• Title/Summary/Keyword: 건강 문제

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Economic and Political Responses to Globalization: Economic Restructuring and Local Government as an Entrepreneur (세계화에 따른 경제${\cdot}$정치적 동향: 경제재구조와 기업가로서의 지방정부)

  • Koh, Tae-Kyung
    • Journal of the Korean Geographical Society
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    • v.31 no.4
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    • pp.662-671
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    • 1996
  • Since the world's economic and political structures have changed, the term 'globlization' has shown up as a dominant power and as a necessity for regional and national development. Each nation is responding to the globalization process economically and politically in various ways. In general, however, the economic response to the globalization is economic restructuring from the Fordist industries to 'flexible specialization'. And the political response to the globalization is 'global localization' as a new type of local politics(i.e., local policy activism or growth-enhancing local development policies). The crisis of Fordism shifted the role of local governments towards more involovement with local economic development. Local governments are mobilizing for loca economic development, they are taken into a process of institutional change that tends to redefine their responsibilities inside the state. Local governments thus tend to act as an entrepreneur in order to restructure theiir local economies and to compete with other national and international regions. State restructuring towards enerepreneurialism and efficient regional policy pursuing a pro-growth coalition trategy is chosen as a new mode of regulation for the post-Fordism at the local level. The flexible specialization as the post-Fordist economy and the local government as an entrepreneur are the global choice for globalization and a post-Fordist society. The paper focuses on the regulation theory which comprises the political economic perspective on resturcturing. Economic restructuring and state restructuring will be discussed in detail. And the paper tries to combine the economic globalization and the global localization as economic and political responses to globalization.

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The Correlation between Bronchostenosis and Changes in the Levels of Interferon-γ and Transforming Growth Factor-β during the Treatment in patients with Endobronchial Tuberculosis (기관지 결핵 치료 후의 기관지 협착 발생과 Interferon-γ 및 Transforming Growth Factor-β 농도 변화의 연관성)

  • Kim, Ki Uk;Lee, Su Jin;Lee, Jae Hyung;Cho, Woo Hyun;Jung, Kyung Sik;Joe, Jin Hoon;Kim, Yun Seong;Lee, Min Ki;Kim, Yeong Dae;Choi, Young Min;Park, Soon Kew
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.1
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    • pp.18-24
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    • 2005
  • Background : Endobronchial tuberculosis often complicates bronchostenosis, which can cause dyspnea due to an airway obstruction, and can be misdiagnosed as bronchial asthma or lung cancer. This study investigated the possible correlation between the $interferon-{\gamma}$($IFN-{\gamma}$) and transforming growth $factor-{\beta}$($TGF-{\beta}$) levels in the serum and bronchial washing fluid and the treatment results in endobronchial tuberculosis patients. Methods : Sixteen patients, who were diagnosed as endobronchial tuberculosis using bronchoscopy, and 10 healthy control subjects were enrolled in this study. The $IFN-{\gamma}$ and $TGF-{\beta}$ levels were measured in the serum and bronchial washing fluid of 16 endobronchial tuberculosis patients before and after treatment using the ELISA method. The endobronchial tuberculosis patients were divided into those who showed bronchial fibrostenosis after treatment and those who did not. Results : The $IFN-{\gamma}$ and $TGF-{\beta}$ levels in the bronchial washing fluid in endobronchial tuberculosis patients were elevated comparing to the control (p<0.05). After treatment, 7 of the 16 endobronchial tuberculosis patients showed bronchial fibrostenosis and the other 9 cases healed without this sequela. In the patients with fibrostenosis after treatment, the initial serum $TGF-{\beta}$ level was lower than the patients without fibrostenosis after treatment (p<0.05). Moreover, the serum $TGF-{\beta}$ level after treatment further decreased comparing to the patients without fibrostenosis after treatment(p<0.05). Conclusion : Elevated $IFN-{\gamma}$ and $TGF-{\beta}$ levels in the bronchial washing fluid in endobronchial tuberculosis patients are believed to be related to the pathogenesis of endobronchial tuberculosis. The decreased initial serum $TGF-{\beta}$ level and the change in the serum $TGF-{\beta}$ level after treatment are believed to be involved in bronchial fibrostenosis during the course of the disease.

