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A Study on Nursing Service of Chronic Diseases by the First Step and Third Step Medical Treatment (1차 및 3차 진료기관 이용 만성질환자의 간호서비스에 관한 연구)

  • Cho Chong Sook
    • Journal of Korean Public Health Nursing
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    • v.10 no.2
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    • pp.103-118
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    • 1996
  • It is to be growing up the interest of community health affairs through visiting nursing care. The health medical treatment of Korea has been changed largely on the period. The juvenile population has decreased. This means that is has took the population consensus of advanced national organization to be increased by the old age. The transition of disease has changed from the contagious disease importance to the chronicity disease omportance because the domestic district population has experienced the sudden urbanization circumstance district population has experienced the sudden urbanization circumstance to be growing up $70\%$ of the whole population. When the nursing service has common function to be delivering from all direction to home, this study is getting the great important phase velocity in order to manage the kernel questional adult chronicity disease of health medical institution at the present age. (1) community over system or with people particularity (2) the first of third step medical treatments. The variety of medical treatments organization has quantity of the delivery manpower and specially between consumers and rdlated person. A qualitative difference is showed at the purpose to be seizing. That research related person is use at district health center in Seoul, by foundation on nurse registration book of H collage hospital and public health registration book. According the chronicity disease. age. and sex. nature agree-able standard 54 people took the content analysis on nurse registration book of total 108 people. The results of the study were as follows: 1. General background factors are houses or kind of medical facilities and number of patients in family. The first medical treatment is more patients than third medical treatment organization. The first medical treatment of economic environment os appering to be worse. 2. The chronicity disease frequency have been different speciality according to medical treatment organization. On case of the first medical treatment. Diabetes and High Blood Pressure were good but Cerebrum Vascular Accident(CVA) showed many for bed case. In addition. the number of family is comparative large exception of CVA on according for moving condition and health more than the first medical treatment. However. family condition. whole family percentage is decreasing preferably through the potential resource is increasing by the number of and the construction of family. The ability of real resource is considered to be low. 3. The average percentage of nurse service has appered to be differed two groups by the first step medical treatment(33.72 times) and third step medical treatment(45.70 times). However, the difference (the first step medical treatment and third step medical treatment) is to be limited to issue the medicine at the service. The condition of nurse care was the indirect nursing care. Supportiong area was to be related to volunteer service and administration support. 4. The various nursing care average percentage of the chronicity disease was increased by orders of Diabetes. High Blood Pressure. and CVA in examination result and the medical treatment. The indirect nursing care was also same. At third step medical treatment, orders of chronicity disease were same. The case of other area on service conditions were increased by order of Diabetes. High Blood Pressure, and CVA. However. it is never appearing the difference at bottleneck affairs nursing care. 5. When the visiting nursing care demand particularly. the average percentage of nursing care from the first step medical treatment that the time under a person is many more than the time over two people. However, there was no difference in statistic. Third step medical treatment is $49.81\%$ at the time under a person. The average nursing care service is appeared by more many when the visiting nursing care demand is a few by 12.83 at the time over two people. 6. By visiting nursing care percentage to be frequency that nursing care averaghe percentage and inter-relation are large. The related factor of the first medical treatment is 0.96. However, the related factor of third medical treatment has shown the decreased 0.49 for the condition of relation more than that. Therefore. the nursing care average percentage is related to the visiting times of a nurse. This result is be showing the obvious fact that the first step medical treatment is few more than third step medical treatment.

