• Title/Summary/Keyword: long-term care

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Effects of the Duration of Highly Intensive Exercise on Lymphocyte Cell Death in Rats (고강도운동 지속시간이 rat의 림프구 세포사에 미치는 영향)

  • Kim, Hyeong-Soo;Hyun, Kyung-Yae
    • Journal of Life Science
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    • v.22 no.3
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    • pp.312-317
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    • 2012
  • The time-dependent effects of highly intensive exercise on the hematological properties of leukocytes, as well as $CD4^+$ and $CD8^+$ level changes as T-lymphocyte activation subsets and the cell death of lymphocytes in rats were studied in this research. Twenty, 60, and 120 min of highly intensive exercise was performed daily for 8 weeks. Total leukocyte counts in the blood of rats exercising for 20 min were elevated; they then decreased to less than the level of the control group up to 120 min. The patterns of lymphocyte level changes were directly influenced by exercise duration and the extents of alteration were similar to the total leukocytes counts. The levels of $CD4^+$ and $CD8^+$ in the blood of the exercising rats were not statistically different even when the exercise was continued for 120 min; thus, the exercise did not affect T-lymphocyte activation. Early- and late-stage lymphocyte apoptosis was not affected by the length of exercise, except that late-phase apoptosis was slightly increased at 120 min, suggesting that aging processes for lymphocyte apoptosis might be stimulated at that time. As the exercise time became longer, stimulated necrosis of lymphocytes was observed, so damage in lymphocytes and a potential loss of immunity might be presumed. The current observation suggests that long-term, highly intensive exercise might result in a loss of immunity that could be due to the damage of lymphocytes in terms of both their numbers and inflammation-related functions. The results suggest that under highly intensive exercise conditions, more than 20 min of exercise should not be suggested for health care purposes.

High Prevalence of Hepatocellular Carcinoma in Patients with Chronic Hepatitis B Infection in Thailand

  • Wanich, Nattawat;Vilaichone, Ratha-Korn;Chotivitayatarakorn, Peranart;Siramolpiwat, Sith
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.6
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    • pp.2857-2860
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    • 2016
  • Background: Chronic hepatitis B (CHB) infection is one of the important causes of hepatocellular carcinoma (HCC) in Thailand, involved in the pathogenesis and leading to a development of HCC with or without cirrhotic changes of the liver. This study was aimed to investigate the predictive factors for HCC among CHB patients in a tertiary care center in Thailand. Materials and Methods: We conducted a retrospective study of CHB patients with or without HCC during the period of January 2009 and December 2014 at Thammasat University Hospital, Pathumthani, Thailand. Data on clinical characteristics, biochemical tests and radiologic findings were collected from review of medical records. Results: A total of 266 patients were diagnosed with CHB in Thammasat university hospital during the study period. However, clinical information of only 164/266 CHB patients (98 males, 66 females with mean age of 49.4 years) could be completely retrieved in this study. The prevalence of HCC in CHB infection in this study was 38/164 (23.2%). CHB patients with HCC had a mean age older than those without HCC (59.5 vs 47 years, P-value = 0.01). Furthermore, history of upper GI bleeding, tattooing, blood transfusion, and chronic alcoholism were significantly more common in CHB patients with HCC than patients without HCC (13.2% vs 3.2% P-value 0.03, OR = 4.6, 95%CI = 1.2-18.1, 20% vs 3.9%, P-value = 0.01, OR= 6.1, 95% CI= 1.6-23.6, 20% vs 6.3%, P-value = 0.03, OR = 3.8, 95%CI =1.1-12.7, 62.2% vs 30.3%, P-value <0.0001, OR = 3.7, 95%CI= 1.7-8.1 respectively). Interestingly, more CHB patients with HCC had evidence of cirrhosis than those without HCC (78.9% vs 20.4%, P-value <0.0001, OR = 14.6, 95%CI = 5.8-36.7). In CHB patients with HCC, surgical therapy provided longer survival than radiofrequency ablation (RFA) (72 vs 46.5 months, P-value= 0.04). The mean survival time after HCC diagnosis was 17.2 months. Conclusions: HCC remains a major problem among patients with CHB infection in Thailand. Possible risk factors are male gender, history of upper GI bleeding, chronic alcoholism, tattooing, blood transfusion and evidence of cirrhosis. For early stage HCC patients, surgical treatment provided longer survival time than RFA. Most HCC patients presented with advanced disease and had a grave prognosis. Appropriate screening of CHB patients at risk for HCC might be an appropriate approach for early detection and improvement of long-term outcomes.

