• 제목/요약/키워드: 의료 영역

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Health Management and Services of School-Nurse in Special Schools (특수학교의 보건관리)

  • Lee, Kyung Hee;Park, Jae Yong
    • Journal of the Korean Society of School Health
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    • v.4 no.2
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    • pp.176-192
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    • 1991
  • School nurses, in service of 102 special schools in Korea, were urveyed by mail questionnaires from February to March, 1991 and 77 of hem responded. Collected data were analyzed to establish the direction of health management in special school and to provide basic reference data for improving the quality of the management of school-nurses' services. The major findings are as follows: Out of special schools surveyed, 67.5% is private school and 83.2% is located in city. The average number of classes, students, and educational personnels per special school is 17.2, 194, and 28 respectively. The average age of school-nurses surveyed is 32.7. The proportion of graduates from the junior college and upward was 97.4%, the proportion of the married was 71.4%. Out of respondents, 71.4% has religion : 79.2% has past career in the fields of clinics or public health: 62.3% accompanishes independent services: 77.9% belongs to primary school. About 69% of nursing room in special schools surveyed is located at the first floor. Out of special school surveyed, 90.9% has no organization for school health programms: Only 18.2% entrusted everyone of school doctor, school dentist, and school pharmacists with school health. 46.8% of respondents didn't know about the annual budget for school health programmes. The average annual expenditure for school health programme per special school was 317,000F26. won and the purchase cost for medical supplies accounted for the larger part of them. The monthly average number of students utilizing school nursing room was 71 per school, annual utilization times of school nursing room was 4.4 per student and utilization due to injury was prevalent by 26.6% and there is some differences in using the school nursing room according to disabled area. Rate of referral to medical facilities was 1.4%. The leading reason of referral to medical facilities was high fever among those who have visual handicaps, fracture among those who have emotional disturbance, injury by trauma among others. Nine hundred fifty six students of students in special school surveyed have sufferd from epilepsy and prevalence rate of epilepsy was 6.4%. Only 22.6% of respondents replied that they had physical examination more than 2 times per year. Out of respnodents, 98.7% answered that they had health education and 67.1% of them ansered that they educated in a classroom, 98.7% of respondents emphasized need of sex education. Respondents put the most emphasis on the personal hygiene when they performed health education and they used broadcasting education in the area of visual handicaps, OHP or VTR in hearing handicaps, home correspondence or OHP VTR in other area importantly. About 47% of repondents answered that health education was the most difficult and they emphasized that definite guide on health management was requested. Respondents had self-confidence and high perfomance rate in most of school-nurses' services completely, but so they was not in area of evaluation of school health programmes, an examination of physical strength, evaluation of health education, management of school purification area, suture of wounds. In consideration of above findings, we may conclude that special education for school-nurse in special schools as well as improvement of definite guiding principles are requested to establish direction for health management in special schools and to improve the degree of quality for school-nurses' sevices in special schools.

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Long-Term Results of 2-Dimensional Radiation Therapy in Patients with Nasopharyngeal Cancer (이차원방사선치료를 시행한 코인두암 환자의 장기 추적 결과 및 예후인자 분석)

