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Middle-Old Age's Retirement Transition, Old Age Income Security and the Support of Gradual Retirement (중고령자의 퇴직전환 및 노후소득보장과 점진적 퇴직지원)

  • Ji, Eun-Jeong
    • Korean Journal of Social Welfare
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    • v.58 no.3
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    • pp.135-168
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    • 2006
  • This study reviewed pension reform's overall characteristic and(anticipated) positive negative effect in OECD countries's and then analysed middle-old age's retirement transition and determinants of full/gradual retirement through the $3{\sim}7th$ Korea Labor and Income Panel considering that Korea has been aging society quickly and it is necessary to suggest not only solution of early retirement and working age reduction but also pension reform. As a result of this study, about 1/4 of 50 years and older have been continuing to work through various pathways after retirement and 98% among fully retired older who passed by re-employment step of occupational status including retirement are still searching for jobs. This showed that it is also inappropriate to typical retirement concept itself on the lines of labour market participation in Korea and part-time/temporary work or self-employment have been used by means of alternatives of maintaining works for middle-old ages. However, the duration of changed occupational status of gradual retirees is mostly only $1{\sim}2$ years. Therefore it is necessary to support the gradual retirement to minimize a term of income insecurity and promote the work of the old ages who have will and capacity of work. Most of all, partial pension system which is main program of gradual retirement, should make the rules that beneficiaries are those who age less than pensionable age and benefit levels should be actuarial fairness together with pension system and provide substantial help. But, the introduction of partial pension system is not the only way to solve and needs overall social economic approach. Especially guarantee the increase of quantitative qualitative employment for middle-old ages linking labor market policy and supporting gradual retirement not ought to be abused to force the part time works and early retirement route against their own will.

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Clinical Characteristics of Tuberculosis in Liver or Heart Transplant Recipients (간 또는 심장이식을 시행 받은 환자에서의 결핵의 발생률 및 임상양상)

  • Jung, Hoon;Oh, Yeon-Mok;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Kim, Jae-Joong;Lee, Sung-Gyu;Shim, Tae-Sun
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.5
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    • pp.440-446
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    • 2006
  • Background: Post-transplant tuberculosis (TB) is a serious complication in solid organ transplant recipients worldwide, However there is little or no data on TB in liver or heart transplant recipients in Korea. Methods: The incidence and clinical characteristics of TB of 730 patients who had undergone a liver transplant in a university hospital in Korea between 1992 and 2004, and 110 heart transplant recipients in the same period, were reviewed retrospectively. Results: The incidence of TB was 1.5%(11/730) and 2.7%(3/110) in the liver and heart transplantation, respectively. The median time from the transplant to the development of TB was 8.4 months(1.0-30.8). and the mean time from the symptoms to the diagnosis of TB was $2.1{\pm}3.6$ months(0.3-13.2). Nine patients (65%) had pulmonary TB and five (35%) had extrapulmonary TB. The leukopenia and positive HbeAg at the baseline, post-transplant diabetes mellitus, and chronic rejection were associated with the development of TB in the liver transplant recipients. Ten patients were treated with a 4-drug standard regimen for a mean duration of $7.8{\pm}3.5$ months. One patients died of TB. Conclusion: The incidence of TB in liver or heart transplant recipients was similar to that reported in other countries with a similar TB-burden.

THE COMPARATIVE STUDY ON THE SEDATIVE EFFECT OF DIFFERENT INTRAVENOUS MIDAZOLAM DOSAGES FOR PEDIATRIC DENTAL PATIENTS (소아환자의 Midazolam의 정맥투여 용량에 따른 진정 효과에 관한 비교연구)

  • Kim, Eun-Young;Kim, Jong-Soo;You, Seung-Hoon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.3
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    • pp.416-426
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    • 2005
  • Intravenous sedation have many advantages of rapid onset and recovery, ability of control sedation levels and duration through titration. Midazolam is most commonly used intravenous medication for sedation in pediatrics, endoscopy, oncologic procedures and so on. But in dentistry, midazolam intravenous sedation is usually for adult, and there are few reports for children. Todays, children who need sedation become more and older, intravenous sedation technique is going a matter of concern in pediatric dentistry. The purpose of this paper is to evaluate the efficacy of sedation and clinical success for different initial dosage of midazolam in intravenous sedation for pediatric dental patients. 16 healthy children (male 10, female 6), mean age $54.7{\pm}10.7$ months, who needed at least two separate treatment visits requiring local anesthesia were chosen for this study. Every children were taken 0.3mg/kg, maximum 5mg of midazolam by intramuscular route, and then 30~50% $N_2O-O_2$ for 10 minutes was given. On every visits, one of the following 2 different initial dosage was given by intravenous route : (1) Group I : 0.1mg/kg Midazolam (2) Group II : 0.2mg/kg Midazolam. Additional dosage was half of the first dose. Physiologic parameters (oxygen saturation, heart rate, respiratory rate, end-tidal carbon dioxide pressure) was recorded by ten procedure steps. Behavior was videotaped and rated using Ohio State University Behavioral Rating Scale and Automated Counting System by one investigator, blind to administered dosage. After the treatment, operator evaluated the clinical success. Physiologic parameters were stable and within normal range during treatment in both groups. The analyzed sedative effect, in behavioral evaluation, ratio of favorable Quiet was higher in group II, and clinical success rate of group II was better than group I. Induction time was rapid in group II, and recovery time was rapid in group I. And there was no statistically difference between two groups in every results.

