• Title/Summary/Keyword: Adherence

검색결과 935건 처리시간 0.028초

Novel target genes of hepatocellular carcinoma identified by chip-based functional genomic approaches

  • Kim Dong-Min;Min Sang-Hyun;Lee Dong-Chul;Park Mee-Hee;Lim Soo-Jin;Kim Mi-Na;Han Sang-Mi;Jang Ye-Jin;Yang Suk-Jin;Jung Hai-Yong;Byun Sang-Soon;Lee Jeong-Ju;Oh Jung-Hwa
    • 한국생물정보학회:학술대회논문집
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    • 한국생물정보시스템생물학회 2006년도 Principles and Practice of Microarray for Biomedical Researchers
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    • pp.83-89
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    • 2006
  • Cellular functions are carried out by a concerted action of biochemical pathways whose components have genetic interactions. Abnormalities in the activity of the genes that constitute or modulate these pathways frequently have oncogenic implications. Therefore, identifying the upstream regulatory genes for major biochemical pathways and defining their roles in carcinogenesis can have important consequences in establishing an effective target-oriented antitumor strategy We have analyzed the gene expression profiles of human liver cancer samples using cDNA microarray chips enriched in liver and/or stomach-expressed cDNA elements, and identified groups of genes that can tell tumors from non-tumors or normal liver, or classify tumors according to clinical parameters such as tumor grade, age, and inflammation grade. We also set up a high-throughput cell-based assay system (cell chip) that can monitor the activity of major biochemical pathways through a reporter assay. Then, we applied the cell chip platform for the analysis of the HCC-associated genes discovered from transcriptome profiling, and found a number of cancer marker genes having a potential of modulating the activity of cancer-related biochemical pathways such as E2F, TCF, p53, Stat, Smad, AP-1, c-Myc, HIF and NF-kB. Some of these marker genes were previously blown to modulate these pathways, while most of the others not. Upon a fast-track phenotype analysis, a subset of the genes showed increased colony forming abilities in soft agar and altered cell morphology or adherence characteristics in the presence of purified matrix proteins. We are currently analyzing these selected marker genes in more detail for their effects on various biological Processes and for Possible clinical roles in liver cancer development.

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철도 분기기 밀착검지기 Life expectancy의 유지보수 주기 결정에 관한 연구 (Study on the Maintenance Interval Decisions for Life expectancy in Railway Turnout clearance Detector)

  • 장병목;이종우
    • 한국철도학회논문집
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    • 제20권4호
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    • pp.491-499
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    • 2017
  • 철도 분기기는 철도에 가장 중요한 시스템 중 하나이며, 분기기가 이상이 발생하였을 경우에는 사고가 발생할 수 있다. 분기기의 상태를 검지하기 위해서 밀착검지기를 사용한다. 밀착검지기의 고장은 분기기의 고장으로 간주되어 열차운행에 커다란 장애가 될 수 있다. 분기기 밀착검지기의 고장 특성분석은 분기기의 운용에서 매우 중요하다. 밀착검지기의 운용특성 및 고장특성을 분석하기 위해서, 밀착검지기를 본선(A) 및 측선(B), 분기기 동작 횟수가 10회 미만(C) 및 80회 이상(D)로 분류하였다. 선정된 밀착검지기 140대를 기준으로 밀착검지기 고장특성을 분석하였다. 분기기의 고장은 제어부, 케이블 및 검지센서에 발생하였으며, 이 데이터를 운용 환경(A, B, C, D)에 따라 분류하였으며 각각의 고장밀도함수를 선정하고 모수를 추론하여 사전분포 값을 선정하였다. Bayesian추론을 이용하여 기기의 평균수명과 한계수명(Life expectancy)을 예측하여 밀착검지기 제어부에 대한 교체시점을 제시하였다.