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A Study on the Location of Urban Parks for Green-Network Revitalization - Based on Downtown of Busan - (도시공원 입지특성에 따른 그린네트워크 활성화 연구 - 부산광역시 도심권을 대상으로 -)

  • Kim, Sung-Hwan;Lee, Gyu-Hong;Park, Sung-Bum
    • Journal of the Korean Institute of Landscape Architecture
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    • v.38 no.2
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    • pp.75-93
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    • 2010
  • Seen topographically, Busan is a city that is coastal and hilly. In the city, most parks have been formed around mountain areas that are not so useful. They also are unbalanced in location among different regions of the city. The purpose of this study is to find how to manage urban parks towards green network promotion. For the purpose, this researcher first analyzed physical and environmental characteristics of urban parks located within the main living spheres of Busan. Then, the researcher examined interactive relations between those parks and downtown areas surrounding them to classify types of the parks. In association, the researcher classified the entire of the city into inland and coastal regions. And the researcher examined mountainous and hilly urban parks that were 150 to 300 meters above sea level in the former region and 100 to 150 meters above sea level in the latter. Findings of the study can be summarized as follows. The above examination found that parks of Busan feature physically penetrating and overlapping with downtown areas of the city. How well the green zones of Busan in form of urban park are inter-connective and influential to each other heavily depends on shapes and functions that the downtown areas of the city have. In this study, urban parks of Busan were grouped according to their types and then analyzed. Based on results of the analysis, the researcher tried to find how to increase the utility of another urban parks that are expected to be formed and how to promote so-called the green network that integrates greens. Considering findings of the study, the researcher would make the following suggestions. In case of forming an urban park in a gently sloped green zone which is easily accessible and noticeable, it's important that the park should include a stream to which another green zone is converged or, if the park is located near a costal area, contribute to promote urban functions and openness. While, in a high-altitude green zone, it's more effective to form so-called the green way that consists of some limited usable site of the zone and greens behind it and then form a hub of regional community at the intersection between the main road and main gate to the urban park, contributing to the green network promotion.

Treatment Outcome of Postoperative Radiotherapy in Extrahepatic Bile Duct Cancer (간외담관암의 수술 후 방사선치료 성적)

  • Choi, Young-Min;Cho, Heung-Lae
    • Radiation Oncology Journal
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    • v.21 no.1
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    • pp.27-34
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    • 2003
  • Purpose : To evaluate the efficacy of radiotherapy, and the factors affecting survival in patients of extrahepatic bile duct cancer, by analyzing the results of postoperative radiotherapy Materials and Methods : Between October 1991 and July 2001, 21 patients with extrahepatic bile duct cancer, who received radiotherapy after a radical resection, were retrospectively reviewed. The patients' ages ranged from 39 to 75 years, with a median of 61 years, and a male to female ratio of 16 to 5. The numbers of patients with proximal and distal bile duct cancer were 14 and 7, respectively. From the postoperative pathological examination, 19 of the patients were found to have microscopic residues, and 7 to be lymph node positive. Patients with AJCC stages I, II and III were 10, 10 and 1, respectively. The total radiation dose administered was 4,500$\~$6,300 cGy, with a median dose of 5,040 cGy. The follow up period was 20$\~$81 months, with a median of 57.5 months. Results : The overall and disease free survival rates at 3 and 5 years were 41.0 and 29.3$\%$, and 41.6 and 29.7$\%$, respectively. The influences of age, sex, tumor location, differentiation, microscopic residue, neural invasion, 7 and N stage, the stage itself, the dose of radiation and chemotherapy, on survival were evaluated. The T stage and the stage itself were found to be significant from a univariate analysis (p<0.05), but the degree of significance was limited by the small number of patients. A recurrence occurred in 12 patients (57.1$\%$), 5 in locoregional sites, 4 in distant sites and 3 in a combination of locoregional and distant sites, and the sites of distant metastasis were the liver, 6, and the bone, 1 Grade 2 or 3 acute leucopenias occurred in 2 patients and grade 2 chronic peptic ulcers occurred in 4, who were all recovered by conservative management. Conclusion : Postoperative radiotherapy is feasigbls in extrah데atic bile duct cancer, with tolerable toxicity, but prospective studies, with a large patient enrollment, are needed for the evaluation of the effects of postoperative radiotherapy and the related prognostic factors.

