• Proceedings of the Korean Society of Near Infrared Spectroscopy Conference
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• 2001.06a
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• pp.1247-1247
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• 2001

Constituents of animal biofluids such as milk, blood and urine contain information specifically related to metabolic and health status of the ruminant animals. Some changes in composition of biofluids can be attributed to disease response of the animals. Mastitis is a major problem for the global dairy industry and causes substantial economic losses from decreasing milk production and reducing milk quality. The purpose of this study was to investigate potential of NIRS combined with multivariate analysis for cow's mastitis diagnosis based on NIR spectra of milk, blood and urine. A total of 112 bulk milk, urine and blood samples from 4 Holstein cows were analyzed. The milk samples were collected from morning milking. The urine samples were collected before morning milking and stored at -35$^{\circ}C$ until spectral analysis. The blood samples were collected before morning milking using a catheter inserted into the carotid vein. Heparin was added to blood samples to prevent coagulation. All milk samples were analyzed for somatic cell count (SCC). The SCC content in milk was used as indicator of mastitis and as quantitative parameter for respective urine and blood samples collected at same time. NIR spectra of blood and milk samples were obtained by InfraAlyzer 500 spectrophotometer, using a transflectance mode. NIR spectra of urine samples were obtained by NIR System 6500 spectrophotometer, using 1 mm sample thickness. All samples were divided into calibration set and test set. Class variable was assigned for each sample as follow: healthy (class 1) and mastitic (class 2), based on milk SCC content. SIMCA was implemented to create models of the respective classes based on NIR spectra of milk, blood or urine. For the calibration set of samples, SIMCA models (model for samples from healthy cows and model for samples from mastitic cows), correctly classified from 97.33 to 98.67% of milk samples, from 97.33 to 98.61% of urine samples and from 96.00 to 94.67% of blood samples. From samples in the test set, the percent of correctly classified samples varied from 70.27 to 89.19, depending mainly on spectral data pretreatment. The best results for all data sets were obtained when first derivative spectral data pretreatment was used. The incorrect classified samples were 5 from milk samples,5 and 4 from urine and blood samples, respectively. The analysis of changes in the loading of first PC factor for group of samples from healthy cows and group of samples from mastitic cows showed, that separation between classes was indirect and based on influence of mastitis on the milk, blood and urine components. Results from the present investigation showed that the changes that occur when a cow gets mastitis influence her milk, urine and blood spectra in a specific way. SIMCA allowed extraction of available spectral information from the milk, urine and blood spectra connected with mastitis. The obtained results could be used for development of a new method for mastitis detection.

• Health Policy and Management
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• v.9 no.1
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• pp.30-71
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• 1999

There has been a dramatic increase in public awareness regarding dementia during recent years. However, dementia remains a family affair and patients do not receive adequate care in Korea. This study aims to assist patients and their caregivers by establishing Home and Community based Long-Term Care in a city. The data collected for analysis include five main categories: dementia prevalence, limitations of daily activities of patients, burden of caregivers, the services that patient's family want to utilize, the resources that handle dementia in the community. Major findings can be summarized as follows: 1)The prevalence rate of dementia for elderly people is 13.1 per 100 persons. Alzheimer's disease amount to 38.9% of dementia patients and vascular dementia account for 36.7% of them 2)Eight out of ten patients have mild dementia. Almost all patients have normal ADL. IADL, however, shows different picture. In every items of IADL, about 60% of patients reveals some limitations. 3)The proportion of patients who had medical diagnosis is as low as 20%. Families of patients think dementia as normal aging process and medical doctors in the community do not give special concern to dementia patients. 4)Caregivers does not have proper social support. They suffer from long care time, experience large obstacles in respect of health, daily living, and social activity. 5)Health center and Community welfare center have launched some programs-consultation, home-visiting nursing, day care center, voluntary force mobilization and so on-for dementia patients. But they do not perform expected roles and functions because of lack of skilled personnels and inadequate coordination of relevant organizations for dementia care. 6)Families of dementia patients prefer home helper and home-visiting nurse to hospitalization. For the future, however, demand for institution-based long-term services will increase. We develope community dementia care model based on above findings as follows: 1)Health center execute community cardiovascular control program for the prevention of vascular dementia. 2)Refer to epidemiologic characteristics of patients and preference of family, the most urgent task for dementia care in this city is to expand and organize Home and Community based Long-Term Care. 3)For the continuous and comprehensive care, care plan for a patient must be prepared. Case management team should be builded to prepare this plan and coordinate relevant resources. 4)Special long-term care unit for dementia will be needed in a near future. This unit should have multiple functions, such as day-care center, short stay facility, training center for relevant personnels, besides long-term nursing home considering effective care of dementia and efficient operation of the facility. 5)Voluntary workers deserve their due efforts. Incentive mechanisms must be developed to activate voluntary activities.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.6
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• pp.2527-2530
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• 2015

