• Journal of agricultural medicine and community health
• /
• v.7 no.1
• /
• pp.74-79
• /
• 1982

Recently in Korea, integration of F.P. & MCH programs for effective and efficient implementation of the health programs has been discussed actively. In fact, categorical health workers in fields have been trained and changed as an integrated health workers by government. But one of the most important problems that had to be solved for successful integration of F.P. and MCH programs, is that there must be a common indicator for the evaluation of the two health services (integrated indicator). We regarded reproductive efficiency (=R.E.) that had been proposed by Charlotter M$\ddot{u}$ller et al, as the good integrated indicator. The object of this brief article is to introduce the meaning of reproductive efficiency and to illustrate the usefulnesses of R.E. as the integrated health indicator by applying this indicator to the data from preliminary survey of Seosan demonstration project for integration of F.P. & MCH service supported by WHO. The results and conclusions are as follows 1) Definition of R.E. is the percentage of pregnancies that succeed in production normal, surving children after taking into account the frequency of all measurable types of adverse outcomes (End point for evaluation of survival is one year of age). 2) On the basis of the past pregnant history, reproductive efficiency of the 2,484 eligible women (15-44 years) was roughly 75% (But, in the concept of good births, it is not regarded whether the survived infant is normal health or not). 3) Compared with the results of the other two surveys of the rural area in Korea, reproductive efficiency has been slightly decreased than before, in spite of family planning and MCH services for past 20 years. Because the quantity of increased abortion rate overwhelmed that of the decreased infant mortality rate. 4) Reproductive efficiency has the object for measure many events during the period from the conception (Wanted pregnancy) to an normal surviving children as an 1 year of age. So these heterogenous adversities, ie, induced abortion, still births, spontaneous abortion, neonate & infant death, are aggregated as R.E. However, if the information of these important events and reproductive efficiency were given, R.E. is used as the comprehensive evaluation indicator for F.P. and M.C.H. after meticulous analysis the various components of R.E. 5) Economic loss for adverse outcomes of preg were pregnancy were calculated applying the medical cost at the relatively small sized hospital of small city. Economic loss for 100 cases of adverse outcome is 10,420,000 won, and economic loss for infant death is 46.1% of the total loss. So, it is rational to invest much more effort and than before to MCH programs.

• Journal of Korean Academy of Nursing
• /
• v.15 no.3
• /
• pp.74-80
• /
• 1985

This study was attempted to identify the difference between body image of the patients with lower limb fracture and that of normal persons, and to examine if supportive group care could offer an apportunity for positive change in body image of the patient with lower limb fracture under the Quasi-experimental design. The subjects for this study were obtained by ta-king convenient sample of soldiers; the experimental group were 44 lower limb fractured patients hospitalized on the orthopedic Surgery unit in S Army General Hospital, while the control group were 44 normal enlisted men serving in the B Army regiment. Supportive group nursing care was given to the lower limb fractured patients who belong to the experimental group. Pre-and post-tests were administered to the experimental and the control group. The instruments to measure body image of the subjects were body Cathexis Scale developed by Scord and Jourard (1953) and Body Meaning Scale dove-loped by the reseacher. The reliability coefficients by Cronhach's u-test were .95 in body Cathexis Scale and .89 in Body Meaning Scale in this study. Data for this study were collected over a period 12 days from the 12th to the 24th of October, 1984 by the questionnaire. Data were analyzed by computer. Frequency, Percentage and x²-test were used to examine general chacteristics of the subjects. t-test was used to analyze the hypotheses. Analysis of variance was used to test difference in body image between groups classified by the general characteristics. Pearson Correlation Coefficient was used to identify the correlation between Body Cathexis Scale and Body Cathexis Scale and Body Meaning Scale. The results of this study were as follows: 1. No significant difference was found between the experimental and the control group on general characteristics of the subjects (p> .05). 2. Hypothesis I:“There will be a difference in body image between patiens with lower limb fracture and normal persons,”was supported(Body Cathexis t=6.91, p<.001, Body Meaning t=5.66, p< .001). 3. Hypothesis Ⅱ;“The will be a difference in body image of patients with lower limb fracture bet-ween after and before, supportive group nursing care was provided,”was supported (Body Cathexis t=5.90, p<.001, Body Meaning t=4.45, p <.001). 4. There was no significant difference in body image between groups classified by the general characteristics (p> .05). 5. The correlation between Body Cathexis Scale and Body Meaning Scale: It was reported that Body Cathexis Scale correlated with Body Meaning Scale in total subjects of the experimental and control group (r=.744, p<.001). That is, there was relatively high correlation between two scales. body Cathexis Scale correlated with Body Meaning Scale in the experimental group(r=.738, p <.001) and in the control group (r=.352, p <.001). That is, there was more than moderate correlation between two scales. In conclusion, it was found that there was a difference in body image between patients with lower limb fracture and normal persons, and supportive group nursing care offered an opportunity for positive change in body image of the patient with lower limb fracture.