  • Lee, Nam-Kwon;Park, Young-Je;Yang, Dae-Sik;Yoon, Won-Sup;Lee, Suk;Kim, Chul-Yong
    • Radiation Oncology Journal
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    • v.28 no.4
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    • pp.193-204
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    • 2010
  • Purpose: To analyze the treatment outcomes, complications, prognostic factors after a long-term follow-up of patients with nasopharyngeal carcinoma treated with radiation therapy (RT) alone or concurrent chemoradiation therapy (CCRT). Materials and Methods: Between December 1981 and December 2006, 190 eligible patients with non-metastatic nasopharyngeal carcinoma were treated at our department with a curative intent. Of these patients, 103 were treated with RT alone and 87 patients received CCRT. The median age was 49 years (range, 8~78 years). The distributions of clinical stage according to the AJCC 6th edition included I: 7 (3.6%), IIA: 8 (4.2%), IIB: 33 (17.4%), III: 82 (43.2%), IVA: 31 (16.3%), IVB: 29 (15.3%). The accumulated radiation doses to the primary tumor ranged from 66.6~87.0 Gy (median, 72 Gy). Treatment outcomes and prognostic factors were retrospectively analyzed. Acute and late toxicities were assessed using the RTOG criteria. Results: A total of 96.8% (184/190) of patients completed the planned treatment. With a mean follow-up of 73 months (range, 2~278 months; median, 52 months), 93 (48.9%) patients had relapses that were local 44 (23.2%), nodal 13 (6.8%), or distant 49 (25.8%). The 5- and 10-year overall survival (OS), disease-free survival (DFS), and disease-specific survival (DSS) rates were 55.6% and 44.5%, 54.8% and 51.3%, in addition to 65.3% and 57.4%, respectively. Multivariate analyses revealed that CCRT, age, gender, and stage were significant prognostic factors for OS. The CCRT and gender were independent prognostic factors for both DFS and DSS. There was no grade 4 or 5 acute toxicity, but grade 3 mucositis and hematologic toxicity were present in 42 patients (22.1%) and 18 patients (9.5%), respectively. During follow-up, grade 3 hearing loss in 9 patients and trismus in 6 patients were reported. Conclusion: The results of our study were in accordance with findings of previous studies and we confirmed that CCRT, low stage, female gender, and young age were related to improvement in OS. However, there are limitations in the locoregional control that can be achieved by CCRT with 20 conventional radiation therapy. This observation has led to further studies on clarifying the efficacy of concurrent chemotherapy by intensity modulated radiation therapy.

The ages and stages questionnaire: screening for developmental delay in the setting of a pediatric outpatient clinic (ASQ :소아과외래에서의 발달지연 선별검사)

  • Kim, Eun Young;Sung, In Kyung
    • Clinical and Experimental Pediatrics
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    • v.50 no.11
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    • pp.1061-1066
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    • 2007
  • Purpose : Early identification of developmental disabilities allows intervention at the earliest possible point to improve the developmental potential. The Ages and Stages Questionnaire (ASQ), a parent- completed questionnaire, can be used as a substitute for formal screening tests. The purpose of this study was to evaluate the validity of the Korean version of the ASQ (K-ASQ) as a screening tool for detecting developmental delay of young Korean children in the setting of a busy pediatric outpatient clinic. Methods : Parents completed the K-ASQ in the waiting room of the pediatric outpatient clinic of St. Mary's Hospital, Catholic University Medical College. Out of 150 completed the ASQ, 67 who were born term and had no previous diagnosis of developmental delay, congenital anomalies, or neurological abnormalities were enrolled. The cut-off values of less than 2 standard deviations (SD) below the mean for the ASQ were used to define a "fail", and children who failed in one or more domains tested were classified as "screen-positive". Diagnosis of developmental delay was made when the developmental indices fell below -1 SD of the Bayley Scales of Infant Development-II. Results : (1) The mean age of children was $16.4{\pm}7.4$ months. Ten children (14.9%) were small-for- gestational age infants. The mean birth weight and gestational age were $3.1{\pm}0.6kg$ and $38.8{\pm}1.4$ weeks. Nine children (13.4%) were twins and 33 (49.0%) were male. The mean maternal education in years was $13.6{\pm}2.4$, and 31.3% had full-time jobs. The time for completing the ASQ was $10.2{\pm}3.0$ minutes. (2) Seventeen children (25.4%) were classified as screen-positive, four of them were delayed in development. Among eight children diagnosed with developmental delay, four were screen-positive and the other four were screen-negative by the ASQ. (3) The test characteristics of the ASQ were as follows: sensitivity (50.0%); specificity (78.0%); positive predictive value (23.5%); negative predictive value (92.0%). Conclusion : The high negative predictive value of the K-ASQ supports its use as a screening tool for developmental delay in the setting of a pediatric outpatient clinic.

OBSTETRICIAN'S VIEW OF TEENAGE PREGNANCY:PRESENT STATUS, PREVENTION AND PSYCHIATRIC CONSULTATION (산과 의사가 인지한 10대 임신의 현황, 예방, 정신과 자문)

