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A Study on the Teachers' Health Problems and Their Visiting Frequencies of School Clinics (교직원 건건문제(健建問題) 및 양호실(養護室) 이용실태(利用實態)에 관(關)한 연구(硏究))

  • Choi, Jae Sun
    • Journal of the Korean Society of School Health
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    • v.1 no.1
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    • pp.160-177
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    • 1988
  • This study is an analysis of the teachers' health problems that focuses on the frequencies and types of their visiting to school clinics and the management of health-related problems. The participants for this study are consisted of 1,650 teachers employed at 30 public schools in the Seoul area. Data for the study came from diagnostic records for 1986, the results of a questionaire-type survey conducted between June 20th and of the same year an from other documents recorded by school nurses. The main results of this study are as follows: 1. The teachers' health problems. a) According to health diagnosis records, 6.1 % of all teachers had a health problem. Liver-related ailments topped the list, followed by circulatory and diabetic problems. b) The survey data had 71.9 % of the respondents indicating that trey suffered from some health problem. The most frequent response concerned respiratory problems, followed by gastro-intestinal and nervous system problems. c) A check of clinic utilization records revealed that the main reasons for visiting are concerned with fatigue (30.5 %), gastro-intestinal(18.7 %) and respiratory(18.2 %) ailments. These three categories accounted for 67.4 % of total use. 2. Frequencies of their visiting to school clinics 40.5 % of the teachers indicated that they have visited the school clinic. And 62.0 % visited it with a self-diagnosed ailment and 15.3 % utilized the facility after a problem had been detected in a health examination. Clinics were visited a total of 1,458 times which breaks down to 0.9 times per month per teacher. For a patient, the figures are 2.2 times on the average with a range from 1 to 19. 3. Health management problems a) Of those respondents. 53.4 % stated that they didn't have enough time to consult about their health problems and diagnose their disease b) Also, 47.3 % of the respondents indicated that school nurses should give health counsels and health education. c) When questioned about improvements in the current system, the teachers placed importance on the prevention and management of chronic diseases (35.2 %) and pre- and posteducation concerning periodic health examinations In conclusion, the following points must be considered: First, school administrators need to pay more attention to the health problems of the teachers. Second, school nurses should be more active in managing a health program for teachers. Finally, education and training for nurses should be continually upgraded so that they can dispense proper and timely care for teachers.

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Clinical Patterns of Penetrating Torso Injury at Emergency Department (응급실을 통하여 입원한 체간부 관통상 환자에 관한 임상적인 고찰)

  • Yun, Soon Young;Cheon, Young Jin;Won, Tae Hee
    • Journal of Trauma and Injury
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    • v.18 no.1
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    • pp.47-52
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    • 2005
  • Background: This study was undertaken to evaluate the clinical pattern of the patients with penetrating torso injury. We retrospectively analyzed the clinical symptoms, mechanism of injury, injury type including injured organ, and ultimate outcome of treatment. Our purpose of the study was to establish guideline of management in penetrating torso injury. Methods: This study consists of an analysis of a consecutive series of 94 patients with penetrating injury of trunk treated at one general hospital during 7year period (from January 1995 to April 2003) who was admitted through in our emergency department. All data were collected from the medical records and entered in a database for analysis on the following: age, sex, mechanism of injury, vital sign at admission, clinical outcome including hospital mortality, length of hospital stay, length of intensive care unit stay, requirement of crystalloid fluid and blood product. Results: Among 94 patients, there were 68 men and 26 women, with ages ranging from 19 to 82 years (average 38.2 years). The most frequent mechanism of injury was violence by others including rob (n=54, 57.4%) followed by suicidal attempt (n=24, 25.5%) and accidental injury (n=16, 17.0%). No injury was inflicted from gun. In 37 patients, systolic blood pressure at admission was under 90mmHg. The time interval from injury to admission, and from admission to operation was 57.8minutes and 4hour 12minutes each. Laparotomy was required in 70 patients, thoracotomy in 5 patients, and 3 patients required thoracotomy and laparotomy. Among 94 patients, an average of 1.7 organs were injured. The small bowel and colon were the organs most commonly wounded followed by liver, mesentery, pleura. Of the 94 patients, 6 died for an overall mortality rate of 6.4%, and two of them were not related with hemorrhage. The average length of hospital stay was 18.1 days, and 40 patients required ICU care. Conclusion: Of the 94 patients who were admitted from penetrating torso injury, no patient was injured from firearm. Overall mortality rate was 6.4%. In our hospital, firearm injury was relative rare.

