• Title/Summary/Keyword: 질병(疾病)

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STUDIES ON AVIAN VISCERAL LYMPHOMATOSIS I. THE INCREASED INCIDENSE AMONG CHICKEN FLOCKS AND PATHOLOGIC PICTURES (장기형임파종증(臟器型淋巴腫症)에 관(關)한 연구(硏究) 1. 계군(鷄群)에서의 임파종증(淋巴腫症)의 발생(發生) 및 병리학적소견(病理學的所見))

  • Kim, Uh Ho;Lim, Chang Hyeong
    • Korean Journal of Veterinary Research
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    • v.4 no.1
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    • pp.35-42
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    • 1964
  • 1). An nanlysis was made of 3,500 postmortem diagnoses for the three years 1961 through 1963 to determine whether there was any actual incidence of avian visceral lymphomntosis in the field. Chickens autopsied, which showed gross alterations were 7.6 percent or 266 cases. The diminished incidence of the disease in second and third years seemed due to decreased total numbers of chicken flocks year by year for the reason of difficult feed supply. 2). Because chickens autopsied in this study were not clearly known of their breeds and lines, no distinct data on the incidence in various breeds were made. Some exact breeds were in too small numbers to have any statistical significance. Inconceivably, no other types of avian leukosis than visceral lymphomatosis had been observed in any appreciable number in this analysis. 3). Pathologic analysis for affected organs was made grossly and microscopically. In the gross pictures, liver, spleen, kidney, ovary, and in some case, intestine principally showed lesions, but its manifestation was variable in different organs. In such organs, livers were affected more frequently, and spleens followed next. The organs were classified and arranged according to the gross alterations, and among their distribution one-half of livers were in diffuse variety; one-fourths in nodular; about one-sevenths in mixed; and granular variety followed next. In the spleen samples, two-thirds were in diffuse variety; one-fourths in nodular; and follicular only in three cases. Ovaries almost showed follicular lesions, the diffused were less than one-fifths of total specimens. Kidneys were occurred almost in diffuse variety. And intestine showed only nodular tomors. Microscopically, 42 cases of visceral lymphomatosis composed of 24 livers, 10 spleens, 3 kidneys, 3 intestines and 2 ovaries were examined. The tumor cells were lymphoid cells showing various component in size, shape and stainability. Mitotic figures were usually present. The proportion of the component cells were various in all cases and there were variations in the distribution of the tumor cells. The types of distribution were classified according to the standard proposed by Horiuchi as nodular, infiltrative and diffuse proliferation. In cases of visceral lymphomatosis of the livers and the spleens the types of infiltrative, nodular and diffuse proliferation could be classified. In the cases of the kidneys the types of diffuse and nodular proliferation were observed. In the cases of the intestines and the ovaries the types of infiltrative and diffuse proliferation were observed respectively.

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Radiotherapy in Incompletely Resected Gastric Cancers (불완전 절제된 위암의 방사선 치료)

  • Kim Jong Hoon;Choi Eun Kyung;Cho Jung Gil;Kim Byung Sik;Oh Sung Tae;Kim Dong Kwan;Chang Hyesook
    • Radiation Oncology Journal
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    • v.16 no.1
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    • pp.17-25
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    • 1998
  • Purpose : Although local recurrence rates of stomach cancer after radiocal surgery have been reported in the range of $30-70\%$, the role of postoperative adjuvant therapy has not been established. We report the result of radiotherapy in resected stomach cancer with positive surgical margin to elucidate the role of postoperative radiotherapy. Materials and Methods : From June 1991 to August 1996, twenty five patients with positive surgical margins after radical gastrectomy were treated with postoperative radiotherapy and chemotherapy. Median dose of radiation was 55.8Gy and the range was 44.6-59.4Gy. Second cycle of chemotherapy was delivered concurrently with radiation and total number of six cycles were delivered. Twenty three had adenocarcinoma and the other two had leiornyosarcoma. The numbers of patients with stage I B, II, III A, III B, and IV were 1, 2, 11, 10 and 1 respectively. Positive margins at distal end of the stomach were in 17 patients and proximal in 5. The other three patients had positive margin at the sites of adjacent organ invasion Minimum and median follow-up periods were 12 months and 18 months, respectively, Results : Twenty-four of 25 patients received prescribed radiation dose and RTOG grade 3 toxicity of UGI tract was observed in 3, all of which were weight loss more than $15\%$ of their pretreatment weight. But hematemesis. melena, intestinal obstruction or grade 4 toxicity were not found. Locoregional failure within the radiation field was observed in 7 patients, and distant metastasis in 10 patients. Sites of locoregional recurrences involve anastomosis/remnant stomach in 3, tumor bed/duodenal stump in 3, regional lymph node in 1 patient Peritoneal seeding occurred in 6, liver metastases months and median disease free survival time was 26 months. Stages andradiation dose were not significant prognostic factors for locoregional in 2, and distant nodes in 2 patients. Four year disease specificsurvival rate was $40\%$ and disease free survival was $48\%$. Median survival was 35 failures. Conculsion : Although all patients in this study had positive surgical margins, locoregional failure rate was $28\%$, and 4 year disease specific survival rate was $40\%$. Considering small number of patients and relatively short follow-up period, it is not certain that postoperative radiotherapy lowered locoregional recurrences. but we could find a Possibility of the role of postoperative radiotherapy in Patients with high risk factors.