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Quality Characteristics of Treated with Mild Heat and Minced Ginger during Storage (열처리 조건에 따른 다진생강의 저장 중 품질특성)

  • Kim, Hee-Su;Choi, Jeong-Hee;Lee, Ho-Joon;Jeong, Moon-Cheol;Kim, Byung-Sam;Kim, Dong-Man
    • Food Science and Preservation
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    • v.17 no.6
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    • pp.784-792
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    • 2010
  • Mild heat treatment was applied to ginger rhizomes to achieve shelf-life extension for fresh minced ginger. The rhizomes were treated at 45, 50, 55, or $60^{\circ}C$ for different periods of time, minced, and stored at $10^{\circ}C$ for 9 days. Microbial levels in minced fresh ginger decreased with increases in temperature and duration of heat treatment. The non-treated and treated samples did not significantly differ in color at the initial stage of storage. Changes in color were detected after 3 days, and accelerated after that time. The ${\Delta}E$ value of control samples reached 12.42, whereas that of treated samples (except when $45^{\circ}C$ was applied for 60 min) ranged from 7.67 to 10.96, after 9 days. There was no significant difference in initial pH value between control (pH 6.09) and treated (pH 6,046.20) samples. The pH of control samples increased to 8.02 after 9 days, whereas pH values of samples treated at $50^{\circ}C$ and $60^{\circ}C$ ranged from pH 6.807.83 after 9 days. The percentage of control drip was 25.65% at the initial stage of storage, which was lower than those of treated samples. Drip increased to 38.63% in the control and to 34.20~38.44% in treated samples after 9 days. The sensory characteristics of the control samples were similar to those of treated samples at the initial stage of storage. After 6 days, the control and some treated samples developed off-flavors and discoloration. However, samples treated at $50^{\circ}C$ for 60 min retained favorable quality characteristics for 9 days after storage.

Safety and Significance of Surgical Lung Biopsy for Interstitial Lung Disease (간질성 폐질환에 대한 수술적 폐생검의 의의 및 안전성)

  • Lee, Yu Jin;Joung, Mi Kyong;Chung, Chae Uk;Park, Ji Won;Shin, Ji Young;Jung, Sun Young;Lee, Jeong Eun;Park, Hee Sun;Jung, Sung Soo;Kim, Ju Ock;Kim, Sun Young
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.1
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    • pp.59-66
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    • 2007
  • Background: Surgical lung biopsy is required to establish the etiology and stage of interstitial lung disease(ILD). and this procedure can be safe and meaningful for making clinical decisions. We wanted to determine the safety of surgical lung biopsy(SLB) in patients with interstitial lung disease(ILD). Methods: We conducted a retrospective review of 40 patients with suspected ILD and they underwent surgical lung biopsy from January 2001 to June 2006 at Chungnam University Hospital. We analyzed retrospectively according to their age, gender, pulmonary function, chest tube duration, the arterial blood gases, the procedural technique, and the requirement for supplemental oxygen and mechanical ventilation(MV) at the time of SLB. Results: The mean age of the patients was 56.4${\pm}$16.13 years(range: 21 to 77 years). Overall, the 30-day and 90-day mortality rates were 15% and 20%, respectively. The predictors of perioperative mortality were either the need for mechanical ventilation(MV) at the time of SLB or the need for supplemental oxygen prior to undergoing SLB. Among the 32 patients who were 90-day survivors, the proportion of those patients using the oxygen supplement was 28.1% (n=9). All 8 patients who were 90-day non-survivors used oxygen supplement (p=0.000). The use of the MV was 12.5% (n=4) in the 90-day survivors (n=32) and 62.5% (n=5) in the 90-day non-survivors (n=8); there was a significant difference between the 90-day survivors and non-survivors (p=0.000). Conclusion: Patients who require MV and supplemental oxygen are associated with an increased risk for death following SLB.

