• Journal of agricultural medicine and community health
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• v.49 no.2
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• pp.132-145
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• 2024

Objectives: This study compares cases of Dalgubeol Health Care Project, 301 Network Project, and 3 for 1 Project based on program logic models to derive measures for promoting integrated healthcare and welfare services centered around medical institutions. Methods: From January to December 2021, information on the implementation systems and performance of each institution was collected. Data sources included prior academic research, project reports, operational guidelines, official press releases, media articles, and written surveys from project managers. A program logic model analysis framework was applied, structuring the information based on four elements: situation, input, activity, and output. Results: All three projects aimed to address the fragmentation of health and welfare services and medical blind spots. Despite similar multidisciplinary team compositions, differences existed in specific fields, recruitment scale, and employment types. Variations in funding sources led to differences in community collaboration, support methods, and future directions. There were discrepancies in the number of beneficiaries and medical treatments, with different results observed when comparing the actual number of people to input manpower and project cost per beneficiary. Conclusions: To design an integrated health and welfare service provision system centered on medical institutions, securing a stable funding mechanism and establishing an appropriate target population and service delivery system are crucial. Additionally, installing a dedicated department within the medical institution to link activities across various sectors, rather than outsourcing, is necessary. Ensuring appropriate recruitment and stable employment systems is needed. A comprehensive provision system offering services from mild to severe cases through public-private cooperation is suggested.

• Radiation Oncology Journal
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• v.23 no.3
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• pp.143-156
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• 2005

Background: The best dose-fractionation regimen of the definitive radiotherapy for cervix cancer remains to be clearly determined. It seems to be partially attributed to the complexity of the affecting factors and the lack of detailed information on external and intra-cavitary fractionation. To find optimal practice guidelines, our experiences of the combination of external beam radiotherapy (EBRT) and high-dose-rate intracavitary brachytherapy (HDR-ICBT) were reviewed with detailed information of the various treatment parameters obtained from a large cohort of women treated homogeneously at a single institute. Materials and Methods: The subjects were 743 cervical cancer patients (Stage IB 198, IIA 77, IIB 364, IIIA 7, IIIB 89 and IVA 8) treated by radiotherapy alone, between 1990 and 1996. A total external beam radiotherapy (EBRT) dose of $23.4\~59.4$ Gy (Median 45.0) was delivered to the whole pelvis. High-dose-rate intracavitary brachytherapy (HDR-IBT) was also peformed using various fractionation schemes. A Midline block (MLB) was initiated after the delivery of $14.4\~43.2$ Gy (Median 36.0) of EBRT in 495 patients, while In the other 248 patients EBRT could not be used due to slow tumor regression or the huge initial bulk of tumor. The point A, actual bladder & rectal doses were individually assessed in all patients. The biologically effective dose (BED) to the tumor ($\alpha/\beta$=10) and late-responding tissues ($\alpha/\beta$=3) for both EBRT and HDR-ICBT were calculated. The total BED values to point A, the actual bladder and rectal reference points were the summation of the EBRT and HDR-ICBT. In addition to all the details on dose-fractionation, the other factors (i.e. the overall treatment time, physicians preference) that can affect the schedule of the definitive radiotherapy were also thoroughly analyzed. The association between MD-BED $Gy_3$ and the risk of complication was assessed using serial multiple logistic regression models. The associations between R-BED $Gy_3$ and rectal complications and between V-BED $Gy_3$ and bladder complications were assessed using multiple logistic regression models after adjustment for age, stage, tumor size and treatment duration. Serial Coxs proportional hazard regression models were used to estimate the relative risks of recurrence due to MD-BED $Gy_{10}$, and the treatment duration. Results: The overall complication rate for RTOG Grades $1\~4$ toxicities was $33.1\%$. The 5-year actuarial pelvic control rate for ail 743 patients was $83\%$. The midline cumulative BED dose, which is the sum of external midline BED and HDR-ICBT point A BED, ranged from 62.0 to 121.9 $Gy_{10}$ (median 93.0) for tumors and from 93.6 to 187.3 $Gy_3$ (median 137.6) for late responding tissues. The median cumulative values of actual rectal (R-BED $Gy_3$) and bladder Point BED (V-BED $Gy_3$) were 118.7 $Gy_3$ (range $48.8\~265.2$) and 126.1 $Gy_3$ (range: $54.9\~267.5$), respectively. MD-BED $Gy_3$ showed a good correlation with rectal (p=0.003), but not with bladder complications (p=0.095). R-BED $Gy_3$ had a very strong association (p=<0.0001), and was more predictive of rectal complications than A-BED $Gy_3$. B-BED $Gy_3$ also showed significance in the prediction of bladder complications in a trend test (p=0.0298). No statistically significant dose-response relationship for pelvic control was observed. The Sandwich and Continuous techniques, which differ according to when the ICR was inserted during the EBRT and due to the physicians preference, showed no differences in the local control and complication rates; there were also no differences in the 3 vs. 5 Gy fraction size of HDR-ICBT. Conclusion: The main reasons optimal dose-fractionation guidelines are not easily established is due to the absence of a dose-response relationship for tumor control as a result of the high-dose gradient of HDR-ICBT, individual differences In tumor responses to radiation therapy and the complexity of affecting factors. Therefore, in our opinion, there is a necessity for individualized tailored therapy, along with general guidelines, in the definitive radiation treatment for cervix cancer. This study also demonstrated the strong predictive value of actual rectal and bladder reference dosing therefore, vaginal gauze packing might be very Important. To maintain the BED dose to less than the threshold resulting in complication, early midline shielding, the HDR-ICBT total dose and fractional dose reduction should be considered.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.1
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• pp.57-70
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• 1993