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Patient Satisfaction with Cancer Pain Management (암성통증관리 만족도)

  • Lee, So-Woo;Kim, Si-Young;Hong, Young-Seon;Kim, Eun-Kyung;Kim, Hyun-Sook
    • Journal of Hospice and Palliative Care
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    • v.6 no.1
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    • pp.22-33
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    • 2003
  • Purpose : The purpose of this study was to evaluate the present status of patients' satisfaction and the reasons for any satisfaction or dissatisfaction in cancer pain management Methods : A cross-sectional survey was used to obtain the feedback about pain management. The results of the survey were collected from 59 in- or out-patient who had cancer treatment at two of the teaching hospitals in Seoul from July, 2002 to November, 2002. The data was obtained by a structured questionnaire based on the American Cancer Society Patient Outcome Questionnaire(APS-POQ) and other previous research. The clinical information for all patients were compiled by reviewing their medical records. Resuts : 1) The subjects' mean score of the worst pain was 6.77, the average pain score was 3.80, and the pain score after management was 2.93 for the past 24 hours. The mean score of total pain interference was $25.03{\pm}12.82$. Many of the subjects had false beliefs about pain such as 'the experience of pain is a sign that the illness has gotten worse', 'pain medicine should be 'saved' in case the pain gets worse' and 'people get addicted to pain medicine easily'. 2) 66.1% of the subjects were properly medicated with analgesics. 33.9% of the subjects reported use of various methods in controlling pain other than the prescribed medication. Only 33.9% of the subjects had a chance to be educated about pain management by doctors or nurses. 3) The mean score of patients' satisfaction with pain management was $4.19{\pm}1.14$. 72.9% of the subjects answered 'satisfied' with pain management. The reasons for dissatisfaction were 'the pain was not relieved even after the pain management', 'I was not quickly and promptly treated when I complained of pain', 'doctors and nurses didn't pay much attention to my complaints of pain.', and 'there was no appropriate information given on the methods of administration, effect duration and side effects of pain medicine.' The reasons for satisfaction were: 'the pain was relieved after the pain management.', 'doctors and nurses quickly and promptly controlled my pain.', 'doctors and nurses paid enough attention to my complaints of pain.' and 'trust in my physician'. 4) In pain severity or pain interference, no significant difference was found between the satisfied group and dissatisfied group. On the belief 'good patients avoid talking about pain', a significant difference was found between the satisfied group and dissatisfied group. Conclusions : The patients' satisfaction with cancer pain management has increased over the years but still about 30% of patients reported to be 'not satisfied' for various reasons. The results of this study suggest that patients' education should be done to improve satisfaction in the pain management program.

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Development and Validation of an Analytical Method for Fungicide Fluoxastrobin Determination in Agricultural Products (농산물 중 살균제 Fluoxastrobin의 시험법 개발 및 유효성 검증)

