• Journal of agricultural medicine and community health
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• v.27 no.2
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• pp.75-86
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• 2002

This study was conducted to investigate the changes in patients and medical services before and after the Separation of Prescription and Dispensing in Health Center. For the purpose of this study, prescription data of 5,890 prescribed patients in March 2000(before the Separation of Prescription and Dispensing) and 3,496 prescribed patients in March 2001(after the Separation) in 4 Health Centers located in Gyeongsangbuk-do and Gyeongsangnam-do were collected. For investigation of the change of character of prescribed patients and the disease, sex, age, chief diagnosis, the hind of medical insurance, days of visit, days of prescription were investigated by using National Health Insurance claim data. And for investigation of change of prescription, prescribed drugs per each claim, the use rate of antibiotics, injection, and high-price antiphlogistic drug were investigated for acute respiratory disease and musculoskeletal disease. The major results were as follows: For the changes of prescribed patients of each disease, patients with acute respiratory disease were decreased by 49.7% after the Separation of Prescription and Dispensing than before the Separation of Prescription and Dispensing and patients with hypertension(18.1%), patients with musculoskeletal disease(70.5%), patients with diabetes(8.5%), patients with digestive organ disease(71.2%), patients with chronic respiratory disease(76.4%) were decreased. But patients with urethritis were increased by 66.7%. The mean Health Center visited days of prescribed patients decreased significantly after the Separation of Prescription and Dispensing than before in both male and female(p<0.01) and in health insurance patients(p<0.01). For the each of the disease, hypertension, diabetes, musculoskeletal disease decreased. The mean prescribed days increased after the Separation of Prescription and Dispensing than before(p<0.01). According to the kine of disease, the mean prescribed days increased after the Separation of Prescription and Dispensing than before in all the diseases except the urethritis(p<0.01). For acute respiratory diseases, number of prescribed drugs per each claim decreased significantly after the Separation of Prescription and Dispensing(4.7 drugs) than before(4.9 drugs) and the prescription rate of injection decreased significantly from 63.8% to 7.70%, and the prescription rate of antibiotics decreased significantly from 337% to 19.1%(p<0.01). For musculoskeletal diseases before and after Separation of Prescription and Dispensing, number of prescribed drugs per each claim decreased significantly from 3.7 to 3.2 and the prescription rate of injection decreased significantly from 64.9% to 1.7%, and the prescription rate of high-price antiphlogistic drugs increased significantly from 29.1% to 397%(p<0.01). In consideration of above findings, the mean visited days decreased and on the contrary, the mean prescribed days per each prescription increased after Separation of Prescription and Dispensing than before in health centers. For the prescription pattern of physicians, number of prescribed drugs and the prescription rates of injection and antibiotics per each claim decreased, but the prescription rate of high-price antiphlogistic drugs increased after Separation of Prescription and Dispensing.

• Journal of agricultural medicine and community health
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• v.44 no.4
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• pp.165-184
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• 2019

Objectives: The purpose of this study was to identify and compare the difference and related factors with general characteristic and health behaviors, a experience of diagnosis and treatment of chronic diseases between rural and urban among elderly in Korea. Methods: We used the data of Community Health Survey 2017 which were collected by the Korean Center for Disease Control and Prevention. The study population comprised 67,835 elderly peopled aged 65 years or older who participated in the survey. The chi-square test, univariate and multivariate logistic regression analysis were used to analyze data. Results: We identified many significant difference of health behaviors, an experience of diagnosis and treatment with chronic diseases between rural and urban. Compared to urban elderly, the odds ratios (ORs) (95% confidence interval) of rural elderly were 1.136 (1.092-1.183) for diagnosis of diabetes, 1.278 (1.278-1.386) for diagnosis of dyslipidemia, 0.940 (0.904-0.977) for diagnosis of arthritis, 0.785(0.736-0.837) for treatment of arthritis, 1.159 (1.116-1.203) for diagnosis of cataracts, and 1.285(1.200-1.375) for treatment of cataracts. In the experience of diagnosis and treatment of chronic diseases, various variables were derived as contributing factors for each disease. Especially, there were statistically significant difference in the experience of diabetes diagnosis, arthritis diagnosis, cataract diagnosis and dyslipidemia except for hypertension diagnosis (p <0.01) between urban and rural elderly. There were statistically significant differences in the experience of treatment for arthritis and cataract (p <0.01), but there was no significant difference in the experience of treatment for hypertension, diabetes, dyslipidemia between urban and rural elderly. Conclusion: Therefore, it would be necessary to implement a strategic health management project for diseases that showed significant experience of chronic diseases with diagnosis and treatment, reflecting the related factors of the elderly chronic diseases among the urban and rural areas.