This study was carried out to investigate agreement, content and demand for home nursing care of hospital inpatients in brain, spain and musculoskeletal diseases .The data was collected by interviewing with 242 patients who were hospitalized in university hospital on Taegu, from September 6,60 October 9, 1993. Of 242 patients, 66.1% agreed to home nusing care system and rate of agreement was highest between 30 years to 49 years of age as 75.5%, in middle urban area residents as 75.9% and was lowest in medicaid as 40.0% in general chareacteristics. The rate of agreement according to type of diagnosis was highest inpatients with spinal diseases as 75.6% according to functional status was the highest in patients who had daily living activity freely as 69.4% according to prognosis in patients at terminal stage as 80.0% and the rate of agreement to home nursing care of patients who wanted early discharege was 73.9%. The first-ranking reasom of agreement to home nursing care was asking for continuous relationship with doctor as 37.3% and there was statistically significant difference in reasons of agreement to home nursing care according to functional status of patients. The first-ranking reason of eary discharge among patients who wanted early discharge(74.8%) was because of long time stay in hospital. Among 23 items of nursing activity that patient wanted, the first-ranking item was recovery promotion, prevention of complication, education and counseling for health as 76.4%, drug management was 2nd-ranking item as 62.1% and the third was regular checking of vital signs as 55.9%. The lowest item of demand for home unring care was hospice care(3.9%) and airway keep(9.1%).

• Journal of Hospice and Palliative Care
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• v.2 no.2
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• pp.125-137
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• 1999

