• Journal of Preventive Medicine and Public Health
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• v.11 no.1
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• pp.86-97
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• 1978

The mobile medical service has been operated for many years by a number of medical schools and hospitals as a most convenient means of medical service delivery to the people residing in such area where the geographical and socioeconomic conditions are not good enough to enjoy modern medical care. Despite of official appraisal showing off simply with numbers of outpatients treated and medical persons participated, however, as well recognized, the capability (in respect of budget, equipment and time) of those mobile medical teams is so limitted that it often discourages the recipients as well as medical participants themselves. In the midst of rising need to secure medical service of good quality to all parts of the country, and of developing concept of primary health care system, authors evaluated the effectiveness of and problems associated with mobile medical servies program through the community diagnosis of a village (Opo-myun, Kwangju-gun) to obtain the information which may be halpful for future improvement. 1. Owing to the nationwide Sae-Maul movement powerfully practiced during last several years, living environment of farm villages generally and remarkably improved including houses, water supply and wastes disposal etc. Neverthless, due to limitations in budget time and lack of knowledge (probably the most important), these improvements tend to keep up appearances only and are far from the goal which may being practical benefit in promoting the health of the community. 2. As a result of intensive population policy led by the government since 1962, there has been considerable advances in understanding and the rate of practicing family planning through out the villages and yet, one should see many things, especially education, to be done. Fifty eight per cent of mothers have not received prenatal check and the care for most (72%) delivery was offered by laymen at home. 3. Approximately seven per cent of the population was reported to have chronic illness but since only a few (practically none) of the people has had physical check up by doctors, the actual prevalence of chronic diseases may reach many times of the reported. The same fact was observed also in prevalence of tuberculosis; the patients registered at local health center totaled 31 comprising only 0.51% while the numbers in two neighboring villages (designated as demonstration area of tuberculosis control and mass examination was done recently) were 3.5 and 4.0% respectively. Prevalence rate of all dieseses and injuries expereinced during one month (July, 1977) was 15.8%. Only one tenth of those patients received treatment by physicians and one fifth was not treated at all. The situation was worse as for the chronic patients; 84% of all cases either have never been treated or discontinued therapy, and the main reasons were known to be financial difficulty and ignorance or indifference. 4. Among the patients treated by our mobile clinic, one third was chronic cases and 45% of all patients, by the opinion of doctors attended, were those who may be treated by specially trained nurses or other paramedics (objects of primary care). Besides, 20% of the cases required professional managements of level beyond the mobile team's capability and in this sense one may conclude that the effectiveness (performance) of present mobile medical team is quite limitted. According to above findings, the authors would like to suggest following for mobile medical service and overall medicare program for the people living in remote country side. 1. Establishment of primary health care system secured with effective communication and evacuation (between villages and local medical center) measures. 2. Nationwide enforcement of medical insurance system. 3. Simple outpatient care which now constitutes the main part of the most mobile medical services should largely be yielded up to primary health care unit of the village and the mobile team itself should be assigned on new and more urgent missions such as mass screening health examination of the villagers, health education with modern and effective audiovisual aids, professional training and consultant services for the primary health care organization.

• Journal of Korean Academy of Nursing
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• v.3 no.3
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• pp.97-110
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• 1973

