreed with the necessity of ecological information not only in adaptation practices but also overall affairs in the ecological related division in the local government (RLG 82% and BLG 72%). The current situation of utilizing ecological information which is produced from central orlocal government to civil affairs were only represented as 64 persons (28%) in RLG and 42 persons (18%) in BLG. One of the major obstacles that the respondents confront with when applying ecological information to public practices was deficit of prior knowledge on the ecological information itself, such as awareness of the characteristics of ecological information and the link with public affairs for adaptation plans. Therefore, delivering current knowledge and ecological information on climate change by educational and promotional method is an urgent priority to the civil servant. The future needs on ecological information for local government servants were deduced as basic information on local ecosystem and applied knowledge on local development to meet the biodiversity conservation and ecosystem services at the same time. The respondents expected not only the specific guidelines for using ecological information to apply on the adaptation plans in the relevant divisions of the local governments but also the institution where the usage activation of ecological information would be operated and managed to enhance the information utilizing structure in the local government. In the nation-wide, the capacity of local governments should be enhanced with adaptation knowledge and the application of appropriate information to the public practices by central government's aiding with the better quality of information, its public promotion, and the applicability to civil affairs.

A study on the temperature inside clothing as fundamental data for development of the heat energy harvesting clothing (인체 전력에너지 수확의류 개발을 위한 의복내 온도 측정의 기초적 고찰)

  • Yang, Jin-Hee;Cho, Hyun-Seung;Park, Sun-Hyung;Lee, Joo-Hyeon
    • Science of Emotion and Sensibility
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    • v.16 no.1
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    • pp.125-132
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    • 2013
  • Recently, the consciousness of energy crisis is rapidly growing and sustainable eco-friendly energy sources are becoming issue. Therefore the portable electronic device requires new energy sources for providing continuous power supply and the power energy harvesting system of the human body that enables the power-harvesting research requests anytime, anywhere. One of the sources for energy harvesting is heat energy, which is the difference in temperature of the body and the surrounding environment. We tried to analyze the temperature difference between the environmental temperature and the temperature inside clothing according to the structure of the closed portion. And we examined the temperature difference between the environmental temperature and the temperature inside clothing according to the material of the clothing. The analysis showed that we have been able to get different results at parts of the body in the temperature inside clothing according to the structure of clothing. In upper torso of the chest and back, the temperature inside clothing of 'closed structure' was higher than the temperature inside clothing of 'opened structure'. In the section of arm and leg, it was reduced the difference of temperature inside clothing between 'closed structure' and 'opened structure'. It was particularly noticeable in the section of leg. The results of analysis of the difference between the environmental temperature and the temperature inside clothing according to the material of the clothing, in both cases of the two materials, 'closed structure' was higher than the 'opened structure' in the difference value between the environmental temperature and the temperature inside clothing. There was a difference according to the material in the section of leg. In this study, we outlined the basic guidelines for developing heat energy harvesting clothing by exploring the structure and material of clothing suitable for the heat energy harvesting.

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The Effect of Long-term Steroid Therapy Combined with Azathioprine in Henoch-$Sch{\ddot{o}}nlein$ Nephritis (Henoch-$Sch{\ddot{o}}nlein$(HS) 신염에서 장기 스테로이드와 Azathioprine의 병합치료 효과)

  • Moon, Kyoung-Sang;Jin, So-Young;Kim, Eun-Mi
    • Childhood Kidney Diseases
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    • v.2 no.2
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    • pp.118-124
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    • 1998
  • Purpose : There is no specific treatment guidelines for Henoch-$Sch{\ddot{o}}nlein$(HS) nephritis. Therefore we performed this study to observe the effect of long term steroid therapy combined with azathioprine Methods : Treatment protocols; 1) Steroid pulse therapy: methylprednisolon 30 mg/kg/dose, maximum 1 gm, intravenolisly 6 times for alternate day. 2) Oral steroid was given 2 mg/kg/day for 1 month, 1 mg/kg/day for following 1 month and alternate day oral steroid combined with azathioprine 2 mg/kg/day for 2 years. Results : Time period from HSP to onset of HS nephritis was between 2 weeks to 5 months with mean $7.4{\pm}7.4$ weeks. Clinical remission were seen in 4 cases out of 5 ($80\%$). Mean time period with disappearance of proteinuria and microscopic hematuria were $5{\pm}2.4$ month and $13.3{\pm}2.9$ month respectively. On pathologic findings by ISKDC, 3 cases were grade IIIb, 2 cases were grade IV in first kidney biopsies and showed pathologic improvement in follow up tidneybiopsiesafterlyearstreatment. Conclusion : As there is no definitive treatment for HS nephritis so far, our study of long term oral steroid therapy with azathioprine was effective in clinical and histologic aspect. Therefore further study in HS nephritis with in a large group will be needed in the future.

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Causative Organisms of Community Acquired Urinary Tract Infection and Their Antibiotic Susceptibility at a Secondary hospital in Korea (2차 병원에서의 지역 사회 획득 요로 감염의 원인균 및 항생제 감수성 분석)

  • Jo, Yun Ju;Lee, Eun Jeong;Choi, Kyong Min;Eun, Young Min;Yoo, Hwang Jae;Kim, Cheol Hong;Lee, Hyun Hee;Kim, Pyung Kil
    • Pediatric Infection and Vaccine
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    • v.17 no.1
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    • pp.30-35
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    • 2010
  • Purpose : We investigated the causative organism and its antibiotic susceptibility of community acquired urinary tract infection (UTI) in children at a secondary hospital to test the adequacy of the current guidelines. Methods : Children diagnosed with UTI at the Department of Pediatrics, Kwandong University MyMyongji Hospital by pyuria and bacterial growth of greater than $1.0{\times}10^5CFU/mL$ on clean catch midstream urine from January 2005 to December 2008 were studied retrospectively. The epidemiologic data, causative organism, and the antibiotic susceptibility were analyzed. Results : Sixty two children were diagnosed with sixty four cases of UTI's. Two bacteria were isolated in one case and thus data on 65 urine cultures were analyzed. The male:female ratio was 1.6:1 and 78.1% were less than 12 months of age. Escherichia coli was the predominant cause consisting of 53 cases (82.8%) of the cases. K. pneumoniae (5), Enterobacter (4), Enterococcus (1), $\beta$-streptococcus (1), Diphtheroides (1) were isolated. The antibiotic resistance of E. coli were as follows; ampicillin 69.8%, cefotaxime 1.9%, gentamicin 15.1%, amikacin 0.0%, levofloxacin 1.9%, and trimethoprim/sulfamethoxazole 26.4 %. Only one case of the E. coli was extended spectrum $\beta$-lactamase (ESBL) positive. Conclusion : Compared to prior reports from other tertiary hospitals in Korea, E. coli was the predominant cause in childhood UTI and the rate of ESBL positivity was low. The antibiotic resistance was also different compared to prior reports. We conclude that a difference in the cause and antibiotic resistance of childhood UTI exists between centers and this should be taken into consideration when prescribing antibiotics for childhood UTIs.