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Study of The Area of Nursing Need by the Family Developmental Stage (가족발달단계에 따른 간호요구영역에 관한 연구)

  • 최부옥
    • Journal of Korean Academy of Nursing
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    • v.7 no.2
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    • pp.43-59
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    • 1977
  • The Community Health Service considers the family as a service unit and places the emphasis of its service on the health problems and the nursing needs of the family rather than the individual. From the conceptual point of view that tile community health service is both health maintenance and health promotion of the family, the community health nurse should have a knowledge of the growth and development of the family and be responsible for the comprehensive support of normal family development. The community health nurse often is in a position to make a real contribution to normal family development. In order to investigate the relationship between the areas of nursing need and family development, the following objectives were established 1. To discover the general characteristics of the study population by the stage of family development. 2. To discover specific nursing needs in relation to the family developmental stage, and to determine the intensity of the nursing needs and the ability of the family to cope with these needs. 3. To discover overall family health nursing problems in relation to the family developmental stage and determine the intensity of the nursing need and the problem solving ability of family. Definitions : The family developmental stages as classified by Dually were used stage 1. Married couples(without children) stage 2. Childbearing Families (oldest child birth to 30 months of age) stage 3. Families with preschool children (oldest child 2½-to 6 years) stage 4. Families with schoolchildren (oldest child 6 to 13 years). stage 5. Families with teenagers (oldest child 13 to 20 years) stage 6. Families as launching centers (first child gone to last child′s leaving home). stage 7. Middle- aged parents (empty nest to retirement) stage 8. Aging family member (retirement to death of both spouses) The areas of nursing need were defined as those used in the study, "A Comprehensive Study about Health and Nursing Need and a Social Diagram of the Community", by tile Nursing research Institute and Center for population. and Family Planning, July 1974. The study population defiled and selected were 260 nuclear families ill two myron of Kang Hwa Island. Percent, mean value and F- test were utilized in tile statistical analysis of the study result. Findings : 1. General characteristics of the study population by tile family developmental stage ; 1)The study population was distributed by the family developmental stage as follows : stage 1 : 3 families stage 2 : 13 families stage 3 : 24 families stage 4 : 41 families stage 5 : 50 families stage 6 : 106 families stage 7 : 13 families stage 8 : 10 families 2) Most families had 4 or 5 members except for those in stage, 1, 7, and 8. 3) The parents′ present age was older in the higher developmental stage and their age at marriage was also younger in the higher developmental stages. 4) The educational level of parents was primarily less than elementary school irrespective of the developmental stage. 5) More than half of parents′ occupations were listed as laborers irrespective of the developmental stage, 6) More than half of the parents were atheists irrespective of the developmental stage. 7) The higher the developmental stage(from stage 2 to stage 6 ), the wider the distribution of children′s ages. 8) More than half of the families were of middle or lower socio-economic level. 2. Problems in specific areas of nursing need by family developmental stage, the intensity of nursing need and the problem solving ability of the family : 1) As a whole, many problems, irrespective of the developmental stage, occurred in tile areas of Housing and Sanitation, Eating Patterns, Housekeeping, Preventive Measures and Dental care. Problems occurring ill particular stages included the following ; stage 1 : Prevention of Accident stage 2 : Preventive Vaccination, Family Planning. stage 3 : Preventive Vaccination, Maternal Health, Family Planning, Health of Infant and Preschooler. stage 4, 5 : Preventive Vaccination, Family Planning, Health of School Children. stage 6 : Preventive Vaccination, Health of School Children. 2) The intensity of the nursing need in the area of Acute and Chronic Diseases was generally of moderate degree or above irrespective of the developmental stages except for stage 1. Other areas of need listed as moderate or above were found in the following stages: stage 1 : Maternal Health stage 3 . Horsing and Sanitation, Prevention of Accident. stage 4 . Housing and Sanitation. stage 5 : Housing and Sanitation, Diagnostic and Medical Care. stage 6 : Diagnostic and Medical care stage 7 : Diagnostic and Medical Care, Housekeeping. stage 8 : Housing and Sanitation, Prevention of Accident, Diagnostic and Medical Care, Dental Care, Eating Patterns, Housekeeping. 3) Areas of need with moderate problem solving ability or less were as follows : stage 1 : Diagnostic and Medical Care, Maternal Health. stage 2 : Prevention of Accident, Acute and Chronic Disease, Dental Care. stage 3 : Housing and Sanitation, Acute and Chronic Disease, Diagnostic and Medical Care, Preventive Measure, Dental Care, Maternal Health, Health of Infant and preschooler, Eating Patterns. stage 4 : Housing and Sanitation, Prevention of Accident, Diagnostic and Medical Care, Preventive Measure, Dental Care, Maternal Health, Health of New Born, Health of Infant and Preschooler, Health of school Children, Eating Patterns, Housekeeping. stage 5 . Housing and Sanitation, Prevention of Accident, Acute and Chronic Disease, Diagnostic and Medical Care, Preventive Measure, Dental Care, Preventive Vaccination, Maternal Health, Eating Patterns. stage 7, 8 : Housing and Sanitation, Prevention of Accident, Acute and Chronic Disease, Diagnostic and Medical Care, Preventive Measures, Dental Care, Preventive Vaccination, Eating Patterns , Housekeeping. Problem occurrence, the degree of nursing need and the degree of problem solving ability 1 nursing need areas for the family as a whole were as follows : 1) The higher the stages(except stage 1 ), the lower the rate of problem occurrence. 2) The higher the stage becomes, the lower the intensity of the nursing need becomes. 3) The higher the stages (except stages 7 and 8), the higher. the problem solving ability. Conclusions ; 1) When the nursing care plan for the family is drawn up, depending upon the stage of family development, higher priority should be give to nursing need areas ① at which problems were shown to occur ② where the nursing need is shown to be above moderate degree and ③ where the problem solving ability was shown to be of moderate degree. 2) The priority of the nursing service should be Placed ① not on those families in the high developmental stage but on those families in the low developmental stage ② and on those areas of need shown in stages 7 and 8 where the degree nursing need was high and the ability to cope low.

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A Study on Farmer's Syndrome and Its Risk Factors of Vinyl House Worker and Farmer in a Rural Area (일부 농촌지역 비닐하우스 재배자들의 농부증 실태와 관련요인)

  • Lee, In-Bae;Lee, Yeon-Kyeong;Chang, Sung-Sil;Lee, Sok-Goo;Cho, Young-Che;Lee, Dong-Bae;Lee, Tae-Yong
    • Journal of agricultural medicine and community health
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    • v.24 no.1
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    • pp.13-33
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    • 1999
  • The aim of this study was to investigate fatigue scores, physical complaints, farmer's syndrome and to find out its risk factors among farmers. The questionnaire survey was conducted to 177 vinyl house workers and 213 farmers who lived in Chongyang gun of Chungnam province from February 24 to March 15, 1998. The obtained main results were followings; 1. The fatigue scores were not significantly different between vinyl house workers and farmers. The fatigue scores were higher in female group, lower education group, shorter sleep hours group(under 8 hours), nonsmoker, nondrinker group than otherwise groups. There was not statistically significant difference between the mean fatigue scores and age, eating habit and body mass index. Duration of farming years in vinyl house and farming area and number of farming workers in farmers family showed a slight relationship with the fatigue score. 2. Health scores were not different between vinyl house workers and farmers. The health states was poorer in female group, lower education group, shorter sleep hours group(under 8 hours), nonsmoker group, and nondrinker group than otherwise groups by health scores. Health scores were not related with age, eating habit and body mass index. 3. The proportion of farmer's syndrome was 49.1% in vinyl house workers and 52.1% in farmers. That was higher in female than in male and the higher proportion was found in the lower education group of vinyl house workers and farmers. The proportion of farmer's syndrome was higher in the group of smoker, alcohol drinkers and over or under weight in vinyl house workers, but did not differ in those of farmers. 4. By multiple logistic regression, sex and sleep hours were risk factors affecting to farmer's syndrome. Odds ration for female group was 2.53 (reference group was male) and that for over 8 sleep hours group was 0.74 (reference group was under 8 sleep hours group). 5. The chief complaints by CMI were "I am difficult to work due to aching the back and the limbs", "I feel prickle pain in the limbs", "I sometimes have a twinge in the limbs", "I am not quite well as having a pain in the limbs", "I feel weaker grasping power than before" in both of vinyl house workers and farmers. Vinyl house workers more frequently pointed out skin darkening, skin disease and hemorrhoids than farmers. 6. According to correspondence analysis, skin disease of vinyl house workers was related to vinyl house farmers and digestive and general symptom was associated with male and endocrinological and muscular symptom was associated with female in vinyl house workers. And it revealed that farmer's syndrome was highly related with female and farmers relatively. By the above results, the fatigue scores, perceive health and farmer's syndrome did not much differ in two groups, but aged female farmers should be considered as female farmers represented higher fatigue score, farmers syndrome and poorer perceive health than male farmers in addition to farmer's syndrome was increased with ageing process. Also feeble but distinguished symptoms which might be due to working environment were observed especially in vinyl house workers and that should be considered and investigated continuously.

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Health Concern, Health Practice and ADL of The Elderly Who Stay at Home in a Rural Community (농촌(農村) 재택노인(財宅老人)들의 건강관심도(健康關心度), 건강실천행위(健康實踐行爲)와 일상생활동작능력(日常生活動作能力))

  • Eom, Young-Hee;Kam, Sin;Han, Chang-Hyun;Cha, Byung-Jun;Kim, Sang-Soon
    • Journal of agricultural medicine and community health
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    • v.24 no.2
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    • pp.269-289
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    • 1999
  • This study was conducted to examine the relationship among health concern, health practice and ADL of elderly staying at home in a rural community and their affecting factors. Data were collected through direct interviews made with 480 old people aged more than sixty-five from November 15, 1998 to December 20, 1998. Out of 189 male and 291 female, the high-level group that showed high health concern accounted for 44.4%, the medium-level group for 13.1%, and the low-level group for 42.5%, in the health practice, the high-level group accounted for 3.8%, the medium-level group for 18.8%, and the low-level group for 77.5%. In the self-rated health status, the high-level group accounted for 29.0%, the medium-level group for 31.0%, and the low-level group for 40.0%, and in the ADL, the high ADL group accounted for 91.5%, and the low-level ADL group for 8.5%. The result of the chi-square test showed that for male, there was a significant relation between the health concern and the health practice index score. In the relation between the health practice index score and the self-rated health status, there was significant positive relationship between health practice index and self-rated health status, and in the relation between the health practice Index score and the ADL, old people with higher health practices showed good ADL(but not significant). Old people with good ADL also showed good self-rated health status. In the multiple regression analysis where the health practice was used as a dependent variable, the health concern was added to the sociodemographic variables as an independent variables, a formula was formed for male old people only and ones with high concern in health showed good health practice. In the multiple logistic regression analysis where the sociodemographic variables to which the health practices was added were used as an independent variable and the ADL as a dependent variable, the ADL appeared to be not good if for male old people the living costs were born by their sons and daughters and as for female old people their ages increased, but it was good if old people had sources of health information such as hospitals or health centers. The self-rated health status was worse, for male old people, if they had short living costs or diseases and for female old people, if they had spouses, living costs born by their sons and daughters or diseases, but it was better, for male old people, if they had periodical gatherings or carried out health practices a lot, and for female old people, if they had sources of health information such as hospitals or health centers or carried out health practices a lot. In view of the results stated above, the higher the old people had health concern, the more they carried out health practices, and the more they carried out health practices, the better they had ADL and self-rated health status that served as the level of health. Further, the better ADL, the better self-rated health status.

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Factors associated with Experience of Diagnosis and Utilization of Chronic Diseases among Korean Elderly : Focus on Comparing between Urban and Rural Elderly (한국 노인의 만성질환 진단경험 및 의료이용에 관련된 요인 : 도시와 농촌 간 비교를 중심으로)

  • Lee, Min Ji;Kown, Dong Hyun;Kim, Yong Yook;Kim, Jae Han;Moon, Sung Jun;Park, Keon Woo;Park, Il Woo;Park, Jun Young;Baek, Na Yeon;Son, Gi Seok;Ahn, So Yeon;Yeo, In Uk;Woo, Sang Ah;Yoo, Sung Yun;Lee, Gi Beop;Lim, Soo Beom;Jang, Soo Hyun;Jang, In-Deok;Jeon, Jeong-U;Jeong, Su Jin;Jung, Yeon Ju;Cho, Seong Geon;Cha, Jeong Sik;Hwang, Ki Seok;Lee, Tae-Jun;Lee, Moo-Sik
    • Journal of agricultural medicine and community health
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    • v.44 no.4
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    • pp.165-184
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    • 2019
  • Objectives: The purpose of this study was to identify and compare the difference and related factors with general characteristic and health behaviors, a experience of diagnosis and treatment of chronic diseases between rural and urban among elderly in Korea. Methods: We used the data of Community Health Survey 2017 which were collected by the Korean Center for Disease Control and Prevention. The study population comprised 67,835 elderly peopled aged 65 years or older who participated in the survey. The chi-square test, univariate and multivariate logistic regression analysis were used to analyze data. Results: We identified many significant difference of health behaviors, an experience of diagnosis and treatment with chronic diseases between rural and urban. Compared to urban elderly, the odds ratios (ORs) (95% confidence interval) of rural elderly were 1.136 (1.092-1.183) for diagnosis of diabetes, 1.278 (1.278-1.386) for diagnosis of dyslipidemia, 0.940 (0.904-0.977) for diagnosis of arthritis, 0.785(0.736-0.837) for treatment of arthritis, 1.159 (1.116-1.203) for diagnosis of cataracts, and 1.285(1.200-1.375) for treatment of cataracts. In the experience of diagnosis and treatment of chronic diseases, various variables were derived as contributing factors for each disease. Especially, there were statistically significant difference in the experience of diabetes diagnosis, arthritis diagnosis, cataract diagnosis and dyslipidemia except for hypertension diagnosis (p <0.01) between urban and rural elderly. There were statistically significant differences in the experience of treatment for arthritis and cataract (p <0.01), but there was no significant difference in the experience of treatment for hypertension, diabetes, dyslipidemia between urban and rural elderly. Conclusion: Therefore, it would be necessary to implement a strategic health management project for diseases that showed significant experience of chronic diseases with diagnosis and treatment, reflecting the related factors of the elderly chronic diseases among the urban and rural areas.

Clinical Observations of Gastrointestinal Cow Milk Allergy in Children According to a New Classification (새로운 분류법에 따른 소아 위장관 우유 알레르기 질환에 관한 임상적 고찰)

  • Hwang, Jin Bok;Choi, Seon Yun;Kwon, Tae Chan;Oh, Hoon Kyu;Kam, Sin
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.1
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    • pp.40-47
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    • 2004
  • Purpose: A new classification of gastrointestinal food allergy was published, but the changes of terminology between previously reported terms and the new ones were in a state of disorder. This has resulted in confusion between medical communication and diagnostic and therapeutic approaches. The clinical observations of infants presenting with gastrointestinal cow milk allergy (GI-CMA) were performed, and the changes in the terminology reviewed through the published Korean literature. Methods: Between March 2003 and July 2003, data from 37 consecutive infants with GI-CMA, aged 2 weeks to 15 months, were reviewed. The challenge and elimination test of cow milk, and the endoscopic and histologic findings, were used for the seven subdivisions of GI-CMA according to a new classification on the basis of patients' ages, clinical manifestations and location of gastrointestinal lesions. Results: The 37 patients had a mean age of $5.4{\pm}4.8$ months, with those observed in 26 (70.3%) of patients being below 6 months of age. The seven final diagnoses were; cow milk protein-induced enterocolitis (CMPIE) in 12 (32.4%), cow milk protein proctitis (PROC) in 12 (32.4%), IgE-mediated (IGE) in 6 (16.2%), gastroesophageal reflux-associated cow milk allergy (GERA) in 5 (13.5%) and eosinophilic gastroenterocolitis in 2 (5.4%). CMPIE was revealed as the typical type in 7 (18.9%) and the atypical type in 5 (13.5%), and all of typical CMPIE revealed cow milk protein-induced enteropathy. The mean age at symptom onset was $4.3{\pm}0.8$ months, and for those with typical and atypical CMPIE, and PROC and GERA were $3.8{\pm}4.6$, $10.4{\pm}3.8$, $3.4{\pm}3.9$ and $7.8{\pm}5.7$ months, respectively (p<0.05). The period from onset of symptom to diagnosis was $2.4{\pm}3.3$ (0.5~12) months, with those observed in atypical CMPIE and GERA being over 3months. Although the birth weights in all patients were within the 10~90 percentile range, the body weights on diagnoses were below the 3 percentile in 48.6%; IGE 16.7%, EOS 0%, typical CMPIE 85.7%, atypical CMPIE 60.0%, PROC 25.0% and GERA 100% (p<0.05). Through the review of the Korean literature, 8 case reports and 14 original articles for GI-CMA were found. Conclusion: GI-CMA is not a rare clinical disorder and is subdivided into seven categories on the basis of the patient's age, clinical manifestations and location of the gastrointestinal lesions. The terms for GI-CMA are changing with new classifications, and careful approaches are necessary for medical communications.

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A Survey on the Oral Health Conditions according to Dental Health Behaviors of Elderly People in Community (일부 지역사회 노인들의 구강보건행동에 따른 구강건강상태)

  • Kang, Hyeong-Ku;Yoon, Hyun-Suk;Cho, Young-Chae
    • Journal of agricultural medicine and community health
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    • v.30 no.3
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    • pp.263-277
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    • 2005
  • Objectives: This study aimed to reveal the oral health conditions based on the dental health behaviors of a community-dwelling elderly. Methods: The subjects included 206 rural dwellers(100 men & 106 women) aged over 65 years old, who received dental health check-ups in the local public health center and its branches attached to 6 respective Myons of Chunchongnamdo Province, during the 2-month period from Jan. 1st to Feb. 28th, 2005. They were examined by dentists and given self-administered questionnaires asking about their dental heaith behaviors and subjective symptoms of gingival bleeding. Results: The oral health conditions based on dental health behavior showed that those who have not taken dental health service a year were found to have significantly greater number of missing teeth(p=0.002), DMFT(p=0.002) and CPITN(p=0.018), and those who have not observed intra-oral conditions a week to have significantly less number of filled teeth(p=0.002) and significantly greater number of missing teeth(p=0.000) and CPITN (p=0.000) than their respective counterparts. In terms of brushing, those who brushed their teeth below "3 times/day" were found to have significantly greater number of decayed teeth(p=0.000), missing teeth(p=0.000), DMFT(p=0.000) and CPITN(p=0.000) than their counterparts. In terms of time spent in brushing, those who spends "below 3 minutes" had significantly greater number of missing teeth(p=0.002) and DMFT(p=0.041), and significantly less number of filled teeth(p=0.036). According to the use of aid tools for cleaning teeth, the group who don't use them had significantly greater number of DMFT(p=0.041) and CPITN(p=0.018) than its counterpart. Classified by smoking habits, smoking groups had significantly greater number of decayed teeth(p=0.035) and CPITN(p=0.001) than non-smoking groups. Multiple regression analysis of the study data revealed that the significant factors influencing number of decayed teeth were number of brushing, sex and intra-oral observation (explanatory power of 14.2%). The significant factors for number of filled teeth were sex, intra-oral observation, use of aid tools, frequency of brushing, subjective health conditions and drinking of sweet beverages(explanatory power of 18.2%), those for number of missing teeth, number of brushing and age(explanatory power of 13.9%) those for DMFT, number of brushing, sex, use of dental service, age(explanatory power: 13.5%), and those for CPITN included smoking habits, use of dental service, use of aid tools (explanatory power: 10.8%). Conclusions: The study results revealed that the dental health behavior of the elderly population is in poor conditions and their consequent intra-oral health conditions are not good. To improve their oral conditions, public campaign and education will be needed to modify unhealthy dental health behaviors.

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Development of Root Media Containing Pine Bark for Cultivation of Horticultural Crops (소나무 수피를 포함한 원예작물 재배용 혼합상토의 개발)

  • Park, Eun Young;Choi, Jong Myung
    • Horticultural Science & Technology
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    • v.32 no.4
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    • pp.499-506
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    • 2014
  • This research was conducted to develop root media containing ground and aged pine bark (GAPB) and ground and raw pine bark (GRPB). After analysis of physico chemical properties, the pine barks were blended with peat moss (PM) or coir dust (CD) in various ratios to formulate 12 root media. Then, two out of 12 root media were chosen based on the physical properties for further experiments. The pre-planting nutrient charge fertilizers (PNCF) were incorporated into two root media and chemical properties were analysed again. The total porosity (TP), container capacity (CC), and air-filled porosity (AFP) of GAPB were 78.7%. 39.4%, and 38.3%, respectively, while those of GRPB were 74.7%, 41.2%, and 33.4%, respectively. The percentage of easily available water (EAW, from CC to 4.90 kPa tension) and buffering water (BW, 4.91-9.81 kPa tension) in GAPB were 12.7% and 8.5%, respectively, which were a little lower than the 13.5% and 8.8% in GRPB. The pH and EC were not different significantly, but cation exchange capacity was different between the two pine barks (GAPB: pH 5.26, EC $0.61dS{\cdot}m^{-1}$, CEC $15.7meq{\cdot}100g^{-1}$; GRPB: pH 5.19, EC $0.32dS{\cdot}m^{-1}$, CEC $9.32meq{\cdot}100g^{-1}$). The concentrations of exchangeable cations in GAPB were Ca 0.32, K 0.05, Mg 0.27 and $0.12cmol+{\cdot}kg^{-1}$, whereas those in GRPB were Ca 0.28, K 0.08, Mg 0.25 and $0.09cmol+{\cdot}kg^{-1}$. The concentrations of $PO_4$-P, $NH_4$-N and $NO_3$-N were 485.8, 0.62 and $0.91mg{\cdot}L^{-1}$ in GAPB and 578, 1.00 and $0.82mg{\cdot}L^{-1}$ in GRPB, respectively, when those were analyzed in the solution of the saturated paste. The TP, CC and AFP in the two selected media were 89.3 and 76.3, and 13.0% in PM+GAPB (8:2, v/v) and 88.2, 68.2 and 20.0% in CD+GRPB (8:2), respectively. The pHs and ECs were 3.8 and $0.24dS{\cdot}m^{-1}$ in PM+GAPB which were a little lower than 5.8 and $0.65dS{\cdot}m^{-1}$ in CD+GRPB. However, the pHs analysed before and after incorporation of PNCF in the two root media did not show large differences. This is because the solubility of dolomitic lime is very low, and the pH it is expected to rise gradually when crops are cultivated int he root media. The information obtained in this study should facilitate effective formulation of root media containing pine bark.

Clinical Analysis of Arteriovenous Fistula in Chronic Renal Failure Patients (만성 신부전 환자에서의 동정맥루 조성술의 임상고찰)

  • Song Chang-Min;Ahn Jae-Bum;Kim In-Sub;Kim Woo-Sik;Shin Yong-Chul;Yoo Hwan-Kuk;Kim Byung-Yul
    • Journal of Chest Surgery
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    • v.39 no.9 s.266
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    • pp.692-698
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    • 2006
  • Background: Owing to the fact that the average life span has increased and the progress in medical science has been made, the number of patients with chronic renal failure (CRF) who have to take hemodialysis (HD) has been going up gradually. Accordingly, it is considered to be as a significant issue to obtain blood vessels which can be used repetitively and supply enough blood flows. Therefore, there have been various kinds of study on an inosculation rate andfactors influencing it following an arteriovenous fistula (AV fistula) and lots of studies are ongoing for the purpose of escalating the inosculation rate. The authors analyzed the effects of short-term result, age, sex, diabetes and hypertension on arteriovenous inosculations in 134 anatomical snuffbox operated subjects among the patients who have taken an AV fistula at this center. Material and Method: Based on 134 patients who underwent an AV fistula at the department of thoracic surgery of this center from July, 2000 to May, 2004, the difference in arteriovenous inosculation rate was compared and analyzed depending or age (discriminated by 65-year-old), sex and the condition of the presence or absence of diabetes and hypertension. Correlation analyses were conducted for each parameter and statistical tests were performed by using SPSS for windows Release 11.0.1, which were determined to be statistically significant if p value was below 0.05. Result: The total number of operations was 169 including 35 of re-operations. The male/female rate was 70 : 64 (52% : 48%). The average age was $56.3{\pm}12.26$ years and there were 33 (24%) old aged patients above 65-year-old; there were 103 (71%) patients with hypertension and 90 (67%) patients with diabetes. Overall arteriovenous inosculation rate was $93{\pm}2.4%,\;91{\pm}2.7%,\;89{\pm}3.0%$ at 6, 12, 24 months, respectively. The arteriovenous inosculation rate of above 65-year-old patient group was $85{\pm}4.8%,\;80{\pm}5.8%,\;80{\pm}5.8%$ and below 64-year-old patient group's was $85{\pm}4.8%,\;80{\pm}5.8%,\;80{\pm}5.8%$ at given time points, respectively, which showed higher inosculation rate in below 64-year-old patient group with a statistical significance (p=0.0034). However, no statistical significance was found between the patients with hypertension and diabetes and the patients with no complication. In addition, there was no statistical significance in inosculation rate between male and female. Conclusion: The arteriovenous inosculation ratewas higher in the treated patient below 64-year-old than in the treated patient above 65-year-old. Thus it is advantageous for increase in long-term inosculation rate to obtain hemodialysis routes at an early age. The conditions of sex and the presence or absence of diabetes and hyper- tension do not make statistically significant effect on the arteriovenous inosculation rate.

Study on Medical Records In ${\ulcorner}$the Historical Records of the Three Kingdoms${\lrcorner}$ ("삼국사기(三國史記)"에 기록된 의약내용(醫藥內容) 분석)

  • Shin, Soon-Shik;Choi, Hwan-Soo
    • Journal of The Association for Neo Medicine
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    • v.2 no.1
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    • pp.35-54
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    • 1997
  • We tried to observe the features of ancient medical practice by analysing the records related to medicine in the book, ${\ulcorner}$the Historical Records of the Three Kingdom${\lrcorner}$ of which content includes the features of medicine in mythology, plague, delivery of twins, drugs, medical system, shamanism, constitutional medicine, psychiatry, forensic medicine, deformity, a spa, medical phrase, health and welfare work, religion, death. physiological anatomy, Taoist medicine, acupuncture, the occult af of transformation and etc. