• Title/Summary/Keyword: 진단도

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Preparation and Measures for Elderly with Dementia in Korea : Focus on National Strategies and Action Plan against Dementia (한국의 치매에 대한 대응과 대책 : 국가 전략과 활동계획)

  • Lee, Moo-Sik
    • Journal of agricultural medicine and community health
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    • v.44 no.1
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    • pp.11-27
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    • 2019
  • Dementia is major epidemic disease of the 21st century in the world. Dementia is one of the major issues in public health globally. Also in Korea, the estimated prevalence of dementia was 8.7%(0.47 million) in 2010, the number will reach the 1 million mark in 2024, it will become a 15.1%(2.71 million) by 2050. Among Koreans aged 65 or older, 725,000 are estimated to be suffering from dementia in 2017. Against dementia, Korea developed three National Dementia Plans in 2008, 2012, and 2016. The 1st plan was came into effect in 2008 and focused on prevention, early diagnostic, development and coordination of infrastructures and management, and improving awareness. The 2nd plan was launched in 2012, addressed the same priorities but had a stronger focus on supporting family members. In 2012 the Dementia Management Act established a statutory basis for organization of the National Dementia Plans. Under the Dementia Management Act, the government is required to produce a comprehensive plan for dementia every 5 years. The Act also orders that the government should register the dementia patients and collect statistics on epidemiology and the management of the dementia conditions. The Dementia Management Act of Korea required the operation of the National Institute of Dementia and Metropolitan/Provincial Dementia Centers to make and carry out dementia management plans throughout the nation. The Act also mandate to establish Dementia Counselling Centers in every public health center and the National Dementia Helpline. The 3rd National Dementia Plan of 2016 aims to build a dementia friendly community to ensure people with dementia and their carer live well. This plan focus on community-based prevention and management of dementia, convenient and safe diagnosis, treatment, and care for people with dementia, the reduction of the care burden for family care-givers of people with dementia, and support for dementia research through research, statistics and technology. In 2017, Moon's government will introduce the "National Dementia Responsibility System," which guarantees most of the burden caused by dementia. This plan include that the introduction of a ceiling on self-pay for dementia diseases, expansion of the application of dementia care standards through alleviating the support criteria for long-term care insurance for mild dementia, expansion of dementia support centers, expansion of national and public dementia care facilities. In the meantime, Korea has accomplished many accomplishments by establishing many measures related to dementia and promoting related projects in a short time, but there are still many challenges.

Illness Experiences and Palliative Care Needs in Community Dwelling Persons with Cardiometabolic Diseases (심혈관대사질환이 있는 지역사회 거주 환자의 질환경험 및 완화의료 요구)

  • Cha, EunSeok;Lee, JaeHwan;Lee, KangWook;Hwang, Yujin
    • Journal of Hospice and Palliative Care
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    • v.22 no.1
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    • pp.8-18
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    • 2019
  • Purpose: This study was conducted to better understand the illness experiences and palliative care needs in community-dwelling persons with cardiometabolic diseases. Methods: This qualitative descriptive study was conducted with 11 patients (and three family members) among 28 patients contacted. Interviews were led by the principal investigator in her office or at participants' home depending on their preference. All interviews were digitally recorded and transcribed by a research assistant. The interviews were analyzed by two independent researchers using a conventional method. Results: Participants' ages ranged from 42 to 82 years (nine men and two women). Three themes were identified: (1) same disease, but different illness experiences; (2) I am in charge of my disease(s); (3) preparation for disease progression. Participants were informed of the name of their disease when they were diagnosed, but not provided with explanation of the diagnosis or meant or how to do self-care to delay the disease progression, which increased the feelings of uncertainty, hopelessness and anxiety. Taking medication was considered to be the primary treatment option and self-care a supplemental one. Advanced care plans were considered when they felt the progression of their disease(s) while refraining from sharing it with their family or health care professionals to save their concerns. All participants were willing to withhold life-sustaining treatment without making any preparation in writing. Conclusion: Education on self-care and advanced care planning should be provided to community-dwelling persons with cardiometabolic diseases. A patient-centered education program needs to be developed for this population.