Colon Interposition as a Gastric Substitute after Performing Gastrectomy in Patients with Gastric Cancer (위암 환자에서 위 절제술 후 결장 간치술)

  • Lee, Jun-Hyun;Hur, Hoon;Jeon, Hae-Myung;Kim, Wook
    • Journal of Gastric Cancer
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    • v.8 no.4
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    • pp.217-224
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    • 2008
  • Purpose: For most surgeons, colon interposition after gastrectomy remains an infrequently performed procedure because of its complexity. The aim of this study was to assess its technical feasibility and safety as a post-gastrectomy reconstruction method by reviewing our experience with colon interposition. Materials and Methods: From March 2001 to February 2002, 30 colon interpositions after-gastrectomy were done with using the ileo-ascending or transverse colon. We analyzed the clinicopathologic features and the surgical outcomes. Results: There were 16 males and 14 females in this study with a mean age of 67.5 years (range: 31 to 76 years). Twenty-five ascending colons and 5 transverse colons were used for the interposition, respectively. The mean operation time was 373 minutes (range: 204 to 600 minutes). There were 9 operative morbidities (30%) and 1 operative mortality. The restoration of bowel motility was noted at 3.8 postoperative days; a soft diet was started at 4.9 postoperative days and the duration of the hospital stay was 18.2 days. The percentage of weight loss in the patients with total, proximal and distal gastrectomy was 16.3%, 14.0% and 8.8%, respectively, at 6 months, and thereafter the weight loss gradually recovered as 8.1%, 7.5% and 5.6%, respectively, at 5 years postoperatively. Gastric stasis was the one of the most meaningful long-term complications, and especially in the patients who underwent distal gastrectomy with colon interposition. Conclusion: Colon interposition after gastrectomy was a very complex procedure with a long operating time and many anastomosis sites. The postoperative outcomes failed to achieve satisfactory weight gain and the patients displayed postprandial symptoms. This suggested that this procedure was not an appropriate procedure for conventional reconstruction after gastrectomy.

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Fenton-like Reaction for Treatment of Petroleum-Contaminated Silty Clay after Soil Washing Process (토양세척 후의 유류 오염 Silty Clay 처리를 위한 유사펜톤 산화반응)

  • So, Myung-Ho;Ha, Ji-Yeon;Yu, Jae-Bong;Kim, Chang-Gyun
    • Journal of Korean Society of Environmental Engineers
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    • v.31 no.1
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    • pp.1-8
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    • 2009
  • This research was performed to assess a Fenton-like oxidation using naturally present iron in the field to treat remained oils throughout silty clay residues which finally resided even after a series of soil washing process. Biodegradability was thus tested for reaction products to investigate a possible treatment of the Fenton-like oxidation coupled with a biological treatment process. For those purposes, two types of field soil samples (e.g., dewatered cake after conditioning with a polymer and not-dewatered residue) were tested to remove TPH by adding the various concentration of hydrogen peroxide ($H_2O_2$). Moreover the biodegradability of treated samples was observed based on the ratio of $BOD_5/COD_{Cr}$ after Fenton-like oxidation. The Highest removal of TPH was at 1% of hydrogen peroxide ($H_2O_2$) when hydrogen peroxide ($H_2O_2$) was continuously injected for a period of time rather than that of spot introduction with the same amount of it. For the dewatered cake, TPH was effectively treated when the ratio of solid and water was mixed at 1 : 2. Employing cooking oil could increase solubility of TPH due to enhanced surface-active escalating TPH desorption from silty clay. Nonetheless, the biodegradability was decreased as long as the oxidation duration being extended regardless of operational conditions. It was therefore proved that Fenton-like oxidation using $H_2O_2$ and natural iron minerals was able to remove adsorbed oils in silty clay but the removal efficiency of TPH was low. And if a biological treatment process followed after Fenton-like oxidation, microorganisms would need enough time for acclimation.

Surgical Treatment of the Aortic Dissection (대동맥박리증의 외과적 치료)

