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School Dietitians' Perceptions and Intake of Healthy Functional Foods in Jeonbuk Province (전북지역 일부 학교 영양사의 건강기능식품 인식 및 이용실태)

  • Kang, Young-Ja;Jung, Su-Jin;Yang, Ji-Ae;Cha, Youn-Soo
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.36 no.9
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    • pp.1172-1181
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    • 2007
  • This research involved 226 Jeonbuk Province school dietitians as subjects to investigate intake and perceptions of the healthy functional foods. Sixty nine percent of the school dietitians didn't even know about the law enforcement concerning the health functional foods. Although 68.1% of the respondents said that they slightly knew about health functional foods, only 25% knew exactly what it was. As shown in the survey, most didn't have the cognitive understanding did not understand which should be obtained by education. Sixty two percent of the answerers said they had experience of taking health various functional food products of various kinds such as supplements (57.9%), red ginseng products (52.9%), and chlorella products (30.0%). The motive of intake was in the order of fatigue restoration (25.7%), sickness prevention (22.9%), and nutrient replenishment (22.9%). A fascinating fact from this study was that the reason for healthy functional product intake was different between groups that was primarily interested in the products and those that was not. For those who had interest, the reason for intake was for sickness prevention. On the other hand, for those who didn't have any interest, the reasons was primarily for fatigue restoration and they were mostly persuaded by close friends and relatives. Main concerns were in the order of side effects (4.72), efficacy after intake (4.59), cleanliness (4.51), reliability of the company (4.29), and price (4.23). In view of the study, it is clear that a lot of people are showing interest in healthy functional food products. However, dietitians who are experts in food and nutrition lacked knowledge and information on healthy functional food.

A Study on Perception and Attitudes of Health Workers Towards the Organization and Activities of Urban Health Centers (도시보건소 직원의 보건소 업무에 대한 인식 및 견해)

  • Lee, Jae-Mu;Kang, Pock-Soo;Lee, Kyeong-Soo;Kim, Cheon-Tae
    • Journal of Yeungnam Medical Science
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    • v.12 no.2
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    • pp.347-365
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    • 1995
  • A survey was conducted to study perception and attitudes of health workers towards health center's activities and organization of health services, from August 15 to September 30, 1994. The study population was 310 health workers engaged in seven urban health centers in Taegu City area. A questionnaire method was used to collect data and response rate was 81.3 percent or 252 respondents. The following are summaries of findings: Profiles of study population: Health workers were predominantly female(62.3%); had college education(60.3%); and held medical and nursing positions(39.6%), technicians(30.6%) and public health/administrative positions(29.8%). Perceptions on health center's resources: Slightly more than a half(51.1%) of respondents expressed that physical facilities of the centers are inadequate; equipments needed are short(39.0%); human resource is inadequate(44.8%); and health budget allocated is insufficient(38.5%) to support the performance of health center's activities. Decentralization and health services: The majority revealed that the decentralization of government system would affect the future activities of health centers(51.9%) which may have to change. However, only one quarter of respondents(25.4%) seemed to view the decentralization positively as they expect that it would help perform health activities more effectively. The majority of the respondents(78.6%) insisted that the function and organization of the urban health centers should be changed. Target workload and job satisfaction: A large proportion (43.3%) of respondents felt that present target setting systems for various health activities are unrealistic in terms of community needs and health center's situation while only 11.1 percent responded it positively; the majority(57.5%) revealed that they need further training in professional fields to perform their job more effectively; more than one third(35.7%) expressed that they enjoy their professional autonomy in their job performance; and a considerable proportion (39.3%) said they are satisfied with their present work. Regarding the personnel management, more worker(47.3%) perceived it negatively than positive(11.5%) as most of workers seemed to think the personnel management practiced at the health centers is not fair or justly done. Health services rendered: Among health services rendered, health workers perceived the following services are most successfully delivered; they are, in order of importance, Tb control, curative services, and maternal and child health care. Such areas as health education, oral health, environmental sanitation, and integrated health services are needed to be strengthening. Regarding the community attitudes towards health workers, 41.3 percent of respondents think they are trusted by the community they serve. New areas of concern identified which must be included in future activities of health centers are, in order of priority, health care of elderly population, home health care, rehabilitation services, and such chronic diseases control programs as diabetes, hypertension, school health and mental health care. In conclusion, the study revealed that health workers seemed to have more negative perceptions and attitudes than positive ones towards organization and management of health services and activities performed by the urban health centers where they are engaged. More specifically, the majority of health workers studied revealed to have the following areas of health center's organization and management inadequate or insufficient to support effective performance of their health activities: Namely, physical facilities and equipments required are inadequate; human and financial resources are insufficient; personnel management is unsatisfactory; setting of service target system is unrealistic in terms of the community needs. However, respondents displayed a number of positive perceptions, particularly to those areas as further training needs and implementation of decentralization of government system which will bring more autonomy of local government as they perceived these change would bring the necessary changes to future activities of the health center. They also displayed positive perceptions in their job autonomy and have job satisfactions.