Palliative Care Practitioners' Perception toward Pediatric Palliative Care in the Republic of Korea (소아완화의료에 대한 호스피스 완화의료 전문기관 종사자의 인식)

  • Moon, Yi Ji;Shin, Hee Young;Kim, Min Sun;Song, In Gyu;Kim, Cho Hee;Yu, Juyoun;Park, Hye Yoon
    • Journal of Hospice and Palliative Care
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    • v.22 no.1
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    • pp.39-47
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    • 2019
  • Purpose: This study was performed to investigate the current status of pediatric palliative care provision and how it is perceived by the palliative care experts. Methods: A descriptive study was conducted with 61 hospice institutions. From September through October 2017, a questionnaire was completed by experts from the participating institutions. Data were analyzed using SPSS 21.0. Results: Among 61 institutions, palliative care is currently provided for pediatric cancer patients by 11 institutions (18.0%), all of which are concentrated in Seoul, Incheon and Gyeonggi and Gyengsang provinces; 85.2% of all do not plan to provide specialized pediatric palliative care in the future. According to the experts, the main barriers in providing pediatric palliative care were the insufficient number of trained specialists regardless of the delivery type. Experts said that it was appropriate to intervene when children were diagnosed with cancer that was less likely to be cured (33.7%) and to move to palliative care institutions when their conditions worsened (38.2%); and it was necessary to establish a specialized pediatric palliative care system, independent from the existing institutions for adult patients (73.8%). Conclusion: It is necessary to develop an education program to establish a nationwide pediatric palliative care centers. Pediatric palliative care intervention should be provided upon diagnosis rather than at the point of death. Patients should be transferred to palliative care institutions after intervention by their existing pediatric palliative care team at the hospital is started.

Evaluation of the usefulness of prone position for reducing the image distortion due to respiration in PET/CT (PET/CT 검사 시 호흡에 따른 영상 왜곡 감소를 위한 엎드린 자세의 유용성 평가)

  • Lee, Han Wool;Kim, Jung Yul;Choi, Yong Hoon;Lim, Han Sang;Kim, Jae Sam
    • The Korean Journal of Nuclear Medicine Technology
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    • v.23 no.1
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    • pp.59-63
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    • 2019
  • Purpose The motion due to respiration of patients undergoing PET/CT is a cause of artifacts in image and registration error between PET and CT images. The degree of displacement and distortion for tumor, which affects the measurement of Standard Uptake Value (SUV) and lesion volume, is especially higher for tumors that is small or located at the base of lungs. The purpose of this study was to evaluate the usefulness of prone position in the correction of image distortion due to respiration of patients in PET/CT. Materials and Methods The imaging equipment used in this study was PET/CT Discovery 600 (GE Healthcare, MI, USA). 20 patients whose lesions were identified in the middle and lower lungs from May to August 2018 were enrolled in this study. After acquiring whole body image in the supine position, additional images of the lesion area were obtained in the prone position with the same conditions. SUVmax, SUVmean, and volume of the lesion were measured for each image, and the displacement of the lesion on PET and CT images were measured, compared, and analyzed. Results The SUVmax, SUVmean, and volume, and displacement of the lesion were $4.72{\pm}2.04$, $3.10{\pm}1.38$, $4.68{\pm}3.20$, and $4.64{\pm}1.88$, respectively for image acquired in the supine position and $5.89{\pm}2.42$, $3.97{\pm}1.65$, $2.13{\pm}1.09$, and $2.24{\pm}0.84$, respectively for image acquired in the prone position, indicating that, for all the lesions imaged, SUVmax and SUVmean were higher and volume and displacement were smaller in the images acquired in prone position compared to those acquired in supine one(p<0.05). Conclusion These results showed that the prone position PET/CT imaging improves the quality of the image by increasing the SUV of the lesion and reducing the respiratory artifacts caused by registration error between PET and CT images. It is considered that the PET/CT imaging in the prone position is helpful in the diagnosis of the disease as an economical and efficient methods that correct registration error for the lesions in basal lung and reduce artifacts.

