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Needs Assessment for the Beneficiaries of Home-Based Cancer Patients Management Project (보건소 재가암환자관리사업 대상자의 서비스 요구도 분석)

  • Lee, Ju-Hyung;Park, Jung-Im;Kang, Ji-Hoon;Youm, Jung-Ho;Koh, Dai-Ha;Kwon, Keun-Sang
    • Journal of agricultural medicine and community health
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    • v.36 no.4
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    • pp.238-250
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    • 2011
  • Objectives: This study was performed to investigate the service needs of the beneficiaries who had enrolled in home-based management programs for cancer patients. Methods: From March to May 2009, 676 cancer patients who were registered in home-based cancer patient management programs were selected as subjects for this study. The data were collected using a questionnaire along with a face-to-face interview performed by officers in charge of the home-based care programs of 47 regional health centers. Fifteen patients were excluded due to incomplete data, leaving 661 subjects who were ultimately enrolled in the study. Results: The mean age of subjects was $64.0{\pm}2.5$ years, and males comprised 45.1% (298/661) of the sample. The results of factor analysis for service needs showed that there were five main categories and Cronbach's alpha ranged from 0.593 to 0.890 for each factor. The service needs categories in order of importance were social support, information and education, psychological problems, physical symptoms and household chores. The service needs scores were significantly different when subjects were stratified by age, habitation, religion and disease classification. When we divided the subjects into complete remission, under treatment and terminally ill groups, the needs scores of the terminally ill patient group were significantly higher than those of the other groups (p<0.001). Conclusions: Service provision based on patient and beneficiary needs could be an effective intervention to reduce the economic burden of cancer management and to improve the quality of life of cancer patients receiving home-based care. Therefore, it is recommended that individual cancer patient care programs be developed and administered according to patient age, habitation and disease severity.

Failure Behavior and Separation Criterion for Strengthened Concrete Members with Steel Plates (강판과 콘크리트 접착계면의 파괴거동 및 박리특성)

  • 오병환;조재열;차수원
    • Journal of the Korea Concrete Institute
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    • v.14 no.1
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    • pp.126-135
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    • 2002
  • Plate bonding technique has been widely used in strengthening of existing concrete structures, although it has often a serious problem of premature falure such as interface separation and rip-off. However, this premature failure problem has not been well explored yet especially in view of local failure mechanism around the interface of plate ends. The purpose of the present study is, therefore, to identify the local failure of strengthened plates and to derive a separation criterion at the interface of plates. To this end, a comprehensive experimental program has been set up. The double lap pull-out tests considering pure shear force and half beam tests considering combined flexure-shear force were performed. The main experimental parameters include plate thickness, adhesive thickness, and plate end arrangement. The strains along the longitudinal direction of steel plates have been measured and the shear stress were calculated from those measures strains. The effects of plate thickness, bonded length, and plate end treatment have been also clarified from the present test results. Nonlinear finite element analysis has been performed and compared with test results. The Interface properties are also modeled to present the separation failure behavior of strengthened members. The cracking patterns as well as maximum failure loads agree well with test data. The relation between maximum shear and normal stresses at the interface has been derived to propose a separation failure criterion of strengthened members. The present study allows more realistic analysis and design of externally strengthened flexural member with steel plates.

Blood Pressure Cuff Bladders Tailored For Koreans (한국인 맞춤형 혈압계 커프 블래더)