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Relationship between Insomnia and Depression in Type 2 Diabetics (2형 당뇨병 환자에서 불면증과 우울 증상의 관련성)

  • Lee, Jin Hwan;Cheon, Jin Sook;Choi, Young Sik;Kim, Ho Chan;Oh, Byoung Hoon
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.1
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    • pp.50-59
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    • 2019
  • Objectives : Many of the patients with type 2 diabetes are associated with sleep problems, and the rate of insomnia is known to be higher in the general population. The aims of this study were to know the frequency and clnical characteristics of insomnia, and related variables to insomnia in patients diagnosed with type 2 diabetes. Methods : For 99 patients from 18 to 80 years of age (65 males and 34 females) with type 2 diabetes, interviews were performed. Total sleep time and sleep latency was evaluated. Insomnia was evaluated using the Korean Version of the Insomnia Severity Index (ISI-K). Severity of depressive symptoms were evaluted using the Korean version of the Hamilton Depression Scale (K-HDRM). According to the cutoff score of 15.5 on the ISI-K, subjects were divided into the group of type 2 diabetics with insomnia (N=34) and those without insomnia (N=65) at first, and then statistically analyzed. Results : TInsomnia could be found in 34.34% of type 2 diabetics. Type 2 diabetics with insomnia had significantly more single or divorced (respectively 11.8%, p<0.05), higher total scores of the K-HDRS ($11.76{\pm}5.52$, p<0.001), shorter total sleep time ($5.35{\pm}2.00hours$, p<0.001), and longer sleep latency ($50.29{\pm}33.80minutes$, p<0.001). The all item scores of the ISI-K in type 2 diabetics with insomnia were significantly higher than those in type 2 diabetics without insomnia, that is, total ($18.38{\pm}2.69$), A1 (Initial insomnia) ($2.97{\pm}0.76$), A2 (Middle insomnia) ($3.06{\pm}0.69$), A3 (Terminal insomnia) ($2.76{\pm}0.61$), B (Satisfaction) ($3.18{\pm}0.72$), C (Interference) ($2.09{\pm}0.97$), D (Noticeability) ($2.12{\pm}1.09$) and E (Distress) ($2.21{\pm}0.81$) (respectively p<0.001). Variables associated with insomnia in type 2 diabetics were as following. Age had significant negative correlation with A3 items of the ISI-K (${\beta}=-0.241$, p<0.05). Total scores of the K-HDRS had significant positive correlation, while total sleep time had significant negative correlation with all items of the ISI-K (respectively p<0.05). Sleep latency had significant positive correlation with total,, A1, B and E item scores of the ISI-K (respectively p<0.05). Conclusions : Insomnia was found in about 1/3 of type 2 diabetics. According to the presence of insomnia, clinical characteristics including sleep quality as well as quantity seemed to be different. Because depression seemed to be correlated with insomnia, clinicians should pay attention to early detection and intervention of depression among type 2 diabetics.

Aspect-Based Sentiment Analysis Using BERT: Developing Aspect Category Sentiment Classification Models (BERT를 활용한 속성기반 감성분석: 속성카테고리 감성분류 모델 개발)