  • So Eun, Lee;Su Jung, Lee;Sun Young, Gu;Chae Young, Park;Hye-Sun, Shin;Sung Eun, Kang;Jung Mi, Lee;Yun Mi, Chung;Gui Hyun, Jang;Guiim, Moon
    • Journal of Food Hygiene and Safety
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    • v.37 no.6
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    • pp.373-384
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    • 2022
  • Fluoxastrobin a fungicide developed from Strobilurus species mushroom extracts, can be used as an effective pesticide to control fungal diseases. In this study, we optimized the extraction and purification of fluoxastrobin according to its physical and chemical properties using the QuEChERS method and developed an LC-MS/MS-based analysis method. For extraction, we used acetonitrile as the extraction solvent, along with MgSO4 and PSA. The limit of quantitation of fluoxastrobin was 0.01 mg/kg. We used 0.01, 0.1, and 0.5 mg/kg of five representative agricultural products and treated them with fluoxastrobin. The coefficients of determination (R2) of fluoxastrobin and fluoxastrobin Z isomer were > 0.998. The average recovery rates of fluoxastrobin (n=5) and fluoxastrobin Z isomer were 75.5-100.3% and 75.0-103.9%, respectively. The relative standard deviations (RSDs) were < 5.5% and < 4.3% for fluoxastrobin and fluoxastrobin Z isomer, respectively. We also performed an interlaboratory validation at Gwangju Regional Food and Drug Administration and compared the recovery rates and RSDs obtained for fluoxastrobin and fluoxastrobin Z isomer at the external lab with our results to validate our analysis method. In the external lab, the average recovery rates and RSDs of fluoxastrobin and fluoxastrobin Z isomer at each concentration were 79.5-100.5% and 78.8-104.7% and < 18.1% and < 10.2%, respectively. In all treatment groups, the concentrations were less than those described by the 'Codex Alimentarius Commission' and the 'Standard procedure for preparing test methods for food, etc.'. Therefore, fluoxastrobin is safe for use as a pesticide.

The Literary Investigation On Types and Cooking Method of Bap (Boiled Rice) During Joseon Dynasty($1400's{\sim}1900's$) (조선시대 밥류의 종류와 조리방법에 대한 문헌적 고찰(1400년대${\sim}1900$년대까지))

  • Bok, Hye-Ja
    • Journal of the Korean Society of Food Culture
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    • v.22 no.6
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    • pp.721-741
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    • 2007
  • 1. For the types of boiled rice, there were 1 type of bap, 1 type of jebap cooked with glutinous rice, 13 types of boiled rice cooked by mixing grains and nuts such as daemakban, somakban, jobap, cheongryangmiban, jobap, gijangbap, yulmubap, hyeonmibap, boribap and patmulbap as well as patbap, congbap, byeolbap and bambap etc as ogokbap. Also, there were 12 types of bap cooked by mixing herb medicinal ingredients such as cheongjeong, oban, boksungabap, gumeunsaekbap, hwanggukgamchobap, yeongeunbap, okjeongbap, gogumabap, dububap, samssibap, dorajibap, gamjabap, songibap and jukshilbap. There were 7 types bap cooked as unique one bowl dish at the present as bapby mixing fish, meat, shellfish and milk as ingredients are hwangtang, gyejanggukbap, janggukbap, gulbap, kimchibap, chusaban and bibimbap, etc and the types of bap that have been analyzed are 34 total. 2. For the food ingredients used in bap types 23 types of miscellaneous grains, 5 types of nuts and 11 types of meat, 6 types of fish, 35 types of vegetables, 2 types of fruit including pears or peaches were used. Garlic wasn't used perhaps because of it being boiled rice 3. Types of Sap by Cooking Methods. (1) The ssalbap was cooked by first boiling water, putting in rice grains and boiling hard to be cooked as overcooked bap (rice). (2) The japgokbap (boiled cereals) has used buckwheat, barley job's tear, etc to be boiled down by soaking the ones with large grains (beans) first in advance to be boiled down or cooked by crushing into fine pieces. The red bean, etc was boiled down in advance or placed at the bottom of pot by cutting into two pieces while jujube or nut was cut into three pieces to cook the bap by pouring a lot of water and mixing other ingredients. (3) The gukbap (soup boiled rice), etc were cooked by squeezing out the yellow chrysanthemum that has dried chrysanthemum to cook the boiled rice by putting in rice and gukbap, meat or bones, etc were boiled down for a long time and decorated with meat or wild greens by mixing the bap in the meat juice. For gulbap (oyster boiled rice), etc, it was cooked as ingredients were stir fried in advance or washed and put in when the bap was about half cooked. (4) For bibimbap (mixed boiled rice), after the bap was overcooked first with rice, the wild greens were mixed lightly with bap beforehand, then the wild greens, decorations and garnishings were laid above rice and red pepper powder was sprinkled. (5) Namchok leaves, etc were boiled to cook the boiled rice with rice after being cooled while namchok stem and leaves were pounded to make juice and cooked the bap with rice. The peach, lotus root and yams were cut into fine pieces to be put in together when rice was about half done. The bellflower was soaked in water to be boiled down for a long time while potatoes and pine mushrooms, etc were cut into fine pieces to cook the bap (boiled rice) with rice.