A Survey on the 'House Diseases' for Vinyl House Cultivation Farmers (비닐하우스 재배농민에 대한 'house병'의 실태 조사)

  • Jen Jae-Kynn
    • The Journal of Korean Physical Therapy
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    • v.8 no.1
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    • pp.21-32
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    • 1996
  • This study was conducted in an attempt to grasp the health problems and environmental situation of the farmers and their vinyl houses. The study was done between Aug. 10, 1995 and Sep. 10, 1995, for one month period. with two hundred and nine vinyl house cultivation farmers chosen at random as subjects in five areas in and around Kim Chun City. The following are the results of the study carried out through direct interviews and surveys with the subjects : 1. The career of farming on vinyl house facilities by sex(male vs female) averages 17.29 and 15.08 years is shorter than that of general farmer's average of 31.24 and 25.58 years(P<0.05). Hours of labor between the two are silimar : monthly labor hours for vinyl house farmers are average 28 and 27.52 days. longer than the general farmers' average of 26.57 and 25.95 hours respectively. 2. The comp aints of physical symptoms among the vinyl house farmers range from lumbago, shoulder pain dullness in the limbs and dizziness, which show no remarkable differences from those of general farmers. 3. The frequency of application of chemicals on vinyl house forming for a period of one year averages 23.79, three times as often as the general farmer's average or 8.36(P<0.05). In the addiction rate of chemicals, too, the vinyl house farmer stowed a higher percentage of $9.09\%$ over the general farmer's $1.24\%$(P<0.01). 4. In temperature, humidity and disconfort indices of in and outside of the vinyl house, room temperature is on an average $34.6{\pm}5.05^{\circ}C,\;11.7^{\circ}C$ higher than that of outside, while in humidity inside was lower than outside by $10.6\%$ point, $65.9\%$ over $76.5\%$. The discomfort index was higher inside by $83{\pm}4.61\;vs\;70.64{\pm}5.61$. 5. The status of physical treatment over the past one year shows : for vinyl house farmers-physiotheraphy$(43.06\%)$, pharmacy$(24.04\%)$, clinic(18.66%), herbal medicine(574%) : for general farmers-pharmacy$(34.16\%)$, Physiotherapy$(27.33\%)$, Clinic$(18.63\%)$, Folk Medicine$(11.18\%)$ (P<0.01).

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The Effect of Cold Shock on Function and Morphology of Dog Epididymal Spermatozoa (개에서 cold shock이 정소상체유래의 정자의 기능과 형태에 미치는 영향)

  • Yu Il-jeoung
    • Journal of Veterinary Clinics
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    • v.21 no.4
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    • pp.329-335
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    • 2004
  • Dog spermatozoa were recovered from the caudae epididymides of 23 domestic dogs which were 11 pure breed and 12 mix-breed dogs ranging in age from 0.6 to 3 years. The experimental designs were as follows: 1) the effect of chilling to 0. 10 or 37$^{\circ}C$. 2) the kinetics of chilling injury at 0 or 4$^{\circ}C$, and 3) the effect of sugars at $0^{\circ}C$. Viable spermatozoa were recovered by percoll gradient separation and adjusted to 5${\times}$10$^{7}$ spermatozoa/ml. In experiment 1, spermatozoa were diluted with 0.33 M glucose supplemented with 3% BSA (G-BSA) at 1:2 dilution. Spermatozoa were loaded into straws and exposed at 0, 10 or 37$^{\circ}C$ for 30 min. In experiment 2, spermatozoa were prepared as the experiment 1 and exposed for 0.5, 5, 15, or 30 min at 0 or 4$^{\circ}C$. In experiment 3, spermatozoa were diluted with different sugars (0.33 M galactose, glucose, fructose, mannitol, lactose, sucrose, raffinose) and cooled to $0^{\circ}C$ for 30 min. Sperm membrane integrity, motility and acrosome integrity were assayed after rewarming at 37$^{\circ}C$ for 5 min. Sperm motility and membrane integrity abruptly decreased with decreasing temperature but acrosome integrity gradually decreased (P<0.05). Sperm motility was more sensitive to cold shock than membrane integrity and acrosome integrity. Spermatozoa cooled to $0^{\circ}C$ were more damaged than those at 4$^{\circ}C$. Sperm motility was not different among exposed times at both. 0 and 4$^{\circ}C$. However, membrane integrity of spermatozoa exposed for 30 min at both 0 and 4$^{\circ}C$ was significantly lower (P<0.05). Spermatozoa diluted in 0.33 M fructose or galactose showed lower motility and higher morphological abnormality with coiled tail at $0^{\circ}C$. These sperm characteristics were strongly related. These results indicate that dog epididymal spermatozoa are relatively sensitive to rapid cooling and higher morphological abnormality at $0^{\circ}C$ was shown in spermatozoa diluted in fructose and galactose.