  • Park, Hyun-jung;Shin, Kyung-shik
    • Journal of Intelligence and Information Systems
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    • v.26 no.4
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    • pp.1-25
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    • 2020
  • Sentiment Analysis (SA) is a Natural Language Processing (NLP) task that analyzes the sentiments consumers or the public feel about an arbitrary object from written texts. Furthermore, Aspect-Based Sentiment Analysis (ABSA) is a fine-grained analysis of the sentiments towards each aspect of an object. Since having a more practical value in terms of business, ABSA is drawing attention from both academic and industrial organizations. When there is a review that says "The restaurant is expensive but the food is really fantastic", for example, the general SA evaluates the overall sentiment towards the 'restaurant' as 'positive', while ABSA identifies the restaurant's aspect 'price' as 'negative' and 'food' aspect as 'positive'. Thus, ABSA enables a more specific and effective marketing strategy. In order to perform ABSA, it is necessary to identify what are the aspect terms or aspect categories included in the text, and judge the sentiments towards them. Accordingly, there exist four main areas in ABSA; aspect term extraction, aspect category detection, Aspect Term Sentiment Classification (ATSC), and Aspect Category Sentiment Classification (ACSC). It is usually conducted by extracting aspect terms and then performing ATSC to analyze sentiments for the given aspect terms, or by extracting aspect categories and then performing ACSC to analyze sentiments for the given aspect category. Here, an aspect category is expressed in one or more aspect terms, or indirectly inferred by other words. In the preceding example sentence, 'price' and 'food' are both aspect categories, and the aspect category 'food' is expressed by the aspect term 'food' included in the review. If the review sentence includes 'pasta', 'steak', or 'grilled chicken special', these can all be aspect terms for the aspect category 'food'. As such, an aspect category referred to by one or more specific aspect terms is called an explicit aspect. On the other hand, the aspect category like 'price', which does not have any specific aspect terms but can be indirectly guessed with an emotional word 'expensive,' is called an implicit aspect. So far, the 'aspect category' has been used to avoid confusion about 'aspect term'. From now on, we will consider 'aspect category' and 'aspect' as the same concept and use the word 'aspect' more for convenience. And one thing to note is that ATSC analyzes the sentiment towards given aspect terms, so it deals only with explicit aspects, and ACSC treats not only explicit aspects but also implicit aspects. This study seeks to find answers to the following issues ignored in the previous studies when applying the BERT pre-trained language model to ACSC and derives superior ACSC models. First, is it more effective to reflect the output vector of tokens for aspect categories than to use only the final output vector of [CLS] token as a classification vector? Second, is there any performance difference between QA (Question Answering) and NLI (Natural Language Inference) types in the sentence-pair configuration of input data? Third, is there any performance difference according to the order of sentence including aspect category in the QA or NLI type sentence-pair configuration of input data? To achieve these research objectives, we implemented 12 ACSC models and conducted experiments on 4 English benchmark datasets. As a result, ACSC models that provide performance beyond the existing studies without expanding the training dataset were derived. In addition, it was found that it is more effective to reflect the output vector of the aspect category token than to use only the output vector for the [CLS] token as a classification vector. It was also found that QA type input generally provides better performance than NLI, and the order of the sentence with the aspect category in QA type is irrelevant with performance. There may be some differences depending on the characteristics of the dataset, but when using NLI type sentence-pair input, placing the sentence containing the aspect category second seems to provide better performance. The new methodology for designing the ACSC model used in this study could be similarly applied to other studies such as ATSC.

A Study on the Wooden Seated Vairocana Tri-kaya Buddha Images in the Daeungjeon Hall of Hwaeomsa Temple (화엄사 대웅전 목조비로자나삼신 불좌상에 대한 고찰)