The Development of the Korean Evaluation Scale for Hearing Handicap (KESHH) for the Geriatric Hearing Los (노인성난청을 위한 청각장애평가지수(KESHH)의 개발)

  • Ku, Ho-Lim;Kim, Jin-Sook
    • 한국노년학
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    • v.30 no.3
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    • pp.973-992
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    • 2010
  • The hearing impairment is the representative disorder that affects the quality of the routine life of the aged period. This study was aimed to develop the Korean evaluation scale for hearing handicap(KESHH) with which we can evaluate social and psychological effects of the hearing impairment. Applying this scale clinically, we can analyze the geriatric hearing loss specifically and improve the quality of the aural rehabilitation that can help the hardness of the hearing impairment. Data were collected from 288 participants(176 hearing aid users and 112 non-hearing aid users) and the average age of the participants was 67.4 years old ( 60.15 for the hearing aids users and 78.9 for the non hearing users). The composition ratio of the male and female participants were 58.0% and 42.0% and extrovert and introvert personality were 49.3% and 50.7% showing balanced formation. The tentative draft of KESHH measurements were produced with 30 items and following 5 subscales. Using factor analysis, 6 items were erased and 4 subscales - social effect, psycho/emotional effect, interpersonal effect, and perception of hearing aids - were identified. As each subscale consisted of 6 items, 24 items were corrected and remained totally. Conclusively, the KESHH was developed with 24 items and 4 subscales including 6 items on each subscale. In addition, the KESHH was divided into type-1 and 2 depending on hearing aid users and non hearing aid users. The results of this study can be summarized as the following 5 parts. Firstly, the reliabilities of the KESHH were proved to be high because the subscales' Cronbach alpha values were from 0.723 through 0.895. Secondly, the KESHH showed systematically increasing score as the hearing impairment increased. The lowest score was 24 and the highest score was 117 and the average scores of the hearing impaired and non-hearing impaired are 72.06(SD=15.67) and 66.98(SD=20.94) showing 5.08 increased score for the hearing impaired. Depending on the degree of the hearing loss, the scores recorded 52.63 at the below of the mild hearing loss, 67.29 for the moderate hearing loss, 71.89 for the moderately severe hearing loss, and 75.57 for the severe hearing loss The comparison of the scores by hearing levels indicated that the higher the hearing levels were, the higher the scores of the KESHH with statistical significance(p<0.001). Thirdly, the correlation among 4 subscales was 0.384~0.880(p<0.001). Also, the pure tone average, personality, and the four subscales correlations showed statistical significance with 0.148~0.880 except for the pure tone average and personality and the pure tone average and perception of hearing aids. Fourthly, the total variances explained for the independent subscles were analyzed with multiple regression. The social effect was explained 17.4% with pure tone average, personality, and the status of hearing aid use variances. The psycho/emotional effect was explained 14.4% with puretone average, personality, and age variances. The interpersonal effect was explained 11.2% with pure tone average, personality, and the status of hearing aid use variances. The perception of hearing aids effect was explained 2.2% with only personality. Finally, test-retest reliability was proved to be high with 0.791(p<0.001). Conclusively, the KESHH that was developed considering Korean culture can be a useful instrument for expressing the hearing handicaps of the Korean aged hearing impaired in scores for both hearing aid users and non-users. Also, it is thought that the KESHH is useful clinically for identifying the changes of the hearing handicap scores before and after wearing hearing aids and aural rehabilitation at diverse situations.