Antioxidant activity and anti-tumor immunity by Propolis in mice

  • Choi, In-Sook;Itokawa, Yuka;Maenaka, Toshihiro;Yamashita, Takenori;Mitsumoto, Morihide;Tano, Kaoru;Kondo, Hiroyo;Ishida, Torao;Nakamura, Takashi;Saito, Kiyoto;Terai, Kaoru;Monzen, Hajime;Oshima, Masami;Takeuchi, Tetsuo;Mituhana, Yuicti;Bamen, Kenichi;Ahn, Kyoo-Seok;Gu, Yeun-Hwa
    • Advances in Traditional Medicine
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    • v.5 no.2
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    • pp.100-109
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    • 2005
  • In South America, natural products with unknown drug effects are used as folk remedies and for preventive medicine. Among South American natural products, we directed our attention to Propolis, which have been known as medicinal plants, and examined the mechanisms by which these substances affect antioxidant activity, anti-tumor activity and immunoresponse. When the antioxidant activities of Propolis were examined by the DPPH and Rhoudan iron methods, since Propolis contains high levels of flavonoids, it is thought that flavonoids may be responsible for the antioxidant activity in this study. In the examination of immunoenhancement activity, we measured lymphocyte versus polymorphonuclear leukocyte ratios (L/P activity). The number of lymphocytes was significantly increased in groups treated with Proplolis. Specifically, slightly high levels of $IFN-{\gamma}$ were measured in mice bearing the S-180 carcinoma, after administration of Propolis. This strongly suggests that cellular immunity is especially activated by treatment with Propolis, because production of $IFN-{\alpha}$ is limited to the T cells and NK cells stimulated by mitogen and sensitized antigen. $TNF-{\alpha}$ shows a different extent and mechanism of action depending on the target cells. When $TNF-{\alpha}$ was measured in mice bearing the S-180 carcinoma, mice treated with Propolis showed slightly higher $TNF-{\alpha}$ levels as compared to the control group. This suggests that activated macrophages produce $TNF-{\alpha}$ in mice treated with Prapolis, since activated macrophages and lymphocytes are the source of most $TNF-{\alpha}$. When anti-tumor action was examined using two kinds of sarcoma (Ehrlich solid carcinoma and Sarcoma-180 carcinoma), tumor-suppressive ratios after treatment with Propolis was 29.1%. When Sarcoma-180 solid carcinoma was used, tumor-suppressive ratios were 62%. Thus, Propolis showed strong anti-tumor activity against two kinds of solid carcinoma. Taken altogether, this strongly suggests that Propolis enhances original functions of macrophages and NK cells, and as a result, secondarily enhances the immune reaction and suppresses tumor growth.

THE EFFECT OF NEW BONE FORMATION OF ONLAY BONE GRAFT USING VARIOUS GRAFT MATERIALS WITH A TITANIUM CAP ON THE RABBIT CALVARIUM (가토의 두개골에서 티타늄 반구를 이용한 다양한 onlay bone graft시 골형성 능력)

  • Park, Young-Jun;Choi, Guen-Ho;Jang, Jung-Rok;Jung, Seung-Gon;Han, Man-Seung;Yu, Min-Gi;Kook, Min-Suk;Park, Hong-Ju;Ryu, Sun-Youl;Oh, Hee-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.6
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    • pp.469-477
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    • 2009
  • Purpose: This study was performed to evaluate the effect of various graft materials used with a titanium cap on the ability of new bone formation in the rabbit calvarium. Materials and Methods: A total of 32 sites of artificial bony defects were prepared on the calvaria of sixteen rabbits by using a trephine bur 8 mm in diameter. Each rabbit had two defect sites. 0.2 mm deep grooves were formed on the calvaria of sixteen rabbits by using a trephine bur 8 mm in diameter for the fixation of a titanium cap. The treatments were performed respectively as follows: without any graft for the control group (n=8), autogenous iliac bone graft for experimental group 1 (n=8), alloplastic bone graft ($SynthoGraft^{(R)}$, USA) for experimental group 2 (n=8), and xenogenic bone graft ($NuOss^{(R)}$, USA) for experimental group 3 (n=8). After the treatments, a titanium cap (8 mm in diameter, 4 mm high, and 0.2 mm thick) was fixed into the groove. At the third and sixth postoperative weeks, rabbits in each group were sacrificed for histological analysis. Results: 1. In gross examination, the surgical sites showed no signs of inflammation or wound dehiscence, and semicircular-shaped bone remodeling was shown both in the experimental and control groups. 2. In histological analysis, the control group at the third week showed bone remodeling along the inner surface of the cap and at the contact region of the calvarium without any specific infiltration of inflammation tissue. Also, there was no soft tissue infiltration. Bone remodeling was observed around the grafted bone and along the inner surface of the titanium cap in experimental group 1, 2, and 3. 3. Histologically, all groups at the sixth week showed the increased area of bone remodeling and maturation compared to those at the third week. In experimental group 2, the grafted bone was partially absorbed by multi nucleated giant cells and new bone was formed by osteoblasts. In group 3, however, resorption of the grafted bone was not observed. 4. Autogenous bone at the third and sixth week showed the most powerful ability of new bone formation. The size of newly formed bone was in decreasing order by autogenous, alloplastic, and heterogenous bone graft. There was no statistically significant difference among autogenous, alloplastic, and heterogenous bones(p>0.05). Summary: This result suggests that autogenous bone is the best choice for new bone formation, but when autogenous bone graft is in limited availability, alloplastic and xenogenic bone graft also can be an alternative bone graft material to use with a suitably guided membrane.