A Study on Safety and Performance Evaluation of Smart All-in-one Cardiopulmonary Assist Device (스마트올인원 심폐순환보조장치의 안전성 및 성능평가에 관한 연구)

  • Park, Junhyun;Ho, YeJi;Lee, Yerim;Lee, Duck Hee;Choi, Jaesoon
    • Journal of Biomedical Engineering Research
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    • v.40 no.5
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    • pp.197-205
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    • 2019
  • The existing Extracorporeal membrane oxygenation(ECMO) and Cardiopulmonary bypass system(CPB) have been developed and applied to various devices according to their respective indications. However, due to the complicated configuration and difficult usage method, it causes inconvenience to users and there is a risk of an accident. Therefore, smart all-in-one cardiopulmonary circulation device is being developed recently. The smart all-in-one cardiopulmonary assist device consists of a blood pump for cardiopulmonary bypass, a blood oxidizer for cardiopulmonary bypass, a blood circuit for cardiopulmonary bypass, and an artificial cardiopulmonary device. It is an integrated cardiopulmonary bypass device that can be used for a variety of purposes such as emergency, intraoperative, post-operative intensive care, and long-term cardiopulmonary assist, combined with CPB used in open heart surgery and ECMO used when patient's cardiopulmonary function does not work normally. The smart all-in-one cardiopulmonary assist device does not exist as a standard and international standard applicable to advanced medical devices. Therefore, in this study, we will refer to the International Standard for Blood Components, the International Standard for Blood, the Guideline for Blood Products, and prepare applicable performance and safety guidelines to help quality control of medical devices, and contribute to the improvement of the health of people. The guideline, which is the result of conducted a survey of the method of safety and performance test, is based on the principle of all-in-one cardiopulmonary aiding device, related domestic foreign standards, the status of domestic and foreign patents, related literature, blood pump(ISO 18242), blood oxygenator (ISO 7199), and blood circuit (ISO 15676) for cardiopulmonary bypass.The items on blood safety are as follows: American Society for Testing and Materials ASTM F1841-97R17), and in the 2010 Food and Drug Administration's Safety Assessment Guidelines for Medical Assisted Circulatory Devices. In addition, after reviewing the guidelines drawn up through expert consultation bodies including manufacturers / importers, testing inspectors, academia, etc. the final guideline was established through revision and supplementation process. Therefore, we propose guidelines for evaluating the safety and performance of smart all-in-one cardiopulmonary assist devices in line with growing technology.

Percutaneous Endoscopic Gastrostomy Tube Insertion-induced Superior Mesenteric Artery Injury Treated with Angiography (경피 내시경하 위루술 후 발생한 상장간막 동맥 손상 1예)

  • Lee, Seo Hee;Moon, Hee Seok;Park, Jae Ho;Kim, Ju Seok;Kang, Sun Hyung;Lee, Eaum Seok;Kim, Seok Hyun;Sung, Jae Kyu;Lee, Byung Seok;Jeong, Hyun Yong
    • The Korean Journal of Gastroenterology
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    • v.72 no.6
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    • pp.308-312
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    • 2018
  • Percutaneous endoscopic gastrostomy (PEG) is widely used to provide nutritional support for patients with dysphagia and/or disturbed consciousness preventing oral ingestion, and PEG tube placement is a relatively safe and convenient non-surgical procedure performed under local anesthesia. However, the prevention of PEG-insertion-related complications is important. A 64-year-old man with recurrent pneumonia underwent tracheostomy and nasogastric tube placement for nutritional support and opted for PEG tube insertion for long-term nutrition. However, during the insertion procedure, needle puncture had to be attempted twice before successful PEG tube placement was achieved, and a day after the procedure his hemoglobin had fallen and he developed hypotension. Abdominal computed tomography revealed injury to a pancreatic branch of the superior mesenteric artery (SMA) associated with bleeding, hemoperitoneum, and pancreatitis. Transarterial embolization was performed using a microcatheter to treat hemorrhage from the injured branch of the SMA, and the acute pancreatitis was treated using antibiotics and supportive care. The patient was discharged after an uneventful recovery. Clinicians should be mindful of possible pancreatic injury and bleeding after PEG tube insertion. Possible complications, such as visceral injuries or bleeding, should be considered in patients requiring multiple puncture attempts during a PEG procedure.