  • Choe, Songeun
    • MISULJARYO - National Museum of Korea Art Journal
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    • v.100
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    • pp.140-170
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    • 2021
  • This paper investigates the Wooden Seated Tri-kaya Buddha Images(三身佛像) of Vairocana, Rushana, and Sakyamuni enshrined in Daeungjeon Hall of Hwaeomsa temple(華嚴寺) in Gurae, South Cheolla Province. They were produced in 1634 CE and placed in 1635 CE, about forty years after original images made in the Goryeo period were destroyed by the Japanese army during the war. The reconstruction of Hwaeomsa was conducted by Gakseong, one of the leading monks of Joseon Dynasty in the 17th century, who also conducted the reconstructions of many Buddhist temples after the war. In 2015, a prayer text (dated 1635) concerning the production of Hwaeomsa Tri-kaya Buddha images was found in the repository within Sakyamuni Buddha. It lists the names of participants, including royal family members (i.e., prince Yi Guang, the eighth son of King Seon-jo), and their relatives (i.e., Sin Ik-seong, son-in-law of King Seonjo), court ladies, monk-sculptors, and large numbers of monks and laymen Buddhists. A prayer text (dated 1634) listing the names of monk-sculptors written on the wooden panel inside the pedestal of Rushana Buddha was also found. A recent investigation into the repository within Rushana Buddha in 2020 CE has revealed a prayer text listing participants producing these images, similar to the former one from Sakyamuni Buddha, together with sacred relics of hoo-ryeong-tong copper bottle and a large quantity of Sutra books. These new materials opened a way to understand Hwaeomsa Trikaya images, including who made them and when they were made. The two above-mentioned prayer texts from the repository of Sakyamuni and Rushana Buddha statues, and the wooden panel inside the pedestal of Rushan Buddha tell us that eighteen monk-sculptors, including Eungwon, Cheongheon and Ingyun, who were well-known monk artisans of the 17th century, took part in the construction of these images. As a matter of fact, Cheongheon belonged to a different workshop from Eungwon and Ingyun, who were most likely teacher and disciple or senior and junior colleagues, which means that the production of Hwaeomsa Tri-kaya Buddha images was a collaboration between sculptors from two workshops. Eungwon and Ingyun seem to have belonged to the same community studying under the great Buddhist priest Seonsu, the teacher of Monk Gakseong who was in charge of the reconstruction of Haweonsa temple. Hwaeomsa Tri-kaya Buddha images show a big head, a squarish face with plump cheeks, narrow and drooping shoulders, and a short waist, which depict significant differences in body proportion to those of other Buddha statues of the first half of 17th century, which typically have wide shoulders and long waists. The body proportion shown in the Hwaeomsa images could be linked with images of late Goryeo and early Joseon period. Rushana Buddha, raising his two arms in a preaching hand gesture and wearing a crown and bracelets, shows unique iconography of the Bodhisattva form. This iconography of Rushana Buddha had appeared in a few Sutra paintings of Northern Song and Late Goryeo period of 13th and 14th century. BodhaSri-mudra of Vairocana Buddha, unlike the general type of BodhaSri-mudra that shows the right hand holding the left index finger, places his right hand upon the left hand in a fist. It is similar to that of Vairocana images of Northern and Southern Song, whose left hand is placed on the top of right hand in a fist. This type of mudra was most likely introduced during the Goryeo period. The dried lacquer Seated Vairocana image of Bulheosa Temple in Naju is datable to late Goryeo period, and exhibits similar forms of the mudra. Hwaeomsa Tri-kaya Buddha images also show new iconographic aspects, as well as traditional stylistic and iconographic features. The earth-touching (bhumisparsa) mudra of Sakymuni Buddha, putting his left thumb close to the middle finger, as if to make a preaching mudra, can be regarded as a new aspect that was influenced by the Sutra illustrations of the Ming dynasty, which were imported by the royal court of Joseon dynasty and most likely had an impact on Joseon Buddhist art from the 15th and 16th centuries. Stylistic and iconographical features of Hwaeomsa Tri-kaya Buddha images indicate that the traditional aspects of Goryeo period and new iconography of Joseon period are rendered together, side by side, in these sculptures. The coexistence of old and new aspects in one set of images could indicate that monk sculptors tried to find a new way to produce Hwaeomsa images based on the old traditional style of Goryeo period when the original Tri-kaya Buddha images were made, although some new iconography popular in Joseon period was also employed in the images. It is also probable that monk sculptors of Hwaeomsa Tri-kaya Buddha images intended to reconstruct these images following the original images of Goryeo period, which was recollected by surviving monks at Hwaeomsa, who had witnessed the original Tri-kaya Buddha images.

Comparison of One-day and Two-day Protocol of $^{11}C$-Acetate and $^{18}F$-FDG Scan in Hepatoma (간암환자에 있어서 $^{11}C$-Acetate와 $^{18}F$-FDG PET/CT 검사의 당일 검사법과 양일 검사법의 비교)