The goal of modern nursing is to provide comprehensive nursing care to patients. If comprehensive nursing care to children (within the hospital setting) is to be provided, consideration of the stage of growth and development of the child is especially important. From clinical observation, it appeared that nurses often disregarded individual requirements of children in giving nursing care. Therefore, the purpose of this study is to show that comprehensive nursing care which is based on an understanding of the growth and development of the child contributes to both the child and the mother's adaptability to the child's hospitalization. Method: Sixty children, three to three year of age, hospitalized at the Yonsei University Pediatric Ward ware studied. From April 1, 1973 to May 5, 1973, children admitted to the hospital were assigned to either an experimental or a compare groups. There were 30 children in each group. The sex and age of the children in each group was similar. In both groups were more male than female children. In the experimental group, each mother stayed with hot child continuously during his hospitalization. In the compare groups, the mother or some other member of the family stayed with the child. Each day on the child's admission the investigator visited the ward from 1-2 P.M. to 9-10 P.M., in order to provide comprehensive care for the experimental -group. The assistance given the nurses by the investigator was in the form of conferences regarding care and in giving direct care to the child and his mother. The compare group of children received nursing care as usually provided by the hospital. The instruments used to obtain the data for analysis were as follows: 1. The fear and anxiety reaction of the child was recorded by observation of the investigator for four areas: 1) separation from parent and relatives 2) reaction to Doctor and Nurse with white gowns 3) reaction to nursing care 4) reaction to injection and tests, etc. 2. Regression in area of eating, sleeping, and elimination were recorded by the investigator by questioning the mother and by observation. 3. Adaptability to the hospitalization was recorded by direct questioning of the children for areas of emotional and social adjustment. For children older than 3 years of age or children not seriously ill, using the simple I. Q. test this was possible for only 35 of the total 60 children. Result: 1. 55 percents of the total 60 children had been prepared by their parents for hospitalization. The children who had received prior preparation accepted hospitalization more readily than those who had received no preparation. (χ²=4.6 Ρ<0.05) 2. On admission 31.7 percent of the children expressed verbal fear of their discase or treatment. 25 percent felt that the disease was due to their mistake. 3. There was a significant difference in the reaction of the child to separation from the parent or relatives between the two groups. The experimental groups showed less anxiety due to separation than the compare group. (χ²=4.34 Ρ<0.05) In both groups there was less anxiety due to separation among school age (6-12 years) children than among preschool age (3-5 years) children. (χ²=9.22 Ρ<0.05) 4. More than half of the children in both groups reacted with fear and avoidance to doctor and/or nurses wearing white gowns. (χ²=0.06 Ρ<0.05) 5. The experimental group reacted more favorably to nursing in general than the compare group. (χ²=4.8 Ρ<0.05) 6. There was no difference in the fear and refused reaction to special tests and/or such as X-rays and injections, etc. between the groups. (χ²=3.77 Ρ<0.05) 7. More children in the compare group showed regressive tendencies in eating, sleeping, and elimination habits than in experimental groups. (χ²=2.3 Ρ<0.05 χ²=3.88 Ρ<0.05 χ²=4.9 Ρ<0.05) 8. There was a significant difference in the adaptability to hospitalization between the two groups. The experimental groups adapted more readily. (χ²=2.02 Ρ<0.05) 9. For children who had higher I.Q. s the adaptability to hospitalization was better regardless of the group. (χ²=5.03 Ρ<0.05) However, because of the small number of cases (60), this finding cannot be extrapolated without further verification. The date demonstrates that there was a greater adaptability to hospitalization by the child when comprehensive nursing care was given. By planning care and applying knowledge of growth and development to meet, nurses are in a position to prevent some of the psychological trauma associated with hospitalization.

• Journal of Radiation Protection and Research
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• v.26 no.2
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• pp.59-66
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• 2001

It is a hot issue to determine the spatial location and shape of tumor boundary in fractionated stereotactic radiotherapy (FSRT). We could get consecutive transaxial plane images from the phantom (paraffin) and 4 patients with brain tumor using helical computed tomography(HCT). K-means classification algorithm was adjusted to change raw data pixel value in CT images into classified average pixel value. The classified images consists of 5 regions that ate tumor region (TR), normal region (NR), combination region (CR), uncommitted region (UR) and artifact region (AR). The major concern was how to separate the normal region from tumor region in the combination area. Relative average deviation analysis was adjusted to alter average pixel values of 5 regions into 2 regions of normal and tumor region to define maximum point among average deviation pixel values. And then we drawn gross tumor volume (GTV) boundary by connecting maximum points in images using semi-automatic contour method by IDL(Interactive Data Language) program. The error limit of the ROI boundary in homogeneous phantom is estimated within ${\pm}1%$. In case of 4 patients, we could confirm that the tumor lesions described by physician and the lesions described automatically by the K-mean classification algorithm and relative average deviation analyses were similar. These methods can make uncertain boundary between normal and tumor region into clear boundary. Therefore it will be useful in the CT images-based treatment planning especially to use above procedure apply prescribed method when CT images intermittently fail to visualize tumor volume comparing to MRI images.

• Progress in Medical Physics
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• v.20 no.4
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• pp.324-330
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• 2009

In this study, we evaluated accuracy and usefulness of CyberKnife Respiratory Tracking System ($Synchrony^{TM}$, Accuray, USA) about a moving during stereotactic radiosurgery. For this study, we used moving phantom that can move the target. We also used Respiratory Tracking System called Synchrony of the Cyberknife in order to track the moving target. For treatment planning of the moving target, we obtained an image using 4D-CT. To measure dose distribution and point dose at the moving target, ion chamber (0.62 cc) and gafchromic EBT film were used. We compared dose distribution (80% isodose line of prescription dose) of static target to that of moving target in order to evaluate the accuracy of Respiratory Tracking System. We also measured the point dose at the target. The mean difference of synchronization for TLS (target localization system) and Synchrony were $11.5{\pm}3.09\;mm$ for desynchronization and $0.14{\pm}0.08\;mm$ for synchronization. The mean difference between static target plan and moving target plan using 4D CT images was $0.18{\pm}0.06\;mm$. And, the accuracy of Respiratory Tracking System was less 1 mm. Estimation of usefulness in Respiratory Tracking System was $17.39{\pm}0.14\;mm$ for inactivity and $1.37{\pm}0.11\;mm$ for activity. The mean difference of absolute dose was $0.68{\pm}0.38%$ in static target and $1.31{\pm}0.81%$ in moving target. As a conclusion, when we treat about the moving target, we consider that it is important to use 4D-CT and the Respiratory Tracking System. In this study, we confirmed the accuracy and usefulness of Respiratory Tracking System in the Cyberknife.