Effects of a 12-week, school-based obesity management program on obese primary school children (12주간의 학교 비만 관리 프로그램이 초등학교 비만 아동에 미치는 효과)

  • Kim, Han Gyu;Lim, Goh-woon;Kim, Hae Soon;Hong, Young Mi
    • Clinical and Experimental Pediatrics
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    • v.53 no.3
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    • pp.335-340
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    • 2010
  • Purpose : This study was designed to determine the effects of a school-based obesity-management program on obese primary school children. Methods : A total of 995 children (6-2 years old) in a primary school were screened in March 2008, and of those, 101 obese students (44 boys and 57 girls, body mass index (BMI) ${\geq}95$ percentile) were enrolled for a study group. The schoo-lbased, obesity management program, which includes physical exercise and nutritional education, was conducted as part of an extracurricular program for 12 weeks. The measurement of height, weight, waist circumference, blood pressure (BP), and bioelectrical impedance analysis (BIA) was performed before and after the program.Results : Height and weight increased significantly (P <0.05). The BMI and obesity index decreased significantly (P <0.01). Systolic and diastolic BP decreased significantly (P <0.01). BMI decreased in 61.4% of boys and 66.7% of girls. Protein and basal metabolic rate (BMR) increased significantly on the BIA (P <0.01). Fat decreased significantly (P <0.05). The total body water (TBW) and percent body fat (PBF) decreased significantly (P <0.01). The changes in protein, fat, TBW, PBF, and BMR significantly correlated to the change in BMI (P <0.05). In a multiple logistic regression analysis, BMI change was significantly correlated to the changes in protein and fat content (P <0.01). Conclusion : The school-based obesity management program is a very effective way to manage obesity for obese primary school children.

Proposal for Amendment of the Basic Environmental Policy Act ('BEPA') Article 31 (환경정책기본법 제31조 무과실책임규정의 개정방안)

  • Koh, Moon-Hyun
    • Journal of Environmental Policy
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    • v.8 no.4
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    • pp.125-147
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    • 2009
  • The Basic Environmental Policy Act (BEPA) (Law No. 4257 effective 1. August 1990) sets forth the basic policies and administrative framework for environmental preservation, leaving more detailed regulations, and emission controls to separate laws targeting air, water, and solid waste, etc. The BEPA Article 31 adopts an unprecedented strict liability standard for damages as an absolute liability. The BEPA Article 31 provides for liability as follows. If a company is alleged to have caused damage through pollution of the environment, it will be liable for damages unless it can show that the pollution did not cause damages, or that it did not actually cause pollution. If the company did cause pollution, and if the pollution is the cause for the damages in question, the company will be liable irrespective of whether it was negligent or otherwise at fault. If there are two or more companies involved in the pollution, but it is unclear which company caused the damages, all of the companies will be jointly and severally liable for the damages. In this paper, the author attempts to uncover the problems of BEPA Article 31 and then seeks desirable amendments by comparing it to the German Environmental Liability Act. First, it will be necessary to provide definitions of 'companies etc.'. Second, it will be necessary to enumerate the kinds of company facilities. Third, it will be necessary to provide exclusionary clauses on material damages. Fourth, it will be necessary to show 'presumption of cause and effect'. Fifth, it will be necessary to provide a clause on 'right to information'. Sixth, it will be necessary to provide a clause for force majeure. Seventh, it will be necessary to take measures to secure abundant liability for damages which can be caused by the owner of the facility, the potential polluter. Finally, it is appropriate that Korea now legislate an Environmental Liability Act akin to the German Environmental Liability Act.

