• Title/Summary/Keyword: Management methods

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The Development of On-Line Statistics Program for Radiation Oncology (방사선종양학과 On-line 통계처리프로그램의 개발)

  • Kim Yoon-Jong;Lee Dong-Hoon;Ji Young-Hoon;Lee Dong-Han;Jo Chul-Ku;Kim Mi-Sook;Ru Sung-Rul;Hong Seung-Hong
    • Radiation Oncology Journal
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    • v.19 no.4
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    • pp.369-380
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    • 2001
  • Purpose : By developing on-line statistics program to record the information of radiation oncology to share the information with internet. It is possible to supply basic reference data for administrative plans to improve radiation oncology. Materials and methods : The information of radiation oncology statistics had been collected by paper forms about 52 hospitals in the past. Now, we can input the data by internet web browsers. The statistics program used windows NT 4.0 operation system, Internal Information Server 4.0 (IIS4.0) as a web server and the Microsoft Access MDB. We used Structured Query Language (SQL), Visual Basic, VBScript and JAVAScript to display the statistics according to years and hospitals. Results : This program shows present conditions about man power, research, therapy machines, technics, brachytherapy, clinic statistics, radiation safety management, institution, quality assurance and radioisotopes in radiation oncology department. The database consists of 38 inputs and 6 outputs windows. Statistical output windows can be increased continuously according to user's need. Conclusion : We have developed statistics program to process all of the data in department of radiation oncology for reference information. Users easily could input the data by internet web browsers and share the information.

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Diagnostic Performance of Routine Objective Tests and Cost-Effective Approach for Chronic Cough (만성 기침의 진단 성적과 경제적 접근 모델)

  • Jeon, Gang;Jang, Seung Hun;Song, Hae Geun;Ha, Jun-Wook;Eom, Kwang-Seok;Bahn, Joon-Woo;Kim, Dong-Gyu;Shin, Tae Rim;Park, Sang Myon;Park, Yong Bum;Kim, Chul-Hong;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.6
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    • pp.535-542
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    • 2004
  • Background : Despite the clinical clues of bronchial asthma, some chronic coughers fail to be diagnosed due to negative test results. This study was aimed at evaluating the diagnostic performance of routine objective tests and identifying a cost-effective approach for asthmatics with a chronic cough. Methods : Patients with a chronic cough of more than 3 weeks duration, and showing normal chest radiograph and spirometry were enrolled. On the first visit, objective tests, composed of serum total IgE, peripheral blood eosinophil count, spontaneous sputum eosinophil count, methacholine bronchial provocation test (MBPT) and paranasal sinus radiograph, were performed, with the simultaneous administration of oral prednisolone (0.5mg/kg) for one week. The final diagnoses were made on the basis of the test results, and the patients grouped according to their steroid responsiveness. The role of the etiologic diagnosis tests was evaluated, and the medical costs of the final management plan simulated with respect to three assumed models. Results : Sixty chronic coughers were finally analyzed. The final diagnoses were as follows: bronchial asthma 21.7%, eosinophilic bronchitis 6.7%, paranasal sinusitis 18.3%, presumptive allergy 8.3% and non-diagnostic case 45.0%. Ninety percent were steroid responder. With the bronchial asthma cases, the positive rate of MBPT was 38.5%, with sputum eosinophil count in 84.6%, serum total IgE in 38.5%, and a peripheral blood eosinophil count rate of 30.8%. When the test results and steroid responsiveness data were applied to the 3 models, the chest radiograph, spirometry, sputum eosinophil count and paranasal sinus radiograph test results, and simultaneous short term steroid treatment seemed to have acceptable diagnostic performances, which could be used as a further guide to cost-effective planning. Conclusion : Objective tests, composed of chest radiograph, spirometry, paranasal sinus radiograph and sputum eosinophil count, with simultaneous short term steroid treatment, are suggested as cost-effective approaches for asthmatics with a chronic cough.