• Genomics & Informatics
• /
• v.15 no.3
• /
• pp.87-97
• /
• 2017

Multiple myeloma (MM) is a malignant disease caused by an abnormal proliferation of plasma cells, of which the prognostic factors include chromosomal abnormality, ${\beta}$-2 microglobulin, and albumin. Recently, the term chromothripsis has emerged, which is the massive but highly localized chromosomal rearrangement in response to a one-step catastrophic event. Many studies have shown an association of chromothripsis with the prognosis in several cancers; however, few studies have investigated it in MM. Here, we studied the association between chromothripsis-like patterns and treatment resistance or prognosis. First, we analyzed nine MM cell lines (U266, MM.1S, RPMI8226, KMS-11, KMS-12-BM, KMS-12-PE, KMS-28-BM, KMS-28-PE, and NCI-H929) and bone marrow samples of four patients who were diagnosed with MM by next-generation sequencing-based copy number variation analysis. The frequency of the chromothripsis-like pattern was observed in seven cell lines. We analyzed the treatment-induced chromothripsis-like patterns in KMS-12-BM and KMS-12-PE cells. As a result, breakpoints and chromothripsis-like patterns were increased after drug treatment in the relatively resistant KMS-12-BM. We further analyzed the patients' results according to the therapeutic response, which was divided into sensitive and resistant, as suggested by the International Myeloma Working Group. The chromothripsis-like pattern was more frequently observed in the resistant group. In the sensitive group, the frequency of the chromothripsis-like pattern decreased after treatment, whereas the resistant group showed increased chromothripsis-like patterns after the treatment. These results suggest that the chromothripsis-like pattern is associated with treatment response in MM.

• The Journal of Internal Korean Medicine
• /
• v.33 no.2
• /
• pp.222-230
• /
• 2012

Background : Interstitial cystitis is a disorder of the bladder characterized by urgency and frequency of urination, and pelvic pain. The cause of interstitial cystitis is not clear. Modern medical treatments include behavioral therapy, medication, intravesical infusion therapy, and surgical treatment, but the goal of treatment is based on symptom relief rather than a cure. According to a recent report, in an animal model, oriental medicine treatment, Yukmijihwang-tang improved the symptoms of interstitial cystitis. However, clinical studies and experimental research are lacking. Objectives : In this study, We investigated Chuknyojetong-tang, acupuncture, moxibustion and bee venom effect on interstitial cystitis. Methods : We targeted 25 patients diagnosed with interstitial cystitis at the university hospital and treated them for more than one month. We used acupuncture, Chuknyojetong-tang, and bee venom. The effects were evaluated using ICSI and ICPI at the begin of treatment and at the end of treatment. Results : All of the 25 patients were female, average age was $53.3{\pm}13.5$ years, and the average month of disease-duration was $69.0{\pm}59.8$. The duration of treatment was $8.0{\pm}5.4$ months, and 60% of patients were improved. After treatment, we used correlation coefficient method, multiple regression analysis. ICSI difference increased as treatment period increased. ICPI difference increased as age decreased. Total difference also increased as treatment period increased. These results imply that treatment effect was improved. Conclusions : These findings suggest that oriental medicine therapy using Chuknyojetong-tang, acupuncture, moxibustion, and bee venom would be very effective on interstitial cystitis.

• Women's Health Nursing
• /
• v.5 no.1
• /
• pp.133-145
• /
• 1999

The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.

• The Journal of Korean Academy of Prosthodontics
• /
• v.43 no.4
• /
• pp.438-452
• /
• 2005