Purpose : Surveying the rates, severity, and variables influencing depression and their correlation between pain and depression in Korean cancer patients, we attempted to provide a basic database for the effective depression management program. Methods : The results of survey were colleted from 10 patients who were hospitalized at Seoul National University Hospital for cancer treatment from February to June of 1999. Factors of depression and the level of pain were examined by self-reported survey employing Korean version of Beck Depression Inventory(BDI) and an abridged version of Brief pain Inventory respectively. The purpose of this study and guidelines for the questionnaires were clearly explained to participating patients by Resgitered Nurses before answering the survey. Demographic and clinical characteristics of patients were compiled by reviewing their medical records in corporation with a family physician. The difference in the level of depression among patient groups was analyzed with the t-test and ANOVA, and the correlation between variables with Pearson correlation coefficient. Results : 1) 142 subjects comprised 79 male and 63 female, and their mean age was 51.86. 2) The mean scores of the worst pain for last 24-hours was 6.08(SD 2.23), the average pain for last 24-hours 4.44(SD 1.85), and the mean scores of pain at the time of survey 3.48(SD 2.25), while the mean scores of the least pain for last 24-hours 2.25(SD 1.83). 3) The mean BDI scores were 23.73(SD 0.99), and 55.6% of patients were evaluated to be in depression(cutting point 21). Scores of depression for cancer patients were higher than normal population. 4) The correlation between worst pain for last 24-hours and depression(r=0.252, P=0.002), average pain for last 24-hours and depression(r=0.225, P=0.007), present pain and depression(r=0.291, P=0.000) were significant. 5) Significant differences were found among groups of cancer patients with pain with respect to gender(t=3.59, p=0.000), level of education(F=4.063, P=0.009), ECOG(F=3.352, P=0.021). There was significant positive correlation between depression and pain(r=0.171, P=0.042). Conclusions : More than 50% of cancer patients with pain are suffering from depression. We have shown that the variables like the degree of pain, gender, level of education, ECOG, and age are significantly related to the depression in cancer patients. The findings of this study may be used for assessing high-risk patients in need of intervention and for planning effective therapeutic strategies for them after the routine assessment. Further study is necessary to investigate the cultural differences and the variables influencing on depression in Korean cancer patients.

• The Journal of Korean Society for Radiation Therapy
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• v.24 no.1
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• pp.39-43
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• 2012

Purpose: In hospital image-guided radiation therapy in patients with bladder cancer to enhance the reproducibility of the appropriate amount, depending on the patient's condition, and image-guided injection of saline system (On-Board Imager system, OBI, VARIAN, USA) three of the Cone-Beam CT dimensional matching (3D-3D matching) to be the treatment. In this study, the treatment of patients with bladder cancer at Cone-Beam CT image obtained through the analysis of the bones based matching and matching based on the bladder to learn about the differences, the bladder's volume change injected saline solution by looking at the bladder for the treatment of patients with a more appropriate image matching is to assess how the discussion. Materials and Methods: At our hospital from January 2009 to April 2010 admitted for radiation therapy patients, 7 patients with bladder cancer using a Folly catheter of residual urine in the bladder after removing the amount determined according to individual patient enough to inject saline CT-Sim was designed after the treatment plan. After that, using OBI before treatment to confirm position with Cone-Beam CT scan was physician in charge of matching was performed in all patients. CBCT images using a total of 45 bones, bladder, based on image matching and image matching based on the difference were analyzed. In addition, changes in bladder volume of Eclipse (version 8.0, VARIAN, USA) persuaded through. Results: Bones, one based image matching based on the bladder and re-matching the X axis is the difference between the average $3{\pm}2mm$, Y axis, $1.8{\pm}1.3mm$, Z-axis travel distance is $2.3{\pm}1.7mm$ and the overall $4.8{\pm}2.0mm$, respectively. The volume of the bladder compared to the baseline showed a difference of $4.03{\pm}3.97%$. Conclusion: Anatomical location and nature of the bladder due to internal movement of the bones, even after matching with the image of the bladder occurred in different locations. In addition, the volume of saline-filled bladder showed up the difference between the 4.03 percent, but matched in both images to be included in the planned volumes were able to confirm. Thus, after injection of saline into the bladder base by providing a more accurate image matching will be able to conduct therapy.

• Korean Security Journal
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• no.9
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• pp.99-131
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• 2005

