• Journal of Korean Society of Health-System Pharmacists
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• v.35 no.4
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• pp.441-452
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• 2018

Background : The prevalence of the chronic metabolic disease is increasing due to the aging society. Therefore, Korean Society of Health-system Pharmacists (KSHP) has a specialty pharmacist system to improve the professionalism of pharmacists. The purpose of this study is to suggest the difference between specialty pharmacist and non-specialty pharmacist with regards to their knowledge, delivery of information on medication, service provision, and job satisfaction. Methods : An online survey research was conducted for hospital pharmacists. The reliability of the questionnaire items was presented using Cronbach's ${\alpha}$ test. The t-test or ANOVA analysis was used for evaluating differences in continuous variables. Results : A total of 171 pharmacists responded to the questionnaire, and 87.7% of the respondents were aged less than 30 years (76.6%) and four-year graduates (86.0%). Typically, 108 (63.2%) were candidates for the pharmacist's specialty certificate, and the remaining 63 (36.8%) were not enrolled. Considering the field of specialty with overlapping, the total number of certificated patients was 140 (26.3% of the total of 532 in 2016). The results of the reliability analysis of the specific questionnaire showed that the Cronbach's ${\alpha}$ value was over 0.78. There was no significant difference in customer directionality between the two groups. However, there was a significant difference (p<0.05) with respect to overall knowledge about the treatment process, drug efficacy, and side effects, information about medicines and adverse drug reactions, and in providing appropriate information to medical staff including patients and physicians. Conclusions : The pharmacist with specialization showed a positive result of self-evaluation of items such as knowledge about drugs, communication of information on medications, and service provision, compared to other pharmacists, and the result was in correlation with the numbers of specialization. There was no difference in job satisfaction related to working environment. Henceforth, it is hypothesized that there is a necessity for continuous improvement in the working environment to suit the purpose of the pharmacy specialist system.

• Women's Health Nursing
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• v.7 no.4
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• pp.419-431
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• 2001

The purpose of this study was to provide the correct knowledge on GDM(Gestational Diabetes Mellitus) to nurses for effective care of pregnant women with GDM by investigating the knowledge of nurses about GDM. The subjects of this study were 557 nurses who work at six general hospitals in Seoul and Gyung-Gi province of Korea. The data were collected from November, 2000 to December, 2000, using a 30-item knowledge questionnaire about GDM consisted of eight areas developed by Choi et al. (2000): characteristics and diagnosis, influence on pregnancy, goal and method of management, diet therapy, exercise therapy, insulin therapy, hypoglycemia and hyperglycemia and postpartum care of GDM. The data were analyzed by SAS program for t-test, ANOVA and Scheffe test. The results were as follows: 1. The mean score of knowledge on GDM was 23.18. 2. There were significant differences according to age(p= 0.002), education background (p= 0.045). working period(p= 0.000), working unit(p= 0000), working experience of obstetric and gynecologic (OS & GY) units(p= 0.000), experience of pregnancy (p=0.003) and experience of delivery (p=0.014) in GDM knowledge. 3. The level of each area on GDM knowledge was as follows; 1) Area of characteristics and diagnosis of GDM The mean score of this area was 0.79. Nurses' knowledges were significantly different by age(p=0.003), marital status (p=0.018), working period(p=0.002) working unit(p=0.007), working experience of OB & GY units(p=0.005), experience of pregnancy(p=0.034) and experience of delivery(p=0.033). 2) Area of influence on pregnancy The mean score of this area was 0.93. Nurses' knowledges were significantly different by age(p=0.006), working unit (p=0.000) and working experience of OB & GY units(p= 0.000). 3) Area of goal and method of management The mean score of this area was 0.70. Nurses' knowledges were significantly different by age(p=0.004), region(p=0.006), education background(p=0.013), marital status(p=0.007), working period(p=0.000), working unit(p=0.011), working experience of OB & GY units(p=0.002), experience of pregnancy(p=0.025) and experience of delivery(p=0.043). 4) Area of diet therapy. The mean score of this area was 0.74. Nurses' knowledges were significantly different by age(p=0.002), region(p=0.011), marital status (p=0.001). working period (p=0.007). working unit(p=0.002), working experience of OB & GY units(p=0.001), experience of pregnancy(p=0.001), experience of delivery(p=0.011) and diabetes patients in family members(p=0.032). 5) Area of exercise therapy. The mean score of this area was 0.83. There were not significant differences in all general characteristics. 6) Area of insulin therapy The mean score of this area was 0.61. Nurses' knowledges were significant differences by age (p=0.024), marital status (p=0.048), working period(p=0.027), working unit(p=0.002), working experience of OB & GY units(p=0.000), experience of pregnancy (p=0.047) and experience of delivery(p=0.040). 7) Area of hypoglycemia and hyperglycemia. The mean score of this area was 0.83. Nurses' knowledges were significantly different by marital status (p=0.027), working period(p=0.001). experience of pregnancy(p=0.020) and experience of delivery(p=0.010). 8) Area of postpartum care The mean score of this area was 0.69. Nurses' knowledges were significantly different by working unit(p=0.000), working experience of OB & GY units (p=0.000) and working experience of medical unit(p=0.047). The results of this study are suggested that nurses might be taught systemically and individually about GDM so that they can become more proficient in detecting and preventing GDM, and therefore they will feel confident to teach GDM to women.