• Journal of the Korean Geographical Society
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• v.29 no.1
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• pp.84-104
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• 1994

The migration of population into the city has been on the increase according as Korea has been industrialized repidly since the 1960's. And there is a steady decrease in rural population. Thus lack of the number of the students forced many elementary Schools to be abolished. The aim of this study is to grasp the abolition types and the regional characteristics with the subject region of Chungbuk province. From the viewpoint of the increasing abolition of the elementary schools, I think it is very important to understand how the elementary schools have been abolished so far and predict how the subject region will have been changed in geography. Data for this study are based on Annual Establishment-Abolition Situation of the Schools published by Chungbuk office of Education in 1992, and many Kinds of the statistical reports, and the interview with the related. The results are as follows: 1. By examining the change of the number of the elementary schools and students in Chnugbuk, the numder of the students had also decreased since 1969 and was less than the half in 1990. As the number of the schools began to decrease ten years later than the students began to, the abolition of the elementary schools has started in reality from 1980's. 2. The 72 elementary schools were aboilshed between 1980 and 1992: the principal school is 9.7%, the branch school is 90.3%. The most fifteen schools are abolished in Yongdong-county and Chechon-county, and the least one school is abolished in Chechon-city and Okchon-county, and there is no abolition in Chongju-city and Chungju-city: According to the type of the abolition process, the least seven principal schools are abolished, and the principal school is reorganized as a branch school and twenty eight branch schools are abolished, and the most thirty seven branch schools are abolished. 3. When special change of the abolition is classified into the first perio (1980-1986) and the second period (1987-1992), in the first period the principal and branch schools were abolished and they are 13.9% of total abolition. The abolition out of them by building a dam is 60%. The principal schools in the submerged area though they have many students, were abolished. In the second period sixty two branch schools are abolished and they are 86.1% of total abolition. The most fifteen schools are abolished in Yongdong-county, thirteen in Chechon-county, seven in Tanyang-county, six in Chongwon-county, five in Chungwon-county and Koesan-county. Unlike the first period, the schools were abolished in this period because the number of students was so small. In this period sixty branch schools were abolished. All the students in the abolished schools except six schools transfered to the principal schools. The 58 school authorities help the students attend school by bus or support the expenses for attending school after that. 4. The abolition types of city, county and myon are classified into five types by the number of the abolished schools. The most forty nine abolished schools in type II are 68.1 of the total abolition. The least three abolished ones in type I are 12.5%. Considering the relation between the abolition type ane the number of schools and students, the number of the schools, increased in type I, II, III, V except IV from 1980 and then have decreased by abolition since 1980, while the more students decreased than they did in 1970 and the more the abolished school increases, the less the students decreases. The average students per school decreased in every abolition type and the most students decreased in type IV. 5. Considering the relation between the abolition type and the regional characteristics, most abolished schools were located between 100m and 300m above the sea level and it is 71% of the total abolition. The region without the abolition is high in the ratio of the cultivate land, ratio of rice field, and the part-time farmer, but the region with many abolition is low in the ratio of cultivated land. As for the manufacturing there are the most city, county and myon in the abolition type in Youngdong-county and Chechon-county where the manufacturing ratio of employing is low but Chongju-city without the abolition is a region where the manufacturing ratio is high. Consequently the development of the manufacturing causes the population to emigation out and the decrease of the population leads the transport is difficult of access, the facilities sold after being abolished are not being used in many ways. 7. Take an example of Youndong-county where the most schools were abolished, I have examined the school district and the population characteristics of the abolition. Though there were more villages, households, populations in the region that is higher than low above the sea level, the schools were abolished. Therefore we know that above the sea level had a great effect on the abolition. As a result of the regional analysis of the abolition, many schools were abolished by the artificial buildings such as a dam in the early 1980's but the schools in the late 1980's were abolished ten years later after the students decreased. More schools were abolished in the region where the manufacturing industry didn't develop. And the higher the school position was above the sea level, the sooner the school was abolished. It is also proved that both the beautiful natural scenery and accessibility are the important factor in using the abolished facilities practically.

