• Title/Summary/Keyword: 일차성

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Factors Affecting the Registration and Access Levels of the Pilot Project for the General Physician System among People with Disabilities (장애인 건강주치의 시범사업 수요자의 등록 및 이용수준 영향 요인 분석)

  • Eunhee Choe;Yeojeong Gu;Seungji Lim
    • Health Policy and Management
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    • v.34 no.2
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    • pp.185-195
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    • 2024
  • Background: Disabled people have particularly restricted access to health care. In response to this, the pilot project for the general physician (GP) system for disabled people was implemented in 2018, based on the rights of people with disability to the Health Act in South Korea. However, its participants were 0.2% among the total of those with severe disabilities in 2021. Therefore, this study examined the factors related to registering with a GP and the access level to its services to suggest implications for activating the participation of disabled people. Methods: We analyzed factors affecting the registration with a GP and the number of using the services among the participants of the GP system during May 2018 and December 2021 by conducting hierarchical logistic regression and hierarchical regression. The data were linked with the national health insurance data to examine various predictors, including disability types, socioeconomic status, health status, and GP registration. Results: As a result of analyzing the factors affecting whether or not to register for the pilot project, those with disabilities (physical disabilities, brain lesions, visual, intellectual, mental, and autistic disability) eligible for disability care (odds ratio [OR], 4.157) than other disability, and those living in metropolitan (OR, 4.330) or cities (OR, 3.332) than rural residences were highly likely to enroll the pilot study. Health-related variables also predicted the registration status of the pilot project. The predictors related to GP enrollment types (membership type: general health or disability care, GP's affiliation: clinics or hospitals) significantly influenced levels of access to services. Conclusion: It is necessary to develop the GP project for disabled people by considering the variation in types of disability, residences, and health. Further study will be needed to investigate the impact of GPs on the level of participation among disabled people.

Study on Intestinal Viability and Optimum Feeding Method of Lactobacillus in Broiler Chickens (육계에 대한 유산균의 장내 생존성 및 적정 급여방법에 대한 연구)

  • Kim, Dong-Wook;Kim, Ji-Hyuk;Kang, Geun-Ho;Kang, Hwan-Ku;Lee, Sang-Jin;Lee, Won-Jun;Kim, Sang-Ho
    • Journal of Animal Science and Technology
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    • v.50 no.6
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    • pp.807-818
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    • 2008
  • This study was conducted to prove the optimum feeding method of Lactobacillus in broiler chickens by investigating the intestinal viability of ingested Lactobacillus and the effect of feeding levels and frequency of Lactobacillus on growth performance in broiler chickens. In experiment 1, A total of one hundred, 5 weeks old male broiler chickens(Abor Acre) were fed Lactobacillus reuteri avibro2 expressed green fluorescent protein(GFP) at 104cfu/g diet to investigate the retention time of ingested Lactobacillus in the intestine for 1 day. The percentage of Lactobacillus expressed GFP in intestinal contents was 26% at 1 day after fed Lactobacillus expressed GFP. The percentage of Lactobacillus expressed GFP in intestinal contents was decreased in length of time. In experiment 2, A total of four hundred eighty, 1-d-old male broiler chicks(Abor Acre) were randomly divided into 4 groups with 4 replicates of 30 birds each to prove the optimum feeding level of Lactobacillus. The treatments were control(free antibiotics), Lactobacillus reuteri avibro2 5.0×10cfu/mL, 5.0×103cfu/mL, and 5.0×105cfu/mL. The final body weight and body wight gain of Lactobacillus reuteri avibro2 5.0×103cfu/mL were the highest in all groups(P<0.05). Feed conversion ratio was not significantly difference among the groups. The number of intestinal lactic acid bacteria in Lactobacillus treated groups tended to be improved or significantly increased as compared to that of control(P<0.05). Protein and fat digestibility in Lactobacillus 5.0×103cfu/mL and 5.0×105cfu/mL treated groups were significantly improved(P<0.05). No significant differences were observed on the availability of dry matter and crude ash in Lactobacillus treatments compared to those of control. In experiment 3, A total of six hundred 1-d-old male broiler chicks(Abor Acre) were randomly divided into 4 groups with 4 replicates of 30 birds each and were fed Lactobacillus reuteri avibro2 at intervals of 1, 2, 3, and 5 day for five weeks. Feeding level of Lactobacillus was 5.0×103cfu/mL The final body weight and body wight gain of Lactobacillus reuteri avibro2 5.0×103cfu/mL were the highest in all groups(P<0.05). The final body weight and body weight gain were significantly increased, when Lactobacillus was fed at intervals of 1 days, or 2 days. There were no significant differences in feed intake and feed conversion ratio among the all groups. The number of intestinal lactic acid bacteria in Lactobacillus treated groups tended to be improved or significantly increased as compared to that of control(P<0.05). No significant differences were observed on the number of coliform bacteria and Salmonella of ileum and cecum. Consequently, supplemental Lactobacillus influenced positive effects on the growth performance, nutrient availability and intestinal microflora. The optimum feeding level of Lactobacillus was 5.0×103cfu/mL, and the constant feeding of Lactobacillus was effective.