Research on the usage of oral hygiene devices and the general knowledge, attitude on oral health care in the orthodontic patients (교정환자의 구강건강관리에 관한 지식도와 태도 및 구강위생용품 사용실태)

  • Min, Hee-Hong;Na, Eun-Joo;Jun, Ji-Hean;Park, Young-Nam
    • Journal of Korean society of Dental Hygiene
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    • v.12 no.2
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    • pp.399-407
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    • 2012
  • Objectives : Purpose of this research is to determined the general knowledge on oral health and the usage of oral hygiene products in the orthodontic patients and try to provide an appropriate oral hygiene products for the patients. Methods : Orthodontic patients who visited a dental clinic in Daejeon were selected and data from 352 patients were collected. Questionnaire based on survey was conducted from 1st of March to 30th in 2011 and all the data was analysed by using SPSS statistical program (VER 15.0). Frequency analysis, $x^2$ test, T-test and the amount of diurnal variance analysis (one-way ANOVA) were also used. After that, scheffe's post-test method was conducted. Results : According to the general characteristics of oral health care knowledge score was $2.87{\pm}0.60$, the attitude score was $2.96{\pm}0.57$. toothbrush replacement cycle were less than 3 months (p=0.007, p=0.000) and frequency of brushing one day more than three times higher in patients with knowledge to help attitude. according to the sex, age, and duration of orthodontic treatment with oral hygiene devices of usage was higher in the calibration toothbrush usage, awareness was higher in the interdental toothbrushes. according to the type of orthodontic devices from the oral hygiene devices usage, removable group was the orthodontic toothbrush and electric toothbrush group were highest in the 'unknown', the fixed group was orthodontic toothbrush(67.3%) and electric toothbrushes(40.8%) was higher in the usage. Patients who used oral hygiene devices such as orthodontic tooth brush, interdental brush, electric toothbrush, water pik and fern solution showed wider knowledge on oral health care and oral hygiene devices compared to patients who answered as does not aware of oral hygiene devices and never used these products before. Conclusions : Orthodontic patient's oral health attitudes, knowledge, and oral hygiene devices usage are the general characteristics of the highest in the orthodontic toothbrush usage, awareness was higher in the interdental brush. Water pik and fern solution, rubber and gingival interdental stimulator turned massage does not use or low. Based on results from research, overall orthodontic patients who visited a dental clinic had low awareness and usage of oral hygiene devices. Therefore, it is required to educate general publics and the orthodontic patients and also promote the importance of usage of oral hygiene devices.

Intravascular Plugging in Clinical and Experimental Coronary Artery Occlusion and Recanalization (허혈 및 재관류시 관상혈관내 혈전형성에 관한 임상 및 실험적 연구)

  • Kim, Ho-Dirk;Jung, Hye-Lim;Oh, Seung-Hwan;Rah, Bong-Jin
    • Applied Microscopy
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    • v.23 no.1
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    • pp.139-163
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    • 1993
  • Background: It has been well established and is now no longer a controversial issue that ischemia produces a series of inflammatory reactions and the ischemic myocardium cannot survive without adequate restoration of coronary flow, ie, reperfusion. Nevertheless, controversies that intravascular pluggings (IVP) by polymorphonuclear leukocytes (PMNs) or platelets may cause contractile dysfunction in ischemia and even in repefusion still remain. Accordingly, we attempted to examine the intravascular plug fomation as well as the ultrastructural changes in myocytes and microvessels and to determine the relation among them. Methods: 1) Human (n= 10, 39-63 years of age; 3 females and 7 males): left ventricular myocardium (LVM) was biopsied from chronic ischemic heart disease patient during bypass surgery. 2) Calf (Holstein-Friesian species, n=4): Circumflex branch of the left coronary artery (LCx) was occluded (ischemia) for 45 minutes and recanalized (reperfusion) for 3 and 6 hours, respectively and LVMs were biopsied after occlusion and recanalization, respectiverly. 3) Rat (Sprague-Dawley species, n=20): Left coronary artery (LCA) was occluded for 20 minutes and recanalized for an hour as the method described by Selye et al., (1960) and hearts were removed after occlusion and recanalization, respectively. 4) Pig (landrace type, n=7): Anterior ascending branch of the left coronary artery (LAD) was coccluded for 45 minutes and recanalized for 2 hours and LVMs were biopsied after occlusion and recanalization, repectively. All of the LVMs were routinely prepared for transmissiom electron microscopy. Rseults: In human, most of the LVM showed irreversible ultrastructural changes in myocytes and frequent IVPs by PMNs or platelets without any significant correlation with age or sex. In the animal LVM, myocytes showed reversible ultrastructural changes with slight variations in accordance with the species, duration of ischemia and reperfusion or site of biopsy, however, injuries were more severe in the subendocardial myocytes and IVPs by PMNs or platelets were frequently observed. Ultrastructural changes in the myocytes seemed to be gradually improved by recanalization, howerver, IVPs were still observed after recanalization. Conclusion: These results suggest that microvessels are more resistant to ischemic insult than the myocytes themselves and IVP by PMNs and platelets may play an important role to produce ischemic or reperfusion injuries. Thus, it is favorable that angioplasty is preceded by thrombolysis and it is likely that restoration of myocardial function requires relarively long period of time even after recanalization.