Clinical Benefits and Complications of Cryotherapy in Advanced Lung Cancer with Central Airway Obstruction (중심성 기도 폐쇄를 동반한 폐암에서 냉동치료의 임상적 유용성 및 부작용)

  • Jung, Jin Yong;Lee, Sung Yong;Kim, Dae Hyun;Lee, Kyung Joo;Lee, Eun Joo;Kang, Eun Hae;Jung, Ki Hwan;Kim, Je Hyeong;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung Ho;Yoo, Se Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.4
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    • pp.272-277
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    • 2008
  • Background: The efficacy of the use of the interventional bronchoscope for palliation of patients with central airway obstruction has been established. In the palliative setting to alleviate central airway obstruction, the use of laser resection, electrocautery, argon plasma coagulation, photodynamic therapy and cryotherapy can provide relief of an airway obstruction. Cryotherapy is the therapeutic application of extreme cold for the local destruction of living tissue. Recently, this technique has been used for endoscopic management of central airway obstructions in Korea. We report the role and complications of the use of cryotherapy for airway obstructions in patients with advanced lung cancer. Methods: We used a flexible cryoprobe for cryotherapy using nitrous oxide as a cryogen. The cryoprobe was applied through the working channel of a flexible fiberoptic bronchoscope. The temperature of the tip was approximately $-89^{\circ}C$, and the icing time was 5~20 seconds. Results: Four patients with a central airway obstruction from advanced lung cancer were treated with cryotherapy. Three of the four patients were treated successfully and the airway obstruction was improved after the cryotherapy procedure. Dyspnea, hypoxia and atelectais were improved in three cases. Two patients experienced complications- one patient experienced pneumomediastinum and the other patient experienced massive hemoptysis during the cryotherapy procedure. However, these complications resolved and did not influence mortality. Conclusion: This technique is effective and relatively safe for palliation of inoperable advanced lung cancer with a central airway obstruction.

Present Conditions of Mental Health Care in Rural Areas: Community Mental Health Program of Public Health Center (농촌지역 정신보건관리실태: 보건소 지역사회정신보건사업)

  • Lee, Weon-Young;Kim, Dong-Moon
    • Journal of agricultural medicine and community health
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    • v.28 no.2
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    • pp.1-14
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    • 2003
  • Objectives: This paper introduces need and supply level of rural mental health care service and especially focuses on the evaluation for the community mental health programs of Public Health Centers(PHCs) in rural areas as the facilities for primary mental health care. Methods: We defined the need as prevalance rate and service utilization rate, for which reviewed the results of the epidemiological study of mental disorders using Korean Composite International Diagnostic Interview surveyed on a nationwide scale in 2001. Supply was appraised in terms of psychiatric beds and primary mental heath care facilities such as private psychiatric clinics, facilities for social rehabilitation, PHCs running community mental health programs. For this, we reveiwed a variety of annual reports related mental health published by Ministry of Health and Welfare. To evaluate the community mental health programs of PHCs in rural areas, we selected. randomly samples out of the 3rd community health plans including the contents of community mental health programs, which submitted by 89 rural counties and 44 cities mixed with rural areas, and used the program's guideline established by central government as a standard. Results: Prevalence rates of major psychiatric diseases such as schizophrenia, alcoholism, major depression, anxiety disorder were higher in rural area than in urban area and 8.9% of psychiatric patients in both areas stayed at homes contacted with mental health manpower more than one time during the last year. Psychiatric beds were sufficiently supplied, but urban area had less beds than rural area contrary to general health care service. Psychiatric clinics were supplied very insufficiently in rural areas and PHCs bridged the gap instead. However rural PHCs got less financial support for community mental health programs from higher positioned agencies than urban PHCs. Rural community health programs not supported hardly worked out. Conclusions: Central government should consider a special policy for rural primary mental health care, because private psychiatric clinics can't be introduced in rural areas due to demand-deficiency and the financial independence of rural counties was very vulnerable.