Clinical Results and Risk Factor Analysis of Surgical Treatment for Esophageal Perforation (식도천공의 수술적 치료의 임상결과와 위험인자 분석)

  • Cho, Sung-Woo;Hong, Ki-Woo;Kim, Shin;Lee, Hee-Sung;Kim, Hyoung-Soo;Lee, Jae-Woong;Choi, Goang-Min;Shin, Yoon-Cheol;Shin, Ho-Seung;Lee, Won-Yong
    • Journal of Chest Surgery
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    • v.41 no.3
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    • pp.347-353
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    • 2008
  • Background: Esophageal perforation is an emergency that. requires early diagnosis and effective treatment. A delay in diagnosis and treatment. significantly increases morbidity and mortality. Material and Method: Thirty-seven patients with esophageal perforation were surgically treated at our institutions between January 1990 and December 2006. We retrospectively reviewed the results of surgical treatment for esophageal perforation to understand the risk factors affecting survival inpatients. Result: Patients ranged in age from 21 to 87 years, with an average age of $52.7{\pm}16.98$ years. Thirty-one of the patients were men and six were women. There were 23 patients (62%) with spontaneous perforations, 10 patients (27%) with a traumatic perforation, and 4 patients (11%) with an iatrogenic perforation. The site of esophageal perforation was the cervical esophagus in 5 patients, the thoracic esophagus in 31 patients, and the abdominal esophagus in one patient. Twenty-nine patients underwent primary closure of the perforation and five patients had T-tube drainage. Exclusion-diversion procedures were performed in two patients and an esophagectomy was performed in one patient. There were six cases of mortality (16.22%) and 25 cases of postoperative complications in 15 patients (40.5%). Patients that were treated later than 24 hours after detection of the perforation showed a statistically significant high morbidity and mortality rate (p<0.05). Conclusion: The most important risk factor of esophageal perforation was the time interval between detection of the perforation and the initiation of treatment. A prompt diagnosis and effective treatment are necessary to decrease morbidity and mortality.

Some Tertiary Interactions in 5S rRNA from Xanthomonas celebensis (Xanthomonas celebensis 5S rRNA의 몇 가지 삼차상호작용)

  • Bongrae Cho;Yeonghoon Lee;Myung-Un Choi;Inwon Park
    • Journal of the Korean Chemical Society
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    • v.37 no.2
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    • pp.237-243
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    • 1993
  • The primary and secondary structure of the 5S rRNA isolated from Xanthomonas celebensis were determined by enzymatic and chemical degradation methods. It consists of 119 nucleotides and contains no modified nucleosides. As with the 5S rRNAs of X. maltophilia and X. citri, it contains an additional uridine residue on the 5'-terminus. Its secondary structure was almost identical to the models previously proposed by us for the 5S rRNA of two Xanthomonas species. Its secondary structure consists of five helices, five loops and two bulges. The tertiary interactions in the 5S rRNA molecule were analyzed by Fe(II)-EDTA treatment and hybridization method using deoxyhexamer. From the fact that some adenine residues in loop M, region $I_1-C$, loop $H_1$, and loop $H_2$ become susceptible to diethylpyrocarbonate when the 5S rRNA was hybridized with deoxyhexamer complementary to the sequence $U_{35}CCCAU_{40}$ and that some nucleotide residues in loop M, loop $H_1$ and region $D-I_2$ become resistant Fe(II)-EDTA cleavage in the presence of $Mg^{2+}$, it is presumed that loops $H_1$ and $H_2$ interact with loop M in some way. In the tertiary interaction, the regions $I_1-C$ and $D-I_2$ seem to act as hinges in folding the stems $B-I_1-C$ and $D-I_2-E.$ It was found that loop $H_1$ changes into a smaller loop of three bases by forming noncanonical A : C base-pairs ih acidic environment.