• Journal of Preventive Medicine and Public Health
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• v.37 no.4
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• pp.300-305
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• 2004

Objectives : The exposure to particulate air pollution during the pregnancy has reported to result in adverse pregnancy outcome such as low birth weight, preterm birth, still birth, and intrauterine growth retardation (IUGR). We aim to assess whether prenatal exposure of particulate matter less than 10 (m in diameter ($PM_{10}$) is associated with preterm birth in Seoul, South Korea. Methods : We included 382,100 women who delivered a singleton at 25-42 weeks of gestation between 1998 and 2000. We calculated the average PM10 exposures for each trimester period and month of pregnancy, from the first to the ninth months, based on the birth date and gestational age. We used three different models to evaluate the effect of air pollution on preterm birth; the logistic regression model, the generalized additive logistic regression model, and the proportional hazard model. Results : The monthly analysis using logistic regression model suggested that the risks of preterm birth increase with PM10 exposure between the sixth and ninth months of pregnancy and the highest risk was observed in the seventh month (adjusted odds ratio=1.07, 95% CI=1.01-1.14). We also found the similar results using generalized additive model. In the proportional hazard model, the adjusted odds ratio for preterm births due to PM10 exposure of third trimester was 1.04 (95% CI=0.96-1.13) and PM10 exposure between the seventh month and ninth months of pregnancy was associated with the preterm births. Conclusions : We found that there were consistent results when we applied the three different models. These findings suggest that air pollution exposure during the third trimester pregnancy has an adverse effect on preterm birth in South Korea.

• Progress in Medical Physics
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• v.20 no.1
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• pp.21-29
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• 2009

Breast cancer is the most common form of cancer among korean woman. Therefore, the early detection activities of breast cancer such as breast self-examinations, clinical breast examinations, mammography are important. A yearly mammography examination has been recommended for women aged 40 and older for the early detection of breast cancer in asymptomatic periods. However, the glandular tissue of breast is the most radiation-sensitive tissue, and the determination of average glandular dose (AGD) forms an important part of the quality control of the mammographic systems. Because of the difficulty of estimating AGD directly, it is often estimated from the measurements of the incident air kerma and by applying the appropriate conversion factors. The primary objective of this study was to standardize the method of measuring AGD. The secondary objective was to evaluate the relationships between AGD per various composition and thickness of the breast using Monte Carlo simulations. As a result, we standardized the method of measuring AGD according to International Atomic Energy Agency (IAEA) guidelines (CoP: an international code of practice). Overall, AGD for mammographic practice in Korea was less than 3.0 mGy recommended by the Korea Food and Drug Adminstration (KFDA) protocol, and Korean Institute for Accreditation of Medical Image (KIAMI). The measured and simulated AGD for a given condition were calculated as 1.7 and 1.6 mGy, respectively. For the AGDs obtained, there was no significant difference between them. The simulated AGD was dependent on the fraction of glandular tissue of the breast. The AGD increases with increasing of the breast glandularity due to increasing absorption of low energy photons. The AGD also increases as a function of breast thickness. In conclusion, the results of this study could be used as a baseline to establish a reference level of radiation dose in mammography.