자가간호증진을 위한 건강계약이 고혈압자의 건강행위 이행에 미치는 영향 (A Study of the Effects of Health Contracting on Compliance with Health Behaviors in Clients with Hypertension)

  • 이향련
    • 대한간호학회지
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    • 제17권3호
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    • pp.204-217
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    • 1987
  • It is generally accepted that the delivery of health care is undergoing many changes specially those related to acute, contagious disease care and to the increase of chronic illnesses which can not be cured but are controlable. The health care practitioner can not be soley responsible for the control of their clients' care. Because the clients will play a vital role in controlling their illnesses, long term participation by both the health care provider and the client is necessary. Since most individuals with hypertension do not experience signs or symptoms, the disease is difficult to detect and even when diagnosed, clients do not comply well with their hypertension regimens. The noncompliant client is at increased risk for compliants involving the heart, brain, kidney and other organs. In an effort to explore methods of increasing patient participation in and adherence to treatment programs for hypertension, the researcher used health contracting to promote self care. The research questions are; 1) Will the health contracting increase compliance in health behavior and reduce the blood pressure\ulcorner 2) If clients comply with their regimens will this reduce their blood pressure\ulcorner The research design utilized in this study was a quasi-experimental design. A purposive sample, was abtained from two churches in the 1. area, consisting of 64 clients with hypertension. The data was collected from the middle of January to the 1st of September 1985. Randomization was only of the two church groups into experimental and control groups. Compliance with health behavior related to the hypertensive regimen, blood pressure and body weight were measured, compared and analyzed. In the experimental group measurements were made 6 times; one month before the education program after education program when health contracting was done and 4 more times once a month for 4 months. In the control group measurements were made 3 times; one month before the education program after the education program, and once 4 months later. There was no health contracting. The data were analyzed by t-test, Pearson correlation and ANOVA according to purpose of the study. The result of this study may be summarized as follows: The result related to the hypothesis on the effect of health contracting are as follows: H$_1$; “The hypothesis that the experimental group, with a health contractual agreement will demonstrate increased compliance levels for health behavior than the control group” was supported(t=-5.29, df=62, p=.000). H$_2$; “The hypothesis that the experimental group, with a health contractual agreement, will demonstrate a greater reduction in blood pressure than the control group” was supported (for systolic blood pressure t=2.72, df=62, p=.009, for diastolic blood pressure t=1.95, df=62, p=.050). H$_3$; The hypothesis that the greater the compliance of the client with health behavior the lower the client's blood pressure will be was partially supported (for systolic pressure r=-.2981, p=.008, for diastolic pressure r=-.1720, p=.087). From the examination of the results of this study it can be concluded that the interaction between the nurse and the client, contracting to define goals and reinforcing compliant behavior, leads to improved compliance with health care behaviors and thus to an increase in the effectiveness of nursing care. Further consideration need to be given to the inclusion of the concept of health contracting in primary nursing and to further research in this area.

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성인 남성의 혈압과 식이섭취 실태 및 기타 환경 요인과의 관계에 대한 사례연구 (Correlations among Blood Pressures, Dietary Intakes and Other Environmental Factors in Korean Adult Males)

  • 이일하
    • 대한가정학회지
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    • 제24권4호
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    • pp.57-68
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    • 1986
  • The present survey was designed to investigate correlations among blood pressure, nutritional intakes, and various environmental factors in Korean adult males, and to observe the difference in dietary intakes between hypertensive patients and normotensive subjects. Two hundred forty-three adult men from Seoul and rural areas were interviewed about their food intakes, dietary patterns, food habits, and general environmental factors from December 20, 1982 to February 15, 1983. Their dietary intakes were surveyed by means of 24-hour recall diet method. Dietary score card was used in order to evaluate the quality of routine diet of the subject. Variables of environmental factors and factors related to hypertension were expressed as percentage, and the differences in nutrient intake and food score of each sub-group were examined by means of t-test. Correlation of all the variables were analyzed by Pearsons Correlation Coefficient. The results obtained are summarized as follows: 1. 38% of the subjects were between the ages of 40~49, and about one-half of the subjects were middle or high school graduates. 28% of the subjects earned 210, 000~350, 000 Won per month, and income distribution was almost identical to that of the urban population of Korea. 2. There was more overweight or obese found in the hypertensive patients than in the normotensive subjects. About 40% of the hypertensive patients reported a family history of hypertension, and their knowledge about hypertension was rather poor, but slightly better than the normotensive subjects. The patient group had less adherence to smoking and alcohol compared with the normotensive subjects, but no difference was observed in coffee drinking. The mean value of the blood pressure for the normotensive subjects was 127/86mmHg and 175/109mmHg for the hypertensive group. 3. Nutrient intake for the hypertensive group was lower for most of nutrients than in the healthy group. Hypertensive patients on diet therapy consumed less calories and carbohydrates compared with those who do not follow diet therapy. 4. There was no difference intake of these food groups between patients and the healthy group. Food score was strongly related to consumption of animal protein, saturated fats, Calcium, Iron, Vitamin A, Riboflavin, and Vitamin C, which are prone to be deficient in the typical Korean diet. 5. Blood pressure had a strong positive correlation with age, body weight, and socioeconomic level. In addition, monthly income was positively related with age and education level. 6. Three was a positive relationship between blood pressure and consumption of vegetable protein, and a negative relationship with consumption of Calories, Carbohydrates, Calcium, Iron, Vitamin A, Vitamin B1, Niacin, and Vitamin C. Animal protein intake increased as income and education levels increased, but this tendency was opposite for carbohydrates. In summary, nutritional intakes are strongly correlated with various environmental factors and the level of blood pressure. There was no difference between normotensive and hypertensive subjects with respect to the quality of food consumed except restricting energy and carbohydrate in the patient group.