Effects of climate change on biodiversity and measures for them (생물다양성에 대한 기후변화의 영향과 그 대책)

  • An, Ji Hong;Lim, Chi Hong;Jung, Song Hie;Kim, A Reum;Lee, Chang Seok
    • Journal of Wetlands Research
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    • v.18 no.4
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    • pp.474-480
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    • 2016
  • In this study, formation background of biodiversity and its changes in the process of geologic history, and effects of climate change on biodiversity and human were discussed and the alternatives to reduce the effects of climate change were suggested. Biodiversity is 'the variety of life' and refers collectively to variation at all levels of biological organization. That is, biodiversity encompasses the genes, species and ecosystems and their interactions. It provides the basis for ecosystems and the services on which all people fundamentally depend. Nevertheless, today, biodiversity is increasingly threatened, usually as the result of human activity. Diverse organisms on earth, which are estimated as 10 to 30 million species, are the result of adaptation and evolution to various environments through long history of four billion years since the birth of life. Countlessly many organisms composing biodiversity have specific characteristics, respectively and are interrelated with each other through diverse relationship. Environment of the earth, on which we live, has also created for long years through extensive relationship and interaction of those organisms. We mankind also live through interrelationship with the other organisms as an organism. The man cannot lives without the other organisms around him. Even though so, human beings accelerate mean extinction rate about 1,000 times compared with that of the past for recent several years. We have to conserve biodiversity for plentiful life of our future generation and are responsible for sustainable use of biodiversity. Korea has achieved faster economic growth than any other countries in the world. On the other hand, Korea had hold originally rich biodiversity as it is not only a peninsula country stretched lengthily from north to south but also three sides are surrounded by sea. But they disappeared increasingly in the process of fast economic growth. Korean people have created specific Korean culture by coexistence with nature through a long history of agriculture, forestry, and fishery. But in recent years, the relationship between Korean and nature became far in the processes of introduction of western culture and development of science and technology and specific natural feature born from harmonious combination between nature and culture disappears more and more. Population of Korea is expected to be reduced as contrasted with world population growing continuously. At this time, we need to restore biodiversity damaged in the processes of rapid population growth and economic development in concert with recovery of natural ecosystem due to population decrease. There were grand extinction events of five times since the birth of life on the earth. Modern extinction is very rapid and human activity is major causal factor. In these respects, it is distinguished from the past one. Climate change is real. Biodiversity is very vulnerable to climate change. If organisms did not find a survival method such as 'adaptation through evolution', 'movement to the other place where they can exist', and so on in the changed environment, they would extinct. In this respect, if climate change is continued, biodiversity should be damaged greatly. Furthermore, climate change would also influence on human life and socio-economic environment through change of biodiversity. Therefore, we need to grasp the effects that climate change influences on biodiversity more actively and further to prepare the alternatives to reduce the damage. Change of phenology, change of distribution range including vegetation shift, disharmony of interaction among organisms, reduction of reproduction and growth rates due to odd food chain, degradation of coral reef, and so on are emerged as the effects of climate change on biodiversity. Expansion of infectious disease, reduction of food production, change of cultivation range of crops, change of fishing ground and time, and so on appear as the effects on human. To solve climate change problem, first of all, we need to mitigate climate change by reducing discharge of warming gases. But even though we now stop discharge of warming gases, climate change is expected to be continued for the time being. In this respect, preparing adaptive strategy of climate change can be more realistic. Continuous monitoring to observe the effects of climate change on biodiversity and establishment of monitoring system have to be preceded over all others. Insurance of diverse ecological spaces where biodiversity can establish, assisted migration, and establishment of horizontal network from south to north and vertical one from lowland to upland ecological networks could be recommended as the alternatives to aid adaptation of biodiversity to the changing climate.

Variation of Vital Sign according to Time in Full Immersion of Hot and Cool Bath (온.냉욕 전신침수욕시 기간에 따른 vital sign의 변화)