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A Study of well-being in Caregivers Caring for Chronically Ill Family Members (만성 질환자 가족의 부담감에 관한 연구)

  • 서미혜;오가실
    • Journal of Korean Academy of Nursing
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    • v.23 no.3
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    • pp.467-486
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    • 1993
  • Today, more chronically ill and handicapped people are being cared for at home by a family member caregiver. The task of caring for a family momber may mean that the caregiver has less time and money and more work which may result in increased fatigue and symptoms of illness. This study was done to examine the well-being of family caregivers. Fifty three family caregivers were interviewed. Concepts were measured using existing tools and included : Burden(25 item 5 point scale), Social sup-port (21 item 7 point scale), Health status defined by a symptom checklist(48 item S point scale), and Well -being defined by a quality of life scale (14 item 7 point scale) and caregiving activities. Data collection was done by interview and Q-sort. Social support and well - being were positively correlated as were symptoms and burden. Symptoms and burden were negatively correlated with social support and well-being. Items on the quality of life scale had a mean score range from 3.09 to 4.96. Quality of life related to income was lowest (3.09) but the desire to use more money for the patient was rated 2.90 on the burden scale where the item means ranged from 0.73 to 3.55. The high mean of 3.55 was for obligation to give care and the low 0.73 was (or not feeling that this was helping the patient. Mean scores for symptoms ranged from 0.26 to 2.15 with the 2.15 being for “worry about all the things that have to be done.” Over half of the patients were dependent for help with some activities of daily living. The caregivers reported doing an average of 3.40 out of five patient care activities including bathing (77.4%), shampooing (67.9%), and washing face and hands (49.1%), and 3.74 out of seven home maintenance activities including laundry (98.1%), cooking (83.0%), and arranging bed-ding(75.5%). The caregivers reported their spouse as one of the main sources of social support, including in times of loneliness and anger The mean score for loneliness as burden was 2.15 and ranked fourth and 31 (58.5%) of the sample reported being lonely recently and not being satisfied with the support received. Similarly anger caused by the patient was given a mean score of 2.13, and anger was reported to have been present recently by 38 (71.7%) of the sample and satis-faction with the support given was low. Having someone to help deal with anger ranked twelfth out of 21 items on the social support scale and had a mean score of 3.98 (range 3.49 to 5.98). Spouses were reported as a major source of social support but the fact that 50% of the caregivers were caring for a spouse, may account for the quality of this source of social support having been affected. These caregivers faced the same problems as others at the same stage of life. but because of the situation, there was a strain on their resources, particularly financial and social. In conclusion it was found that burden is correlated negatively to quality of life and positively to symptoms, but in this sample, symptoms and bur-den were scored relatively low. Does this indicate that the caregivers accept caregiving as part of their destiny and accept the quality of their lives with burden and symptoms just being a part of caregiving\ulcorner Does the correlation between the bur-den and symptoms indicate they are a measure of the same phenomenon or that the sample was of a more mobile, less burdened group of caregivers\ulcorner Quality of life was the one variable that was significant in explaining the varience on burden. Further study is needed to validate the conclusions found in this study but they indicate a need for nurses to ap-proach these caregivers with a plan tailored to each individual situation and to give consideration to interventions directed at improving quality of life and expanding social support networks for those caring for spouses.

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Interaction of Rifampin and Warfarin (리팜핀이 와파린의 항응고 효과에 미치는 영향)

  • Oh, Yeon-Mok
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.6
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    • pp.768-774
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    • 1999
  • Background: It is well known that rifampin decreases the hypoprothrombinemic effect of warfarin by induction of cytochrome P-450 enzyme in healthy volunteer. However, in patients the dosage schedule of warfarin during rifampin therapy is not established. Therefore, patients taking both rifampin and warfarin were reviewed to find out the adequate dosage schedule of warfarin in addition to side effects by interaction of two drugs. Method: Patients taking both rifampin and warfarin were retrieved from patients who were admitted due to heart disease and tuberculosis at Boochun Sejong Hospital from January of 1995 to August of 1999. To decide the adequate dosage of warfarin, the dosage of warfarin before, during, and after rifampin was evaluated in patients who kept adequate hypoprothrombinemic effect of warfarin during rifampin. To decide the adequate dosage schedule of warfarin, the time interval from the beginning of rifampin to normalization of prothrombin time(INR$\geq$1.1) was evaluated. And, the side effects by interaction of two drugs were reviewed. Results: All 12 patients taking both rifampin and warfarin were retrieved. Among them only 6 kept adequate hypoprothrombinemic effect of warfarin during rifampin. The dosage of warfarin during rifampin was $2.4{\pm}0.6$(mean$\pm$standard deviation) times as much as that before rifampin but the dosage after rifampin was the same as that before rifampin. The time interval from the beginning of rifampin to normalization of prothrombin time was $5.8{\pm}2.9$(mean${\pm}$standard deviation) days. 2 out of 12 had complication related to the interaction of rifampin and warfarin, one cerebral embolism just after the beginning of rifampin and the other cerebral hemorrhage just after the discontinuation of rifampin. Conclusion: When both rifampin and warfarin are prescribed, it would be a possible method to be confirmed by prospective study that warfarin be gradually increased about 2 times more than that without rifampin over 1 week or so after the beginning of rifampin and be tapered to the same dosage as that before rifampin when rifampin is discontinued. And, it would be prudent that prothrombin time be monitored frequently during rifampin and warfarin therapy, especially the beginning or discontinuation of rifampin.

