• Journal of Hospice and Palliative Care
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• v.23 no.3
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• pp.162-165
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• 2020

Purpose: The coronavirus disease 2019 (COVID-19) pandemic has brought the world to a standstill and has exposed the lack of preparedness of most nations' health care systems. Even in usual times, palliative care has not received its fair share of recognition as an important component of patient care; instead, the emphasis is often placed on aggressive patient management. Now, with the entire medical community and decision-making committees focussed on intensive patient care, end-of-life care has taken a backseat. Methods: This article is a brief communication. Results: COVID 19 infection has been shown to lead to greater mortality and morbidity in patients with pre-existing illnesses such as hypertension, diabetes, renal failure, and cancer. Patients typically in need of end-of-life care, such as those with late-stage cancer or heart failure, are therefore at a higher risk of both contracting COVID-19 and suffering a more severe disease course. The strict nationwide lockdowns being imposed in most countries have deterred patients from seeking medical attention or hospice care. Every day new research is coming to light regarding COVID 19. This has helped significantly in creating awareness and limiting the spread of disease. However, misinformation is also rampant, leading to discrimination and mistreatment of infected patients. Conclusion: This pandemic has been a terrifying ordeal for all and has exposed our entire population physically, psychologically, emotionally, and financially to unimaginable stresses. In the present scenario, EOL care is as much a necessity as intensive care and should be given at least a fraction of its importance.

• The Korean Journal of Food And Nutrition
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• v.33 no.4
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• pp.428-439
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• 2020

The purpose of this study was to investigate the current status of chronic diseases according to obesity in the elderly older than age 65 using data from the 7th Korea National Health and Nutrition Examination Survey (2016~2018). The subjects of the survey were 3,245 elderly older than age 65 who participated in the health survey and nutrition survey, 45.8% of the subjects were males and 54.2% of the subjects were female. 37.5% of all the elderly were obese, and the females (42.4%) were more obese than the males (31.8%) (p<0.001). Diabetes, hypertension, and hypertriglyceridemia had a similar prevalence of 24.6%, 63.0%, and 12.7% in males and females, respectively. Hypercholesterolemia was higher in the elderly females (44.2%) than in the elderly males (24.9%) (p<0.001). Through the logistic regression analysis, it was found that the prevalence of chronic diseases was higher in obesity than normal in elderly males and females (p<0.001). The total food intake increased from 'under weight' to 'obesity' in males (p<0.01) and females (p<0.001). In the case of the elderly males, the higher the degree of obesity, the higher the energy intake (p<0.05), and 'pre-obesity' consumed the most energy in elderly females. As a result of this study, the higher the obesity rate of the elderly, the higher the prevalence of chronic diseases.

• Research in Community and Public Health Nursing
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• v.13 no.2
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• pp.260-271
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• 2002

Objectives: The purpose of this study was to identify basic health needs of adult clients to develop a community nursing center model in Seoul. Methods: Data were collected using a questionnaire survey from 894 adults registered at a public health center who were health management members, and visiting 4 community nursing centers, University of Wisconsin, Milwaukee during the period from July 1999 to January 2000. The data were analyzed using frequency, percentile, t-test, and ANOVA. Results: 1) The University of Wisconsin- Milwaukee School of Nursing has a long tradition of developing 4 community nursing centers with innovative health care programs. CNCs integrate the ability to implement and test effective intervention strategies with education, research, and practices of nursing students and faculty. They were designed to enhance the health status and quality of life for urban communities through the development of productive, outcome focused, collaborative partnerships among UWM-Nursing faculties and staff, other health and human service providers, consumers, and policy makers. It links the financial resources between UWM and 9 voluntary agencies and 12 public funding organizations including federal. state, and local governments. 2) Of the total health management members, 37.4% were reported to have at least one type of chronic disease such as hypertension, diabetes, and arthritis. Ten percent of them reported having obesity, and 44.2% reported lack of exercise. The health status of the subjects was within normal range in laboratory tests. However, female subjects showed more significant differences in obesity and cholesterol levels than male subjects. The subjects, who were in their 50s, showed more significant differences in obesity, SGOT, SGPT, and cholesterol levels than the subjects in other age groups. Conclusion: A community nursing center needs to be developed, that has a link between the nursing college and the public health center, with partnerships and a multidisciplinary approach. Based on the study results, exercise programs for middle aged adults are considered necessary. In particular, specific exercise programs for pre-menopausal women needs to be implemented in the future to prevent them from developing osteoporosis.