• Journal of Hospice and Palliative Care
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• v.2 no.2
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• pp.125-137
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• 1999

Purpose : Surveying the rates, severity, and variables influencing depression and their correlation between pain and depression in Korean cancer patients, we attempted to provide a basic database for the effective depression management program. Methods : The results of survey were colleted from 10 patients who were hospitalized at Seoul National University Hospital for cancer treatment from February to June of 1999. Factors of depression and the level of pain were examined by self-reported survey employing Korean version of Beck Depression Inventory(BDI) and an abridged version of Brief pain Inventory respectively. The purpose of this study and guidelines for the questionnaires were clearly explained to participating patients by Resgitered Nurses before answering the survey. Demographic and clinical characteristics of patients were compiled by reviewing their medical records in corporation with a family physician. The difference in the level of depression among patient groups was analyzed with the t-test and ANOVA, and the correlation between variables with Pearson correlation coefficient. Results : 1) 142 subjects comprised 79 male and 63 female, and their mean age was 51.86. 2) The mean scores of the worst pain for last 24-hours was 6.08(SD 2.23), the average pain for last 24-hours 4.44(SD 1.85), and the mean scores of pain at the time of survey 3.48(SD 2.25), while the mean scores of the least pain for last 24-hours 2.25(SD 1.83). 3) The mean BDI scores were 23.73(SD 0.99), and 55.6% of patients were evaluated to be in depression(cutting point 21). Scores of depression for cancer patients were higher than normal population. 4) The correlation between worst pain for last 24-hours and depression(r=0.252, P=0.002), average pain for last 24-hours and depression(r=0.225, P=0.007), present pain and depression(r=0.291, P=0.000) were significant. 5) Significant differences were found among groups of cancer patients with pain with respect to gender(t=3.59, p=0.000), level of education(F=4.063, P=0.009), ECOG(F=3.352, P=0.021). There was significant positive correlation between depression and pain(r=0.171, P=0.042). Conclusions : More than 50% of cancer patients with pain are suffering from depression. We have shown that the variables like the degree of pain, gender, level of education, ECOG, and age are significantly related to the depression in cancer patients. The findings of this study may be used for assessing high-risk patients in need of intervention and for planning effective therapeutic strategies for them after the routine assessment. Further study is necessary to investigate the cultural differences and the variables influencing on depression in Korean cancer patients.

• Journal of Food Hygiene and Safety
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• v.28 no.3
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• pp.279-285
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• 2013

To establish sample preparation method for detection of food-borne pathogens from lettuce, perilla leaves, cucumber, pepper, and cherry tomato, the influences of diluent composition, processing time, and proportion of diluent to sample were examined. Each produce was inoculated with 6.0 log $CFU/cm^2$ of Escherichia coli O157:H7, Salmonella Typhimurium, Listeria monocytogenes, Staphylococcus aureus, and Bacillus cereus. Each produce was treated with 0.1% peptone water, and D/E neutralizing broth. Processing time of produce was 30, 60, 90, and 120s, and the proportion of diluent to sample was 2 : 1, 4 : 1, 9 : 1, and 19 : 1. The number of bacteria after treatment of D/E neutralizing broth was higher than that of 0.1% peptone water (P<0.05). In cherry tomato, the population of S. typhimurium recovered from treated with D/E broth was higher than that recovered from treated with 0.1% peptone water by 1.05 log $CFU/cm^2$ (P<0.05). No difference in numbers of pathogens was observed in processing time. Optimum proportion of diluent to perilla leaf, iceberg lettuce, cucumber, green pepper, and tomato was 9 : 1, 4 : 1, 2 : 1, 2 : 1, and 2 : 1, respectively. These data suggest that D/E neutralizing broth should be recommend as diluent, and the diluent volume applied to produce should be determined in proportion to produce surface area per weight (g).