  • Hwang, Lark Hoon;Park, Woo Sung;Na, Seung Kwon
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.38C no.9
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    • pp.822-829
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    • 2013
  • Hypertension is one of the most common clinical diseases, with an increasing prevalence globally. Hypertension triggers various harmful consequences and affects multiple organs. Life-long care may be required in some cases. According to the Korea Center for Disease Control and Prevention, the prevalence of hypertension is gradually increasing. A 2011 survey revealed that 28.9% of Korean adults had hypertension. The prevalence rates were slightly higher among men than women. Accurate measurement of blood pressure(BP) is crucial to classify patients, to identify BP-related risks, and to inform correct treatment. For accurate blood pressure measurement, the use of a cuff bladder size appropriate for the mid-upper arm circumference(MUAC) is essential. Incorrect sized cuff bladder is one of the main causes of equipment error affecting sphygmomanometer accuracy. When commercial sphygmomanometers were examined, the cuff bladders differed from the dimensions specified in the ISO 81060-1:2007 standards. Undercuffing is responsible for a spurious overestimation of BP in patients with large arms leading to overdiagnosis of hypertension, whereas overcuffing (that is, use of relatively large cuffs with small arms), may be responsible for an opposite problem, leading to erroneous underestimation of BP levels. The cuff bladder sizes recommended by the American Heart Association(AHA) are an arm circumference(AC) of 17-25 cm for small-sized adults, AC of 24-32 cm for adults, AC of 32-42 cm for normal-sized adults, and AC of 42-50 cm for obese adults. In contrast, the AC of Korean adults ranges from 23-31 cm, belonging to a single type of adult bladder. Three types of bladders are necessary for Korean adults with an AC of 23-31cm. Hospitals often use one or two differently-sized Western cuffs for adult patients, which can yield inaccurate BP determinations. Cuff bladders with dimensions based on anthropometric reference data obtained from Koreans will aid hospitals to measure BP more accurately.

An Experimental Study on Evaluation of Axially Compressive Buckling Strength of Corroded Temporary Steel (부식 손상된 가시설 강재의 축압축 좌굴강도 추정에 관한 실험적 연구)

  • Kim, In Tae;Lee, Myoung Jin;Shin, Chang Hee
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.15 no.6
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    • pp.135-146
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    • 2011
  • Steel structures have been generally painted to prevent corrosion damage. However, the painted film is deteriorated with increase in service life, and then corrosion damage resulting in cross sectional area occurs on steel surface. As a result, the buckling strength of steel structures can be decreased due to the corrosion damages. The evaluation method of the axial buckling strength of columns about a variety of section shapes and supporting conditions have been presented, but evaluation method of buckling strength about irregular nonprismatic columns is not established. In this study, the axial buckling strength of corroded steels was evaluated based on the buckling test results of corroded steel specimens that were cut off at a temporary steel structure. The corroded specimens were picked up total 10 specimens according to various slenderness ratio from the web of a temporary structure's main beam. The length of specimens is 200, 300, 400, 500 and 600mm respectively. The rust productions were removed by the chemical treatment. Then, the surface geometry was measured at intervals of $1{\times}1mm$ by using the optical 3D digitizing system, and the residual thickness of the specimens was calculated. The axial buckling test was performed on 10 corroded specimens and 12 non-corroded specimens under the fixed-fixed support condition. From the test results, the effect of corrosion damages on axial buckling load was investigated. Regardless of corrosion damage degree, the axial buckling strength of corroded specimens and non-corroded specimens was evaluated identically by using minimum average residual thickness or average residual thickness to minus its standard deviation. Reasonable measuring intervals of residual thickness was proposed by using the results to apply for practical works.

Solubility Improvement of Cuttle Bone Powder Using Organic Acids (유기산처리에 의한 갑오징어갑 분말의 가용성 개선)

  • KIM Jin-Soo;CHO Moon-LAE;HEU Min-Soo;CHO Tae-Jong;AN Hwa-Jin;CHA Yong-Jun
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.36 no.1
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    • pp.11-17
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    • 2003
  • As a pan of a study on effective use of seafood processing by-products, such as cuttle bone as a calcium source, we examined on the kind of organic acid (acetic acid and lactic acid), reaction concentration (mole ratio of calcium to mole of organic acid), reaction temperature $(20\~60^{\circ}C)$ and reaction time (6$\~$24 hours) as reaction conditions for the solubility improvement of cuttle bone powder. The high soluble cuttle bone powder was also prepared from the optimal reaction conditions and partially characterized. From the results on examination of reaction conditions, the high soluble cuttle bone powder was prepared with 0.4 in mole ratio of a calcium to mole of a acetic acid at room temperature for 12 hours, Judging from the patterns of IR and X-ray diffraction, the main component of the high soluble cuttle bone powder was presented as a form of calcium acetate, and a scanning electron micrograph showed an irregular form. The soluble calcium content in the high soluble cuttle bone powder was $5.3\%$ and it was improved about 1,380 times compared to a raw cuttle bone powder. For the effective use of the high soluble cuttle bone powder as a material for a functional improvement in processing, it should be used after the calcium treatment at room temperature for about 1 hour in tap water or distilled water. from these results, we concluded that it is possible to use the high soluble cut시e bone powder as a material for a functional improvement in processing.