• Health Policy and Management
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• v.24 no.1
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• pp.24-34
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• 2014

Background: Bankrupted households have recently been increased due to excessive medical expenditure in Korea. They have not been protected from economic risk when household's member has severe diseases that need a lot of money for treatment. Purpose of this study examines policy effect by comparing unmet needs' change of policy object households and non-object groups. Methods: We used Korea Health panel 2nd 4th data collected by Korea Institute for Health and Social Affairs and National Health Insurance Service. Analysis subjects were 381 households (pre-policy) and 393 households (post-policy) that had cancer and cardiovascular and cerebrovascular diseases. Since it was major concern that estimates benefit strengthening policy started by certain time, we setup comparing households which had diabetes, hypertension disease. Comparison subjects were 393,247 households, respectively and we evaluated policy effect using difference in difference (DID) model. Results: Although unmet needs of policy object households were higher than non-object groups, policy execution variable affected negative direction. But interaction-term which shows pure effect of policy was not statistically significant. We utilized multi-DID model to examine factors affecting unmet needs causes. Copayment assistance policy did not significantly affect households that responded to 'economic reason,' and 'no have time to visit' for unmet needs causes. Conclusion: The second copayment assistance policy did not significantly give positive effect to beneficiary households than non-beneficiary groups. When we consider that primary purpose of public insurance guarantee high medical expenditure occurred by unexpected events, it needs to deliberate on switch of benefit strengthening policy that can assist vulnerable people. Also, we suggest that government forward a policy covering non-reimbursable medical expenses as well as switch of benefit strengthening direction because benefit policy do not affect non-covered medical cost which accounts for quarter of total health expenditure.

• Journal of Chest Surgery
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• v.26 no.2
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• pp.141-147
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• 1993

A total of 40 patients having a diagnosis of atherosclerotic coronary arterial disease were analysed on the operative outcomes according to variables as follows: 1) preoperative risk factors such as age, sex, CCS (Canadian Cardiovascular Society) functional class, type of angina, number of diseased vessel, presence of left main coronary artery stenosis, previous history of habitual smoking and presence of other medical diseases (diabetes mellitus, essential hypertension), 2) preoperative management such as intravenous infusion of nitroglycerine, preoperative IABP (intra-aortic balloon pump) support and whether the operation was scheduled as emergency or not, 3) intraoperative variables such as infusion method and composition of cardioplegic solutions, number of distal anastomosis, use of internal mammary artery, total cardiopulmonary bypass time and total cross clamp time. Complications included operative death in 12.5％, perioperative myocardial infarction in 25.0％ and perioperative arrhythmia in 17.5％. Nineteen perioperative variables were analyzed to identify risk factors for these end points. For operative death, presence of left main coronary artery stenosis (p = 0.056) and cardiopulmonary bypass time (p = 0.029) were significant in the univariate analysis, but presence of left main coronary artery lesion (p = 0.011, $\chi$$^2$= 6.45) and abscence of preoperative of IABP support (p = 0.069, $\chi$$^2$ = 3.30) were independent predictor in multivariate analysis (stepwise linear logistic regression).

• Research in Community and Public Health Nursing
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• v.15 no.1
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• pp.56-66
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• 2004

Objectives: The purpose of this study was to verify a change for family nursing phenomena and satisfaction of clients of vulnerable families in an urban community. Methods: The study subjects were 711 families, randomly selected, who had chronic diseases(arthritis diabetes, stroke, hypertension, mental disease, cancer, dementia) with basic social welfare services from the nation and had disabled persons in an urban community, South Korea. The instruments used were the family nursing phenomena in Korea by ICNP and client satisfaction. Client satisfaction consisted of client satisfaction on home visiting nurses(4 Likert scales) and home visiting services(3 Likert scales). Results: The average visiting number is 3.82. The service number of education and counseling is 3.16, patient and symptom management 3.08, assessment and diagnosis 3.08, test 2.02, medication service 1.71회, dressing 1.01, referral to social welfare institute 1.00회, referral to medical service institute 0.21. In both, pre home visiting and post home visiting, the highest rated phenomenon was the 'lack of social support system' and following that 'deficit of financial management skill and support'. 'lack of family interaction in community', and 'social isolation' 'unhealthy life style' and 'inadequate care management of sick member', in that order. The percentages of phenomena besides 'deficit of financial management skill and support' decreased. The satisfaction level of clients towards the nurses was 3.27 points on a scale of 4, and the nursing services was 2.70 points on a scale of 3. Conclusion: Home visiting nursing services should continue to provide comprehensive healthcare services and support for vulnerable families, in urban communities.