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Effect of a Dose-Escalation Regimen for Improving Adherence to Roflumilast in Patients with Chronic Obstructive Pulmonary Disease

  • Hwang, Hyunjung;Shin, Ji Young;Park, Kyu Ree;Shin, Jae Ouk;Song, Kyoung-hwan;Park, Joonhyung;Park, Jeong Woong
    • Tuberculosis and Respiratory Diseases
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    • 제78권4호
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    • pp.321-325
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    • 2015
  • Background: The adverse effects of the phosphodiesterase-4 inhibitor roflumilast, appear to be more frequent in clinical practice than what was observed in chronic obstructive pulmonary disease (COPD) clinical trials. Thus, we designed this study to determine whether adverse effects could be reduced by starting roflumilast at half the dose, and then increasing a few weeks later to $500{\mu}g$ daily. Methods: We retrospectively investigated 85 patients with COPD who had taken either $500{\mu}g$ roflumilast, or a starting dose of $250{\mu}g$ and then increased to $500{\mu}g$. We analyzed all adverse events and assessed differences between patients who continued taking the drug after dose escalation and those who had stopped. Results: Adverse events were reported by 22 of the 85 patients (25.9%). The most common adverse event was diarrhea (10.6%). Of the 52 patients who had increased from a starting dose of $250{\mu}g$ roflumilast to $500{\mu}g$, 43 (82.7%) successfully maintained the $500{\mu}g$ roflumilast dose. No difference in factors likely to affect the risk of adverse effects, was detected between the dose-escalated and the discontinued groups. Of the 26 patients who started with the $500{\mu}g$ roflumilast regimen, seven (26.9%) discontinued because of adverse effects. There was no statistically significant difference in discontinuation rate between the dose-escalated and the control groups (p=0.22). Conclusion: Escalating the roflumilast dose may reduce treatment-related adverse effects and improve tolerance to the full dose. This study suggests that the dose-escalated regimen reduced the rate of discontinuation. However, longer-term and larger-scale studies are needed to support the full benefit of a dose escalation strategy.

세계보건기구의 마스크 사용 지침에 대한 한국 보건당국의 이행 분석과 함의: 코로나 바이러스 감염병을 중심으로 (Analysis and Implications of Korean Health Authorities' Fulfillment on World Health Organization's Recommendations for Mask Use: Focused on COVID-19)

  • 김명희
    • 융합정보논문지
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    • 제10권8호
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    • pp.77-86
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    • 2020
  • 이 연구는 코로나 19 확산에 따른 WHO의 마스크 사용 지침에 대한 한국 보건당국의 이행 및 불이행 내용을 분석하고 그것의 원인과 대안 선택의 결과를 도출하여 전염병 예방에서 지침의 한계와 연구의 함의를 제시하는데 목표가 있다. 이를 위해 국내·외 마스크 관련 문헌들을 고찰하고 WHO의 마스크 지침과 한국 보건당국의 마스크 권고사항을 분석대상으로 한다. 분석 결과는 다음과 같다. 첫째, 한국의 보건당국은 두 차례의 권고 사항에서 WHO의 "제한된 마스크 사용자 관점"을 기본적으로 수용하고 적용해왔다. 둘째, 한국의 보건당국은 마스크 수급이 부족해지면서 WHO 마스크 지침과는 상이한 이행을 하였다. 셋째, 한국의 보건당국은 보편적 마스크의 필요성에 따른 마스크 공급 안정화를 기반으로 코로나 19 초기 방역에 성공할 수 있었다. 넷째, WHO 마스크 지침에서 마스크 사용자 제한은 결과론적으로 지침으로서의 부분적 오류를 드러냈다. 분석에서 도출된 함의는 의학적 근거에 따른 국제 지침일지라도 일단 감염병 팬데믹 상황에선 국제 규칙의 엄격한 준수보다 각국의 방역상황 및 역량에 따라 자율적인 지침을 따르도록 허용할 필요가 있다는 점이다.