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Development and Evaluation of a Community Staged Education Program for the Cardiocerebrovascular Disease High-risk Patients (심뇌혈관질환 고위험군을 위한 지역사회 단계별 교육프로그램 개발 및 효과 평가)

  • Lee, Hye-Jin;Lee, Jung-Jeung;Hwang, Tae-Yoon;Kam, Sin
    • Journal of agricultural medicine and community health
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    • v.37 no.3
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    • pp.167-180
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    • 2012
  • Objective: This study was conducted to evaluate an education program for cardiocerebrovascular high-risk patients. Methods: This program was developed according to Tyler's model for curriculum development. To evaluate the effects of this program, we measured clinical outcome change (weight, waist circumference, systolic blood pressure, diastolic blood pressure) and behavior change stages (checking blood pressure, blood sugar levels, doing physical activity, consistent maintenance of food intake, eating low amounts of salt, abstention from tobacco and alcohol) before and 4 weeks after participation in the education program. The group of subjects consisted of High-risk group patients who attended basic program(32 patients), and staged program(37 patients) during KHyDDI meetings from Oct. 2009 to May 2010. Results: The staged educational program was developed three aspects(disease, nutrition and exercise)and three stages(basic, in-depth and individual education). In the staged education program, the evaluations were made by measuring clinical outcome and stage of behavior before and after education. Significant differences were found in waist circumference, systolic blood pressure, diastolic blood pressure, consistent maintenance of food intake(p<0.05), and eating low salt(p<0.001)and their self efficacy. Conclusion: In the practice-oriented staged education program, significant differences were found in the clinical outcomes and stage of behavior before and after education. Possible limitations of the study include the small number of participating subjects and the short follow-up management period, but the results indicate that continued application of this program could contribute to the prevention of cardiocerebrovascular diseases for the elderly patients with long periods of chronic diseases.

A Survey on the Workplace Environment and Personal Protective Equipment of Poultry Farmers (양계 농업인의 작업장 환경 및 개인보호구 착용 실태조사)

  • Kim, Insoo;Kim, Kyung-Ran;Lee, Kyung-Suk;Chae, Hye-Seon;Kim, Sungwoo
    • Journal of Environmental Health Sciences
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    • v.40 no.6
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    • pp.454-468
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    • 2014
  • Objectives: This study was conducted to investigate the actual condition of the farm work environment and personal protective equipment as part of the effort to improve livestock work for the safety and health of poultry farmers and provide basic data for establishing plans to improve and develop personal protective equipment. Methods: For this purpose, a questionnaire survey on general information about stables, the poultry work environment, accidents, the wearing of work clothes and personal protective equipment, and the level of awareness related to personal protective equipment was conducted among 148 poultry farmers. Results: As a result, it was found that poultry workplace environment was exposed to such risks as fine dusts; organic dusts; poisonous gases; odorous substances; chicken excrement; contact with chickens, bacteria or viruses; and accidents related to machine operation. Thirteen percent of respondents suffered severe respiratory diseases, and the most frequently injured sites due to accidents were the hands (25.7%), knees (23.8%), arms (17.3%), and head (10.9%). The most frequent type of accident was collisions between the body and obstacles or machinery during movement (36.4%), followed by erroneous machine operation such as feeders and electric shocks (8.5%). Regarding the wearing of work clothes and personal protective equipment, 51.7% of the respondents wore worn-out clothing or everyday clothes, whereas only 32.0% wore work clothes. The percentage of farmers who wore proper protective equipment for the work environment during poultry work was 48.4%. The most frequently used type of protective equipment was boots (38.9%), followed by mask (36.7%), gloves (36.3%), appropriate work clothes (22.6%), quarantine clothes (17.6%), helmets (13.4%), and goggles (12.6%). The rate of wearing goggles was low because they were considered inconvenient and lowered work efficiency. Furthermore, they purchased everyday products available on the market for their personal protective equipment which were not appropriate for maintaining safety in an actual harmful environment and its consequent risks. As a result of the survey of the awareness level related to personal protective equipment, their levels of awareness of accidents and attitude proved to be average or higher, but the practice of wearing protective equipment and the level of knowledge and management of personal protective equipment were lower. Conclusion: This survey found that the wearing status of personal protective equipment among poultry farmers was insufficient even though they were exposed to risks. Most respondents were aware of the necessity of wearing personal protective equipment and of the potential for accidents, but they did not wear proper protective equipment. Their wearing rate was low due to a lack of knowledge about protective equipment, as well as the inconvenience of wearing it. Therefore there is a need to improve and develop specialized personal protective equipment for respiration, hands, and eyes, as well as work clothes that can protect farmers from major harmful matter that is generated in the poultry workplace. Based on the results of this investigation, we will conduct further studies on the required performance and design directions of personal protective equipment while collecting more objective data through field-oriented assessments.