A Study on the Change of Image Quality According to the Change of Tube Voltage in Computed Tomography Pediatric Chest Examination (전산화단층촬영 소아 흉부검사에서 관전압의 변화에 따른 화질변화에 관한 연구)

  • Kim, Gu;Kim, Gyeong Rip;Sung, Soon Ki;Kwak, Jong Hyeok
    • Journal of the Korean Society of Radiology
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    • v.13 no.4
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    • pp.503-508
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    • 2019
  • In short a binary value according to a change in the tube voltage by using one of VOLUME AXIAL MODE of scanning techniques of chest CT image quality evaluation in order to obtain high image and to present the appropriate tube voltage. CT instruments were GE Revolution (GE Healthcare, Wisconsin USA) model and Phantom used Pediatric Whole Body Phantom PBU-70. The test method was examined in Volume Axial mode using the pediatric protocol used in the Y university hospital of mass-produced material. The tube voltage was set to 70kvp, 80kvp, 100kvp, and mAs was set to smart mA-ODM. The mean SNR difference of the heart was $-4.53{\pm}0.26$ at 70 kvp, $-3.34{\pm}0.18$ at 80 kvp, $-1.87{\pm}0.15$ at 100 kvp, and SNR at 70 kvp was about -2.66 higher than 100 kvp and statistically significant (p<0.05) In the Lung SNR mean difference analysis, $-78.20{\pm}4.16$ at 70 kvp, $-79.10{\pm}4.39$ at 80 kvp, $-77.43{\pm}4.72$ at 100 kvp, and SNR at 70 kvp at about -0.77 higher than 100 kvp were statistically significant. (p<0.05). Lung CNR mean difference was $73.67{\pm}3.95$ at 70 kvp, $75.76{\pm}4.25$ at 80 kvp, $75.57{\pm}4.62$ at 100 kvp and 20.9 CNR at 80 kvp higher than 70 kvp and statistically significant (p<0.05) At 100 kvp of tube voltage, the SNR was close to 1 while maintaining the quality of the heart image when 70 kvp and 80 kvp were compared. However, there is no difference in SNR between 70 kvp and 80 kvp, and 70 kvp can be used to reduce the radiation dose. On the other and, CNR showed an approximate value of 1 at 70 kvp. There is no difference between 80 kvp and 100 kvp. Therefore, 80 kvp can reduce the radiation dose by pediatric chest CT. In addition, it is possible to perform a scan with a short scan time of 0.3 seconds in the volume axial mode test, which is useful for pediatric patients who need to move or relax.

Effects of vocal aerobic treatment on voice improvement in patients with voice disorders (성대에어로빅치료법이 음성장애환자의 음성개선에 미치는 효과)

  • Park, Jun-Hee;Yoo, Jae-Yeon;Lee, Ha-Na
    • Phonetics and Speech Sciences
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    • v.11 no.3
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    • pp.69-76
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    • 2019
  • This study aimed to investigate the effects of vocal aerobic treatment (VAT) on the improvement of voice in patients with voice disorders. Twenty patients (13 males, 7 females) were diagnosed with voice disorders on the basis of videostroboscopy and voice evaluations. Acoustic evaluation was performed with the Multidimensional voice program (MDVP) and Voice Range Profile (VRP) of Computerized Speech Lab (CSL), and aerodynamic evaluation with PAS (Phonatory Aerodynamic System). The changes in F0, Jitter, Shimmer, and NHR before and after treatment were measured by MDVP. F0 range and Energy range were measured with VRP before and after treatment, and the changes in Expiratory Volume (FVC), Phonation Time (PHOT), Mean Expiratory Airflow (MEAF), Mean Peak Air Pressure (MPAP), and Aerodynamic Efficiency (AEFF) with PAS. Videostroboscopy was performed to evaluate the regularity, symmetry, mucosal wave, and amplitude changes of both vocal cords before and after treatment. Voice therapy was performed once a week for each patient using the VAT program in a holistic voice therapy approach. The average number of treatments per patient was 6.5. In the MDVP, Jitter, Shimmer, and NHR showed statistically significant decreases (p < .001, p < .01, p < .05). VRP results showed that Hz and semitones in the frequency range improved significantly after treatment (p < .01, p < .05), as did PAS, FVC, and PHOT (p < .01, p < .001). The results for videostroboscopy, functional voice disorder, laryngopharyngeal reflux, and benign vocal fold lesions were normal. Thus, the VAT program was found to be effective in improving the acoustic and aerodynamic aspects of the voice of patients with voice disorders. In future studies, the effect of VAT on the same group of voice disorders should be studied. It is also necessary to investigate subjective voice improvement and objective voice improvement. Furthermore, it is necessary to examine the effects of VAT in professional voice users.