Usability index evaluation system for mobile WAP service (무선인터넷 서비스 사용성 지수 평가 체계)

  • Park, Hwan-Su
    • 한국HCI학회:학술대회논문집
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    • 2008.02b
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    • pp.152-157
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    • 2008
  • The customer satisfaction of WAP service greatly relies on the usability of the service due to the limited display size of a mobile phone and limitation in realizing UI (User Interface) for function keys, browser, and OS (operating system) Currently, a number of contents providers develop and deliver varying services, and thus, it is critical to control quality level of UI in consistent standards and manner. This study suggests usability index evaluation system to achieve consistent UI quality control of various WAP services. The system adopts both top-down and bottom-up approaches. The former concerns deriving UI design components and evaluation checklists for the WAP, based on the usability attributes and UI principles. The latter concerns deriving usability-related evaluation checklists from the established UI design features, and then grouping them from the viewpoint of usability principles and attributes. This bidirectional approach has two outstanding advantages: it allows thorough examination of potential elements that can cause usability problems from the standpoint of usability attributes, and also derives specific evaluation elements from the perspective of UI design components that are relevant to the real service environment. The evaluation system constitutes a hierarchical structure by networking usability attributes, UI guideline which indicates usability principles for each attribute, and usability evaluation checklist for each UI component that enables specific evaluation. Especially, each evaluation checklist contains concrete contents and format so that it can be readily marked in O/X. The score is based on the ratio of number of items that received positive answer to the number of total items. This enables a quantitative evaluation of the usability of mobile WAP service. The validity of the proposed evaluation system has been proved through comparative analysis with the real usability problems based on the user test. A software was developed that provides guideline for evaluation objects, criteria and examples for each checklist, and automatically calculates a score. The software was applied to evaluating and improving the real mobile WAP service.

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A Study on the Estimation Method of the Repair Rates in Finishing Materials of Domestic Office Buildings (국내 업무시설 건축 마감재의 수선율 산정 방안에 관한 연구)

