• Radiation Oncology Journal
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• v.34 no.3
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• pp.177-185
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• 2016

Purpose: To investigate whether preoperative chemoradiotherapy (PCRT) followed by local excision (LE) is feasible approach in clinical T2N0 rectal cancer patients. Materials and Methods: Patients who received PCRT and LE because of clinical T2 rectal cancer within 7 cm from anal verge between January 2006 and June 2014 were retrospectively analyzed. LE was performed in case of a good clinical response after PCRT. Patients' characteristics, treatment record, tumor recurrence, and treatment-related complications were reviewed at a median follow-up of 49 months. Results: All patients received transanal excision or transanal minimally invasive surgery. Of 34 patients, 19 patients (55.9%) presented pathologic complete response (pCR). The 3-year local recurrence-free survival and disease free-survival were 100.0% and 97.1%, respectively. There was no recurrence among the patients with pCR. Except for 1 case of grade 4 enterovesical fistula, all other late complications were mild and self-limiting. Conclusion: PCRT followed by an LE might be feasible as an alternative to total mesorectal excision in good responders with clinical T2N0 distal rectal cancer.

• Journal of the Korean Society of School Health
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• v.12 no.2
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• pp.217-230
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• 1999

The purpose of this study is to find out problems in obesity management through survey and analysis of the actual conditions from the view of a elementary schools school-nurses and to establish fundamental data for efficient obesity management. The subjects for this study were 313 numbers of elementary school-nurses in Kyung-Sang-Pook-Do. The data were collected through mail questionaries from November 1 to November 30, 1997. The major findings in this survey were as follows: 49.8% of the school-nurses who responded in the survey were in their 30s. The average career was 7.3years. The average service duration in their present school was 2.3 years, 55.6% of them were serving at schools which have less than ten classes total 77.2% of them were serving rural areas, 79.6% of them were serving at schools with fewer than 100 obese students. The total obesity prevalence rate was 11.4%, 13.3% were girls, 9.3% were boys. The measurement of height and weight is performed once a year for all surveyed students (91.7%), but obese students were measured as much five times (51.1%). The rate of obesity management planning was 74.1%, however the rates of evaluation and role assignment were 41. 2%, and 24.3%. 79.6% of the surveyed schools have health education classes for obesity, the rate compared (8.0 periods per year) to the whole of health education (79.1 periods per year) is 10.1%. 99.9% of the schools had counseling rooms for obesity (combined with nursing rooms) but they were used. The roote of individual counseling was 84.3%. The frequency counseling was six times a year for about 15 minutes. Obesity counseling records were kept 93.6% of the time and individual information cards were kept 98.7% of the time. The frequency of parents counseling was 42.8% and the survey shows that the main problem here was insufficient counseling facilities. The frequency of dietary guidance and exercise therapy was 84.3% and the dietary instructor was usually the school nurse at 51.7%. The frequency of obesity student exercise was 1-2 times a week and more-than-10-minutes at a time. They skip rope during the morning self-study class. The number on problem of exercise guidance at 56.2% was students' non-cooperativeness. School-nurses, 87.9%, answered that obesity management at school is necessary and 86.9% mentioned the shortage of obesity related information in present physical exercise books. From the plural responses of executing the obesity management, there are many similar problems: lack of knowledge and non-cooperation in parents at 41.9%, is predominant followed by of knowledge and non-cooperation in the children. The third problem is the lack of funds and facilities.

• Clinical and Experimental Pediatrics
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• v.52 no.5
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• pp.622-626
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• 2009

Kikuchi-Fujimoto disease was initially described as a self-limiting histiocytic necrotizing lymphadenitis in Japan in 1972, and is predominantly observed in women under the age of 30 year and in Asian populations. The pathogenesis is still poorly understood but is thought to include infections, and autoimmune and neoplastic diseases. The most common clinical manifestations are fever and painless cervical lymphadenitis. Diagnosis is based on the histopathological findings, characterized by focal necrosis in the paracortical region with abundant karyorrhexis, aggregates of atypical mononuclear cells around the zone of necrosis, absence of neutrophils and plasma cells, and usually intact lymph node capsule. There is no specific therapy for the condition, and aseptic meningitis can occur as one of the complications. Here, we report the case of a patient with Kikuchi-Fujimoto disease accompanied with aseptic meningitis, which may be confused as a case of tuberculous meningitis and lymphadenitis.