  • Kang, Sin-Chang;Park, Hoon-Hee;Kim, Jung-Yul;Lim, Han-Sang;Kim, Jae-Sam;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.3-8
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    • 2010
  • Purpose: $^{11}C$-Acetate PET/CT is useful in detecting lesions that are related to livers in the human body and leads to a sensitivity of 87.3%. On the other hand, $^{18}F$-FDG PET/CT has a sensitivity of 47.3% and it has been reported that if both $^{18}F$-FDG and $^{11}C$-Acetate PET/CT are carried out together, their cumulative sensitivity is around 100%. However, the normal intake of the pancreas and the spleen in $^{11}C$-Acetate PET/CT can influence the $^{18}F$-FDG PET/CT leading to an inaccurate diagnosis. This research was aimed at the verification of the usefulness of how much influence these two radioactive medical supplies can cause on the medical images through comparative analysis between the one-day and two-day protocol. Materials and Methods: This research was carried out based on 46 patients who were diagnosed with liver cancer and have gone through the PET/CT (35 male, 11 female participants, average age: $54{\pm}10.6$ years, age range: 29-69 years). The equipment used for this test was the Biograph TruePoint40 PET/CT (Siemens Medical Systems, USA) and 21 participants who went through the one-day protocol test were first given the $^{11}C$-Acetate PET/CT and the $^{18}F$-FDG PET/CT, the latter exactly after one hour. The other 25 participants who went through the two-day protocol test were given the $^{11}C$-Acetate PET/CT on the first day and the $^{18}F$-FDG PET/CT on the next day. These two groups were then graded comparatively by assigning identical areas of interest of the pancreas and the spleen in the $^{18}F$-FDG images and by measuring the Standard Uptake Value (SUV). SPSS Ver.17 (SPSS Inc., USA) was used for statistical analysis, where statistical significance was found through the unpaired t-test. Results: After analyzing the participants' medical images from each of the two different protocol types, the average${\pm}$standard deviation of the SUV of the pancreas carried out under the two-day protocol were as follows: head $1.62{\pm}0.32$ g/mL, body $1.57{\pm}0.37$ g/mL, tail $1.49{\pm}0.33$ g/mL and the spleen $1.53{\pm}0.28$ g/mL. Whereas, the results for participants carried out under the one-day protocol were as follows: head $1.65{\pm}0.35$ g/mL, body $1.58{\pm}0.27$ g/mL, tail $1.49{\pm}0.28$ g/mL and the spleen $1.66{\pm}0.29$ g/mL. Conclusion: It was found that no statistical significant difference existed between the one-day and two-day protocol SUV in the pancreas and the spleen (p<0.05), and nothing which could be misconceived as false positive were found from the PET/CT medical image analysis. From this research, it was also found that no overestimation of the SUV occurred from the influence of $^{11}C$-Acetate on the $^{18}F$-FDG medical images where those two tests were carried out for one day. This result was supported by the statistical significance of the SUV of measurement. If $^{11}C$-Acetate becomes commercialized in the future, the diagnostic ability of liver diseases can be improved by $^{18}F$-FDG and one-day protocol. It is from this result where tests can be accomplished in one day without the interference phenomenon of the two radioactive medical supplies and furthermore, could reduce the waiting time improving customer satisfaction.

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EVALUATION OF CONDYLAR POSITION USING COMPUTED TOMOGRAPH FOLLOWING BILATERAL SAGITTAL SPLIT RAMUS OSTEOTOMY (전산화단층촬영법을 이용한 하악 전돌증 환자의 하악지 시상 골절단술후 하악과두 위치변화 분석)