Statement of problem: The use of Ceromer is increasing in dentistry. But, the research of Ceromer has not been conducted much. Purpose : This study was to evaluate the marginal fidelity and internal adaptation according to marginal position. Materials and Methods: In this study 60 resin crowns were fabricated. The measurements of the marginal fidelity were carried out using stereomicroscope $SZ-40^{(R)}$ (Olympus, Japan) and the measurements of fracture strength were done using Instron $8871^{(R)}$ (Instron Co., U.S.A.) at a cross head speed of 1mm/min. All of the measurements were statistically analyzed by ANOVA test, multiple range test and Weibull analysis. Statistical significance was set in advance at the probability level of less than 0.05. All of the measurements were analyzed with Window $SPSS^{(R)}$ Version 10.0 soft ware for the personal computer. Results : 1. There were no statistical differences of the marginal fidelity between $Targis^{(R)}$ and $Tescera^{(R)}$, but difference between these two and $BelleGlass^{(R)}$ according to materials. 2. There were no statistical differences of the marginal fidelity between no fiber group and fiber group. There were no interactions between each maerial and with/without fiber group in the marginal fidelity 3. There were statistical differences of the fracture strength between $Tescera^{(R)}$ and $BelleGlass^{(R)}$ but no statistical differences of the fracture strength between $Targis^{(R)}$ and $Tescera^{(R)}$, $Targis^{(R)}$ and $BelleGlass^{(R)}$ according to materials. 4 There were statistical differences of the fracture strength between no fiber group and fiber group. There were no interactions between each material and with/without fiber group in the fracture strength. 5. When comparing the fracture surface, no fiber group showed the resin which were fractured at the labial surface and separated from the adhesion surface. In fiber group, the fractures took a place in resin compartments. Conclusion. The marginal fidelity and the fracture strength were clinically acceptable. From these results, $Targis^{(R)}$ and $Tescera^{(R)}$ were superior than $BelleGlass^{(R)}$ in the marginal fidelity But, when applying these resin crowns in clinic, more careful consideration is needed and further study is recommended.

• The Journal of Advanced Prosthodontics
• /
• v.9 no.4
• /
• pp.244-251
• /
• 2017

PURPOSE. The purpose of this study was to determine fracture resistance and failure modes of three-unit fixed dental prostheses (FDPs) made of lithium disilicate pressed on zirconia (LZ), monolithic lithium disilicate (ML), and monolithic zirconia (MZ). MATERIALS AND METHODS. Co-Cr alloy three-unit metal FDPs model with maxillary first premolar and first molar abutments was fabricated. Three different FDPs groups, LZ, ML, and MZ, were prepared (n = 5 per group). The three-unit FDPs designs were identical for all specimens and cemented with resin cement on the prepared metal model. The region of pontic in FDPs was given 50,000 times of cyclic preloading at 2 Hz via dental chewing simulator and received a static load until fracture with universal testing machine fixed at $10^{\circ}$. The fracture resistance and mode of failure were recorded. Statistical analyses were performed using the Kruskal-Wallis test and Mann-Whitney U test with Bonferroni's correction (${\alpha}=0.05/3=0.017$). RESULTS. A significant difference in fracture resistance was found between LZ ($4943.87{\pm}1243.70N$) and ML ($2872.61{\pm}658.78N$) groups, as well as between ML and MZ ($4948.02{\pm}974.51N$) groups (P<.05), but no significant difference was found between LZ and MZ groups (P>.05). With regard to fracture pattern, there were three cases of veneer chipping and two interfacial fractures in LZ group, and complete fracture was observed in all the specimens of ML and MZ groups. CONCLUSION. Compared to monolithic lithium disilicate FDPs, monolithic zirconia FDPs and lithium disilicate glass ceramics pressed on zirconia-based FDPs showed superior fracture resistance while they manifested comparable fracture resistances.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.5
• /
• pp.1949-1953
• /
• 2014

Background: CA125 and HE4 are used in calculating Risk of Malignancy Algorithm (ROMA); and Risk of Malignancy Index (RMI). However, studies showed that normal levels of CA125, and HE4 differ among ethnicities such as between Asians and Caucasians, thus affecting the accuracy of the RMI score and ROMA in predicting ovarian malignancy. This study aimed to determine whether new or modified cutoff values for Ca125, HE4, the RMI score, and ROMA resulted in a better prediction of malignancy compared with the previous or standard ones. Materials and Methods: Serum level of CA125 and HE4 from 128 patients with diagnosis of ovarian tumor that had been collected before surgery at Cipto Mangunkusumo General Hospital (CMH) in Jakarta from November 2010 until May 2011 were reviewed and analysed. The standard cutoff values of these biomarkers, RMI, and ROMA were modified by using logistic regression model. The modified cutoff values were compared to the standard cutoff values in terms of sensitivity, specificity, and accuracy. Results: The modified cutoff value of CA125, HE4, RMI score and ROMA were 165.2 U/mL, 103.4 pM, 368.7, 28/54. The sensitivity and specificity of the modified cutoff values CA125, HE 4, RMI score and ROMA in differentiating benign from malignant and borderline were 67% and 75,4%; 73.1% and 85.2%; 73.1% and 80.3%; and 77.6% and 86.9%. While the sensitivity and specificity of the standard cutoff value of CA125; HE4; RMI score; and ROMA were 91% and 24.6%; 83.6% and 65%; 80.6% and 65.6%; and 91.0% and 42.6%. The accuracy of modified cutoff values compared with standard cutoff values were: 71.2% vs 59.3%, 78.9% vs 75% vs, 76.5% vs 73.4%, and 82% vs 67.9%. Conclusions: The new or modified cutoff values of Ca125, HE4, RMI score and ROMA resulted in higher accuracy compared to the previous or standard ones, at the cost of reduced sensitivity.