• Journal of Preventive Medicine and Public Health
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• v.38 no.1
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• pp.45-52
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• 2005

Objectives : To investigate the fatigue subjective symptoms and VDT related risk factors in bank workers. Methods : A total of 2178 workers (62.8% male, 37.2% female) were surveyed with a self-administered and structured questionnaire consisting of 30 fatigue symptoms and other VDT related factors regarding work characteristics, work postures, work environments, personal medical histories, etc. Fatigue subjective symptoms were divided into 3 groups of 10 questions each: a dull, drowsy and exhausted feeling (Group I), a mental decline of working motivation (Group II), or a feeling of incongruity in the body and dysfunction of autonomic nervous system (Group III). Each question was weighted as 0 for 'none', 1 for 'sometimes', and 2 for 'always'. Results : Mean age was $35.8{\pm}7.2$ years ($38.9{\pm}6.0$ in males, $30.6{\pm}5.8$ in females), Mean work duration was $7.7{\pm}7.1$ years ($8.4{\pm}7.4$ in males, $6.5{\pm}6.4$ in females). Mean symptom score in males was $11.0{\pm}8.1$ ($4.9{\pm}3.1$ in Group I, $3.0{\pm}3.1$ in Group II, $3.1{\pm}2.8$ in Group III) and in females was $17.5{\pm}9.5$ ($7.0{\pm}3.8$ in Group I, $4.6{\pm}3.5$ in Group II, $5.9{\pm}3.4$ in Group III). Mean scores were higher in the order of Group I>III>II. Females had significantly higher scores than males in all three groups (p<0.001). Most common symptoms complained of as 'always' or 'sometimes' were feel strained in the eyes' (85.4%) among Group I, 'find difficulty in thinking'(54.2%) among Group II, and 'feel stiff in the shoulders (72.3%) among Group III. In multiple regression analysis, female, non-straight spine at workstation, more VDT work hours, history of physical therapy, glare of screen, overtime work, young age, and non-horizontal elbow position were significantly related with high score of symptoms. Conclusions : More supportive VDT work environment and education for correct work postures for VDT workers are recommended.

• Health Policy and Management
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• v.30 no.2
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• pp.185-191
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• 2020

Background: From January 2018, a policy was applied to differentially apply the co-payment for medical expenses of 15,000 won or more from 30% to 10%-30% for each medical fee. This policy lowers the burden on the medical use of the elderly, and it is necessary to analyze the effect of the policy by confirming changes in medical use and supply behavior after 2 years. Methods: The National Health Insurance Service's national medical use database was used. As for the analysis method, first, the medical use and medical supply behavior change over the age of 65 years were confirmed, and second, in order to check the net effect of the policy, the 66-year-old as the experimental group and the 63-year-old as the control group were selected as the control group. The propensity score matching was performed using the variables of age, living alone, income quartile, residence, disability, chronic disease, and co-morbid disease scores, and then it was analyzed using the difference in difference analysis method. Results: The share of the number of treatments under 15,000 won decreased from 37.0% in 2017 to 20.2% in 2018, while the share of the number of treatments under 15,001-20,000 won increased from 8.0% to 22.7%. It was confirmed that the reason for the increase in the cost of treatment per treatment was the result of the increase in the amount of physical therapy and examination. As a result of the policy effect, the burden of co-payment per person was reduced, and as a result, the number of hospital visits per person and the total medical cost per person increased. Conclusion: The self-pay rate differential policy reduced the burden of medical expenses for the elderly and confirmed the increase in medical use. However, the interpretation of the increase in medical use was not able to distinguish whether the unsatisfactory medical care was satisfied or the inducement demand. Efficient allocation of resources is a more important point in the future when the super-aged society is in front. It is necessary to prepare a plan to induce rational medical use within a range that does not impair the medical accessibility of the elderly.