• Proceedings of the Korea Hospitality Industry Research Society Conference
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• 2002.11a
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• pp.83-98
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• 2002

The old testament of the Bible has written the milk and curd. God said, I will ive you to how the milk and honey. The present study was designed to examine the effects of different homogenization pressure, homogenization temperature and $\beta$-cyclodextrin concentration on cholesterol removal rate of cheese, and to optimize the factors of cheese manufacture Process. In addition, the characteristics from cholesterol removed cheese and control are compared in the rheological and ensory analysis. The optimized process condition for cholesterol removal was for homogenization pressure, 74$^{\circ}C$ for homogenization temperature and 2% for $\beta$-cyclodextrin concentration, it showed 875% of the highest cholesterol removal rate in milk. Therefore, manufacture conditions of cholesterol removed cheese were chosen 74$^{\circ}C$ for homogenization temperature, for homogenization pressure, and I or 2% for $\beta$-cyclodextrin concentration. Cholesterol removed cheese and control were compared with yield, cholesterol removal, meltability, stretchability, textural properties and sensory analysis. Cholesterol content of control cheese containing 23.8% milk fat was cheese made from milk treated with 2% $\beta$-cyclodextrin and homogenization pressure was cholesterol removal. Yield of cholesterol removed cheese. As the homogenization pressure increased, oiling off reduced with showed better surface appearance. Stretchability of cholesterol removed cheese was lower 5~10cm than over 30cm of control. Meltability of cholesterol removed cheese also was lower than control. The hardness, gumminess, chewiness reduced to respectively. In the result of sensory analysis, treatment of homogenization for cholesterol removed cheese improved appearance and flavor, however texture fell. In addition, the resent result of the study indicated that about 75% of cholesterol in cheese could be removed, and the possibility of development of cholesterol removed cheese was observed. We have hope to research manufacture cheese global wide.

• Journal of Preventive Medicine and Public Health
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• v.25 no.2 s.38
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• pp.127-140
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• 1992

This study was done to identify the association between serum copper and zinc levels and the cirrhosis and hepatocellular carcinoma(HCC), and to evaluate its diagnostic value on liver diseases. Sixty-three healthy persons, 60 patients with cirrhosis and 33 patients with hepatocellular carcinoma were rendomly selected and investigated for their general characteristics from October 1990 to August 1991. For analysis of the biochemical markers in liver function test and the serum copper and zinc levels, their fasting venous blood were sampled at 9:00 to 11:00 in the morning and centrifuged to separate the serum within one hour. All the samples were immediately analysed for biochemical markers and stored at $-20^{\circ}C$ in polypropylene tubes further copper and zinc analysis. Mean of serum coppper levels was $91.97{\pm}4.76{\mu}g/dl$ in control, $106.21{\pm}2.73{\mu}g/dl$ in cirrhosis and $127.05{\pm}0.77{\mu}g/dl$ in HCC. The value of HCC was statistically significantly higher than that of the control and cirrhosis(p<0.05). Serum zinc levels were $110.82{\pm}7.24{\mu}g/dl$ in control, $68.10{\pm}5.43{\mu}g/dl$ in cirrhosis and $63.78{\pm}2.20{\mu}g/dl$ in HCC. The values of cirrhosis and HCC were statistically significantly lower than that of control(p<0.05). The Cu/Zn ratio was statiatically significantly different among three groups(p<0.05). Test total protein, albumin, ALP and total bilirubin of biochemical markers of liver function were statistically significantly different among three groups(p<0.05). Differences between cirrhosis and HCC for ALT and AST, and between the control and HCC for direct bilirubin were not statistically significant. Biochemical markers statistically significantly correlated with serum copper and zinc levels and Cu/Zn ratio(p<0.05), were variable in three groups. In multiple logistic regression, odds ratio of serum copper level and Cu/Zn ratio had no statistical significance on the cirrhosis and the HCC, but that of serum sinc was statistically significant as 0.951 and 0.952(p<0.05). Serum copper and zinc levels and Cu/Zn ratio were not statistically significantly different between the cirrhosis and HCC. H\Albumin, ALP, zinc, total bilirubin and age among all variables were selected as main variables for three-group discriminant analysis. Percentage of 'grouped' cases correctly classified by these five variables was 98.4 for control, 73.4 for cirrhosis, 75.7 for HCC and 84.0 for all subjects. This study suggests that zinc level is considered to play a role as diagnostic marker on the hepatic disorders and be more useful than serum copper level and Cu/Zn ratio in diagnosis of the liver diseases.