Efficient Treatment Methods for Reducing Escherichia coli Populations in Commercially-Available Red Pepper Powder in Korea (국내 유통 고춧가루의 병원성 대장균 오염 및 대장균 저감화 방법)

  • Song, Young-Jin;Park, Se-Won;Chun, Se-Chul;Choi, Mi-Jung;Chung, Koo-Chun;Lee, Si-Kyung
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.41 no.6
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    • pp.875-880
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    • 2012
  • This study was conducted to investigate the level of contamination of pathogenic Escherichia (E.) coli in 50 types of red pepper powders collected domestically. Pathogenic E. coli was confirmed using real-time PCR to confirm the 4 types of EAEC, EPEC, EHEC and ETEC. One sample out of 50 was contaminated with pathogenic E. coli. The type of pathogenic E. coli detected in the sample was EAEC. This study was also conducted to determine the effect of alcohol treatment on the reduction of E. coli populations in red pepper powder. The amount of E. coli in the control was $1.2{\times}10^6$ cfu/mL. The amount of E. coli in 10 minutes immersion treatment with 10% alcohol was $1.1{\times}10^6$ cfu/mL. In samples treated with over 20% alcohol, E. coli was not detected. This showed that 10 minutes of immersion in over 20% alcohol might be effective to reduce E. coli. This study was also conducted to determine the effect of UV irradiation on E. coli reduction. The number of E. coli in the control group was $5.0{\times}10^5$ cfu/mL. However, the number of E. coli in 45 min of the UV irradiated sample decreased to $1.0{\times}10^3$ cfu/mL, by $10^2$ cfu/mL. In contrast, E. coli was not detected in an over 60 min UV irradiated sample in $10^{-2}dilution$. This study showed that over 20% alcohol treatment and UV irradiation for 60 min was effective to control E. coli in red pepper powder.

The Necessity and Method of Stand Density Control Considering the Shape Ratio of Pinus thunbergii Coastal Disaster Prevention Forests in South Korea (곰솔 해안방재림의 형상비를 고려한 밀도 관리의 필요성과 방안)

  • Kim, Suk-Woo;Chun, Kun-Woo;Park, Ki-Hyung;Lim, Young-Hyup;Yun, Ju-Ung;Kwon, Se-Myoung;Youn, Ho-Joong;Lee, Jin-Ho;Teramoto, Yukiyoshi;Ezaki, Tsugio
    • Journal of Korean Society of Forest Science
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    • v.104 no.3
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    • pp.411-420
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    • 2015
  • This study examined methods for stand density control by using shape ratio (tree height/DBH) and its application for effective management of Pinus thunbergii coastal disaster prevention forests. We analyzed the present conditions (height, DBH, and density) of P. thunbergii coastal disaster prevention forests at 123 study sites on Jeju Island and west, south, and east coasts of South Korea and compared them with results from previous studies. The average shape ratio for P. thunbergii showed positive correlations with stand density and was significantly higher on the west coast (66.32) than on the south (49.57) and east (48.19) coasts and Jeju Island (48.29). Stands with shape ratio higher than 70 accounted for 50% of the total study sites on the west coast, indicating a decrease in their disaster prevention function compared to that of other previous studies. The stand density in most coastal areas, except the east coast, was significantly higher than the standards recommended by the Korea Forest Service and the Forestry and Forest Products Research Institute of Japan, indicating the need for stand density control. According to the growth estimation equation for P. thunbergii in the coastal area of South Korea, density control is required for young stands less than 14 years old, which show drastic increase in the shape ratio, to conserve their disaster prevention function. Particularly, the first thinning of P. thunbergii forests should be implemented before the stand age of 8 years that a shape ratio exceeds 70. For disaster-prone young stands (${\leq}20cm$ DBH) of P. thunbergii, the stand density was higher in the standard of Japan considering shape ratio than in that of Korea aiming timber production. Hence, the standard guidelines employed in Japan, which assign higher importance to disaster prevention function based on field surveys, can be applied effectively for controlling the stand density of P. thunbergii coastal forests in South Korea, to improve their disaster prevention function.