  • Chol, Kang-Young;Lee, Sang-Han
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.4
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    • pp.570-593
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    • 1996
  • This study was intended to perform the influence of condyle positional change after surgical correction of skeletal Class III malocclusion after BSSRO in 20 patients(males 9, females 11) using computed tomogram that were taken in centric occlusion before, immediate, and long term after surgery and lateral cephalogram that were taken in centric occlusion before, 7 days within the period intermaxillary fixation, 24hour after removing intermaxillary fixation and long term after surgery. 1. Mean intercondylar distance was $84.45{\pm}4.01mm$ and horizontal long axis of condylar angle was $11.89{\pm}5.19^{\circ}$on right, $11.65{\pm}2.09^{\circ}$on left side and condylar lateral poles were located about 12mm and medial poles about 7mm from reference line(AA') on the axial tomograph. Mean intercondylar distance was $84.43{\pm}3.96mm$ and vertical axis angle of condylar angle was $78.72{\pm}3.43^{\circ}$on right, $78.09{\pm}6.12^{\circ}$on left. 2. No statistical significance was found on the condylar change(T2C-T1C) but it had definitive increasing tendency. There was significant decreasing of the distance between both condylar pole and the AA'(p<0.05) during the long term(TLC-T2C). 3. On the lateral cephalogram, no statistical significance was found between immediate after surgery and 24 hours after the removing of intermaxillary fixation but only the lower incisor tip moved forward about 0.33mm(p<0.05). Considering individual relapse rate, mean relapse rate was 1.2% on L1, 5.0% on B, 2.0% on Pog, 9.1% on Gn, 10.3% on Me(p<0.05). 4. There was statistical significance on the influence of the mandibular set-back to the total mandibular relapse(p<0.05). 5. There was no statistical significance on the influence of the mandibular set-back(T2-T1) to the condylar change(T2C-T1C), the condylar change(T2C-T1C, TLC-T2C) to the mandibular total relapse, the pre-operative condylar position to the condylar change(T2C-T1C, TLC-T2C), the pre-operative mandibular posture to the condylar change(T2C-T1C, TLC-T2C)(p>0.05). 6. The result of multiple regression analysis on the influence of the pre-operative condylar position to the total mandibular relapse revealed that the more increasing of intercondylar distance and condylar vertical axis angle and decreasing of condyalr head long axis angle, the more increasing of mandibular horizontal relapse(L1,B,Pog,Gn,Me) on the right side condyle. The same result was founded in the case of horizontal relapse(L1,Me) on the left side condyle.(p<0.05). 7. The result of multiple regression analysis on the influence of the pre-operative condylar position to the pre-operative mandibular posture revealed that the more increasing of intercondylar distance and condylar vertical axis angle and decreasing of condylar head long axis angle, the more increasing of mandibular vertical length on the right side condyle. and increasing of vertical lengh & prognathism on the left side condyle(p<0.05). 8. The result of simple regression analysis on the influence of the pre-operative mandibular posture to the mandibular total relapse revealed that the more increasing of prognathism, the more increasing of mandibular total relapse in B and the more increasing of over-jet the more increasing of mandibular total relapse(p<0.05). Consequently, surgical mandibular repositioning was not significantly influenced to the change of condylar position with condylar reposition method.

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The Value of Interleukin-12 as an Activity Marker of Pulmonary Sarcoidosis (폐유육종증의 활동성 지표로서 IL-12의 효용성에 관한 연구)

  • Kim, Tae-Hyung;Jeon, Yong-Gam;Shim, Tae-Sun;Lim, Chae-Man;Koh, Yun-Suck;Lee, Sang-Do;Kim, Woo-Sung;Kim, Won-Dong;Kim, Dong-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.2
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    • pp.215-228
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    • 1999
  • Background: Sarcoidosis is a chronic granulomatous inflammatory disease of unknown etiology often involving the lungs and intrathoracic lymph nodes. The natural course of sarcoidosis is variable from spontaneous remission to significant morbidity or death. But, the mechanisms causing the variable clinical outcomes or any single parameter to predict the prognosis was not known. In sarcoidosis, the number and the activity of CD4 + lymphocytes are significantly increased at the loci of disease and their oligoclonality suggests that the CD4 + lymphocytes hyperreactivity may be caused by persistent antigenic stimulus. Recently, it has been known that CD4+ lymphocytes can be subdivided into 2 distinct population(Th1 and Th2) defined by the spectrum of cytokines produced by these cells. Th1 cells promote cellular immunity associated with delayed type hypersensitivity reactions by generating IL-2 and IFN-$\gamma$. Th2 cells playa role in allergic responses and immediate hypersensitivity reactions by secreting IL-4, IL-5, and IL-10. CD4+ lymphocytes in pulmonary sarcoidosis were reported to be mainly Th1 cells. IL-12 has been known to play an important role in differentiation of undifferentiated naive T cells to Th1 cells. And, Moller et al. observed increased IL-12 in bronchoalveolar lavage fluid(BALF) in patients with sarcoidosis. So it is possible that the elevated level of IL-12 is necessary for the continuous progression of the disease in active sarcoidosis. This study was performed to test the assumption that IL-12 can be a marker of active pulmonary sarcoidosis. Methods: We measured the concentration of IL-12 in BALF and in conditioned medium of alveolar macrophage(AM) using ELISA(enzyme-linked immunosorbent assay) method in 26 patients with pulmonary sarcoidosis(10 males, 16 females, mean age: $39.8{\pm}2.1$ years) and 11 normal control. Clinically, 14 patients had active sarcoidosis and 12 patients had inactive. Results: Total cells counts, percentage and number of lymhocytes, number of AM and CD4/CD8 lymphocyte ratio in BALF were significantly higher in patients with sarcoidosis than in control group. But none of these parameters could differentiate active sarcoidosis from inactive disease. The concentration of IL-12 in BALF was significantly increased in sarcoidosis patients ($49.3{\pm}9.2$ pg/ml) than in normal control ($2.5{\pm}0.4$ pg/ml) (p<0.001). Moreover it was significantly higher in patients with active sarcoidosis ($70.3{\pm}14.8$ pg/ml) than in inactive disease ($24.8{\pm}3.l$ pg/ml) (p=0.001). Also, the concentration of IL-12 in BALF showed significant correlation with the percentage of AM(p<0.001), percentage(p<0.001) and number of lymphocyte(p<0.001) in BALF, suggesting the close relationship between the level of IL-12 in BALF and the inflammatory cell infiltration in the lungs. Furthermore, we found a significant correlation between the level of IL-12 and the concentration of soluble ICAM-1 : in serum(p<0.001) and BALF (p=0.001), and also between IL-12 level and ICAM-1 expression of AM(p<0.001). The AM from patients with pulmonary sarcoidosis secreted significantly larger amount of IL-12 ($206.2{\pm}61.9$ pg/ml) than those of control ($68.3{\pm}43.7$ pg/ml) (p<0.008), but, there was no difference between inactive and active disease group. Conclusion : Our data suggest that the BALF IL-12 level can be used as a marker of the activity of pulmonary sarcoidosis.