  • Kim, Sun-Nam;Yoo, Hyun-Seok;Kim, Young-Suk
    • Korean Journal of Construction Engineering and Management
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    • v.16 no.1
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    • pp.52-63
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    • 2015
  • Business facilities among domestic architectures have rapidly been constructed along with domestic economic development. It is an important facility taking the second largest proportion next to apartment buildings among current 31 building types of fire department classification of 2012 year for urban architectures. The expected service life of business facilities is 15 years, but 70% of those in urban areas have surpassed the 15 year service life as of the present 2014. Thus, the demand for urgent rehabilitation of such facilities is constantly increasing due to the aging and performance deterioration of the facilities'main finishing materials. Especially, the business facilities are being used for the lease of company office or private office, and such problems as aging and performance deterioration of the facilities could cause less competitive edge for leasing and real estate value depreciation for the O&M (Operation & Management) agent and the owner, respectively. Therefore, an effective planned rehabilitation as a preventive measure according to the standardized repair rate by the number of years after the construction is in need in order to prevent the aging and performance deterioration of the facilities(La et al. 2001). Nonetheless, domestic repair/rehabilitation standards based on the repair rate are mainly limited to apartment buildings and pubic institutions, resulting in impractical application of such standards to business facilities. It has been investigated and analyzed that annual repair rate data for each finishing material are required for examination of the applicability of the repair rate standard for the purpose of establishment of a repair plan. Hence, this study aimed at developing a repair rate computation model for finishing materials of the facilities and verifying the appropriateness of the annual repair rate for each finishing material through a case study after collecting and analyzing the repair history data of six business facilities. The results of this study are expected to contribute to the planning and implementation of more efficient repair/rehabilitation budget by preventing the waste of unpredicted repair cost and opportunity cost for the sake of the business facilities' owners and O&M agents.

Thyroplasty for the Restoration of a Normal Voice (음성개선을 위한 갑상연골성형술)

  • 김기령;김광문;정명현;이원상;정승규
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1982.05a
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    • pp.10.1-10
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    • 1982
  • The use of phonosurgery in the recent development of laryngomicrosurgery has enabled the restoration of a normal voice in respect to functional laryngeal surgery which in Korea in the past limited to simple removal of benign laryngeal tumor such as laryngeal polyp or nodules and cordal injection of $Teflon^{{\circledR}}$ for the treatment of recurrent nerve paralysis under the vision of suspension laryngoscopy. Performance of phonosurgery for the treatment of cord paralysis, mutational dysphonia, vocal cord atrophy, hyperkinetic dysphonia and sulcus vocalis is a happy event in the view point of development of phonosurgery in Korea. In this aspect thyroplasty to change the position and physical characteristics of the cord outside the glottis instead of the direct handling of the vocal cord through direct endoscopy is popular. Among the 4 types of thyroplasty, classified by Insshiki(1974), type I thyroplasty(1ateral compression of vocal cord) and type IV thyroplasty(lengthening of vocal cord) were effective in the treatment of unilateral vocal cord paralysis. Advantages of this operation are the fine adjustment of the degree of lateral compression under local anesthesia according to the phonation of the patient during operation and avoidance of dyspnea and intralaryngeal hemorrhage due to the manipulation outside the internal perichondrium of the thyroid cartilage. We did 7 cases of thyroplasty for the treatment of unilateral vocal cord paralysis in the 7 months from September 1981 to March 1982. Before the operation aerodynamic study, psychoacoustical evaluation, stroboscopy and sound spectrographic analysis were done. Two months after the operation the above procedures were performed again. Results of preoperative and postoperative examination were compared and the following results were obtained. 1) In the aerodynamic study, maximum phonation time increased to 158% of the preoperative value and the phonation quotient and the mean flow rate decreased to 58% and 54% of preoperative values. 2) The degree of hoarseness improved in the psychoacoustical evaluation and the glottic chink during phonation was decreased in the stroboscopic examiantion. 3) In the sound spectrographic analysis, periodicity was much restored and noise distribution decreased especially in the high frequency area.

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Prevalence and Risk Factors Associated with Esophagitis in Children with Abdominal Pain (복통이 있는 소아청소년에서 식도염의 유병률과 위험인자)