  • Kim, Eun-Young;Kim, Boong-Nyun;Hong, Kang-E;Lee, Young-Sik
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.13 no.1
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    • pp.117-128
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    • 2002
  • Objectives:For the purpose of obtaining the more vivid present status and prevention program of teenage pregnancy, this survey was done by Obstetricians, as study subject, who manage the pregnant teenager in real clinical situation. Methods:Structured survey form about teenage pregnancy was sent to 2,800 obstetricians. That form contained frequency, characteristics, decision making processes, and psychiatric aspects of the teenage pregnancy. 349 obstetricians replied that survey form and we analysed these datas. Results:(1) The trend of teenage pregnancy was mildly increased. (2) The most common cases were unwanted pregnancy by continuing sexual relationship with boyfriends rather than by forced, accidental sexual relationship with multiple partners. (3) The most common reason of labor was loss the time of artificial abotion. (4) Problems of pregnant girls' were conduct behaviors and poor informations about contraception rather than sexual abuse or mental retardation. (5) Most obstetricians percepted the necessity of psychiatric consultation, however psychiatric consultation was rare due to parents refusal and abscense of available psychiatric facility. (6) For the prevention of teenage pregnancy, the most important thing was practical education about contraception. Conclusions:Based on the result of this study, further study using structured interview schedule with pregnant girl is needed for the detecting risk factor of teenage pregnancy and effective systematic approach to pregnant girl.

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Petrochmical study on the Volcanic Rocks Related to Depth to the Benioff Zone and Crustal Thickness in the Kyongsang Basin, Korea: A Review (경상분지 화산암류의 지화학적 연구. 섭입대(베니오프대)의 깊이와 지각의 두께)

  • Jong Gyu Sung
    • Economic and Environmental Geology
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    • v.32 no.4
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    • pp.323-337
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    • 1999
  • Late Cretaceous to early Tertiary volcanic rocks in the Kyongsang basin exhibit high-K calc-alkaline characteristics, and originated from the magmatism related genetically to subduction of Kula-Pacific plate. They represent HFSE depletion and LlLE enrichment characteristics as shown by magmas related to subduction. Early studies on the depth of magma generation has been estimated as 180-230 km based on K-h relation should be reevaluated, because the depth of peridotite partial melting with 0.4 wt. % water is 80-120 km at subduction zone, and subducting slab in premature arc can melted even lower than 70 km. Moreover the increase of potassium contents depends on either contamination of crustal material and fluids of subducting slab or low degree of partial melting. If the inclination of subduction zone is 30 degrees and the depth to the Benioff zone is 180-230 km, the calculated distance between the volcanic zone and trench axis would be 310-400 km. It is unlikely because the distance between the Kyongsang basin and trench during late Cretaceous to early Tertiary is closer than this value and not comparable with generally-accepted models in subduction zone magmatism. $K_{55}$ of the volcanics in the Kyongsang basin is 0.3-2.3 wt.% and the average indicate that the depth ranges between 80-170 km on the diagram of Marsh, Carmichael (1974). Fractionation from garnet lherzolite, assumed the depth of 180-230km, is not consistent with the REE patterns of the volcanoes in the Kyongsang basin. Futhermore, the range of depth suggested by many workers, who studied magmatism related to subduction, imply shallower than this depth. Crustal thickness calculated by the content of CaO and $Na_2O$ is about 30 km and about 35 km, respectively. Paleo-crustal thickness during late Cretaceous to early Tertiary times in the Kyongsang basin inferred about 30 km calculated by La/Sm versus LaJYb data, which is also supported by many previous studies.

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The Evaluation of the Radiation Dose and Image Quality Through the Change of the Tube Voltage in Cerebral CT Angiography (전산화단층촬영장치를 이용한 뇌 혈관조영 검사에서 관전압 변화에 따른 방사선량과 영상의 질 평가)

  • LEE, Ji-Won;Jung, Kang-Kyo;Cho, Pyong-Kon
    • Journal of radiological science and technology
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    • v.38 no.2
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    • pp.121-126
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    • 2015
  • To image diagnosis in neurovascular diseases using Multi-Detector Computed Tomography(MDCT), injected the same contrast material when inspecting Brain Computed Tomography Angiography(BCTA) to examine radiation dose and Image quality on changing Cerebral Artery CT number by tube voltage. Executed an examination with same condition[Beam Collimation $128{\times}0.6mm$, Pitch 0.6, Rotation Time 0.5s, Slice Thickness 5.0mm, Increment 5.0mm, Delay Time 3.0sec, Care Dose 4D(Demension ; D)] except for tube voltage on 50 call patients for BCTA and divided them into two groups (25 people for a group, group A: 80, group B: 120kVp). From all the acquired images, set a ROI(Region of Interest) on four spots such as left cerebral artery, right cerebral artery, posterior cerebral artery and cerebral parenchyma to compare quantitative evaluation, qualitative evaluation and effective dose after measuring CT number value from Picture Archiving Communications System(PACS). Evaluating images with CT number acquired from BCTA examination, images with 80 kVp was 18% higher in Signal to Noise Ratio and 19% in Contrast to Noise Ratio than those with 120 kVp. It was seen that expose dose was decreased by over 50% with tube voltage 80 kVp than with 120 kVp. Group A (25 patients) was examination with tube voltage 80kVp while group B with 120 kVp to examine radiation dose and Image quality. It is considered effective to inspect with lower tube voltage than with conventional high kVp, which can reduce radiation dose without any affect on diagnosis.