Characteristics of School Menus from the Daegu and Gyeongbuk Area (대구·경북지역 학교급식 제공 메뉴 특성 분석)

  • Ahn, Seon Woo;Choi, Mi-Kyung
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.42 no.6
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    • pp.983-990
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    • 2013
  • The purpose of this study was to analyze the characteristics of menu items offered for school meals in the Daegu and Gyeongbuk area. A total of 538 menu items were collected from six schools (two elementary schools, two middle schools, and two high schools). There was a significant difference in food costs according to menu groups (p<0.001), with the highest food costs for meat and fish dishes (881.66 won) and the lowest cost for kimchi (114.50 won). The proportion of menu items using processed foods and with low operational efficiency were significantly higher in middle schools (p<0.01). In addition, menu items containing animal products were significantly higher in the non-traditional menu items in middle schools (p<0.001). Traditional menu items were less frequently cooked with oil (p<0.001) and processed foods (p<0.001), and their operational efficiency was higher (p<0.001). In conclusion, we found that traditional menu items in school meals were being offered with healthier ingredients and cooking methods, as well as a more efficient foodservice management, than non-traditional menu items.

Prognostically Significant Fusion Oncogenes in Pakistani Patients with Adult Acute Lymphoblastic Leukemia and their Association with Disease Biology and Outcome

  • Sabir, Noreen;Iqbal, Zafar;Aleem, Aamer;Awan, Tashfeen;Naeem, Tahir;Asad, Sultan;Tahir, Ammara H;Absar, Muhammad;Hasanato, Rana MW;Basit, Sulman;Chishti, Muhammad Azhar;Ul-Haque, Muhammad Faiyaz;Khalid, Ahmad Muktar;Sabar, Muhammad Farooq;Rasool, Mahmood;Karim, Sajjad;Khan, Mahwish;Samreen, Baila;Akram, Afia M;Siddiqi, Muhammad Hassan;Shahzadi, Saba;Shahbaz, Sana;Ali, Agha Shabbir
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.7
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    • pp.3349-3355
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    • 2012
  • Background and objectives: Chromosomal abnormalities play an important role in genesis of acute lymphoblastic leukemia (ALL) and have prognostic implications. Five major risk stratifying fusion genes in ALL are BCR-ABL, MLL-AF4, ETV6-RUNX11, E2A-PBX1 and SIL-TAL1. This work aimed to detect common chromosomal translocations and associated fusion oncogenes in adult ALL patients and study their relationship with clinical features and treatment outcome. Methods: We studied fusion oncogenes in 104 adult ALL patients using RT-PCR and interphase-FISH at diagnosis and their association with clinical characteristics and treatment outcome. Results: Five most common fusion genes i.e. BCR-ABL (t 9; 22), TCF3-PBX1 (t 1; 19), ETV6-RUNX1 (t 12; 21), MLL-AF4 (t 4; 11) and SIL-TAL1 (Del 1p32) were found in 82/104 (79%) patients. TCF3-PBX1 fusion gene was associated with lymphadenopathy, SIL-TAL1 positive patients had frequent organomegaly and usually presented with a platelets count of less than $50{\times}10^9/l$. Survival of patients with fusion gene ETV6-RUNX1 was better when compared to patients harboring other genes. MLL-AF4 and BCR-ABL positivity characterized a subset of adult ALL patients with aggressive clinical behaviour and a poor outcome. Conclusions: This is the first study from Pakistan which investigated the frequency of5 fusion oncogenes in adult ALL patients, and their association with clinical features, treatment response and outcome. Frequencies of some of the oncogenes were different from those reported elsewhere and they appear to be associated with distinct clinical characteristics and treatment outcome. This information will help in the prognostic stratification and risk adapted management of adult ALL patients.