• Journal of Life Science
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• v.25 no.6
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• pp.724-731
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• 2015

Mesenchymal stem cells (MSCs) are characterized by their multipotency capacity, which allows them to differentiate into diverse cell types (bone, cartilage, fat, tendon, and neuron-like cells) and secrete a variety of trophic factors (ANG, FGF-2, HGF, IGF-1, PIGF, SDF-1α, TGF-β, and VEGF). MSCs can be easily isolated from human bone-marrow, fat, and umbilical-cord tissues. These features indicate that MSCs might be of use in stem-cell therapy. However, MSCs undergo cellular senescence during long-term expansion, and this is accompanied by functional declines in stem-cell potency. In the human body, because of their senescence and declines in their microenvironmental niches stem cells fail to maintain tissue homeostasis, and as a result, senescent cells accumulate in tissues. This can lead to age-related diseases, including degenerative disorders and cancers. Recent studies suggest that the number of histone modifications to stem cells’ genomes and aberrant alterations to their DNA methylation increase as stem cells progress into senescence. These epigenetic alterations have been partly reversed with treatments in which DNA methyltransferase (DNMT) inhibitors or histone deacetylase (HDAC) inhibitors are introduced into replicative senescent-MSCs. This review focuses on epigenetic alteration in replicative senescent-MSCs and explains how epigenetic modifications are widely associated with stem-cell senescences such as differentiation, proliferation, migration, calcium signaling, and apoptosis.

• Journal of Music and Human Behavior
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• v.8 no.2
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• pp.47-64
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• 2011

This study was to examine music preferences of school-aged cochlear implant(CI) recipients in comparison with normal hearing(NH) children. Participants were 12 CI recipients and 155 NH children. CI children were recruited from a hospital in Seoul and they had cochlear implants for longer than two years(M = 4.7). NH children were randomly sampled. All participants were asked to respond to a questionnaire and rate their music preferences. The results showed that while 58.33% of CI recipients preferred child voices, 71.61% of NH children preferred adult voices. For preferred frequency range, both of CI and NH groups preferred higher frequency. With regard to preferred musical styles, while CI children gave the highest rating(M = 3.58) to Korean folk songs on the 5-point Likert scale, popular music and TV and soundtrack music were found to be the highest-rated styles(M = 3.83) for NH children. These results indicate that self-rated music preferences of CI recipients may be affected by a musical environment that these children have experienced. The results also implies that the provision of appropriate musical input and experiences would significantly affect future music preferences and appreciation of CI children. Providing useful information about music preferences of CI recipients in comparison with NH children, this study has significant implications for further studies on this population.

• Korean Journal of Biological Psychiatry
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• v.3 no.1
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• pp.96-101
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• 1996

Objects : There has been the controversy that menopause may or may not influence the psychological distresses. The purpose of this study was to investigate the correlation between the hormonal status and traits of depression & anxiety in menopausal women. Method : Among the women attending menopausal clinic. menopausal women, defined as who having a amenorrhea for more than 12 months, were selected as a study group(n=83). The control group(n=73), who visited to screen the cervix cancer with regular menstruation, hod no history of hormone replacement therapy. Individual data were collected by self-reporting questionnaires. Depression state was evaluated by Beck Depression Inventory(BDI) and anxiety state by Stale Trail Anxiety Inventory(STAI), and the female hormones such as E2, FSH, and LH were obtained by blood sampling at visting clinic. Statistically the data were processed by t-test and pearson correlation analysis(p<0.05). Results : 1) The mean age of menopausal was 45.3 years. 2) In menopausal women the scores of BDI & STAI were significantly higher than in control group(p<0.05). 3) There were significant differences between menopausal and control group by E2 & FSH. 4) There was no correlation between female hormonal status and the STAI & BDI scores in both groups. Conclusion : Although menopausal women had more traits of depression & anxiety than control group, it was difficult to insist that the lack of estrogen was the only etiological factor for the traits of depression & anxiety in menopausal period. In further studies, we must consider another factors, including biological, sociocultural, psychological factor, as the cause of psychological symptoms during menopausal period.