The Study on the Confidence Building for Evaluation Methods of a Fracture System and Its Hydraulic Conductivity (단열체계 및 수리전도도의 해석신뢰도 향상을 위한 평가방법 연구)

  • Cho Sung-Il;Kim Chun-Soo;Bae Dae-Seok;Kim Kyung-Su;Song Moo-Young
    • The Journal of Engineering Geology
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    • v.15 no.2 s.42
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    • pp.213-227
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    • 2005
  • This study aims to assess the problems with investigation method and to suggest the complementary solutions by comparing the predicted data from surface investigation with the outcome data from underground cavern. In the study area, one(NE-1) of 6 fracture zones predicted during the surface investigation was only confirmed in underground caverns. Therefore, it is necessary to improve the confidence level for prediction. In this study, the fracture classification criteria was quantitatively suggested on the basis of the BHTV images of NE-1 fracture zone. The major orientation of background fractures in rock mass was changed at the depth of the storage cavern, the length and intensity were decreased. These characteristics result in the deviation of predieted predicted fracture properties and generate the investigation bias depending on the bore hole directions and investigated scales. The evaluation of hydraulic connectivity in the surface investigation stage needs to be analyze by the groundwater pressures and hydrochemical properties from the monitoring bore hole(s) equipped with a double completion or multi-packer system during the test bore hole is pumping or injecting. The hydraulic conductivities in geometric mean measured in the underground caverns are 2-3 times lower than those from the surface and furthermore the horizontal hydraulic conductivity in geometric mean is six times lower than the vertical one. To improve confidence level of the hydraulic conductivity, the orientation of test hole should be considered during the analysis of the hydraulic conductivity and the methodology of hydro-testing and interpretation should be based on the characteristics of rock mass and investigation purposes.

Comparison of Innovation Efficiency of Pre-IPO and Post-IPO in Korea: Case of Pharmaceutical Industry (IPO 전후 혁신의 효율성 비교 연구: 의약산업 중심으로)

  • Kim, Eunhee
    • Journal of Technology Innovation
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    • v.24 no.1
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    • pp.143-167
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    • 2016
  • The purpose of this study is to analyze changes of innovation activities and their performance in pre-IPO and post-IPO of KOSDAQ IPO listed companies in medical and pharmaceutical fields, which require high R&D investment, from 2000 to 2005 in Korea. The innovation efficiencies of the IPO companies were measured before and after three years based on the DEA model. The financial data and patent information of the listed company during total 6 years, which were 3 years before IPO and 3 years after IPO, were collected. The main results of this research are as follows. First, it took an average 12.86 years until IPO in the start-up of the IPO companies in the pharmaceutical sector, and innovation was on average more active than the IPO before. R&D investment was higher than the IPO before, and the number of the applied patent during 3 years after IPO was 16.67 which was increased from 8.43 during 3 years before IPO. In addition, the average scope of technology of the IPO companies was expanded from 11 to 22 technology fields during previous 3 year and after 3 year each, and financial growth after IPO was lower than the previous IPO. Second, the financial performance of R&D investment and the performance of patent activity were weakened in the efficiency after the IPO, and the integrated performance from the patenting activities and the R&D investment was decreased after the IPO. Finally, the efficiency of the financial performance of the patenting activity was lower than the efficiency of the financial performance of the patent and R&D investment and patent activities under the R&D investment. In particular, the inefficiency of the firms' patenting activities performance after the IPO was caused by the decreasing return to scale, according to the results of this study. This results implicate that the expansion of R&D investments through the IPO had not lead to the financial performance of the market, and that the overall inefficiency since the IPO is due to the inefficiencies at the stage for the outcome of innovation activity rather than the output obtained through the R&D investments that appear to lead the performance of the market.