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Clinical investigation of lipoid pneumonia in adults (성인에서 발생한 지방성 폐렴의 임상적 고찰)

  • Hyun, Jae Geun;Rhee, Chong H.
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.965-975
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    • 1996
  • Background : Exogenous lipoid pneumonia is caused by inhalation or aspiration of animal, vegetable or mineral oil. Most cases are ascribed to aspiration of oil in laxatives or nose drops Petroleum, another pure hydrocarbon used as a base in various medications, is occasionally involved. Especially animal oil produces severe tissue inflammatory reaction, but most patients present with only abnormal chest X-ray and no specific clinical symptoms or signs. Method: Seven patients, 3 males and 4 females, with exogenous lipoid pneumonia, who was hospitalized or referred to pulmonary division at Samsung Medical Center from December 1994 10 July 1996, were included. They hadn a history of laking shark liver oil(so-called "squalene") for varying period of time. We reviewed clinical, radioloic and pathologic findings. Result: Patients look 7 to 30 capsules of "squalene" a day for at least one month to 5 years. Six cases had chronic disease such as diabetes, hypertension, or cerebrovascular accident. Respiratory symptoms of mild fever, cough and sputum were present in 3 cases and in 3 cases there was no clinical symptoms and signs but abnormal findings by chest X - ray. The major radiologic findings by simple chest X - ray and computed tomography consisted of consolidation, infiltration involving mainly right middle and both lower lobes, and ground-glass opacity. Five of six bronchoscopic examinations demonstrated both lipid droplets floating on the surface of bronchoalveolar lavage fluid and Lipid-laden macrophages in bronchoalveolar lavage fluid or lung tissue. Follow-up chest X -ray showed improvement in 4 cases but no marked interval change in 3 cases after removal of exposure to "squalene". Conclusion: Shark liver oil can induce lipoid pneumonia in adults. In case of high clinical suspicion, confirmation of "squalene" use by careful history taking is required and bronchoscopy is helpful in diagnosis.

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Effects of Usual Source of Care by Patients with Diabetes on Use of Medical Service and Medical Expenses (당뇨병 환자의 상용치료원 보유가 의료이용 및 의료비에 미치는 영향)

  • Lee, So Dam;Shin, Euichul;Lim, Jae-Young;Lee, Sang Gyu;Kim, Ji Man
    • Korea Journal of Hospital Management
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    • v.22 no.3
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    • pp.1-17
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    • 2017
  • Purposes: Diabetes is a metabolic disorder that requires continuous care in order to prevent complications, as it can impose a critical burden on families and society due to various complications, including terminal renal failure, non-traumatic lower extremity amputation, and adult blindness. The usual sources of care are "specified private clinics, public health centers, or other facilities to visit when ill or when health-related advice is needed". These usual sources of care offer preventative services, have a high overall satisfaction rate in terms of public health care, and decrease the inpatient rates and medical costs of medical aid recipients. This study analyzed the current status of diabetic patients over 20 years of age based on their possession of a usual source of care, and the effects of this possession on the frequency of their medical service usage and its costs. Methodology: Based on data from the 7th Korea Health Panel, a Tobit analysis was used to analyze the different factors that can affect the frequency of medical service usage and its costs for diabetic patients with and without a usual source of care. Findings: The medical costs of diabetic patients with a usual source of care decreased in terms of inpatient, and the outpatient visits and inpatient costs of the group with a usual source of care in the form of a mainly-visiting doctor decreased more than those of the group with a mainly-visiting medical institution only. Practical Implications: Having a usual source of care can increase the treatment continuity, leading to reduced inpatient, and having a mainly-visiting doctor as the usual source of care further increases the treatment continuity. Based on these results, a new policy is needed to increase and strengthen diabetic patients? possession of a usual source of care.