  • Jung, Jong-Pil;Song, Hyun;Cho, You-Won;Kim, Chang-Hoi;Lee, Jay-Won;Song, Meong-Gun
    • Journal of Chest Surgery
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    • v.29 no.12
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    • pp.1360-1365
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    • 1996
  • From September 1992 to May 1996, 38 patients ranging in age from 23 to 78, were operated for aortic dissection at Asan medical center There were 21 men and 17 women. The underlying aortic pathology were acute aortic dissection in 23, chronic aortic dissection in 15. Eight patients had Martian syndrome. In 34 cases of DeBakey type I, II patients, femoral artery and vein and/or right atrial auricle were used as cannulation site. With deep hypothermic c rculatory arrest (esophageal temperature 12 $\pm$ 2.5$^{\circ}C$) and retrograde cerebral perfusion of cold oxygenated blood through SVC, we replaced the ascending aorta and the part of arch if necessary. The mean duration of the total circulatory arrest time was 25 $\pm$ 1.7 mintstuts. In 4 cases of DeBakey type III patients, we replaced descending thoracic aorta or thoracoabdomlnal aorta without shunt or bypass under normothermia with an average 30: 1.5 minutesaortic cross clamp time. One death(2.6%) occurred on the twenty-second postoperative day owing to asphyxia related to ulcer bleeding. Postoperative complications were myocardial infarction with transient left peroneal palsy in 1 case, transient lower extremity weakness in 1 case and prolonged ventilatory support in 1 case. Two patients required reoperation due to retrograde extended dissection and aortic insufuciency. There was no late death with an average 25 months follow-up period.

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The Mid Term Clinical Result and the Risk Factor Analysis of Isolated Aortic Valve Replacement (단독 대동맥판막 치환술의 중기 성적과 그 위험인자에 대한 분석)

  • Park Jae-Min;Jun Hee-Jae;Yoon Young-Chul;Lee Yang-Hang;Hwang Yoon-Ho;Cho Kwang Hyun;Han Il-Yong
    • Journal of Chest Surgery
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    • v.38 no.2 s.247
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    • pp.110-115
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    • 2005
  • Background: The aims of this paper were to review the mid term clinical results and to analyze the preoperative risk factors of isolated aortic valve replacement (AVR). Material and Method: Between January 1992 and February 2003, 80 patients underwent isolated AVR. 58 were male and 22 were female patients, raging from 12 to 75 years of age (mean :$46.8{\pm}13.0$ years). 74 patients except one early death and 5 follow-up loss were contacted by OPD or by telephone. The mean duration of follow-up was $44.2{\pm}29.7$ months and the total cumulative period was 272.8 patient-year. Result: The complications in hospital occurred in 35 cases : 12 wound problems (11 superficial, 1 deep), 11 arrhythmias (9 temporary, 2 persistent), 3 low cardiac output, and so forth. The late deaths were 4 cases : the heart-related deaths were 2 cases ($0.7\%$ patient-year). Conclusion: The risk factors that influenced the early mortality and morbidity were older age (> 60 years)(p=0.04), poor preoperative NYHA functional class (> 3) (p=0.048), high preoperative serum creatinin level (> 1.2 mg/100 ml)(p=0.031), long operation time (aortic clamping time>90 min)(p=0.042). The same factors influenced the late mortality and morbidity. Freedom from valve-related complication was $86.4{\pm}5.3\%,$ actuarial survival rate were $96.8{\pm}2.3\%$ at 3 years and $90.8{\pm}4.6\%$ at 10 years.

Radiation Therapy for Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis (간문맥종양혈전증을 동반한 간세포암에서의 방사선 치료)

  • Park, Seung-Gyu;Kim, Jin-Hee;Byun, Sang-Jun;Kim, Ok-Bae;Hwang, Jae-Seok;Oh, Young-Kee;Choi, Tae-Jin
    • Radiation Oncology Journal
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    • v.29 no.1
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    • pp.36-43
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    • 2011
  • Purpose: To evaluate the effectiveness of radiation therapy (RT) for hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) and to analyze the prognostic factors. Materials and Methods: From December 2004 to April 2009, 70 patients who had HCC with PVTT were treated with RT at Keimyung University Dongsan Medical Center. Nineteen patients whose total dose was below 30 Gy and one patient who underwent liver transplantation were excluded. The remaining 50 patients (45 males, 5 females; median age 55 years) were analyzed. According to the LCSGJ TNM stage, there were 27 patients (54.0%) with stage III and 23 (46.0%) with stage IV. Total dose of 30~54 Gy was administered (median 45). Thirty patients (60.0%) were treated with concurrent chemoradiation therapy (CCRT). The median follow-up duration was from 13.5 months (range, 3 to 70 months). Results: The median survival time from the start of RT was 9 months. One-year and 2-year overall survival rates were 24.9% and 11.2%, respectively. At the follow-up time, three patients (6.0%) displayed no evidence of disease. Seven patients (14.0%) were alive with disease, and 40 (80.0%) patients had expired due to disease progression. CCRT was associated with worse survival than RT alone (p=0.034), Response to RT (p=0.037), CLIP stage (p=0.017), and TNM stage (p=0.041) were statistically significant prognostic factors. There was no radiation-induced liver disease. Conclusion: RT is an effective and safe modality for HCC with PVTT. Further studies such as prospective randomized trials are needed to confirm the role of RT for HCC with PVTT.