Heart Rate Variability and Lipid Profile in Patients with Major Depressive Disorder (주요우울장애 환자에서의 심박변이도와 혈중 지질 농도와의 연관성)

  • Ahn, Eun-Jung;Choi, Jin-Sook;Jang, Yong-Lee;Lee, Hae-Woo;Sim, Hyun-Bo
    • Sleep Medicine and Psychophysiology
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    • v.19 no.1
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    • pp.27-34
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    • 2012
  • Objectives: The analysis of heart rate variability (HRV) is a useful non-invasive tool to investigate the autonomic nerve function. Previous studies on the relationship between HRV and depression have been reported controversial results. Similarly, the correlation between the serum lipids and depression is debatable. The purpose of this study is to examine the relationship between heart rate variability, lipid profile and depression. Methods: A total of 42 patients with major depressive disorder (MDD) and 32 age and sex-matched normal subjects who had no previous history of major medical and mental illnesses were recruited for this study. A structured-interview was used to assess the general characteristics and psychiatric illness. HRV measures were assessed by time-domain and frequency-domain analyses. Psychological symptoms were measured using the Hamilton rating scale for anxiety (HAM-A), Hamilton rating scale for depression (HAM-D). In addition, the evaluation for lipid profile was performed by blood test. Results: In serum lipid profile test, MDD group showed higher cholesterol ($197.68{\pm}42.94$ mg/dL vs. $176.85{\pm}34.68$ mg/dL, p=0.044), TG ($139.45{\pm}92.54$ mg/dL vs. $91.4{\pm}65.68$ mg/dL, p=0.018), LDL ($130.03{\pm}33.18$ vs. $106.62{\pm}27.08$, p=0.004) level than normal control group. In HRV time domain analyses, the standard deviation of the NN interval (SDNN) was decreased in MDD group than normal control group, but was not significant ($32.82{\pm}14.33$ ms vs. $40.36{\pm}21.40$ms, p=0.078). ApEn (Approximate Entrophy) was significantly increased in MDD group than normal control group ($1.13{\pm}0.11$ vs. $0.91{\pm}0.18$, p<0.001). ApEn was correlated with LDL level (r=0.277, p=0.028), HAM-D scores (r=0.534, p<0.001) and HAM-A scores (r=0.470, p<0.001). Conclusions: MDD patients showed increased ApEn, one of the HRV measurement. And this ApEn was correlated with LDL, HAM-D and HAM-A scores. In this study, the analysis of ApEn would be a useful test of MDD.

Clinical Characteristics of Tuberculosis in North Korean Refugees (북한이탈주민에서의 결핵의 임상적 고찰)

  • Choi, Chang-Min;Jeong, Woo-Kyoung;Kang, Cheol-In;Kim, Doh-Hyung;Kim, Young-Keun;Heo, Sang-Taek;Kim, Hee-Jin
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.3
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    • pp.285-289
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    • 2006
  • Background : North Korea's economic and public health problems began in the early 1990s as a result of the gradual loss of economic support from its communist allies, combined with an inordinate number of natural disasters. The decline in public health has increased the incidence of tuberculosis in North Koreans and refugees. This study investigated tuberculosis situation in North Korean refugees in order to prepare for the future impact of tuberculosis control in Korea. Material and Methods : From 2001 to 2005, tuberculosis patients among North Korean refugees who were diagnosed before or after arriving in South Korea, based on the official records of OO hospital, were enrolled in this study. The demographic and clinical data of the cases were evaluated retrospectively. Results : A total of 42 TB cases were reviewed during the study period. Of these, 37 (88.1%) cases were pulmonary TB. based on the cases identified among the number of North Korean refugees' arriving each year, the annual incidence of pulmonary TB were 900 per 100,000 in 2004, 700 in 2003, The number of smear-positive patients was 20 (47.6%) and the number of culture-positive patients was 18 (42.9%). Of the M. tuberculosis isolates, 2 cases were found to be susceptible to all anti-TB drugs available, 4 were resistant to isoniazid, and 3 were multi-drug resistant. Conclusion : The prevalence of pulmonary TB in North Korean Refugees is high. In addition, North Korean refugees suffer from more severe tuberculosis in bacteriological and radiological aspects.