Background: The cancer of the prostate risk assessment (CAPRA) score has been defined to predict prostate cancer recurrence based on the pre-clinical data, then pathological data have also been incorporated. Thus, CAPRA post-surgical (CAPRA-S) score has been developed based on six criteria (prostate specific antigen (PSA) at diagnosis, pathological Gleason score, and information on surgical margin, seminal vesicle invasion, extracapsular extension and lymph node involvement) for the prediction of post-surgical recurrences. In the present study, biochemical recurrence (BCR)-free probabilities after open retropubic radical prostatectomy (RP) were evaluated by the CAPRA-S scoring system and its three-risk level model. Materials and Methods: CAPRA-S scores (0-12) of our 240 radical prostatectomies performed between January 2000-May 2011 were calculated. Patients were distributed into CAPRA-S score groups and also into three-risk groups as low, intermediate and high. BCR-free probabilities were assessed and compared using Kaplan-Meier analysis and Cox proportional hazards regression. Ability of CAPRA-S in BCR detection was evaluated by concordance index (c-index). Results: BCR was present in 41 of total 240 patients (17.1%) and the mean follow-up time was $51.7{\pm}33.0$ months. Mean BCR-free survival time was 98.3 months (95% CI: 92.3-104.2). Of the patients in low, intermediate and high risk groups, 5.4%, 22.0% and 58.8% had BCR, respectively and the difference among the three groups was significant (P = 0.0001). C-indices of CAPRA-S score and three-risk groups for detecting BCR-free probabilities in 5-yr were 0.87 and 0.81, respectively. Conclusions: Both CAPRA-S score and its three-risk level model well predicted BCR after RP with high c-index levels in our center. Therefore, it is a clinically reliable post-operative risk stratifier and disease recurrence predictor for prostate cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.23
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• pp.10505-10508
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• 2015

Background: Breast cancer is an important cause of death among women. One way of classifying different forms of breast cancer is by molecular features, usually in terms of the four subtypes: luminal A, luminal B, HER2-enriched, and triple negative. Objectives: This study aimed to investigate the association between molecular subtypes and survival among breast cancer patients treated with radiotherapy. Materials and Methods: A retrospective cohort study was conducted. The subjects were 272 breast cancer patients who had received treatment in the radiotherapy unit at Srinagarind Hospital, Thailand, between 1 January, 1999, and 31 May, 2009. The end of the study was 1 June, 2014. Overall survival was defined as the time elapsing between initial registration at the radiotherapy unit and death or the end of the study. Survival curves were estimated by the Kaplan-Meier method, and a multivariate analysis was performed using Cox's proportional hazard regression model. Results: The patient mean age was $47.5{\pm}10.4$ at the time of diagnosis. Of the 272 patients, 146 (53.7%) were classified as luminal A, 12 (4.4%) as luminal B, 30 (11.0%) as HER2-enriched, and 84 (30.9%) as triple negative. The overall survival rates at 1, 3 and 5 years were 87.1%, 68.4% and 59.2%, respectively. According to molecular subtypes, HER2-enriched patients had the lowest 5-year survival rate (30.0 %, 95%CI: 15.02-46.55). The median follow-up time was 8.37 years. In the Cox model analysis a higher risk of death was found for patients with HER2-enriched ($HR_{adj}=3.34$, 95%CI:1.96-5.67), triple negative ($HR_{adj}=2.17$, 95%CI: 1.44-3.27), and stage IIlB ($HR_{adj}=2.20$, 95%CI: 1.16-4.17) cancers. Conclusions: The worst survival rates were among patients classified as HER2-enriched, triple negative and at stage IIIB. Early detection and an advanced treatment modality are needed to help these patients.