  • Kwon, Hyun-Jung;Yi, Dae-Yong;Ryoo, Eell;Cho, Kang-Ho;Son, Dong-Woo;Tcha, Han
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.2
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    • pp.103-109
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    • 2008
  • Purpose: Children with esophagitis express a variety of nonspecific symptoms and signs depending on their age, and diagnosis is limited because gastrointestinal endoscopy (GFS) and biopsy are difficult to perform. The aim of this study was to examine the prevalence of esophagitis in children with upper abdominal pain, to determine the necessity of esophageal biopsy, and to evaluate the associated risk factors. Methods: We reviewed 266 pediatric patients with upper abdominal pain who underwent history-taking, physical examination, and GFS with esophageal and gastric biopsies between January 2006 and December 2007. Esophagitis was confirmed on biopsy. We analyzed the risk factors for histologic esophagitis and the necessity of esophageal biopsy. Results: The prevalence of esophagitis was 19.9% (53/266 patients). The sensitivity and specificity of endoscopic diagnosis were 41.5% and 77%. Of 53 patients with histologic esophagitis, reflux esophagitis was seen in 50 patients, eosinophilic esophagitis was seen in 2 patients, and esophageal candidiasis was seen in 1 patient. Vomiting was a significant factor in patients under 8 yr of age (p<0.05). H. pylori infection was documented in 41.5% of patients with histologic esophagitis, compared with 58.5% of patients not infected with H. pylori (p<0.05). The possibility of histologic esophagitis was higher in patients with H. pylori infection (OR 2.5, 95% CI 1.2544 to 4.8286) and in those who visited in the spring (OR 2.5, 95% CI 1.2544 to 4.8286). Conclusion: We believe esophageal tissue biopsy should be performed in pediatric patients with upper gastrointestinal symptoms who are undergoing GFS and stomach tissue biopsy, especially preschoolers and H. pylori-infected children in the spring.

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Cryosurgery of Lung with 2.4 mm Cryoprobe: An Experimental in vivo Study of the Cryosurgery in Canine Model (냉동침을 이용한 폐 냉동수술의 동물실험: 냉동수술 방법의 비교 실험)

  • Kim Kwang-Taik;Chung Bong-Kyu;Lee Sung-Ho;Cho Jong-Ho;Son Ho-Sung;Fang Young-Ho;Sun Kyung;Park Sung-Min
    • Journal of Chest Surgery
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    • v.39 no.7 s.264
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    • pp.520-526
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    • 2006
  • Background: The clinical application of cryosurgery the management of lung cancer is limited because the response of lung at low temperature is not well understood. The purpose of this study is to investigate the response of the pulmonary tissue at extreme low temperature. Material and Method: After general anesthesia the lungs of twelve Mongrel dogs were exposed through the fifth intercostal space. Cryosurgical probe (Galil Medical, Israel) with diameter 2.4 mm were placed into the lung 20 mm deep and four thermosensors (T1-4) were inserted at 5 mm intervals from the cryoprobe. The animals were divided into group A (n=8) and group B (n=4). In group A the temperature of the cryoprobe was decreased to $-120^{\circ}C$ and maintained for 20 minutes. After 5 minutes of thawing this freezing cycle was repeated. In group B same freezing temperature was maintained for 40 minutes continuously without thawing. The lungs were removed for microscopic examination on f day after the cryosurgery. In four dogs of the group A the lung was removed 7 days after the cryosurgery to examine the delayed changes of the cryoinjured tissue, Result: In group A the temperatures of T1 and T2 were decreased to the $4.1{\pm}11^{\circ}C\;and\;31{\pm}5^{\circ}C$ respectively in first freezing cycle. During the second freezing period the temperatures of the thermosensors were decreased lower than the temperature during the first freezing time: $T1\;-56.4{\pm}9.7^{\circ}C,\;T2\;-18.4{\pm}14.2^{\circ}C,\;T3\;18.5{\pm}9.4^{\circ}C\;and\;T4\;35.9{\pm}2.9^{\circ}C$. Comparing the temperature-distance graph of the first cycle to that of the second cycle revealed the changes of temperature-distance relationship from curve to linear. In group B the temperatures of thermosensors were decreased and maintained throughout the 40 minutes of freezing. On light microscopy, hemorrhagic infarctions of diameter $18.6{\pm}6.4mm$ were found in group A. The infarction size was $14{\pm}3mm$ in group B. No viable cell was found within the infarction area. Conclusion: The conductivity of the lung is changed during the thawing period resulting further decrease in temperature of the lung tissue during the second freezing cycle and expanding the area of cell destruction.