• Journal of Sasang Constitutional Medicine
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• v.18 no.3
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• pp.75-93
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• 2006

1. Objectives and Methods Sasang Constitutional Medicine is the original Korean Medicine. The purpose of this study was to objectify the diagnosis of Sasang Constitution. 212 Women's sentences were analyzed into 228 factors like Pitch, APQ, Shimmer, Octave and Energy, etc. Women's sentences were classified into 3 categories: total group, under 54 years old group and over 55 years old group. 2. Results 1) In Total group Soyangin's Center feq.(3) was significantly high compared with Taeyangin and Taeumin groups. Taeumin's Pitch2 was significantly high compared with Soeumin and Taeyangin groups. Taeyangin's Pitch S.D. was significantly high compared with Soyangin group. Taeyangin's Octave6 was significantly high compared with Soeumin group. There were no significant differences among constitutional groups in APQ and Shimmer segment. On the point of Energy, Taeyangin's G Tot E(1), G# Tot E(1), G dev.(1), G# dev.(1), G Tot E(2), G# Tot E(2), G dev.(4) and G# dev.(4) were significantly high compared with other groups. Soyangin's A#S.D.(2) was significantly high compared with Taeyangin group. Taeyangin's A#S.D.(3) was significantly high compared with Taeumin group. Taeyangin's F S.D.(5), F# S.D.(5) and Max Average were significantly high compared with Soeumin group. Taeumin's Peak3 and Peak4 were significantly high compared with Taeyangin group. Taeumin's PeakValue1 was significantly high compared with Soeumin group. Taeyangin's PeakValue2 was significantly high compared with Soeumin group. Taeyangin's PeakValue3 and PeakValue5 were significantly high compared with Other groups. 2) In Under 54 years old group, there were no significant differences among constitutional groups in APQ, Shimmer and Octave segment. Taeumin's Center freq.(2) was significantly high compared with Taeyangin and Soyangin groups. Taeumin's Pitch(2) and Pitch(3) were significantly high compared with Taeyangin and Soeumin groups. Taeyangin's and Taeumin's Pitch S.D. were significantly high compared with Soyangin group. Taeyangin's and Soyangin's Octave2 were significantly high compared with Taeumin group. On the point of Energy, Taeyangin's and Soyangin's A# S.D.(2) were significantly high compared with Soeumin group. Taeyangin's and Soyangin's G# dev.(1), G# dev.(2) were significantly high compared with Taeumin group. Taeyangin's and Taeumin's F# S.D.(3) were significantly high compared with Soeumin group. Taeyangin's and Soyangin's Max Average were significantly high compared with Soeumin group. Taeumin's Peak3 was significantly high compared with Taeyangin and Soeumin groups. Taeyangin's and Taeumin's PeakValue2 were significantly high compared with Soeumin group. Taeyangin's and Soeumin's PeakValue3 were significantly high compared with Taeumin group. Taeyangin's and Soyangin's PeakValue5 were significantly high compared with Soeumin group. Taeyangin's and Soyangin's PeakValue9 were significantly high compared with Taeumin group 3) In Over 55 years old group, there were no significant differences among constitutional groups in Pitch, APQ, and Peak segment. Soeumin's F Shimmer(1) and F Shimmer(2) were significantly high compared with Taeyangin and Taeumin groups. Soeumin's G# Shimmer(1) and G# Shimmer(2) were significantly high compared with Soyangin group. Taeyangin's Octave5 and Octave6 were significantly high compared with Soeumin group. On the point of Energy, Soyangin's C S.D., F# S.D.(1), F# S.D.(2) and G dev.(2) were significantly high compared with other groups. Soyangin's F# S.D.(3) was significantly high compared with Taeumin and Soeumin groups. Taeyangin's and Taeumin's G# S.D.(2) and G# S.D.(3) were significantly high compared with Soyangin group 3. Conclusions From above result, there is the possibility of efficient standard guide for constitution diagnosis by analysis of voice

• Progress in Medical Physics
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• v.24 no.4
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• pp.278-283
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• 2013