• Journal of Preventive Medicine and Public Health
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• v.26 no.4 s.44
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• pp.628-649
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• 1993

This study was conducted to investigate the factors related to the poor school performance of the elementary school children. Two schools in Taegu, one in the affluent area and the other in the poor area, were selected and a total of 175 children whose school performance was within low 10 percentile (poor performers) and 97 children whose school performance were within high 5 percentile (good performers) in each class of 2nd, 4th and 6th grades were tested for the physical health, behavioral problem and family background. Each child had gone through a battery of tests including visual and hearing acuity, anthropometry (body weight, height, head circumference), intelligence (Kodae Stanford-Binet test), test anxiety (TAI-K), neurologic examination by a developmental pediatrician and heavy metal content (Pb, Cd, Zn) in hair by atomic absorption spectrophotometry. A questionnaire was administered to the mothers for prenatal and prenatal courses of the child, family environment, child's developmental history, and child's behavioral and learning problems. Another questionnaire was administered to the teachers of the children for the child's family background, arithmatic & language abilities and behavioral problem. The poor school performance had a significant correlation with male gender, high birth order, broken home, low educational and occupational levels of parents, visual problem, high test anxiety score, attention deficit hyperactivity disorder (ADHD), poor physical growth (weight, height, head circumference) and low I.Q. score. The factors that had a significant correlation with the poor school performance in multiple logistic regression analysis were child's birth order (odds ratio=2.06), male gender(odds ratio=5.91), broken home(odds ratio=9.29), test anxiety score(odds ratio=1.07), ADHD (odds ratio=9.67), I.Q. score (odds ratio=0.85) and height less than Korean standard mean-1S.D.(odds ratio=11.12). The heavy metal contents in hair did not show any significant correlation with poor school performance. However the lead and cadmium contents were high in males than in females. The lead content was negatively correlated with child's grade(P<0.05) and zinc was positively correlated with grade (P<0.05). among the factors that showed a significant correlation with the poor school performance, high birth order, short stature and ADHD may be modified by a good family planning, good feeding practice for infant and child, and early detection and treatment of ADHD. Also, teacher and parents should restrain themselves from inducing excessive test anxiety by forcing the child to study and over-expecting beyond the child's intellectual capability.

• Journal of Dairy Science and Biotechnology
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• v.29 no.1
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• pp.23-31
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• 2011

Domestic dairy industry is now standing at the crossroad for planning next fifty years, mainly because economic and environmental situations surrounding Korean peninsula are fast changing. For the aspects of dairy consumption, fresh milk consumed less, while consumption of the other milk and dairy products is slightly increasing every year. In 2010, it is approximately estimated that 1,939,000 tons of raw milk was used and the supply would be short by about 35,000 tons, based on the amounts in the previous year. Currently, multilateral negotiations against US and EU are underway. When it will be in effect in the future, significant damage would be expected in the dairy and livestock sectors, leading to cut domestic milk supply. Quality of farm-gate milk is graded as 1A on average 90% or more, loaded with very low in microbial and somatic cell counts. Therefore, policy implications have to be placed toward switch currently the UHT processing method to Pasteurization or the LTLT technology, by which natural flavors and nutrients in milk mostly remain after heat treatment. Domestic cheese products comprise only 10% and the rest is occupied by the various kinds of imported natural products. The market size keeps increasing up to 65,423,000 tons last year. When it comes to vitalization of our natural cheese industry, cheese whey, which is a main by-product in cheese manufacture, is a critical issue to be solved and also "On-Farm Processing" would be combined with a growth of big dairy companies when few immediate issues among the relevant regulations will be eased and alleviated in the near future. Fermented milk market is recorded as a single area of gradual increase in the past 10 years, Korea. Fermented yogurts with health claims targeted stomach, liver, and intestine are popular and has grown fast in sales amounts. In this context, researches on beneficial probiotic lactic acid bacteria are one of the important projects for domestic milk and dairy industries. Labelling regulations on efficacy or health-promoting effects of functional dairy products, which is the most important issue facing domestic dairy processors, should be urgently examined toward commercial expression of the functionality by lawful means. Colostrum, a nutrition-rich yellowish fluid, is roaded with immune, growth and tissue repair factors. Bovine colostrum, a raw material for immune milk preparations and infant formula, can be used to treat or prevent infections of the gastrointestinal tract. Nanotechnology can be applied to develop new milk and dairy products such as micro-encapsulated lactase milk for consumers suffering lactose intolerance. Raw milk is suggested to be managed by its usage in the processing line because imbalance of supply and demand is structural problem in every country and thus the usage systems as in the advanced dairy countries is worth of bench-marking to stabilize milk supply and demand. Raw milk produced is desirable to divide into the three parts; domestic, import, and buffering purposes. It is strongly recommended that a domestic dairy control center as an institutional framework should be urgently established as is Dairy Board in New Zealand and Australia. Lastly, government policy should be directed to foster the highly-educated people who are majoring in Dairy Sciences or working in the dairy industry by means of financial support in studying and training abroad as well.