An Analysis of Prognostic Factors Affecting the Outcome of Radiation Therapy for Nasopharyngeal Carcinoma (비인강암의 방사선치료 곁과 및 생존율에 관한 예후인자 분석)

  • Jung, Young-Yeon;Kim, Ok-Bae;Kim, Jin-Hee
    • Radiation Oncology Journal
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    • v.23 no.2
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    • pp.71-77
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    • 2005
  • Purpose: This retrospective study was conduced to analyze the treatment results and to evaluate the prognostic factors affecting the survival of nasopharyngeal carcinoma patients. Materials and Methods: From 1987 to 2002, we analyzed 43 patients who had nasopharyngeal carcinomas that were histologically confirmed and who had also completed the planned radiation therapy course at Keimyung University Dongsan Medical Center According to the 6th edition of American Joint Committee on Cancer staging system, 12 patients ($27.9\%$) were at Stage 11, 13 ($30.2\%$) were at Stage III and 18 ($41.9\%$) were at Stage IV Histopathologically, there were 15 ($34.9\%$) squamous cell carcinomas, 8 ($18.5\%$) nonkeratinizing carcinomas, 17 ($39.5\%$) undifferentiated carcinomas, and 3 ($7.0\%$) lymphoepitheliomas. Among the total 43 patients, 31 patients ($72.1\%$) were treated with only radiation therapy. Neoadjuvant chemotherapy was peformed on 7 patients ($16.3\%$) and concurrent chemoradiotherapy was performed on S patients ($11.6\%$). Cisplatin and 5-Fluorouracil were administered to 11 patients for 4 cycles, and Cisplatin and Taxotere were administered to 1 patient for 6 cycles. The range of the total radiation dose delivered to the primary tumor was from 61.2 to 84 Gy (median 70.4 Gy), The follow-up period ranged from 2 to 197 months with median follow-up of 84 months. Results: The local control rate at 6 months after radiation therapy was $90.7\%$. The five year overall survival and disease free survival rates were $50.7\%$ and $48.9\%$, respectively. On the multivariate analysis, the age, T-stage ($T_{1-3}\;vs\;T_4$), N-stage and AJCC stage were the statistically significant prognostic factors affecting survival (p<0.05). The patterns of failure were as follows: local failure only in 3 patients ($7.0\%$), local and systemic failure in 1 patient ($2.3\%$), and distant metastasis only in 11 patients ($25.6\%$). Conclusion: The prognostic factors affecting the outcome of nasopharyngeal carcinoma were age, T-stage (7$T_{1-3}\;vs\;T_4$), N-stage and stage. Because systemic metastasis was the main failure pattern noted for nasopharyngeal carcinoma, systemic chemotherapy is needed to decrease the rate of distant metastasis for nasopharyngeal carcinoma. In audition, research for more effective chemotherapeutical regimens and schedules is also needed.