Current Status and Future Directions of the Dream Start Program in Korea (드림스타트, 지난 10년의 성장과 향후 10년을 위한 과제)

  • Lee, Sang-Gyun
    • Journal of the Korean Society of Child Welfare
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    • no.59
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    • pp.115-150
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    • 2017
  • The purpose of this study was to examine the current status of the Dream Start program from the perspective of social investment strategy, and as well as to suggest future directions. The program has become a major government welfare program in korea since it was introduced in 2007 as a demonstration project, following research evidence and a sound rationale about the extensive success of Head Start in the U.S. and Sure Start Programme in the UK. The aim of Dream Start is to provide integrated services for the vulnerable children, aged 0 to 12, and their families who are identified using a national administration data record of disadvantaged families with children. In order to promote the vulnerable child's well-being, to overcome inequalities, and to give every child the best start in life, Dream Start adopted a local, "whole family" approach. Case management services form an essential part of the Dream Start to customize and integrate comprehensive services such as counseling, health care, parenting advice and education, academic tutoring, and after-school activities. Although there has been a general improvement in key factors since its inception, Dream Start has not yet sufficiently shown the strong and hoped-for impact. In the meantime, Dream Start must be given financial expansion and extensive policy supports to get the chance of realizing and evaluating long-term gains for children and their families. More work need to be done to overcome inequalities and to make Dream Start service more accessible for the most disadvantaged families with children in Korea. Practical and policy suggestions for future directions of the Dream Start programs were discussed.

Effects of Innovativeness on Customer Satisfaction in Long-Term Care Hospitals: The Effect of Internal Capacity and Location Strategy in Hospital (요양병원의 혁신성이 고객만족도에 미치는 영향 : 내부역량과 입지전략의 매개효과)

  • KIM, Duck-Ki;KIM, Woo-Jong;KIM, Mi-Ran
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.3
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    • pp.110-124
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    • 2019
  • In recent years, over-supply of hospitals has made hospital management more difficult and hospitals have introduced innovative hospital management to enhance customer satisfaction. The purpose of this study is to investigate the effect of innovativeness of hospitals on customer satisfaction by using mediating effects of hospital capacity and location strategy. The subjects of this study were selected from 120 patients and caregivers who were hospitalized in Seoul and Metropolitan area hospitals and conducted questionnaire and statistical analysis. The results of this study are as follows: Firstly, this paper shows hospital Innovativeness does not significantly affect customer satisfaction. Unlike private companies, it is urgent to develop innovativeness measuring tools that are unique to hospitals differentiated from those of general companies. Secondly, although the impact of Innovativeness on hospital internal competency and location strategy was similar, location strategy(${\beta}=0.357$) had a greater impact on customer satisfaction than internal competency(${\beta}=0.283$). This suggests that the medical institution should take precedence over the detailed preparations based on its location marketability, traffic infrastructure, building sales and medical concentration from the time of its opening. Thirdly, this paper confirms through empirical analysis that the relationship between hospital Innovativeness and customer satisfaction is completely mediated by internal capacity and location strategy. The hospital's Innovativeness is affecting customer satisfaction by enhancing the hospital's internal competencies and inducing an active attitude toward establishing a location strategy.

The Effects of Safety Income System on Recipient's Economic Independence and Life Satisfaction under the Social Security System (사회보장제도의 안심소득제가 수혜자의 경제적 자립과 생활만족에 미치는 영향)

  • Kim, Sung-Ki
    • The Journal of the Korea Contents Association
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    • v.19 no.4
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    • pp.598-608
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    • 2019
  • This study is empirically intended to look into the effects of safety income system on recipient's economic independence and life satisfaction under the social security system. To achieve this, a survey was carried out to 650 adult householders benefiting from the social security system. The SPSS 23 statistical program was used to apply measurement variables related to the safety income system. The results of this study are summarized as follows. The social insurance and the social assistance of safety income system were adopted, having a significant effect on the economic independence. The effect of economic independence on life satisfaction was rejected, while the effect of social assistance on life satisfaction was adopted, showing a difference in the effect of each factor. The findings imply that social insurance and social assistance with support for safe income can be a positive help for economic independence, and unemployment benefit, national pension, long-term care subsidy and health insurance can help to achieve real economic independence, adopting only social assistance with limitation to life satisfaction. Consequently, the safety income system is very useful in helping recipients to achieve their economic independence through its introduction, but there is some distance to meet their life satisfaction.