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Processing Factor of Matrine in Chilli Pepper (홍고추 중 matrine의 가공계수)

  • Noh, Hyun Ho;Lee, Jae Yun;Kim, Jin Chan;Jeong, Oh Seok;Kim, Hye Sung;Lee, Yong Hun;Choi, Ji Hee;Om, Ae Son;Hong, Su Myeong;Paik, Min Kyoung;Kim, Doo Ho;Kyung, Kee Sung
    • The Korean Journal of Pesticide Science
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    • v.17 no.4
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    • pp.244-248
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    • 2013
  • This study was carried out to investigate the residual characteristics and calculate processing factor of the environment friendly material matrine in fresh chilli pepper by drying. Spray solution of matrine was prepared by dilution of the commercial product (2% active ingredient) with water at 1 : 1000 (v/v) ratio and sprayed onto chilli pepper plants at seven day intervals. Samples were collected at 0, 1, 3, 5 and 7 days after last application and then dried using a hot air dry oven at $60^{\circ}C$ for 36 hours until the water content was reduced to 14%. Recoveries and storage period stabilities of matrine in the samples ranged from 106.6 to 119.1% and 106.6 to 113.1%, respectively. The residual concentrations of matrine in fresh chilli pepper and dried chilli peppers treated only once were found to be from less than 0.01 to 0.11 and from 0.03 to 0.25 mg/kg, respectively. In case of plants sprayed twice with matrine, the residual concentrations ranged from 0.02 to 0.12 and from 0.04 to 0.4 mg/kg, respectively. Processing factor of matrine in the fresh chilli pepper by drying was found to be from 1.5 to 3.3, indicating that the residual concentration of matrine in dried chilli pepper increased about two or three times by drying.

Diagnostic Efficacy of Anorectal Manometry for the Diagnosis of Hirschsprung's Disease (Hirschsprung병에서 항문직장 내압검사의 진단적 유용성)

  • Chang, Soo-Hee;Min, Uoo-Gyung;Choi, Ok-Ja;Kim, Dae-Yeon;Kim, Seong-Chul;Yu, Chang-Sik;Kim, Jin-Cheon;Kim, In-Koo;Yoon, Jong-Hyun;Kim, Kyung-Mo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.6 no.1
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    • pp.24-31
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    • 2003
  • Purpose: As diagnostic tools for Hirschsprung's disease (HD), barium enema and rectal biopsy have radiation exposure and invasiveness respectively; however anorectal manometry does not have these disadvantages. We therefore performed this study to evaluate the diagnostic efficacy of anorectal manometry. Methods: We reviewed medical records of infants with one or two symptoms of vomiting, abdominal distension, chronic diarrhea or constipation who had a anorectal manometry followed by barium enema and/or biopsy from July 1995 to May 2002. We evaluated the sensitivity, specificity and predictive value of anorectal manometry and barium enema for diagnosis of HD. We also measured sphincter length, median value of balloon volume at which rectoanal inhibitory reflex (RAIR) occurred. Results: All 61 patients received anorectal manometry, 33 of 61 received barium enema. 18 of 61 were diagnosed as HD according to histology and 43 of 61 were evaluated as a control. The sensitivity, specificity, positive predictive value, negative predictive value of anorectal manometry and barium enema for diagnosis of HD were 1.00, 0.91, 0.82, 1.00 and 0.93, 0.67, 0.70, 0.92 respectively. The mean value of sphincter length in control was $1.68{\pm}0.67$ cm and correlated with age, weight and significantly longitudinal length. The median value of balloon volume at which RAIR occurred was 10 mL and did not correlated with age, weight and longitudinal length. Conclusion: This study suggests that anorectal manometry is an excellent initial screening test for Hirschsprung's disease because of its safety and accuracy.