직접 대면 방식과 병행한 전화를 이용한 복약상담이 제 2형 당뇨병 환자의 치료성과에 미치는 영향 (The Effects of Follow-up Telephone Calls Combined with Face-to-face Meetings on Clinical and Humanistic Outcomes in Patients with Type 2 Diabetes Mellitus)

  • 곽은정;신현정;천부순
    • 약학회지
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    • 제59권6호
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    • pp.270-277
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    • 2015
  • There is a lack of evidence on the impact of pharmacist interventions in diabetes care in South Korea. The aim of this study was to investigate the effects of pharmacist counseling on clinical and humanistic outcomes in patients with type 2 diabetes. An uncontrolled before-and-after study was conducted at the outpatient diabetes clinic in a teaching hospital in Gyeongnam, South Korea between January 2 and November 30, 2014. A total of 37 patients were enrolled. During the study periods, the participants and pharmacists met every 2 weeks via follow-up telephone calls in addition to face-to-face meetings upon returning for care visit. At each meeting, a structured patient counseling was performed and the average duration of each meeting was 15~30 minutes. The participants were requested to record daily self-care activities. At the end of this study, patients' satisfaction on pharmacist care was evaluated using the questionnaire developed by us. Compared to baseline, significant reductions (mean${\pm}$standard deviation, p<0.05) in HbA1c were observed at each follow-up period: $-0.32{\pm}0.72%$ from baseline to 3 months; $-0.52{\pm}0.76%$ from baseline to 6 months; $-0.72{\pm}0.76%$ from baseline to 9 months. Over the same follow-up period, the proportions of patients achieving target HbA1c (defined as HbA1c<6.5%) were 3.1%, 10.3%, and 20%, respectively. The proportions of patients who never missed a dose during the same follow-up period were 43.8%, 31.0%, and 20.0%, respectively. The results from the patient satisfaction survey indicated that pharmacist counseling improved patients' knowledge about diabetes and possible drug interactions. Especially, the information on a healthy diet and lifestyle was the most satisfying. To conclude, follow-up telephone calls combined with face-to-face meetings improved clinical and humanistic outcomes in patients with type 2 diabetes mellitus.

케톤음료를 보충한 저탄수화물·고지방식이 섭취가 치매고위험 노인의 인지기능 및 신체활동 능력 변화에 미치는 영향 (Effects of Low-carbohydrate and High-fat Diet Supplemented with Ketogenic Drink on Cognitive Function and Physical Performance in the Elderly at High Risk for Dementia)

  • 김은지;박정식;최원선;박유경
    • 대한지역사회영양학회지
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    • 제24권6호
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    • pp.525-534
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    • 2019
  • Objectives: Reduced glucose utilization in the main parts of the brain involved in memory is a major cause of Alzheimer's disease, in which ketone bodies are used as the only and effective alternative energy source of glucose. This study examined the effects of a low-carbohydrate and high-fat (LCHF) diet supplemented with a ketogenic nutrition drink on cognitive function and physical activity in the elderly at high risk for dementia. Methods: The participants of this study were 28 healthy elderly aged 60-91 years showing a high risk factor of dementia or whose Korean Mini-Mental State Examination (K-MMSE) score was less than 24 points. Over 3 weeks, the case group was given an LCHF diet with nutrition drinks consisting of a ketone/non-ketone ratio of 1.73:1, whereas the control group consumed well-balanced nutrition drinks while maintaining a normal diet. After 3 weeks, K-MMSE, body composition, urine ketone bodies, and physical ability were all evaluated. Results: Urine ketone bodies of all case group subjects were positive, and K-MMSE score was significantly elevated in the case group only (p=0.021). Weight and BMI were elevated in the control group only (p<0.05). Grip strength was elevated in all subjects (p<0.01), and measurements of gait speed and one leg balance were improved only in the case group (p<0.05). Conclusions: We suggest that adherence to the LCHF diet supplemented with a ketogenic drink could possibly influence cognitive and physical function in the elderly with a high risk factor for dementia. Further, we confirmed the applicability of this dietary intervention in the elderly based on its lack of any side effects or changes in nutritional status.

보철학적 교합 재구성을 위한 교합진단과 치료계획 (The Occlusal Evaluation and Treatment Planning for Prosthodontic Full Mouth Rehabilitation)

  • 이승규;이성복;최대균
    • 구강회복응용과학지
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    • 제16권2호
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    • pp.149-159
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    • 2000
  • Occlusal disease is comparable to periodontitis in that it is generally not reversible. Occlusal disease, however, like periodontitis, often maintainable. It does itself to treatment and when restorative dentistry is utilized it becomes, in that sense, reversible. Moreover, a systematized and integrated approach will lead to a prognosis that is favorable and predictable. This approach facilitates development of optimum oral function, comfort, and esthetics, resulting in a satisfied patient. Such a systematized approach consists of four logical phase : (1) patient evaluation, (2) comprehensive analysis and treatment planning, (3) integrated and systematic reconstruction, and (4) postoperative maintenance. An integrated treatment plan is first developed on one set of diagnostic casts, properly mounted on a semiadjustable articulator using jaw relationship records. This is accomplished by using wax to make reconstructive modifications to the casts. These modified casts become the blueprint for planned occlusal changes and the fabrication of provisional restorations. The treatment goals are : (1) comfortably functioning temporomandibular joints and stomatognathic musculature, (2) adherence to the basic principle of occlusion advocated by Schuyler, (3) anterior guidance that is in harmony with the envelope of function, (4) restorations that will not violate the patient's neutral zone. This report shows the treatment procedures for a patient whose mandibular position has been altered due to posterior bite collapse. Migration of the maxillary anterior teeth had occurred, and the posterior occlusal contacts showed pathologic interference. Precise diagnosis using mounted casts was executed and prosthodontic reconstruction by the aid of an unconventional orthodontic correction on maxillary flaring was planned. An unconventional orthodontic correction can be accomplished by using preexisting natural teeth, which can be modified for use in active tooth movement or splinted together for orthodontic anchorage. This technique has an advantage over conventional fixed appliance orthodontic therapy because it can accomplish tooth movement concurrently with restorative and periodontal therapy. On occasion, minor tooth movement can be necessary to achieve the optimum occlusal scheme, crown form, and tooth position for the forces of occlusion to be displaced down the long axis of the periodontally compromised teeth. Once the occlusion, periodontal health, and crown contours for the provisional splinted restoration are acceptable, the final splinted restoration can be similarly fabricated, and it becomes an excellent orthodontic retainer.

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완전 구강 회복술 (Full Mouth Rehabilitation)

  • 이승규;이성복;권긍록;최대균
    • 구강회복응용과학지
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    • 제16권3호
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    • pp.171-185
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    • 2000
  • The treatment objectives of the complete oral rehabilitation are : (1) comfortably functioning temporomandibular joints and stomatognathic musculature, (2) adherence to the basic principle of occlusion advocated by Schuyler, (3) anterior guidance that is in harmony with the envelope of function, (4) restorations that will not violate the patient's neutral zone. There may be many roads to achieving these objectives, but they all convey varing degrees of stress and strain on the dentist and patient. There are no "easy" cases of oral rehabilitation. Time must be taken to think, time must be taken to plan, and time must be taken to perform, since time is the critical element in both success and failure. Moreover, a systematized and integrated approach will lead to a prognosis that is favorable and predictable. This approach facilitates development of optimum oral function, comfort, and esthetics, resulting in a satisfied patient. Such a systematized approach consists of four logical phase : (1) patient evaluation, (2) comprehensive analysis and treatment planning, (3) integrated and systematic reconstruction, and (4) postoperative maintenance. Firstly, we must evaluate the mandibular position. The results of a repetitive, unstrained, nondeflective, nonmanipulated mandibular closure into complete maxillomandibular intercuspation is not so much a "centric" occlusion as it is a stable occlusion. Accordingly, we ought to concern ourselves less with mandibular centricity and more with mandibular stability, which actually is the relationship we are trying to establish. The key to this stability is intercuspal precision. Once neuromuscular passivity has been achieved during an appropriate period of occlusal adjustment and provisionalization, subsequent intercuspal precision becomes the controlling factors in maintaining a stable mandibular position. Secondly, we must evaluate the planned vertical dimension of occlusion in relationship to what may now be an altered(generally diminished), and avoid the hazard of using such an abnormal position to indicate ultimate occlusal contacting points. There are no hard and fast rules to follow, no formulas, and no precise ratios between the vertical dimension of occlusion. Like centric relation, it is an area, not a point.

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