The Cause-and-Effect Relationship between Perceptual Satisfaction and Expectation Factors for Special Hospitals by Busan and Gyungnam Medical Consumers (부산·경남지역 의료소비자들의 전문병원에 대한 지각 만족도와 기대요소 간의 인과관계)

  • Park, Ki-Hyeok;Shin, Jin-Ho
    • Journal of Convergence for Information Technology
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    • v.11 no.7
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    • pp.181-188
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    • 2021
  • This study was performed to examine the strategy method for the sustainable stability and effectiveness of small and medium hospital, where the relationship between perceptual satisfaction and expectation factors for special hospital was analyzed. The structural questionnaire was given to the residents of Busan and Gyungnam over the age of 20 and the square contingency and the logistical regression were employed for the analysis of the results. First, the respondent with 68.0% has realized the hospital claiming to be characterization as the special hospital and the Ministry of Health and Welfare designated hospital was identified to the respondent of 21.3%. Second, perceptual satisfaction with expectation level was satisfied to the most visitor in case of visiting special hospitals with subjective perception and was confirmed to the intention of revisiting consistently. Third, for the perceptual satisfaction of visiting with expectation level, the safety and the quality of treatment affected significantly the cause-and-effect. The result has provided the useful information with the establishment of a strategy for the long-term and continued effect through the perceptual satisfaction and the emotional attachment.

A Review on Physical Activity for Health Care in the Era of COVID-19 (COVID-19 시대의 건강관리를 위한 신체활동 고찰)

  • Yoo, Jae-Hyun
    • Journal of Korea Entertainment Industry Association
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    • v.15 no.2
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    • pp.149-157
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    • 2021
  • One year has passed since the pandemic of COVID-19, which occurred in Wuhan, China, in November 2019 began. Worldwide, as of January 2021, more than 95 million people have been infected, and the death toll is higher than 2 million. In Korea, there are 74,262 infected and 1,328 dead, and government policies such as social distancing to prevent infection are being implemented. Accordingly, many inconveniences occurred in the physical activity environment, such as the closure of various sports facilities. It was necessary to consider physical activities to maintain healthy life while cooperating with the national policy while preventing infection. This study investigated the benefits of physical activity to reduce the risk of trichomoniasis and diabetes, improve bone mineral density, prolong healthy lifespan, maintain activity performance with aging, and improve psychological anxiety and depression. In addition, the physiological changes that may occur in the situation of stopping exercise due to social distancing to prevent COVID-19 infection were reviewed. In addition, moderate-intensity exercise that helps strengthen immune function by activating natural killer cells, neutrophils, and antibody responses was investigated. In addition, it reduces the level and function of blood B-cells, T-cells, and natural killer cells for several hours, decreases phagocytosis of neutrophils in the nasal cavity, increases inflammatory cytokines, decreases immune function, and increases infection. High-intensity exercise was considered. Therefore, in the age of COVID-19, long-term high-intensity exercise such as marathon, which causes impaired immune function, should be refrained from. And you should do moderate-intensity regular aerobic exercise such as fast walking to help prevent infection. It is also recommended to participate in resistance exercises to prevent loss of muscle mass.

Implant surgery and prosthodontic treatment of Temporomandibular disorder patient combined SERAFIN clear aligner system : Clinical case report (세라핀 투명교정 시스템을 활용한 교합 장애 및 치아 결손 증례의 치료)

  • Won-Gun, Chang
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.31 no.1
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    • pp.11-18
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    • 2022
  • Adult patients who need implant and prosthodontic treatment often need treatment to improve the existing occlusion through orthodontic treatment for long-term stable treatment results. However, due to non-aesthetic and uncomfortable orthodontic treatment with orthodontic brackets and wires, many adult patients give up treatment even though they know the need for it. Recently, as digital dentistry has affected all areas of dentistry, clear aligner orthodontic systems have begun to be widely used, and their use is increasing in adults and old-aged people due to the esthetic advantage and convenient oral care. SERAFIN clear aligner system developed in Korea has been developed with the aim of implementing a functional occlusion harmony and is used not only for partial orthodontic treatment but also comprehensive orthodontic treatment. This patient presentation is shown the treatment using SERAFIN clear aligner system for the treatment of patient with TMD, severe extrusion of maxillary second molars, and extracted teeth.