• Korean Journal of Community Nutrition
• /
• v.7 no.6
• /
• pp.852-862
• /
• 2002

The purposes of this study were 1) to review the Medical Nutrition Therapy (MNT) Act of the United States, 2) to introduce the efforts of the American Dietetic Association (ADA) to expand the Medicare coverage for MNT and 3) to provide information about the reimbursement under Medicare Part B for the cost of MNT. The MNT Act defined MNT services as “the nutritional diagnostic, therapeutic, and counseling services provided by a Registered Dietitian or nutritional professional for the purpose of managing diabetes or renal diseases”. Also, the MNT Act defined “conditions for coverage of MNT”, “limitations on coverage of MNT”, and “qualifications of MNT service provider”. To expand the coverage of Medicare to include MNT, the ADA realized the need for development of a protocol for MNT, as well as studies to evaluate the effectiveness and cost-effectiveness of the MNT protocol developed. Therefore, the ADA supported the studies to develop a strong database of scientific investigations of nutritional services. Furthermore, the ADA needed credible data that could be used by Policy makers, so the ADA contracted with the Lewin Group to if out the study to gather the additional data needed to strengthen the ADA's position. In the report of the Lewin Group, which was entitled, “The Cost of Covering Medical Nutrition Therapy under Medicare : 1998 through 2004”, it was concluded, that if coverage for MNT in the Part B portion of Medicare had begun in 1998, by 2004, approximately $ 2.3 billion would have been saved through reduced hospital spending under Part A of Medicare ($ 1.2 billion) and reduced physician visits under Part B ($ 1.1 billion) Effective January 1 2002, the US Congress extended Medicare coverage to include MNT to beneficiaries with diabetes or renal diseases. The Centers for Medicare and Medicaid Services (CMS) established the duration and frequency for the MNT based on published reports or generally accepted protocols (for example, protocols suggested by the ADA). The number of hours covered by Medicare is 3 hours for the initial MNT and 2 hours for a follow-up MM. In 2002, a Medicare coverage policy was made to define the Physician's Current Procedural Terminology (CPT) codes 97802, 97803, and 97804 for MNT.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.9
• /
• pp.5107-5110
• /
• 2013

Background: Among women with haematuria, defining individuals under high risk for bladder cancer based on reproductive factors prior to cystoscopy would be of great benefit in the management of this condition. The aim of this study was to compare age and reproductive factors such as menopausal status, parity, age at first delivery and age at the last delivery between women who have haematuria with or without bladder cancer. Materials and Methods: A total of 463 patients underwent diagnostic cystoscopy in D$\ddot{u}$zce University Faculty of Medicine between 1 June 2008 and 1 June 2013. Female patients who presented with persistent microscopic or macroscopic haematuria and underwent standard evaluation for haematuria including urinalysis, urine culture, urine cytology, urinary tract imaging with excretory urography or computerized tomography with contrast enhancement and endoscopic evaluation of the urethra and bladder were included in this study. Exclusion criteria were tobacco use and high risk occupations for bladder cancer such as textile, dry cleaning, painting and etc. Forteen women had hematuria due to benign conditions, and 18 due to bladder cancer. Data were retrospectively retrieved from the medical records of Duzce University Hospital. Results: Patients with haematuria due to benign reasons did not significantly differ from patients who were found to have bladder cancer in terms of age (p=0.28), menopausal status (p=0.29), mean parity (p=0.38), being nulliparous (p=0.57), parity ${\geq}3$ (p=0.22), age ${\leq}18$ years at first delivery (p=1.00), age ${\geq}30$ years at last delivery (p=0.26), age ${\geq}35$ years at last delivery (p=0.23) and percentage of the patients with advanced age (${\geq}65$ years) (p=0.18). Conclusions: It is difficult to predict a high risk for developing bladder cancer in women with haematuria based solely on reproductive factors.