• The Korean Journal of Nuclear Medicine
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• v.38 no.3
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• pp.259-267
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• 2004

Purpose: NEMA NU2-2001 was proposed as a new standard for performance evaluation of whole body PET scanners. in this study, system performance of Siemens CTI ECAT EXACT 47 PET scanner including spatial resolution, sensitivity, scatter fraction, and count rate performance in 2D and 3D mode was evaluated using this new standard method. Methods: ECAT EXACT 47 is a BGO crystal based PET scanner and covers an axial field of view (FOV) of 16.2 cm. Retractable septa allow 2D and 3D data acquisition. All the PET data were acquired according to the NEMA NU2-2001 protocols (coincidence window: 12 ns, energy window: $250{\sim}650$ keV). For the spatial resolution measurement, F-18 point source was placed at the center of the axial FOV((a) x=0, and y=1, (b)x=0, and y=10, (c)x=70, and y=0cm) and a position one fourth of the axial FOV from the center ((a) x=0, and y=1, (b)x=0, and y=10, (c)x=10, and y=0cm). In this case, x and y are transaxial horizontal and vertical, and z is the scanner's axial direction. Images were reconstructed using FBP with ramp filter without any post processing. To measure the system sensitivity, NEMA sensitivity phantom filled with F-18 solution and surrounded by $1{\sim}5$ aluminum sleeves were scanned at the center of transaxial FOV and 10 cm offset from the center. Attenuation free values of sensitivity wire estimated by extrapolating data to the zero wall thickness. NEMA scatter phantom with length of 70 cm was filled with F-18 or C-11solution (2D: 2,900 MBq, 3D: 407 MBq), and coincidence count rates wire measured for 7 half-lives to obtain noise equivalent count rate (MECR) and scatter fraction. We confirmed that dead time loss of the last flame were below 1%. Scatter fraction was estimated by averaging the true to background (staffer+random) ratios of last 3 frames in which the fractions of random rate art negligibly small. Results: Axial and transverse resolutions at 1cm offset from the center were 0.62 and 0.66 cm (FBP in 2D and 3D), and 0.67 and 0.69 cm (FBP in 2D and 3D). Axial, transverse radial, and transverse tangential resolutions at 10cm offset from the center were 0.72 and 0.68 cm (FBP in 2D and 3D), 0.63 and 0.66 cm (FBP in 2D and 3D), and 0.72 and 0.66 cm (FBP in 2D and 3D). Sensitivity values were 708.6 (2D), 2931.3 (3D) counts/sec/MBq at the center and 728.7 (2D, 3398.2 (3D) counts/sec/MBq at 10 cm offset from the center. Scatter fractions were 0.19 (2D) and 0.49 (3D). Peak true count rate and NECR were 64.0 kcps at 40.1 kBq/mL and 49.6 kcps at 40.1 kBq/mL in 2D and 53.7 kcps at 4.76 kBq/mL and 26.4 kcps at 4.47 kBq/mL in 3D. Conclusion: Information about the performance of CTI ECAT EXACT 47 PET scanner reported in this study will be useful for the quantitative analysis of data and determination of optimal image acquisition protocols using this widely used scanner for clinical and research purposes.