• The Journal of the Korea Contents Association
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• v.13 no.8
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• pp.314-323
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• 2013

This study analyzed the relationship between the level of hospital caseloads and length of stay for the delivery patients. The differences of hospital caseloads were measured by the Internal Herfindahl Index, which measured the concentration of delivery patient in a hospital. And the structure variables of hospitals such as the number of bed, the number of treatment, and the number of doctors and nurses per 100 beds were included as control variables. And average length of stay of delivery patients was used as the dependent variable. Concentration status of delivery patients was measured in two models: (1) first model represents the concentration level of delivery patient in all hospital patients, (2) second model represents the concentration level of delivery patient in all obstetrics and gynecology patients. In regression analysis, patient concentration index was not statistically significant in explaining the variation of average length of stay in two models. But the number of delivery patients and number of beds were statistically significant. The number of delivery patient variable showed negative regression coefficient with average length of stay and the number of beds showed positive coefficient with average length of stay. This study result indicated that the volume of delivery patients in a hospital will play a significant role in reducing the length of stay of delivery patients. Patient volume could contribute in improving the efficiency of patient care in a hospital.

• Journal of Biomedical Engineering Research
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• v.20 no.4
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• pp.471-477
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• 1999

Many researches have been performed whether electrical stimulation could be used for diagnosis and treatment on the auditory system impairment. Unfortunately, there were no standard methods or theoretical background for choosing stimulus conditions because of the lack of understanding on the transmission of electrical stimulation through the auditory pathway. This research was conducted to observe the effect of electrical stimulation on the tinnitus-induced animals. Nine guniea pigs were used for the experment and divided into two groups, five animals for the experimental group(A) and four animals for the control group(B). Experimental conditions were divided into four steps, before tinnitus induction and 1, 6, 12 hours after tinnitus induction using salicylate based on the Jastreboff model. In each experimental condition, ABR and ECochG were obtained, and autocorrelation coefficients were calculated from normalized waveforms based on rms values. Sum of all the autocorrelation coefficients was extracted as a parameter to observe the changes between before and after the electrical stimulation. As a result, ABR parameter values were rapidly increased 6 hours after tinnitus induction, the gradually returned back to the initial state. On the other hand, when electrical stimulation was applied, parameter values did not change compared with the initial sate. Parameter values of ECochG showed that the effect of electrical stimulation appeared 12 hours after the tinnitus induction. It was concluded that an electrical stimulation to the tinnitus-induced model changes the correlation coefficients of ABR and ECochG waveforms.