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The Attitude of the Bereaved Family Attending a Bereavement Memorial Service (사별가족모임과 관련된 사별가족 태도 연구)

  • Jung, In-Soon;Shim, Byoung-Yong;Kim, Young-Seon;Lee, Ok-Kyung;Han, Sun-Ae;Shin, Ju-Hyun;Lee, Jong-Ku;Hwang, Su-Hyun;Ok, Jong-Sun;Kim, Hoon-Kyo
    • Journal of Hospice and Palliative Care
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    • v.8 no.2
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    • pp.143-151
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    • 2005
  • Purpose: Bereavement Memorial Service has been held every year by the hospice team at St. Vincent's Hospital for the purpose of supporting the bereaved family who feel grief and mourning. The purpose of this study is to find out the attitude of the bereaved attending at bereavement memorial service (BMS) and to find out the areas needing improvements to set up better memorial service. Methods: Hospice team sent invitation card to 180 families of patients who admitted and passed away at hospice ward Nov., 2003${\sim}$Oct., 2004. Among them 22 families attended the BMS meeting, which was held on 26th Nov., 2004. The researcher collected data from 22 families with 'Questionnaire' survey. Except identifying data and 2 dichotomy questions, we used open-ended questionnaire. 1 researcher conducted a telephone interview survey in 18 families who couldn't attend at BMS meeting. Results: The median age was 56 (range $16{\sim}19$) and there were 37 females and 3 males. They were patient's wife (22), mother (4), husband (5), daughter (4), mother-in-law (1), siblings (1), brothers wife (1). Duration after bereavement, $1{\sim}3$ months (17) was the highest frequency. 36 families agreed 'the dead experienced the death with dignity'. The reason of agreement to the death with dignity was 'the patient died in preparation' (16). 'the patient died in well-being condition spiritually' (9), 'the patient died in comfort physically (7). 4. persons thought the dead died with indignity. The bereaved defined 'the death with dignity' as follows: 'acceptance of death & death in spiritual well-being' (9), 'death in physical comfort condition' (7), 'the death in psycho-social well-being' (3), non-respondents (10). Most families (21) were still in difficulty to overcome bereavement grief. The answer regarding the method to overcome the difficulty was 'with spiritual sublimation' (13), 'with devotion of oneself in daily life' (10), 'with devotion to mourning as it is' (3). With regard to their attitude to invitation, 'having joy and thanks from hospice team' (21), 'grief' (4), 'suffering' (4). Toward the existence of hesitation about attendance at BMS meeting, the result as follows. Nonexistence of hesitation respondent (34), existence respondent (6), the reason for hesitation was various; 'the meeting reminds me of the suffering times', 'the meeting makes me to recall, and it will be likely to cry', and so on. The needs and feelings to memorial service meeting were various; 'it was meaningful time', 'it was good to recall about the dead', 'more meeting annually' and so on. In respect of the most difficulty after bereavement, in attendant family, 'depression' (10) was the highest frequency, whereas, in non-attendant family, the most difficult thing was 'financial problem/role difficulty (6). Conclusion: This study shows the rate of attendance was high in bereaved whose bereavement duration $1{\sim}3$ month. Most of bereaved were still suffering from bereavement grief within 1 year. Although most families didn't hesitate and felt positive mood to invitation, the rate of attendance was low. Comparing with two groups between attendant family and non-attendant, the latter felt more difficulty in 'financial problem/role difficulty, on the other hand, the former felt difficulty in 'depression'. Hereafter, the additional study about the factor relating to these attitude and needs of the bereaved relating to memorial service will be necessary.