• Korean Journal of Organic Agriculture
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• v.15 no.1
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• pp.71-84
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• 2007

Predicting plant responses to changing atmospheric $CO_2$ and to the possibility of global warming are important concerns. The $CO_2$ concentration of the global atmosphere has increased during the last decades. This increase is expected to result in changes of global temperatures and this will also affect the growth and development of bell pepper (Capsicum annum L.) and other crops. The objective of this study was to evaluate the effects of atmospheric $CO_2$ enrichment and high temperature on the growth and development of bell pepper under three temperature regimes. There was no statistical difference in the days required from seeding to flowering between $CO_2$ treatments, whereas among three temperature regimes, high temperature plots of $35/25^{\circ}C$ showed the shortest days (52.5 days) required from seeding to flowering. The plant height of bell peppers 15 weeks after emergence showed no statistical significance, while plots of $30/20^{\circ}C$ showed the highest plant height among the three temperature regimes. Time-course response of plant height to $CO_2$, enrichment was restrained in high $CO_2$, concentration (800ppm), at the same time higher temperature promoted plant height. Average leaf area per plant of 400ppm was $6,008.8cm^2$ and it was $5,225.1cm^2$ in the plots of 800ppm, showing 15% more leaf area compared to 400ppm $CO_2$ concentration. Leaf dry weight between $CO_2$ concentration and among temperature regimes showed a statistical significance. The average leaf dry weight in the plot of 800ppm showed the highest (44.1g), which was 18.5% higher compared to that of 400ppm (37.2g) and among temperature regimes, it was the highest (49.8g) in the plot of $35/25^{\circ}C$. Above-ground dry weight showed statistical significance between $CO_2$ concentration and among temperature regimes. The average above-ground dry weight of 800ppm $CO_2$ concentration was 141.4g, 17.9% higher compared to 400ppm $CO_2$ concentration (119.9g). Among three temperature regimes, plots of $30/20^{\circ}C$ showed the highest average above-ground dry weight (168.9g), while plots of $35/25^{\circ}C$ were the lowest (102.3g). In the average bell pepper dry weight, 800ppm of $CO_2$ concentration showed higher bell pepper dry weight (59.5g) than that (44.3g) of 400ppm of $CO_2$ concentration. It was judged that high $CO_2$ concentration was profitable fur bell pepper yield and there was a tendency that when there was high $CO_2$, concentration (800ppm), low temperature ($25/15^{\circ}C$) was profitable for bell pepper dry weight, whereas it was the reverse ($30/20^{\circ}C$), in the case of ambient $CO_2$, concentration (400ppm). In the specific leaf area according to $CO_2$, concentration, 800ppm showed 117.4, which was 35.5% higher compared to that (159.1) of 400ppm, showing that leaf becomes thicker as $CO_2$ concentration increases. Regarding correlation coefficients among crop characteristics, leaf area was negatively correlated with the number of bell peppers per plant and bell pepper dry weight, showing that the higher the leaf area, the lower the bell pepper yield. Bell pepper dry weight per plant showed positively significant correlation with the number of bell peppers per plant and total above dry weight, which showed that the higher the number of bell peppers and the total above dry weight, the higher the bell pepper yield.

• Radiation Oncology Journal
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• v.20 no.2
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• pp.116-122
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• 2002

Purpose : A randomized prospective study was conducted to compare the efficacy of early or late alternating schedules of radiotherapy, and carboplatin and ifosfamide chemotherapy in patients with limited-disease small cell lung cancer. Materials and Methods: From August 1993 to August 1996, a total of 44 patients with newly diagnosed, limited-disease small cell lung cancer, PS $H0\~2$, wt $loss<10\%$ were enrolled in a randomized trial which compared early alternating radiotherapy (RT)/chemotherapy (CT) and late alternating RT/CT. The CT regimen included ifosfamide $1.5\;g/m^2$ IV, d1-5 and carboplatin AUC 5/d IV, d2 peformed at 4 week intervals for a total of 6 cycles. RT (54 Gy/30 fr) was started after the first cycle of CT (early arm, N=22) or after the third cycle of CT (late arm, N=22) with a split course of treatment. Results : The pretreatment characteristics between the two arms were well balanced. The response rates in the early $(86\%)$ and late $(85\%)$ arm were similar. The median survival durations and 2-year survival rates were 15 months and $22.7\%$ in the early arm, and 17 months and $14.9\%$ in the late arm (p=0.47 by the log-rank test). The two-year progression free survival rates were $19.1\%$ in the early arm and $19.6\%$ in the late arm (p=0.52 by the log-rank test). Acute grade 3 or 4 hematologic and nonhematologic toxicities were similar between the two arms. Eighteen patients $(82\%)$ completed 6 cycles of CT in the early arm and 17 $(77\%)$ in the late arm. Four patients received less than 45 Gy of RT in the early arm and two in the late arm. There was no significant difference in the failure patterns. The local failure rate was $43\%$ in the early arm and $45\%$ in the late arm. The first site of failure was the brain in $24\%$ of the early arm patients compared to $35\%$ in the late arm (p=0.51). Conclusion : There were no statistical differences in the overall survival rate and the pattern of failure between the early and late alternating RT/CT in patients with limited-disease small cell lung cancer.