  • Yi, Seung-Ju
    • Journal of Korean Physical Therapy Science
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    • v.3 no.3
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    • pp.35-49
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    • 1996
  • This study was conducted to see variation of vital sign of hot and cool bath according to time, a questionnair survey and measurement was carried out for 32 students(sophomore) of department of physical therapy Andong Junior College on the 27th of June, 1995. The result were as follows: The average systolic blood pressure(SBP) of stability for 32 college students who were measured was 105.3mmHg, the average diastolic blood pressure(DBP) was 67.3mmHg, the average pulse frequency(PF) was 70.7(frequency/min), the average respiratory frequency (RF) was 15.6 (frequency/min), and the body temperature(BT) was $36.6^{\circ}C$. As time went on, SBP for 32 students who were measured in hot bath according to stability, 3 min, 6 min, 9 min, and 12 min was decreased(105.15 mmHg, 104.69mmHg, 104.24 mmHg, 103.03 mmHg, and 96.69 mmHg)(P=0.3006). SBP was decreased in cool bath, too(105.15 mmHg, 103.33 mmHg, 103.33 mmHg, and 100.91 mmHg), but it at 12 min was a little higher(l03.09 mmHg)(P=0.7566). As time went on, DBP according to stability, 3 min, 6 min, 9 min, and 12 minutes was decreased in hot bath(66.82 mmHg, 65.45 mmHg, 64.54 mmHg, 63.03 mmHg, and 59.39 mmHg)(P=0.0906). It was similar in cool bath(66.82 mmHg, 67.87 mmHg, 68.48 mmHg, 67.87 mmHg, and 68.78)(P=0.9654). As time went on, PF was significantly increased in hot bath(70.42 times, 86.96 times, 93.57 times, 99.30 times, and 101.78 times)(P=0.0001). It was a little increased in cool bath, too (70.42 times, 70.85 times, 71.63 times, 71.06 times, and 71.45 times)(P=0.9803). As time went on, RF was significantly increased in hot bath(15.75 times, 19.09 times, 22.09 times, 24.94 times, and 26.48 times)(P=0.0001). I t in cool bath of stability, 3 min, and 6 min was a little increased(15.75 times, 19.30 times, 19.39 times), but it in 9 min(18.67 times), and 12 min(18.09 times) was a little decreased(P=0.0176). As time went on, BT was significantly increased in hot bath($36.63^{\circ}C,\;37.45^{\circ}C,\;37.81^{\circ}C,\;38.12^{\circ}C,\;38.33^{\circ}C$)(P=0.0001). It was a little increased in cool bath of stability and 3 min($36.63^{\circ}C,\;37.40^{\circ}C$), but others are similar($37.33^{\circ}C,\;37.37^{\circ}C$, and $37.36^{\circ}C$)(P=0.0001). It was revealed by this study, SBP and DBP according to time in hot and cool bath were decreased. PF, RF, and BT in hot bath were higher, RF and BT in cool bath were higher too. but PF was similar.

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Comparative Analysis of Community Health Practitioner's Activities and Primary Health Post Management Before and After Officialization of Community Health practitioner (보건진료원의 정규직화 전과 후의 보건진료원 활동 및 보건진료소 관리운영체계의 비교 분석)

  • Yun, Suk-Ok;Jung, Moon-Sook
    • Journal of agricultural medicine and community health
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    • v.19 no.2
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    • pp.141-158
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    • 1994
  • To provide better health care services to the rural population, the government has made the Community Health Practitioner(CHP) a regular government official from April 1, 1992. This study was carried out to study the impact of officialization of CHP on the activities and management system of Primary Health Post(PHP). Fifty PHPs were selected by two stage sampling, cluster and simple random, from 595 PHPs in Kyungnam and Kyungpook provinces. Data were collected by a personal interview with CHPs and review of records and reports kept in the PHPs. The study was done for the periods of January 1-March 31, 1992 (before officialization) and January 1-March 31, 1993 (after officialization). Ninety-six percent of the CHPs wanted to become a regular government official in the hope of better job security and higher salary. The proportion of CHPs who were proud of their iob was increased from 24% to 46% after officialization. Those CHPs who felt insecure for their job decreased from 30% to 10%. Monthly salary was increased by 34% from 802,600 Won to 1,076,000 Won and 90% of the CHPs were satisfied with their salary, also more CHPs responded that they have autonomy in their work planning, implementation of plan, management of the post, and evaluation of their activity. There were no appreciable changes in such CHPs' activities as assessment of local health resources, drawing map for the catchment area, utilization of community organization, grasping the current population structure in the catchment area, keeping the family health records, individual and group health education, and school health service. However, the number of home visits was increased from 13.6 times on the average per month per CHP to 27.5 times. More mothers and children were referred to other medical facilities for the immunization and family planning services. Average number of patients of hypertension, cancer, and diabetes in three months period was decreased from 12.7 to 11.6, from 1.5 to 1.2, and 4.3 to 3.4, respectively. Records for the patient care, drug management, and equipment were well kept but not for other records. The level of record keeping was not changed after officialization. The proportion of PHPs which had support from the health center was increased for drug supply from 14.0% to 30.0%, for consumable commodities from 22.0% to 52.0%, for maintenance of PHP from 54.0% to 68.0%, for supply of health education materials from 34.0% to 44.0%, and supply of equipment from 54.0% to 58.0%. Total monthly revenue of a PHP was increased by about 50,000 Won; increased by 22,000 Won in patient care and 34,700 Won in the government subsidy but decreased in the membership due and donation. However, there was no remarkable changes in the expenditure. The proportion of PHPs which had received official notes from the health center for the purpose of guidance and supervision of the CHPs was increased from 20% to 38% during three months period and the average number of telephone call for supervision from the health center per PHP was increased from 1.8 to 2.1 times(p<0.01). However, the proportion of PHPs that had supervisory visit and conference was reduced from 79% to 62%, and from 88% to 74%, respectively. The proportion of CHPs who maintained a cooperative relationship with Myun Health Workers was reduced from 42% to 36%, that with the director of health center from 46% to 24%, that with the chief of public health administration section from 56% to 36%, and that with the chairman of PHP management council from 62% to 38%. Most of the CHPs (92% before and 82% after officialization) stated that the PHP management council is not helpful for the PHP. CHPs who considered the PHP management council unnecessary increased from 4% to 16%(p<0.05). Suggestions made by the CHPs for the improvement of CHP program included emphasis on health education, assurance of autonomy for PHP management, increase of the kind of drugs that can be dispensed by CHPs, and appointment of an experienced CHP in the health center as the supervisor of CHPs. The results of this study revealed that the role and function of CHPs as reflected in their activities have not been changed after officialization. However, satisfaction in job security and salary was improved as well as the autonomy. Support of health center to the PHP was improved but more official notes were sent to the PHPs which required the CHPs more paper works. Number of telephone calls for supervision was increased but there was little administrative and technical guidance for the CHP activities.