Trends and Prospects of Forest Meteorological Studies Based on the Publications in Korean Journal of Agricultural and Forest Meteorology (한국농림기상학회지 수록 논문에 기반한 산림기상 연구 추세와 전망)

  • Moon, Na Hyun;Shin, Man Yong;Moon, Ga Hyun;Chun, Junghwa
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.21 no.3
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    • pp.121-134
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    • 2019
  • This study was conducted to review the trends of forest meteorological studies based on the publications for last 20 years in Korean Journal of Agricultural and Forest Meteorology (KJAFM), and to provide insight for future prospect for researches in the field of forest meteorology. A total of 220 papers related to forest meteorology were published in KJAFM for the last 20 years. That corresponds to 33.5% out of all the papers including agricultural meteorology papers. To review the trends of forest meteorology studies, the 220 published papers were classified into seven categories. They are forest meteorology and forest fire, forest meteorology and tree physiology, forest meteorology and forest protection, micrometeorology in mountain area, climate and forest growth, climate and forest vegetation distribution, and climate change and forest ecosystem. Even if there were differences in paper numbers among the seven categories, it was found that various and very specific studies were conducted in the field of forest meteorology for the last 20 years. It was also expected that the accumulation and utilization of various and accurate forest meteorological information would bring remarkable progress of forest meteorological studies in the near future.

Conservation Scientific Diagnosis and Evaluation of Bird Track Sites from the Haman Formation at Yongsanri in Haman, Korea (함안 용산리 함안층 새발자국 화석산지의 보존과학적 진단 및 평가)

  • Lee, Gyu Hye;Park, Jun Hyoung;Lee, Chan Hee
    • Korean Journal of Heritage: History & Science
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    • v.52 no.3
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    • pp.74-93
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    • 2019
  • The Bird Track Site in the Haman Formation in Yongsanri (Natural Monument No. 222) was reported on the named Koreanaornis hamanensis and Jindongornipes kimi sauropod footprint Brontopodus and ichnospecies Ochlichnus formed by Nematoda. This site has outstanding academic value because it is where the second-highest number of bird tracks have been reported in the world. However, only 25% of the site remains after being designated a natural monument in 1969. This is due to artificial damage caused by worldwide fame and quarrying for flat stone used in Korean floor heating systems. The Haman Formation, including this fossil site, has lithofacies showing reddish-grey siltstone and black shale, alternately. The boundary of the two rocks is progressive, and sedimentary structures like ripple marks and sun cracks can clearly be found. This site was divided into seven formations according to sedimentary sequences and structures. The results of a nondestructive deterioration evaluation showed that chemical and biological damage rates were very low for all formations. Also, physical damage displayed low rates with 0.49% on exfoliation, 0.04% on blistering, 0.28% on break-out; however, the joint crack index was high, 6.20. Additionally, efflorescence was observed on outcrops at the backside and the northwestern side. Physical properties measured by an indirect ultrasonic analysis were found to be moderately weathered (MW). Above all, the southeastern side was much fresher, though some areas around the column of protection facility appeared more weathered. Furthermore, five kinds of discontinuity surface can be found at this site, with the bedding plane showing the higher share. There is the possibility of toppling failure occurring at this site but stable on plane and wedge failure by means of stereographic projection. We concluded that the overall level of deterioration and stability were relatively fine. However, continuous monitoring and conservation treatment and management should be performed as situations such as the physicochemical weathering of the fossil layer, and the efflorescence of the mortar adjoining the protection facility's column appear to be challenging to control.