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Use of Piggyback Contact Lens System to GP Lens Wearers (GP렌즈 착용자에게 피기백 콘택트렌즈 시스템의 적용)

  • Kim, Yong Gil;Kim, Soo Hyun;Kim, Jai Min
    • Journal of Korean Ophthalmic Optics Society
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    • v.15 no.1
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    • pp.47-53
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    • 2010
  • Purpose: This study was performed to achieve an acceptable piggyback fit utilizing each subject's own GP lenses, in subjects with regular low myopic astigmatism. Methods: A randomized, prospective study of 15 subjects with the diagnosis of low myopic astigmatism was conducted. Nine subjects were female and 6 were male, and mean age was: 23.73${\pm}$1.68 years. Subjects were evaluated before participate on this study and then also evaluated with period of at two hours and two weeks after obtaining their lenses. All subjects were submitted to the following tests: measurement of comfort level by means of the analogical visual scale, best corrected visual acuity and over-refraction at distance. contrast sensitivity and stereo acuity. After evaluating the fit of plano soft lens, we applied each subject's own GP lens on top. Results: Vision, visual performance and satisfaction of piggyback contact lens system were stable, if not improved, for the 15 subjects when the data was compared to the patients' wear of rigid gas permeable contact lenses. Fit with a piggyback system had the same or improved comfort, visual acuity and contrast sensitivity compared to previous GP lens wear alone. The visual acuity, contrast sensitivity and stereo acuity did not show differences in relation to the studied lens type. Conclusions: These results suggest that it is possible to achieve a successful piggyback lens fitting utilizing a patient's own GP lens. The piggyback lens system satisfied the visual performance and visual requirements of this subject with GP lens alone for the correction of low myopic astigmatism.

Implantable cardioverter defibrillator therapy in pediatric and congenital heart disease patients: a single tertiary center experience in Korea

  • Jin, Bo Kyung;Bang, Ji Seok;Choi, Eun Young;Kim, Gi Beom;Kwon, Bo Sang;Bae, Eun Jung;Noh, Chung Il;Choi, Jung Yun;Kim, Woong Han
    • Clinical and Experimental Pediatrics
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    • v.56 no.3
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    • pp.125-129
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    • 2013
  • Purpose: The use of implantable cardioverter defibrillators (ICDs) to prevent sudden cardiac death is increasing in children and adolescents. This study investigated the use of ICDs in children with congenital heart disease. Methods: This retrospective study was conducted on the clinical characteristics and effectiveness of ICD implantation at the department of pediatrics of a single tertiary center between 2007 and 2011. Results: Fifteen patients underwent ICD implantation. Their mean age at the time of implantation was $14.5{\pm}5.4$ years (range, 2 to 22 years). The follow-up duration was $28.9{\pm}20.4$ months. The cause of ICD implantation was cardiac arrest in 7, sustained ventricular tachycardia in 6, and syncope in 2 patients. The underlying disorders were as follows: ionic channelopathy in 6 patients (long QT type 3 in 4, catecholaminergic polymorphic ventricular tachycardia [CPVT] in 1, and J wave syndrome in 1), cardiomyopathy in 5 patients, and postoperative congenital heart disease in 4 patients. ICD coils were implanted in the pericardial space in 2 children (ages 2 and 6 years). Five patients received appropriate ICD shock therapy, and 2 patients received inappropriate shocks due to supraventricular tachycardia. During follow-up, 2 patients required lead dysfunction-related revision. One patient with CPVT suffered from an ICD storm that was resolved using sympathetic denervation surgery. Conclusion: The overall ICD outcome was acceptable in most pediatric patients. Early diagnosis and timely ICD implantation are recommended for preventing sudden death in high-risk children and patients with congenital heart disease.