• Imaging Science in Dentistry
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• v.45 no.1
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• pp.15-22
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• 2015

Purpose: This study was performed to assess the reproducibility of identifying the sella turcica landmark in a three-dimensional (3D) model by using a new sella-specific landmark reference system. Materials and Methods: Thirty-two cone-beam computed tomographic scans (3D Accuitomo$^{(R)}$ 170, J. Morita, Kyoto, Japan) were retrospectively collected. The 3D data were exported into the Digital Imaging and Communications in Medicine standard and then imported into the Maxilim$^{(R)}$ software (Medicim NV, Sint-Niklaas, Belgium) to create 3D surface models. Five observers identified four osseous landmarks in order to create the reference frame and then identified two sella landmarks. The x, y, and z coordinates of each landmark were exported. The observations were repeated after four weeks. Statistical analysis was performed using the multiple paired t-test with Bonferroni correction (intraobserver precision: p<0.005, interobserver precision: p<0.0011). Results: The intraobserver mean precision of all landmarks was <1 mm. Significant differences were found when comparing the intraobserver precision of each observer (p<0.005). For the sella landmarks, the intraobserver mean precision ranged from $0.43{\pm}0.34mm$ to $0.51{\pm}0.46mm$. The intraobserver reproducibility was generally good. The overall interobserver mean precision was <1 mm. Significant differences between each pair of observers for all anatomical landmarks were found (p<0.0011). The interobserver reproducibility of sella landmarks was good, with >50% precision in locating the landmark within 1 mm. Conclusion: A newly developed reference system offers high precision and reproducibility for sella turcica identification in a 3D model without being based on two-dimensional images derived from 3D data.

• The Journal of Korean Academy of Prosthodontics
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• v.53 no.3
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• pp.234-243
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• 2015

Developing of digital technique, it is possible to fabricate implant prostheses for edentulous area using intraoral 3-dimentional information throughout implant diagnosis and treatment process. It is being changed that from the method using CAD/CAM, producing prostheses by model scanning after conventional impression and model processing, to the method of fabricating implant provisional restorations and customized abutments by digital impression after connecting digital impression copings (scanbody) and implant fixtures without models. But, this digital method has not been actively used for implant prostheses not yet. Specially, it is short of intraoral digital impression cases for immediate provisional restorations of the maxillary anterior implants. The gingival contour impression of maxillary anterior area is very important for esthetic restorations. Accordingly, in this case report, the using a digital impression coping (scanbody) and digital impression by CEREC Omnicam (Sirona, Bensheim, Germany) or Trios (3shape, Copenhagen, Denmark) were introduced for immediate provisional restorations in 3 cases needed a single implant restoration in maxillary anterior area. The clinical results were satisfactory on the convenience and accuracy of digital impression technique and the good esthetics of final restorations.

• Journal of Physiology & Pathology in Korean Medicine
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• v.23 no.5
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• pp.938-941
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• 2009

In spite of abundant clinical resources of stroke patients, the objective and logical data analyses or diagnostic systems were not established in oriental medicine. In the present study we tried to develop the statistical diagnostic tool discriminating the subtypes of oriental medicine diagnostic system, syndrome differentiation (SD). Discriminant analysis was carried out using clinical data collected from 1,478 stroke patients with the same subtypes diagnosed identically by two clinical experts with more than 3 year experiences. Numerical discriminant models were constructed using important 61 symptom and syndrome indices. Diagnostic accuracy and prediction rate of 5 SD subtypes: The overall diagnostic accuracy of 5 SD subtypes using 61 indices was 74.22%. According to subtypes, the diagnostic accuracy of "phlegm-dampness" was highest (82.84%), and followed by "qi-deficiency", "fire/heat", "static blood", and "yin-deficiency". On the other hand, the overall prediction rate was 67.12% and that of qi-deficiency was highest (73.75%). Diagnostic accuracy and prediction rate of 4 SD subtypes: The overall diagnostic accuracy and prediction rate of 4 SD subtypes except "static blood" were 75.06% and 71.63%, respectively. According to subtypes, the diagnostic accuracy and prediction rate was highest in the "phlegm-dampness" (82.84%) and qi-deficiency (81.69%), respectively. The statistical discriminant model of constructed using 4 SD subtypes, and 61 indices can be used in the field of oriental medicine contributing to the objectification of SD.

• Women's Health Nursing
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• v.5 no.1
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• pp.133-145
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• 1999

The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.