Dietary behaviors and nutritional status according to the bone mineral density status among adult female North Korean refugees in South Korea (한국에 거주하고 있는 북한이탈주민 여성의 골밀도에 따른 식생활과 영양상태)

  • Kim, Su-Hyeon;Lee, Soo-Kyung;Kim, Sin-Gon
    • Journal of Nutrition and Health
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    • v.52 no.5
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    • pp.449-464
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    • 2019
  • Purpose: North Koreans could be at higher risk for their bone health because of previous periods of severe famine and the continuing low availability of food. This study determined the bone mineral density (BMD) status and its relationship with dietary behaviors and nutrient intake of North Korean refugees (NKR) in South Korea (SK). Methods: This cross-sectional study analyzed 110 female NKR from a NORNS cohort of a non-probability sample of adult NKR in Seoul. BMD examined by DEXA was used to divide participants into the normal group (NG) and the non-normal group (NNG) according to the WHO guideline. A self-administered questionnaire included questions on age, the socioeconomic situation in North Korea (NK) and SK, the food security in NK and SK, and the health behaviors, dietary behaviors, and food frequency questionnaire administered in SK. A one-day 24-hr recall was conducted and the results were analyzed by using CanPro. SPSS was used to analyze whether BMD and related dietary behaviors and nutrient intakes differed according to the groups. Results: NG (62.7%) was significantly younger and had a lower abdominal obesity score than NNG (p < 0.001). While 14.5% of NG reported experiencing menopause, all of NNG reported experiencing menopause. The NG more frequently consumed the dairy group of foods (9.6 times a week) than did the NNG (4.8 times a week) after the statistics were adjusted for age (p < 0.007). The NG consumed significantly more animal protein and animal calcium than did the NNG (p = 0.01, p = 0.009, respectively). Calcium intake was low with 49.3% of NG, and 78.0% of the NNG reported consuming calcium lower than the estimated average requirement. Only calcium showed an index of nutrient quality lower than one in both groups. Conclusion: These results showed that NKR women and possibly all North Korean women are at high risk for bone health and they consumed low levels of bone-related nutrients, and this should be considered for the nutrition policy for NKR and North Korea.

Optimization of GFR value according to Kidney Depth Measurement Methods (신장 Depth 측정 방법에 따른 GFR 값의 최적화)

  • Kwon, Hyeong-Jin;Moon, Il-Sang;Noh, Gyeong Woon;Kang, Keon Wook
    • The Korean Journal of Nuclear Medicine Technology
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    • v.23 no.2
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    • pp.25-28
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    • 2019
  • Purpose In patients with unusual kidney position after $^{99m}Tc-DTPA$ renal dynamic imaging study, the GFR(Glomerular Filtration Rate) values are significantly different according to the depth of the kidney. Thus, we tried to compare the difference of the GFR values between the depth measurement methods and in-vitro test. 30 adult patients who were subjected to renal study. 27 patients were in usual position and 3 patients were in unusual. $555{\pm}37MBq$ of $^{99m}Tc-DTPA$ was administrated to all patients. GE infinia gamma camera was used. GFR values were obtained in-vivo(gates method) and in-vitro(blood). The kidney depth in-vivo was calculated by three methods(tonnensen, manual, taylor). In-vitro, GFR was performed by blood test. Differences in the mean values of GFR and correlation between depth and GFR values were evaluated using the SPSS 12.0 statistical program. The GFR values for 27 patients with kidney in the usual position are as follows(1.tonnensen 2.manual 3.taylor 4.invitro); $69.3{\pm}4.2$, $88.2{\pm}5.6$, $77.8{\pm}4.3$, $82.2{\pm}5.8ml/min$. The three unusual cases are as follows, first(congenital renal anomaly): 66.4, 101.24, 69.07, 94.8 ml/min. second(transplantation kidney): 12.22, 29.99, 19.36, 23.5 ml/min. third(horseshoe kidney): 37.37, 93.54, 35.9, 92.5 ml/min. There was a difference between tonnensen and manual in the usual position of the kidney(p<0.05). There was no significant difference between the other methods. However, there was a significant difference in case of the unusual position of the kidneys. Correlation analysis between both kidney depth and GFR value shows person correlation as follows; Rt kidney: 0.298, Lt kidney: 0.322. When compared with the GFR values in-vitro test, it was useful to calculate the GFR value by measuring the kidney depth using a manual formula in the unusual position of the kidneys. GFR values and kidney depth were significantly related.