Concurrent Chemoradiotherapy in Locally Advanced Esophageal Cancer (국소적으로 진행된 식도암에서 동시항암화학방사선치료의 결과)

  • Byun, Sang-Jun;Kim, Jin-Hee;Kim, Ok-Bae;Song, Hong-Suk
    • Radiation Oncology Journal
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    • v.29 no.1
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    • pp.20-27
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    • 2011
  • Purpose: This study was designed to evaluate the results of local control, survival rate, prognostic factors, and failure pattern in locally advanced esophageal cancer. Materials and Methods: We retrospectively studied 50 patients with locally advanced esophageal cancer treated with concurrent chemoradiotherapy at Keimyung University Dongsan Medical Center from June of 1999 to August of 2008. Seven patients with inappropriate data were excluded, and 43 patients were analyzed. There were 39 males and four female patients ranging in age from 43 to 78 years (median, 63 years). There were seven patients with stage IIA and 36 with stage III. Irradiation from 46 Gy to 63 Gy (median, 54 Gy) was carried out 5 days per week, 1.8 Gy once a day. There were eight patients with neo-adjuvant chemotherapy, and we mostly used 5-fluorouracil, cisplatin with 3 cycles for concurrent chemotherapy. The range of follow up periods was from 2 to 82 months (median, 15.5). Results: There were nine patients that exhibited a cornplete response, 23 that exhibited a partial response, 9 that exhibited no response, and 2 that exhibited disease progression. The median survival time was 15 months. Two-year and 5-year survival rates were 36.5% and 17.3%, respectively. Two-year and 5-year disease-free survival rates were 32.4% and 16%, respectively. Treatment failure occurred in 22 patients (51.2%). Patterns of failure were categorized as local failure in 18 patients and distant metastasis in four patients. In a univariate analysis for prognostic factors related to overall survival and disease-free survival, the hemoglobin levels during chemoradiotherapy (${\geq}$ 12 vs. <12, p=0.02(p=0.1) and the response to the treatments (CR/PR vs. NR/PD, p=0.002/p< 0.0001) were statistically significant. In a multivariate analysis, only response to the treatments was revealed to be statistically significant. There was no statistical significance associated with patient age, gender, disease stage, T-stage, smoking history, tumor location, or neo-adjuvant chemotherapy. Conclusion: Our survival rate was similar to those of other institutions. Local recurrence was the main reason for failure. It is suggested that further prospective studies should be performed to improve local control.

Assesment of Bone Strength Using a New Quantitative Ultrasound Device in Children with Renal Diseases (신질환 환아에서 초음파 골량측정법을 이용한 골상태 평가)

  • Kang Ju-Hyung;Shin Yun-Hye;Cho Nam-Han;Pai Ki-Soo
    • Childhood Kidney Diseases
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    • v.9 no.1
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    • pp.21-30
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    • 2005
  • Purpose : Metabolic bone diseases have been mai or problems in children with renal diseases and steroid treatment is the main precipitating factor reducing bone mineral density(BMD). This study was performed to assess the prevalence of osteoporosis and to evaluate the clinical factors associated with decreased BMD in children with renal diseases. Methods : Forty-four children with renal diseases who were diagnosed at the Pediatric no phrology division of Ajou University hospital since Oct. 1994 were included. Using a new quantitative ultrasound device, BMD and the prevalence of osteoporosis were evaluated. The clinical and serological data were analyzed in association with decreased BMD. Results : A total of 44 patients were evaluated. The age at initial diagnosis was 6.7$\pm$4.2 years. At the time of evaluation, the chronological and bone age was 9.3$\pm$4.2 years and 8.2 $\pm$ 4.6 years, respectively. The renal diseases included nephrotic syndrome 24(54.5%), Henoch Schonlein purpura nephritis 7(15.9%), IgA nephropathy 6(13.9%), reflux nephropathy(RN) 2 (4.5%), and other renal disease 5(%). The prevalence of osteoporosis was 11%. There was no difference in the clinical factors between the long-term and the short-term treated steroid groups. Conclusion : The prevalence of osteoporosis was 12% in 44 children with renal diseases No significant factor was found in association with decreased BMD and there was no relationship between osteoporosis and steroid usage duration or cumulative dose. A new quantitative ultrasound, which is relatively easy to perform, especially in children, is expected to be in common use and will enable clinicians to evaluate metabolic bone disorders with ease.