• The Journal of Korean Medicine
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• v.26 no.2 s.62
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• pp.95-104
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• 2005

Objectives: This was a double blinded, randomized, placebo-controlled clinical study for evaluation of safety and effective dose finding of Cardiotonic Pills$^{(R)}$ in patients with chest pain and discomfort. Cardiotonic Pills$^{(R)}$ are composed of Salviae Miltiorrhizae Radix (丹蔘), Notoginseng Radix (三七根) and Borneolum (龍腦). Major effects of Salviae Miltiorrhizae Radix and Notoginseng Radix are vasodilatation, sedation and analgesic action. Borneolum has an antibacterial effect, and can stimulate the central nervous system. All of these substances are oriental herbs that have been used for a long time in east Asia. Cardiotonic Pills fi received Investigational New Drug (IND) approval from the Food and Drug Administration (FDA) in the USA and 40 million people in the world take this pill. We performed a phase IV clinical study to confirm its efficacy and safety in patients who have probable cardiogenic or psychogenic chest pain or chest stifling. Methods: This study was planned for a multi-center clinical trial including four university hospitals of oriental medicine in Korea. This was the first time to evaluate the 'planning treatment according to diagnosis (辨證施治)' of chest pain or chest discomfort according to oriental medical guidelines. The patients who were included in this trial were adult volunteers from 20 to 70 years old who had chest pain or chest discomfort more than twice during a recent month, and we received written consent to participate in this study from all of them. After administration of Cardiotonic Pills$^{(R)}$ for 8 weeks, number of occurrences, duration, appearance and degree of chest pain or chest discomfort was observed and degree of symptoms (severity of illness, global improvement) were measured using a patient's global assessment composite scale. Results: In the patient's global assessment scale, the severity of illness of the Cardiotonic Pills$^{(R)}$ group (n=25) was 14/25=0.56 but of the placebo group (n=25) was 7/25=0.28 (p-value=0.0449). This result indicates Cardiotonic Pills$^{(R)}$have a positive effect on the symptoms of chest pain and discomfort. However, the global improvement of the Cardiotonic Pills$^{(R)}$group was 23/25=0.92, and of the placebo group was 22/25=0.88 (p-value=0.6374). The total symptom score of the Cardiotonic Pills$^{(R)}$ group was $1.68\pm20.06$, and of the placebo group was $16.76\pm72.l4$(p-value=0.2285). The number of symptom events of the Cardiotonic Pills$^{(R)}$ group was $72\pm29.78$, and of the placebo group (n=25) was $10.80\pm38.42$ (p­value=0.3660). We could not find any effects on the other factors examined besides the severity of illness, beyond the difference of standard deviations. Conclusions: Cardiotonic Pills$^{(R)}$ significantly reduced chest pain and chest discomfort in patients. Therefore, we expect that Cardiotonic Pills$^{(R)}$ will be helpful for patients with chest pain and chest discomfort not only caused by heart disease but also by other diseases.

• Progress in Medical Physics
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• v.21 no.1
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• pp.113-119
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• 2010

Software for GafChromic EBT2 film dosimetry was developed in this study. The software provides film calibration functions based on color channels, which are categorized depending on the colors red, green, blue, and gray. Evaluations of the correction effects for light scattering of a flat-bed scanner and thickness differences of the active layer are available. Dosimetric results from EBT2 films can be compared with those from the treatment planning system ECLIPSE or the two-dimensional ionization chamber array MatriXX. Dose verification using EBT2 films is implemented by carrying out the following procedures: file import, noise filtering, background correction and active layer correction, dose calculation, and evaluation. The relative and absolute background corrections are selectively applied. The calibration results and fitting equation for the sensitometric curve are exported to files. After two different types of dose matrixes are aligned through the interpolation of spatial pixel spacing, interactive translation, and rotation, profiles and isodose curves are compared. In addition, the gamma index and gamma histogram are analyzed according to the determined criteria of distance-to-agreement and dose difference. The performance evaluations were achieved by dose verification in the $60^{\circ}$-enhanced dynamic wedged field and intensity-modulated (IM) beams for prostate cancer. All pass ratios for the two types of tests showed more than 99% in the evaluation, and a gamma histogram with 3 mm and 3% criteria was used. The software was developed for use in routine periodic quality assurance and complex IM beam verification. It can also be used as a dedicated radiochromic film software tool for analyzing dose distribution.