• KSBB Journal
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• v.27 no.6
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• pp.381-386
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• 2012

Obesity increases the risk of many adult diseases, such as atherosclerosis, diabetes, hypertension, ischemic heart disease and breast cancer. Inhibition of adipogenesis is an effective way in the anti-obesity management. Because of main components of Saururus chinensis is flavonoid, it has been showed some improvement by its antioxidant effects on the atherosclerosis, heart disease and diabetic hyperlipidemia. But mechanism of anti-obesity effect of S. chinensis is not clear. We investigated the effects of ethanol extracts of S. chinensis on adipogenesis in the 3T3-L1 pre-adipocyte. The 3T3-L1 cell line is commonly used to study adipogenesis in vitro. In this study, ethanol extracts of S. chinensis significantly decrease the lipid accumulation in the 3T3-L1 cells proved by measuring triglyceride contents and Oil red O staining. The proposed mechanism of inhibition of adipogenesis in the 3T3-L1 cells with ethanol extracts of S. chinensis is down-regulation of transcriptional factors and adipocyte-specific genes such CCAAT/enhancer binding protein ${\alpha}$ ($C/EBP{\alpha}$) and Peroxisome proliferator activated receptor ${\gamma}$ ($PPAR{\gamma}$) in concentration dependent pattern. These results suggest that ethanol extracts of S. chinensis inhibits adipognesis in the 3T3-L1 cells and can be used as a safe and efficient natural substance to manage anti-obesity.

• The Journal of Internal Korean Medicine
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• v.20 no.1
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• pp.222-231
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• 1999

Uwhangchungsimwon(UC) has been used in the treatment of a wide variety of conditions including stroke, hypertension, arteriosclerosis, autonomic imbalance, mental instablity, etc in Korean traditional hospitals, In particular it is often initialy chosen for emergency care of acute stroke. The aim of this study was to evaluate the effect of UC on cerebral hemodynamics. Using transcranial Doppler ultrasound, we studied changes of mean flow velocity and pulsatility index(PI) of middle cerebral arteries (MCAs) from 11 health young volunteers who were administrated with 1 pill UC and 11 health controls who were not. We obtained hypercapnia with breath-holding and evaluated cerebrovascular reactivity with breath-holding index(BHI). Systolic blood pressure, diastolic blood pressure, and heart rate were measured using ambulatory blood pressure monitoring(ABPM). In UC administration group, the evaluation was performed during basal condition. and repeated at 20, 40, and 60 min after administration. In controls, the evaluation was performed at corresponding time intervals. Mean flow velocity in middle cerebral artery, systolic blood pressure, diastolic blood pressure, and heart rate did not change during the observation period and were not different between these two groups. However, administration of UC was associated with decreases in PI by $3.6{\sim}12.4%$ in BHI by $17.9{\sim}24.8%$ compared with pre-administration period. Decreases in PI and BHI with UC were significantly different compared with control group (p<0.05). These results indicate that UC decreases PI and BHI in cerebral artery, which is due to a dilation of cerebral resistance vessels.

• Journal of Physiology & Pathology in Korean Medicine
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• v.24 no.1
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• pp.165-170
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• 2010

This study assessed effects of magnetic acu-point therapy as an add-on to conventional antihypertensive managements such as medication or lifestyle modification for hypertensive or pre-hypertensive subjects. This study was conducted with the purpose to evaluate the decreasing effect of the blood pressure on the hypertensive patients who were given to magnetic acu-point therapy. A single-blind, placebo-controlled trial by cross matching was conducted at Daejeon University Oriental Hospital. The washout periods of cross matching are 10 days. 22 hypertensive (systolic BP>140 mmHg or diastolic BP>90 mmHg) volunteers were recruited and treatments were donemagnetic acu-points on Oegwan(TE 5), Jogimeup(GB 41), Naegwan(PC 6), Gongson(SP 4), Hugye(SI 3), Sinmaek(BL 62). The treated group was statistically significant decrease of the blood pressure, while control group show no statistically significant difference of BP. From the results, magnetic acu-point therapy seems to offer a benefit to the treatment of hypertensive patients.

• Proceedings of the Korean Society of Applied Pharmacology
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• 2002.07a
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• pp.203-203
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• 2002

Rheum palmatum L. has been used for treatment of hypertension, lipemia, and paramenia in the oriental gerbal medicines for a long time. We have examined the relaxational response to the water extract of Rheum palmaum L. in isolated thoracic aorta from sprague dawley (SD) rat in the presence and absence of endothelium. Rat thoracic aorta was investigated in vessel segments suspended for isometric tension recording by polygraph. Responses to Rhizoma Rhei were investigated in vessels precontracted with 5-hydroxytryptamine. We found that the ghoracic aorta segments responded to the water extract of Rheum palmatum L. (ERP) with a dose-dependent vasorelaxation. We found that 1.The thoracic aorta sehments responded to ERP with a dose-dependent vasodiliation. 2.The 5-HT induced contraction at 10$\^$-4/M were inhibited by 85.8% after addition of the 0.1 g/mL water extract of ERP. 3. The 5-HT induced contraction at 10$\^$-4/ M with and without endothelium were inhibited by 86.4% and 85.8% after addition of the 0.1g/mL ERP. 4. After pre-treatment of the thoracic aorta with 10$\^$-4/M N$\^$G/-monomethyl-L-arginine(L-NMMA), inducible niric oxide synthase inhibitor, the vessels has not response to the contraction. In conclusion, ERP induced reaxation in the isolated rat thoracic aorta were composed of dose-dependent relaxation. and it has potent vasodilation.