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Limnological Characteristics and Influences of Free-floating Plants on the Woopo Wetland during the Summer (하계우포습지의 육수학적 특성 및 부유수생식물의 영향)

  • Joo, Gea-Jae;Kim, Gu-Yeon;Park, Sung-Bae;Lee, Chan-Woo;Choi, Sang-Ho
    • Korean Journal of Ecology and Environment
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    • v.35 no.4 s.100
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    • pp.273-284
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    • 2002
  • During January 1998-October 1999, the impact of free-floating plants (FFP) on limnology of the wetland ecosystem was evaluated through the investigation of physicochemical characteristics of the Woopo Wetland along with in situ manipulation experiments of aquatic plants. Flooding events occurred in the wetland during the summer period (Jun.-Aug.) and water levels rose to 2-3 m due to precipitation from the catchment and inflow from the main channel of the Nakdong River. Physicochemical parameters and plankton dynamics in the wetland during the summer were greatly influenced by floods and growth of free-floating plants. Dissolved oxygen (Jun.-Sept., 4.5${\pm}$2.5 mg/1; Oct.-May, 8,1 ${\pm}$4.0 mg/1) and pH (Jun.-Sept., 6.9${\pm}$0.4; Oct.-May,7.4${\pm}$0.8) levels were significantly lower during the summer than any other seasons. Three types of enclosure experiments (100 L, treatments with floating plants, screened and opened) were conducted under the presence and absence of sediment for 15 days in the 1999 summer. The treatments with sediment had higher levels of nutrient concentrations than those of the others. Among the treatments with sediment, nutrient concentrations in the treatments with free-floating plants were higher than the others. Zooplankton communities in each treatment showed a similar variation, although the scale of zooplankton densities differed. Rotifer community dominated the zooplankton at the initial phase of the experiment, but decreased drastically along with an increase of cladoceran and copepod communities. In conclusion, low levels of dissolved oxygen and pH in the Woopo Wetland during the summer seemed to be caused by a proliferation of free-floating plants and active decomposition process at the bottom of the sediment.

Pasture Production as Affected by Two Varieties of Tall Fescue(Festuca arundinacea Sch.) Fawn and Roa on Grazing Pasture (방목 혼파초지에서 Endophyte 감염과 비감염 Tall fescue품종 차이에 따른 목초생산성 및 토양 이.화학성에 미치는 영향)

  • Kim, M.C.;Hyun, Y.J.;Chang, D.J.
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.23 no.4
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    • pp.247-254
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    • 2003
  • A study was carried to compare two varieties of tall fescue(Festuca arundinacea Schr.): Fawn (endophyte infection) and Roa(endophyte-free). The study examined plant height, botanical composition, and dry matter yield of mixed pasture. The cattle grazed on a mixed pasture of tall fescue species and orchardgrass(Dactylis glomerata L.), perennial ryegrass(Lolium perenne L.) and white clover(Trifolium repens L.) during March 22, 1997, to September 21, 1997. The number of grazing animals was 4.3/ paddock(50m x50m) and was adjusted according to the condition of pasture. Dry matter yields determined on ungrazed pasture(7-time harvests) were 1,690 $\pm$407kg and 1,128 $\pm$ 238kg/ha on pastures consisting of Fawn and Roa, respectively. This difference was significant(P<0.01). There were 17.71 $\pm$ 1.27cm and 12.83$\pm$0.90cm in average plant lengths of Fawn and Roa(P<0.01), respectively The botanical composition of tall fescue and orchardgrass in the mixture treatment included in the Fawn variety were shown in 34.2 and 3.8%, comparing Roa with 17.1 and 9.6%, on the 21th of September, 1997, respectively. Tall fescue Roa represented a higher botanical composition than orchardgrass(a main species on Cheju). Crude protein content of Fawn was slightly less than that of Roa. From these results, we may conclude that Roa variety is nutritionally better, but is less adaptible to high temperature climate than Fawn. However, Roa variety is still better than orchardgrass in high temperature conditions.