Job Stress and Psychosocial Factors and Its Association with Self Perceived Fatigue among White Collar Male Workers (사무직 남성 근로자의 직무스트레스 및 사회 심리적 요인과 피로수준과의 관련성)

  • Park, Seung-Pil;Kwon, In-Sun;Cho, Young-Chae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.1
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    • pp.301-311
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    • 2011
  • This study was performed to determine the self-perceived fatigue and its association with job stress contents and psychosocial factors among white collar male workers. The self-administered questionnaires were given to 872 workers employed in 42 work places during the period from February 1st to April 30th, 2009. As a results, in terms of levels of self-perceived fatigue according to the job stress contents and psychosocial factors, under significantly higher level of self-perceived fatigue were those with higher level of job demand, lower job autonomy, lower supervisor support and higher locus of control than their respective counterparts. Multiple stepwise analysis revealed that the factors of influence on self-perceived fatigue included age, subjective status of health, job career, experience of sick absence, sense of satisfaction in work, regular exercise, sleeping hours, visiting out-patient department, job demand, supervisor support and self-esteem. The study results indicated that the level of self-perceived fatigue is so complicatedly influenced by variable factors as well as socio-demographic characteristics, job-related characteristics and health-related behaviors, to a greater extent, by JCQ and psychosocial factors.

Spatial Analysis of Colorectal Cancer Cases in Kuala Lumpur

  • Shah, Shamsul Azhar;Neoh, Hui-Min;Syed Abdul Rahim, Syed Sharizman;Azhar, Zahir Izuan;Hassan, Mohd Rohaizat;Safian, Nazarudin;Jamal, Rahman
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.3
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    • pp.1149-1154
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    • 2014
  • Background: In Malaysia, data from the Malaysian Health Ministry showed colorectal cancer (CRC) to be the second most common type of cancer in 2007-2009, after breast cancer. The same was apparent after looking at males and females cases separately. In the present study, the Geographic Information System (GIS) was employed to describe the distribution of CRC cases in Kuala Lumpur (KL), Malaysia, according to socio-demographic factors (age, gender, ethnicity and district). Materials and Methods: This retrospective review concerned data for patients diagnosed with colorectal cancer in the years 1995 to 2011 collected from the Wilayah Persekutuan Health Office, taken from the cancer notification form (NCR-2), and patient medical records from the Surgical Department, Universiti Kebangsaan Malaysia Medical Centre (UKMMC). A total of 146 cases were analyzed. All the data collected were analysed using ArcGIS version 10.0 and SPSS version 19.0. Results: Patients aged 60 to 69 years accounted for the highest proportion of cases (34.2%) and males slightly predominated 76 (52.1%), Chinese had the highest number of registered cases at 108 (74.0%) and staging revealed most cases in the 3rd and 4th stages. Kernel density analysis showed more cases are concentrated up in the northern area of Petaling and Kuala Lumpur subdistricts. Spatial global pattern analysis by average nearest neighbour resulted in nearest neighbour ratio of 0.75, with Z-score of -5.59, p value of <0.01 and the z-score of -5.59. Spatial autocorrelation (Moran's I) showed clustering significant with p<0.01, Z score 3.14 and Moran's Index of 0.007. When mapping clusters with hotspot analysis (Getis-Ord Gi), hot and cold spots were identified. Hot spot areas fell on the northeast side of KL. Conclusions: This study demonstrated significant spatial patterns of cancer incidence in KL. Knowledge about these spatial patterns can provide useful information to policymakers in the planning of screening of CRC in the targeted population and improvement of healthcare facilities to provide better treatment for CRC patients.