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Matrix Metalloproteinase in Idiopathic Pulmonary Fibrosis (특발성 폐섬유화증환자의 기관지폐포세척액 및 폐포대식세포 배양액의 Matrix metalloproteinase의 변화)

  • Park, Joo-Hun;Shim, Tae-Sun;Lim, Chae-Man;Koh, Youn-Suck;Lee, Sang-Do;Kim, Woo-Sung;Kim, Won-Dong;Kim, Dong-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.4
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    • pp.303-314
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    • 2001
  • Background : Matrix metalioproteinase(MMP)-2 and MMP-9 have been known to play an important role in cell migration and the tissue remodeling process by type IV collagen lysis, a major component of the basement membrane. Intra-alveolar fibrosis, secondary to an injury to the basement membrane of the alveolar epithelial lining, is a major process in the pathogenesis of idiopathic pulmonary fibrosis(IPF). Therefore, MMP-2 and MMP-9 was hypothesized to play an important role in IPF pathogenesis. As a result, their level may reflect the activity or prognosis. Method : Forty one progressive IPF patients(age $59.82{\pm}1.73$ years, M:F=23:18), 16 patients with stable IPF for more than one year without therapy(age : $63.6{\pm}2.8$ years, M:F=13:3), and 7 normal controls were enrolled in this study. The MMP-2 and MMP-9 levels in the BAL fluid and alveolar macrophage conditioned media(AM-CM) were measured by zymography and the TIMP-1 level was measured by ELISA. Results : 1) The MMP-2 level in BALF was highest in the progressive IPF group ($1.36{\pm}0.28$) followed by the stable group ($0.46{\pm}0.13$) and the controls ($0.08{\pm}0.09$), which was statistically significant. The MMP-9 level of the IPF ($0.31{\pm}0.058$) and the stable group ($0.22{\pm}0.078$) were higher than that of the control group ($0.002{\pm}0.004$). In the AM-CM, only MMP-9 was detected, which was significantly higher in IPF group ($0.80{\pm}0.1O$) than in the control group($0.23{\pm}0.081$). The TIMP-1 level was also higher in both the IPF ($36.34{\pm}8.62\;{\mu}g/ml$) and stable group ($20.83{\pm}8.53\;{\mu}g/ml$) compared to the control group ($2.80{\pm}1.05\;{\mu}g/ml$) (p<0.05). 3) There was a correlation between the MMP-2 level in the BALF with the total cell number(r=0.298) and neutrophils(r=0.357) (p<0.05), and the MMP-9 level with the number of neutrophils (r=0.407) and lymphocytes (r=0.574)(p<0.05). The TIMP-1 level correlated with the total number of cell (r=0.338, p<0.05) and neutrophils(r=0.449, p=0.059). Conclusion : Both MMP and TIMP appear to play an important role in IPF pathogenesis, and their level may reflect the disease activity.

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