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Dosimetric Characteristics of Edge $Detector^{TM}$ in Small Beam Dosimetry (소조사면 선량 계측을 위한 엣지검출기의 특성 분석)

  • Chang, Kyung-Hwan;Lee, Bo-Ram;Kim, You-Hyun;Choi, Kyoung-Sik;Lee, Jung-Seok;Park, Byung-Moon;Bae, Yong-Ki;Hong, Se-Mie;Lee, Jeong-Woo
    • Progress in Medical Physics
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    • v.20 no.4
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    • pp.191-198
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    • 2009
  • In this study, we evaluated an edge detector for small-beam dosimetry. We measured the dose linearity, dose rate dependence, output factor, beam profiles, and percentage depth dose using an edge detector (Model 1118 Edge) for 6-MV photon beams at different field sizes and depths. The obtained values were compared with those obtained using a standard volume ionization chamber (CC13) and photon diode detector (PFD). The dose linearity results for the three detectors showed good agreement within 1%. The edge detector had the best linearity of ${\pm}0.08%$. The edge detector and PFD showed little dose rate dependency throughout the range of 100~600 MU/min, while CC13 showed a significant discrepancy of approximately -5% at 100 MU/min. The output factors of the three detectors showed good agreement within 1% for the tested field sizes. However, the output factor of CC13 compared to the other two detectors had a maximum difference of 21% for small field sizes (${\sim}4{\times}4\;cm^2$). When analyzing the 20~80% penumbra, the penumbra measured using CC13 was approximately two times wider than that using the edge detector for all field sizes. The width measured using PFD was approximately 30% wider for all field sizes. Compared to the edge detector, the 10~90% penumbras measured using the CC13 and PFD were approximately 55% and 19% wider, respectively. The full width at half maximum (FWHM) of the edge detector was close to the real field size, while the other two detectors measured values that were 8~10% greater for all field sizes. Percentage depth doses measured by the three detectors corresponded to each other for small beams. Based on the results, we consider the edge detector as an appropriate small-beam detector, while CC13 and PFD can lead to some errors when used for small beam fields under $4{\times}4\;cm^2$.

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A Case Study on Students' Mathematical Concepts of Algebra, Connections and Attitudes toward Mathematics in a CAS Environment (CAS 그래핑 계산기를 활용한 수학 수업에 관한 사례 연구)

  • Park, Hui-Jeong;Kim, Kyung-Mi;Whang, Woo-Hyung
    • Communications of Mathematical Education
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    • v.25 no.2
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    • pp.403-430
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    • 2011
  • The purpose of the study was to investigate how the use of graphing calculators influence on forming students' mathematical concept of algebra, students' mathematical connection, and attitude toward mathematics. First, graphing calculators give instant feedback to students as they make students compare their written answers with the results, which helps students learn equations and linear inequalities for themselves. In respect of quadratic inequalities they help students to correct wrong concepts and understand fundamental concepts, and with regard to functions students can draw graphs more easily using graphing calculators, which means that the difficulty of drawing graphs can not be hindrance to student's learning functions. Moreover students could understand functions intuitively by using graphing calculators and explored math problems volunteerly. As a result, students were able to perceive faster the concepts of functions that they considered difficult and remain the concepts in their mind for a long time. Second, most of students could not think of connection among equations, equalities and functions. However, they could understand the connection among equations, equalities and functions more easily. Additionally students could focus on changing the real life into the algebraic expression by modeling without the fear of calculating, which made students relieve the burden of calculating and realize the usefulness of mathematics through the experience of solving the real-life problems. Third, we identified the change of six students' attitude through preliminary and an ex post facto attitude test. Five of six students came to have positive attitude toward mathematics, but only one student came to have negative attitude. However, all of the students showed positive attitude toward using graphing calculators in math class. That's because they could have more interest in mathematics by the strengthened and visualization of graphing calculators which helped them understand difficult algebraic concepts, which gave them a sense of achievement. Also, students could relieve the burden of calculating and have confidence. In a conclusion, using graphing calculators in algebra and function class has many advantages : formulating mathematics concepts, mathematical connection, and enhancing positive attitude toward mathematics. Therefore we need more research of the effect of using calculators, practical classroom materials, instruction models and assessment tools for graphing calculators. Lastly We need to make the classroom environment more adequate for using graphing calculators in math classes.