Hypofractionated Radiotherapy for Breast Cancers - Preliminary Results from a Tertiary Care Center in Eastern India

  • Nandi, Moujhuri;Mahata, Anurupa;Mallick, Indranil;Achari, Rimpa;Chatterjee, Sanjoy
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2505-2510
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    • 2014
  • Background: The standard radiotherapy (RT) fractionation practiced in India and worldwide is 50Gy in 25 fractions over 5 weeks to the chest wall or whole breast followed by tumour bed boost in case of breast conservation (BCS). A body of validated data exists regarding hypofractionation in breast cancer. We here report initial results for 135 patients treated at our center with the START-B type of fractionation. Materials and Methods: From May 2011 till July 2012, women with all stages of breast cancer (excluding metastatic), who had undergone BCS or mastectomy were planned for 40Gy in 15 fractions over 3weeks to chest wall/whole breast and supraclavicular fossa (where indicated) followed by tumour bed boost in BCS patients. Planning was done using Casebow's technique. The primary end point was to assess the acute toxicity and the cosmetic outcomes. Using cosmetic scales; patients were assessed during radiotherapy and at subsequent follow up visits with the radiation oncologist. Results: Of the 135 patients, 62 had undergone BCS and 73 mastectomy. Median age of the population was 52 years. Some 80% were T1&T2 tumours in BCS whereas most patients in mastectomy group were T3&T4 tumours (60%). 45% were node negative in BCS group whilst it was 23% in the mastectomy group. Average NPI scores were 3.9 and 4.9, respectively. Most frequently reported histopathology report was infiltrating ductal carcinoma (87%), grade III being most common (58%), and 69% were ER positive tumours, and 30% were Her 2 Neu positive. Triple negative tumours accounted for 13% and their mean age was young (43 yrs.) The maximum acute skin toxicity at the end of treatment was Grade 1 in 94% of the mastectomy grouppatients and 71% in BCS patients. Grade 2 toxicity was 6% in mast group and 23% in BCS group. Grade 3 was 6% in BCS group, no grade 3 toxicity in mastectomy patients and there was no grade 4 skin toxicity in any case. Post RT at 1 month; 39% of BCS patients had persisting Grade I skin reaction which was only 2% in mastectomy patients. At 3 months post RT, 18% patients had persisting hyperpigmentation. At 6 months 8% patients had persisting erythema in the BCS group only. Some 3% BCS and 8% mastectomy patients had lymph edema till the date of evaluation. Cosmetic outcome in BCS patients remained good to excellent 6 months post surgery and radiotherapy. 1 patient of BCS and 3 patients of mast had developed metastatic disease at the time of evaluation. Conclusions: Hypofractionated RT is well tolerated in Indian population with reduced acute skin toxicity and good cosmetic outcome. Regimens such as these should be encouraged in other centers to increase machine output time. The study is on-going to assess long term results.

Life Event Stress and Coping Strategy in Patient with Atopic Dermatitis (아토피 피부염 환자의 생활사건 스트레스와 대처방식)

  • Han, Duck-Hyun;Choi, Han-Gyu;Kee, Baik-Seok;Nam, Bum-Woo;Seo, Seong-Jun
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.2
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    • pp.226-232
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    • 1999
  • Background : Various type of psychological and stressful events in life have been reported to have much effect in the onset, progress and exacerbation of psychosomatic disorders such as hypertension, bronchial asthma, peptic ulcer, tension headache, alopecia areata, and atopic dermatitis. However, the nature of the association between stress and psychosomatic disorders remains unclear. Objective : The purpose of this study is to determine the relation of stress and the progress of dermatologic disorder. Method : We examined 30 patients with atopic dermatitis and 30 control subjects with tinea pedis and onychomycosis who visited to Dept. of Dermatology, Chung-Ang University Hospital. To evaluate the stress, we used 'Scale of Life Events' and 'Multidemensional Coping Scale'. Result : 1) The score of life events stress in atopic dermatitis group was significantly higher than that of control group. 2) In the result of coping strategies, the atopic dermatitis group was significantly higher than control group at the active forgetting, positive comparison, and emotional pacification, while in control group religious seeking and accomodation tended to be higher with no statistical significance. Conclusion : These findings suggest that psychosocial stress may play a role in life pattern of atopic dermatitis. But further studies are needed to clarity the exact relationship between stress and psychosomatic disorder.

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