Breast cancer is the leading cause of cancer death in women worldwide and the number of women breast cancer patient was increased continuously. Most of breast cancer patient has suffered from unnecessary radiation exposure to heart, lung. Low radiation dose to the heart could lead to the worsening of preexisting cardiovascular lesions caused by radiation induced pneumonitis. Also, several statistical reports demonstrated that left-sided breast cancer patient showed higher mortality than right-sided breast cancer patient because of heart disease. In radiation therapy, Deep Inspiration Breath Hold (DIBH) technique which the patient takes a deep inspiration and holds during treatment and could move the heart away from the chest wall and lung, has showed to lead to reduction in cardiac volume and to minimize the unnecessary radiation exposure to heart during treatment. In this study, we investigated the displacement of heart using DIBH CT data compared to free-breathing (FB) CT data and radiation exposure to heart. Treatment planning was performed on the computed tomography (CT) datasets of 10 patients who had received lumpectomy treatments. Heart, lung and both breasts were outlined. The prescribed dose was 50 Gy divided into 28 fractions. The dose distributions in all the plans were required to fulfill the International Commission on Radiation Units and Measurement specifications that include 100% coverage of the CTV with ${\geq}95%$ of the prescribed dose and that the volume inside the CTV receiving >107% of the prescribed dose should be minimized. Scar boost irradiation was not performed in this study. Displacement of heart was measured by calculating the distance between center of heart and left breast. For the evaluation of radiation dose to heart, minimum, maximum and mean dose to heart were calculated. The present study demonstrates that cardiac dose during left-sided breast radiotherapy can be reduced by applying DIBH breathing control technique.

• Radiation Oncology Journal
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• v.18 no.2
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• pp.157-166
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• 2000

Purpose : This investigation was peformed in order to improve the health care of radiation workers, to predict a risk, to minimize the radiation exposure hazard to them and for them to realize radiation exposure danger when they work in radiation area in hospital. Methods and Materials : The documentations checked regularly for personal radiation exposure in four university hospitals in Pusan city in Korea between January 1, 1993 and December 31, 1997 were analyzed. There were 458 persons in this documented but 111 persons who worked less then one year were excluded and only 347 persons were included in this study. Results : The average of yearly radiation exposure of 347 persons was 1.52$\pm$1.35 mSv. Though it was less than 50mSv, the limitaion of radiation in law but 125 (36%) people received higher radiation exposure than non-radiation workers. Radiation workers under 30 year old have received radiation exposure of mean 1.87$\pm$1.01 mSv/year, mean 1.22$\pm$0.69 mSv between 31 and 40 year old and mean 0.97$\pm$0.43 mSv/year over 41year old (p<0.001). Men received mean 1.67$\pm$1.54 mSv/year were higher than women who received mean 1.13$\pm$0.61 mSv/year (p<0.01). Radiation exposure in the department of nuclear modicine department in spite of low energy sources is higher than other departments that use radiations in hospital (p<0.05). And the workers who received mean 3.59$\pm$1.81 msv/year in parts of management of radiation sources and injection of sources to patient receive high radiation exposure in nuclear medicine department (p<0.01). In department of diagnostic radiology high radiation exposure is in barium enema rooms where workers received mean 3.74$\pm$1.74 mSv/year and other parts where they all use fluoroscopy such as angiography room of mean 1.17$\pm$0.35 mSv/year and upper gastrointestinal room of mean 1.74$\pm$1.34 mSv/year represented higher radiation exposure than average radiation exposure in diagnostic radiology (p<0.01). Doctors and radiation technologists received higher radiation exposure of each mean 1.75$\pm$1.17 mSv/year and mean 1.50$\pm$1.39 mSv/year than other people who work in radiation area in hospital (p<0.05). Especially young doctors and technologists have the high opportunity to receive higher radiation exposure. Conclusions : The training and education of radiation workers for radiation exposure risks are important and it is necessary to rotate worker in short period in high risk area. The hospital management has to concern health of radiation workers more and to put an effort to reduce radiation exposure as low as possible in radiation areas in hospital.