Interventional radiology of Bronchial artery embolization due to massive hemoptysis (대량객혈로 인한 기관지 동맥 색전의 중재적 방사선시술)

  • Min, Byoung-Yun;Lee, Sang-Bock
    • Journal of the Korean Society of Radiology
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    • v.4 no.4
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    • pp.17-24
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    • 2010
  • Hemoptysis which is comparatively common symptom in respiratory disease patients is a clinical symptom which has high risk of death in spite of many curative means. Bronchial tube embolization is a very useful medical procedure when hemoptysis does not stop for treatment of internal medicine or surgery and in addition to the purpose of instant hemostasis, for patients for whom surgical operation is impossible or for the purpose of gaining time to improve the state of the patient before surgical operation. In relation to this, this study is to know of the usefulness of bronchial tube artery embolization. The objects were 60 persons for whom bronchial tube artery embolizations are conducted because of large hemoptysis occurred from March 2007 to December 2009 in J hospital. They had large hemoptysis of 400ml or more per day and 200ml or more at a time or though the quantity of hemoptysis was less than 400ml they did not respond to the treatment of internal medicine for 10 days or longer. The average age was 60.5 years and cause diseases were tuberculosis, bronchiectasis, and pneumonia and lung cancer. Embolus parts were Rt bronchial artery 19 examples, Lt bronchial artery, both bronchial artery, Rt Intercostobronchial artery, and they were the case where embolization for many blood vessels were simultaneously carried out. As embolus materials, PVA (conteour) and microcoil were used. In 76.6% of 60 persons of patients hemorrhage stopped with the lapse of time after the procedure and in 4 examples (6.6) re-embolization was carried out due to re-bleeding after the procedure. Bronchial tube artery embolization has high early success rate and effectively controls hemoptysis in the treatment of hemoptysis and is an effective emergency remedy for hemorrhage due to large hemoptysis and will be a good medical procedure which reduces death rate. In addition, primarily if it is conducted together with the treatment of internal medicine it will be, as an effective curative means for hemorrhage due to large hemoptysis, a good mediate radial rays medical procedure which reduces death rate.

Surgical Results of Complete Atrioventricular Septal Defect - 16 years experience - (완전방실중격결손증에 대한 외과적 교정의 16년 수술결과)

  • 이정렬;김홍관;이정상;김용진;노준량;배은정;노정일;최정연;윤용수
    • Journal of Chest Surgery
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    • v.35 no.12
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    • pp.854-861
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    • 2002
  • In this study, we reviewed our early and long-term surgical results of complete atrioventricular septal defect during the last 16 years at our hospital. Materials and Methods: Between April 1986 and March 2002, 73 patients with complete atrioventricular septal defect underwent total correction without preceding palliation. Age at repair ranged from 2 to 85 (median age, 7) months, and weight ranged from 3 to 22 (median weight, 5.9)kg. Follow-up was complete with a mean duration of 69$\pm$51 months. Results: Overall operative mortality was 16.4%(12) with 3 late deaths. One, 5, and 10 year actuarial survival rates were 96.3 %, 94.2 % and 94.2 % respectively Sixteen of 61 (22.2%) operative survivors have undergone reoperation for postoperative mitral regurgitation or left ventricular outflow tract obstruction (LVOTO). Freedom from mitral reoperation at 1, 5, and 10 years were 87.8 %, 72.4 %, and 57.8 % and freedom from LVOTO at 1, 5, and 10 years were 98.2 %, 86.3 %, and 83.2 % respectively. Summary: In this study, we found that our early surgical results improved with quite an acceptable long-term outcome. Close observation of remaining mitral regurgitation was necessary, A precise evaluation of the atrioventricular valve morphology, a meticulous surgical technique, and the adequate postoperative management are mandatory for the excellent results.