• Journal of Korean Academy of Nursing
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• v.25 no.3
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• pp.472-484
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• 1995

The purpose of this study was to develop a home health care model in the public health system and to test the effectiveness of the model. Seven com-munity health practitioners in Yon- Cheon county. Kyunggi province, carried out home health care service for this research. The subjects of the home health care were a total of 111 community residents with chronic health problems and risk-prone infants and children; 29 persons with hypertension, 18 persons with diabetes, 12 persons with neurologic problems, 12 elderly, and 40 infants and children. During the period of study, from December, 1993 to March, 1995, a demonstrative home health care model was developed in the Yon-Cheon County community health centers with the cooperation of the Yon-Cheon Medical Center and Yon-Cheon Public Health Center for the first six months. A home care practice manual and recording system for home visits were also co-developed by the researchers and community health practitioners. Four workshops and monthly conferences were held for this purpose. Actual home care practice took place for two months, and on-going evaluation and replanning accompanied this process. The result of the evaluation of home care service were as follows. 1) For persons with hypertension, diabetes, neurologic problems, there was significant improvement in knowledge of disease and care, but no significant difference was seen in health behavior or symptoms after home care service. 2) No significant difference was seen in level of self esteem or depression after reminiscence therapy among 12 elderly subjects. 3) There were significant differences in satis-faction toward child rearing and parental sup-port, but no significant difference In education needs for parental role after home care service among parents of infants and children. 4) There was significant improvement in the quality of life among the subjects after the home care service. 5) Subjects responded that they were highly satisfied with the home care service given by the community health practitioners. Although, the actual implementation period was very short, and not all of the evaluation outcomes showed significant improvement, the home health care model of community health practitioners was, in general, positively evaluated. Through this re-search, the possibility of community health practitioners working as active home care personnel in the public health care system is supported. Further research with an expanded area and subjects for a longer period is recommended. Cost effectiveness research is also needed.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.14 no.1
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• pp.3-11
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• 2003

Attention-deficit/Hyperactivity disorder(ADHD) is the most common psychiatric disorder of childhood and among the most prevalent chronic health conditions affecting school-aged children. Children with ADHD experience significant functional problems, such as school difficulties, academic underachievement, troublesome interpersonal relationships with family members and peers, and low self-esteem. The most widely used pharmacological treatments for ADHD are psychostimulants, such as methylphenidate and amphetamine salts. These medications provide clinical efficacy by increasing the availability of catecholamines, primarily dopamine, in the frontal lobe of the brain. immediate-release(IR) formulations of sychostimulants were among the most effective psychotrophic medications in the psychopharmacological treatment. However, there are some limitations of IR formulations：the short half-life and duration of efficacy, which result in the need for multiple daily dosing and the poor compliance. These limitations have led to the development of once-daily, extended-release(ER) formulations of methylphenidate and amphetamine salts. However, these ER formulations may not be as immediately helpful to ADHD children due to delayed onset of action and the acute tolerance which is the failure to sustain the efficacy with the same concentration of drug as the initial stage of medication. OROS-methylphenidate(Concerta$^{\circledR}$) given once a day produces an ascending-pattern plasma drug level generated by the osmotically released, timed drug-delivery system. These new formulations of the psychostimulants have been shown to be a useful alternative to old stimulant medications through the evidence by the clinical trials.