• Toxicological Research
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• v.34 no.4
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• pp.363-370
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• 2018

Many studies reported reduced antioxidant capacity in the vasculature under hypertensive conditions. However, little is known about the effects of antihypertensive treatments on the regulation of vascular antioxidant enzymes. Thus, we hypothesized that antihypertensive treatments prevent the reduction of antioxidant enzyme activity and expression in the small vessels of angiotensin II-induced hypertensive rats (ANG). We observed the small mesenteric arteries and small renal vessels of normotensive rats (NORM), ANG, and ANG treated with a triple antihypertensive therapy of reserpine, hydrochlorothiazide, and hydralazine (ANG + TTx). Systolic blood pressure was increased in ANG, which was attenuated by 2 weeks of triple therapy (127, 191, and 143 mmHg for NORM, ANG, and ANG + TTx, respectively; p < 0.05). Total superoxide dismutase (SOD) activity in the small mesenteric arteries of ANG was lower than that of NORM. The protein expression of SOD1 was lower in ANG than in NORM, whereas SOD2 and SOD3 expression was not different between the groups. Reduced SOD activity and SOD1 expression in ANG was not restored in ANG + TTx. Both SOD activity and SOD isoform expression in the small renal vessels of ANG were not different from those of NORM. Interestingly, SOD activity in the small renal vessels was reduced by TTx. Between groups, there was no difference in catalase activity or expression in both the small mesenteric arteries and small renal vessels. In conclusion, SOD activity in the small mesenteric arteries decreased by angiotensin II administration, but not by hypertension, which is caused by decreased SOD1 expression.

• Health Policy and Management
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• v.19 no.4
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• pp.1-17
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• 2009

The purpose of this study was to find factors affecting health of the rural residents. The data were collected from a sample of 2,587 people aged from 40 to 70 in the year 2005-2006, Wonju City and Pyeongchang County, Gangwon-do, Korea. The theoretical model adopted in this study was the Lalonde's health field(human biology, environment, lifestyle, and health care organization). SF-12 was used to measure subjective health status. In the category of human biology, men were healthier than women. Age and BMI showed negative relation to health status. Income, education and social support showed positive relation to health status in the environment category. In the category of life style, stress showed negative relation to health status. Medical expenses showed negative relation to health status in the category of health care organization. After converting SF-12 score to percentage score, the health determinants portions were 47% lifestyle, 26% environment, 18% human biology and 9% health care organization. These findings suggest that life style, environment and biology are main factors in determinants of health. Especially stress in the life style category is more focused for the community health promotion. We also may be able to improve income, education and social support in the environment category with self empowerment efforts, community supports and government helps. Finally greater attention must be payed to life style in the future health planning and budget allocation priority in the healthcare area.

• Korean Journal of Clinical Pharmacy
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• v.28 no.3
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• pp.194-203
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• 2018

Background: Bone fractures are high in elderly patients with type 2 diabetes mellitus (T2DM). Hyperglycemia and chronic kidney disease may increase the risk of fracture prevalence via altered bone metabolism, but whether glycemic control and kidney function are associated with the risk of fracture prevalence remains unclear. This study evaluated the relationship between glycemic control and baseline estimated glomerular filtration rate (eGFR) and risk of fracture prevalence in older and middle-aged patients with T2DM. Methods: Patients who underwent a general medical check-up between 2009 and 2013 were selected from the Korean National Health Insurance Sharing Service records. Chi-square test and multiple logistic regression analysis were used to assess the relationship between glycemic control and eGFR and risk of fracture prevalence. Results: Cumulative fracture prevalence were higher in patients with T2DM, irrespective of whether they had tight or less stringent glycemic control (fasting blood glucose [FBG] ${\geq}110mg/dL$). After adjustment for baseline age and FBG, tight and less stringent glycemic control was significantly associated with increased adjusted risk of fracture prevalence in middle-aged patients with T2DM (OR=1.13, 95% CI, 1.05-1.21, p=0.0005 vs OR=1.13, 95% CI, 1.06-1.20, p=0.0001), but not in older patients. Baseline eGFR was not significantly related to fracture prevalence in either older or middle-aged patients. Conclusion: Less stringent glycemic control significantly increased the adjusted risk of fracture prevalence in middle-aged patients with T2DM. Further studies are needed to confirm the effect of tight glycemic control on fracture prevalence.