• Journal of Chest Surgery
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• v.37 no.10
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• pp.845-855
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• 2004

Background: No general consensus has been available regarding the necessity of postoperative radiation therapy (PORT) and its optimal techniques in the patients with chest wall invasion (pT3cw) and node negative (N0) non-small cell lung cancer (NSCLC). We did retrospective analyses on the pT3cwN0 NSCLC patients who received PORT because of presumed inadequate resection margin on surgical findings. And we compared them with the pT3cwN0 NSCLC patients who did not received PORT during the same period. Material and Method: From Aug. of 1994 till June of 2002, 22 pT3cwN0 NSCLC patients received PORT-PORT (＋) group- and 16 pT3cwN0 NSCLC patients had no PORT-PORT (-) group. The radiation target volume for PORT (＋) group was confined to the tumor bed plus the immediate adjacent tissue only, and no regional lymphatics were included. The prognostic factors for all patients were analyzed and survival rates, failure patterns were compared with two groups. Result: Age, tumor size, depth of chest wall invasion, postoperative mobidities were greater in PORT (-) group than PORT (＋) group. In PORT (-) group, four patients who were consulted for PORT did not receive the PORT because of self refusal (3 patients) and delay in the wound repair (1 patient). For all patients, overall survival (OS), disease-free survival (DFS), loco-regional recurrence-free survival (LRFS), and distant metastases-free survival (DMFS) rates at 5 years were 35.3%, 30.3%, 80.9%, 36.3%. In univariate and multivariate analysis, only PORT significantly affect the survival. The 5 year as rates were 43.3% in the PORT (＋) group and 25.0% in PORT (-) group (p=0.03). DFS, LRFS, DMFS rates were 36.9%, 84.9%, 43.1 % in PORT (＋) group and 18.8%, 79.4%, 21.9% in PORT(-) group respectively. Three patients in PORT (-) group died of intercurrent disease without the evidence of recurrence. Few suffered from acute and late radiation side effects, all of which were RTOG grade 2 or lower. Conclusion: The strategy of adding PORT to surgery to improve the probability not only of local control but also of survival could be justified, considering that local control was the most important component in the successful treatment of pT3cw NSCLC patients, especially when the resection margin was not adequate. Authors were successful in the marked reduction of the incidence as well as the severity of the acute and late side effects of PORT, without taking too high risk of the regional failures by eliminating the regional lymphatics from the radiation target volume.

• Journal of Chest Surgery
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• v.31 no.2
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• pp.118-124
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• 1998

Minimally invasive coronary artery bypass grafting without using cardiopulmonary bypass (CPB) is a recently accepted modality of myocardial revascularization prcedures which is particularly suitable to the patients with lesions in the left anterior descending(LAD) and the right coronary arteries. Of the consecutive 35 patients of coronary artery bypass grafting performed at Sejong General Hospital from March to August 1996, six patients underwent minimally invasive coronary artery bypass grafting without CPB. All had stenotic lesions of the LAD more than 90%. Bypass grafting of the LAD was approached through midline sternotomy in one, through ministernotomy in two, and through limited left anterior thoracotomy in three patients, respectively. The internal mammary arteries were prepared without the use of thoracoscope. The mobilized mammary arteries were connected directly to the LAD in 5 patients, and the anastomosis required interposition of a segment of the radial artery in the remaining one. The diagonal branch was revascularized with the saphenous vein graft at the same time in one patient. No blood transfusion was necessary in 2 patients, and average blood required during surgery was 800ml in 4 patients. All patients were extubated from 4 to 14 hours(mean 9 hours) after operation. Early postoperative coronary angiography in 5 patients between 7 and 10 days after surgery has proved full patency of the grafts. With these limited clinical experiences, the clinical results demonstrated that minimally invasive coronary artery bypass grafting without CPB is an useful procedure especially in patients with isolated lesion in the proximal LAD.