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The Patterns of Change in Arterial Oxygen Saturation and Heart Rate and Their Related Factors during Voluntary Breath holding and Rebreathing (자발적 호흡정지 및 재개시 동맥혈 산소포화도와 심박수의 변동양상과 이에 영향을 미치는 인자)

  • Lim, Chae-Man;Kim, Woo-Sung;Choi, Kang-Hyun;Koh, Youn-Suck;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.4
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    • pp.379-388
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    • 1994
  • Background : In sleep apnea syndrome, arterial oxygen saturation($SaO_2$) decreases at a variable rate and to a variable degree for a given apneic period from patient to patient, and various kinds of cardiac arrythmia are known to occur. Factors supposed to affect arterial oxygen desaturation during apnea are duration of apnea, lung voulume at which apnea occurs, and oxygen consumption rate of the subject. The lung serves as preferential oxygen source during apnea, and there have been many reports related with the influence of lung volume on $SaO_2$ during apnea, but there are few, if any, studies about the influence of oxygen consumption rate of an individual on $SaO_2$ during breath holding or about the profile of arterial oxygen resaturation after breathing resumed. Methods : To investigate the changes of $SaO_2$ and heart rate(HR) during breath holding(BH) and rebreathing(RB) and to evaluate the physiologic factors responsible for the changes, lung volume measurements, and arterial blood gas analyses were performed in 17 healthy subjects. Nasal airflow by thermistor, $SaO_2$ by pulse oxymeter and ECG tracing were recorded on Polygraph(TA 4000, Gould, U.S.A.) during voluntary BH & RB at total lung capacity(TLC), at functional residual capacity(FRC) and at residual volume(RV), respectively, for the study subjects. Each subject's basal metabolic rate(BMR) was assumed on Harris-Benedict equation. Results: The time needed for $SaO_2$ to drop 2% from the basal level during breath holding(T2%) were $70.1{\pm}14.2$ sec(mean${\pm}$standard deviation) at TLC, $44.0{\pm}11.6$ sec at FRC, and $33.2{\pm}11.1$ sec at RV(TLC vs. FRC, p<0.05; FRC vs. RV, p<0.05). On rebreathing after $SaO_2$ decreased 2%, further decrement in $SaO_2$ was observed and it was significantly greater at RV($4.3{\pm}2.1%$) than at TLC($1.4{\pm}1.0%$)(p<0.05) or at FRC($1.9{\pm}1.4%$)(p<0.05). The time required for $SaO_2$ to return to the basal level after RB(Tr) at TLC was not significantly different from those at FRC or at RV. T2% had no significant correlation either with lung volumes or with BMR respectively. On the other hand, T2% had significant correlation with TLC/BMR(r=0.693, p<0.01) and FRC/BMR (r=0.615, p<0.025) but not with RV/BMR(r=0.227, p>0.05). The differences between maximal and minimal HR(${\Delta}HR$) during the BH-RB manuever were $27.5{\pm}9.2/min$ at TLC, $26.4{\pm}14.0/min$ at RV, and $19.1{\pm}6.0/min$ at FRC which was significantly smaller than those at TLC(p<0.05) or at RV(p<0.05). The mean difference of 5 p-p intervals before and after RB were $0.8{\pm}0.10$ sec and $0.72{\pm}0.09$ sec at TLC(p<0.001), $0.82{\pm}0.11$ sec and $0.73{\pm}0.09$ sec at FRC(p<0.025), and $0.77{\pm}0.09$ sec and $0.72{\pm}0.09$ sec at RV(p<0.05). Conclusion Healthy subjects showed arterial desaturation of various rates and extent during breath holding at different lung volumes. When breath held at lung volume greater than FRC, the rate of arterial desaturation significantly correlated with lung volume/basal metabolic rate, but when breath held at RV, the rate of arterial desaturation did not correlate linearly with RV/BMR. Sinus arrythmias occurred during breath holding and rebreathing manuever irrespective of the size of the lung volume at which breath holding started, and the amount of change was smallest when breath held at FRC and the change in vagal tone induced by alteration in respiratory movement might be the major responsible factor for the sinus arrythmia.

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