Terrorism which became today's common phenomena over the world is one of the most serious threats the world confront. Although International society make and operate outstanding anti-terrorism system, terror would never end without solving fundamental problems. The main body of terrorism converts from nation to organization and from organization to cell, which makes it difficult for us to recognize the main body. Since the target of today's new terrorism is many and unspecified persons, terrorists will never hesitate to use mass destruction weapons such as nuclear, biological, chemical weapons, and also use cyber-technique or cyber-terrorism. So, effective counter-terrorism measures should be performed as follows. First, it must be better for international society should make long-time plan of solving fundamental problems of terrorism other than to operate directly on terror organization and its means. Second, preventive method should be made. The most effective method of eradicating terrorism is prevention. For this, it is necessary to remove environmental elements of terrorism and terrorist bases, and to stop inflow of money and mass destruction weapons to terrorists. Third, integrated anti-terror organization should be organized and operated for continuous counter-terrorism operations. Also international alliance for anti-terrorism should be maintained to share informations and measures. Fourth, concerned department in the government should prepare counter-terrorism plans in their own parts as follows and make efforts to integrate the plans. - Ministry of Government Administration and Home Affairs : conventional terror - Ministry of Health and Welfare : bio-terror - Ministry of Science and Technology : nuclear-terror Especially, they should convert their policy and operation from post-terror actions to pre-terror actions, designate terror as national disaster and organize integrated emergency response organization including civil, government, and military elements. In conclusion, pre-terror activities and remedy of fundamental causes is the best way to prevent terror. Also, strengthening of intelligence activities, international cooperations, and preventive and comprehensive counter-measures must not ignored.

• Journal of Sasang Constitutional Medicine
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• v.12 no.1
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• pp.240-259
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• 2000

1. Background and Purpose I intented to be helpful to understand the consitutional symptoms of soar throat and the application of the prescription through a clinical study of Soeumin Doksamkwankaeijungtang. 2. Methods I studied 16 patients(1 man and 15 women) treated by Doksamkwankaeijungtang in Chewon Oriental Clinic. And then I investigated the characteristics of patients treated by Doksamkwankaeijungtang, remedial values and side effects. 3. Results Doksamkwankaeijungtang was used in the age groups between twenties and sixties. There were 28 kinds of chief complaints including soar throat, tonsilitis, allergic rheum, bitter taste, dry throat, dry cough, stomatitis, lower abdominal pains, climacteric syndrome, etc. The distributions of remedial values were completely recovered (56.25%), much improved (18.75%), slightly improved(6.25%), no improved(12.5%), aggravated(6.25%), side effects(18.75%). There was one aggravated patient. Using the prescription, I prescribed it without any changing and addition according to the symptoms of soar throat. The remedial value of Doksamkwankaeijungtang was effective and not influenced by the dosage of Ginseng. The onset of action was very quick by the changes of dosage without the relation of age. Side effects were upward tendency of blood presser, headache, chest pain, etc. 4. Conclusion Doksamkwankaeijungtang was specifically effective in soar throat of Soeumin.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.10 no.1
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• pp.1-9
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• 1977

The purpose of this study is to complish a method of fish glue malting with residual products such as fish head and skin discarded from sea food processing. Using the skins of Alaska pollack and file fish from fillet packers, the optimum conditions of skin glue processing were investigated and physical and chemical properties of the product were also determined. The yields of Alaska pollack, Thelagra calcogramma, skin and file fish, Novodon modestus, skin to the total body weight were $4.6\%\;and\;5.0\%$ respectively. The optimum conditions for a $49.3\%$n yield Alaska pollack skin glue processing were considered the extraction of previously tinted in $0.1\%$ calcium hydroxide solution for 3 hours with the additional water as much as 3 times of sample weight at $70^{\circ}C$ for 3 hours under the controlled pH 5.0. The conditions for file fish skin glue were similar to those of Alaska pollack except the addition of five times of water to the weight of sample skin needed for extraction. The content of crude protein of Alaska pollack and file fish skin glue were $98.0\%\;and\;96.0\%$ respectively. The contents of crude ash and crude lipid were not different from that of chemical grade gelatin. Relative viscosity, melting point, gelation temperature and jelly strength of Alaska pollack skin glue marked 5.84, $21.8^{\circ}C,\;7.1^{\circ}C\;and\;10.0g$ respectively and those of file fish skin glue showed $5.79,\;25.0^{\circ}C,\;7.4^{\circ}C\;and\;11.6g$ respectively.The color and turbidity of Alaska pollack skin glue are slightly superior to those of file fish skin glue. It is supposed that the extract residue of skin glue is valuable for use the animal feeds by the results of amino acid composition. And the ratio of each amino acid content to the total amino acid of Alaska pollack and file fish skin glue is similar to that of chemical grade gelatin.

• Journal of the Korean Institute of Landscape Architecture
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• v.42 no.6
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• pp.72-88
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• 2014

This study was conducted in order to analyze user behavior and preference factors in the outdoor spaces of mental hospitals. Among hospitals with 250 or more beds, 5 hospitals were selected in consideration of size of garden and diversity of garden elements. The subject of the study was restricted to mild cases of schizophrenia while 30~50 patients were selected on the recommendation of their doctor from 5 hospitals, respectively. The physical environment was analyzed, focusing on space components, after visiting the sites of study. A face to face interview method was selected in consideration of patients' cognitive abilities, a total of 230 questionnaires were used for the analysis. The results of the study can be summarized as follows. Rest facilities occupy the largest numbers in the components of garden, and those are followed by landscape facilities, walking/exercise facilities, and experience facilities. Outdoor walking/exercise programs are classified into group walks and free walks with most patients taking group walks. Most of the patients visit these outdoor spaces every day but some of them rarely use the outdoor areas. In order to increase the efficiency of using these outdoor spaces, the percentage of space for ensuring a sense of control should properly harmonize with the percentage of space to facilitate patients in having social contact. With regard to the reasons for preferring the most widely-used outdoor spaces, landscape/environment property was the most important, followed by functionality and then accessibility. Major activities in the preferred space are mainly composed of walking/exercise and rest. The preferred facilities are waterscape facilities such as ponds, waterfalls and fountains, rest facilities such as pergolas and shade trees, and lawn. It was understood that naturalness should be considered to be the most important factor in constructing a new healing garden, followed by aesthetics and amenities. Single facilities rated by preference for introduction were flower beds, trails, and lawn. According to type, waterscape facilities such as fountains, ponds, waterfalls and waterwheels were most preferred. Space for natural distraction and programs for the cultivation of flower beds were also preferred. The ideal image of a healing garden should be bright, familiar, and orderly as a whole, having plenty of introduced facilities. Open spaces were preferred to enclosed spaces. Finally, the image of a garden that helps patients feel calm was thought to be that of the most ideal garden.

• Sleep Medicine and Psychophysiology
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• v.25 no.2
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• pp.68-73
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• 2018

Objectives: The purpose of this study was to explore insomniac demographic characteristics and the type of consultation provided to hospitalized patients asked to the Department of Psychiatry for insomnia and to compare patient insomnia characteristics by consultation type. Methods: We performed a retrospective chart review of 4,966 patients who were hospitalized from August 1, 2005 to December 31, 2011 that received consultation in the Department of Psychiatry. Among them, 236 patients were referred for insomnia. We compared the differences in demographic characteristics and types of consultation between the insomnia patient group and other patient group. We also compared the difference between demographic characteristics and type of consultation by dividing total subjects into 'with reconsultation' and 'without reconsultation' groups. Results: Our results came from the analysis of 9,689 consecutive consultation requests. There were 4,966 patients that participated in the study over 6 years and 6 months. The overall consultation rate was 3.3% of all admissions and insomnia patients comprised 4.8% of those. The ratio of re-consultation for insomnia was 27.5%. There was no significant difference in mean age between the insomnia 'with reconsultation group' and the insomnia 'without reconsultation group', but the 'with reconsultation' group had significantly more male patients and medical patients than the 'without re-consultation' group. For insomnia patients, consultation types were in the order of Mending request (51.3%), Paralle request (36.6%), Complementary request (9.0%) and this composition differed from that of total admission patients. Conclusion: Hospitalized patients referred for insomnia showed a higher proportion of male patients, lower rates of re-consultation compared with other patients, and most of these were for secondary insomnia. Each doctor should be aware of the possibility of inpatient insomnia, conduct positive assessments and referrals as necessary, and psychiatrists who might be asked for consultation need to prepare an active intervention with initial diagnosis and treatment, as well as recommendations for the timing of reconsultation.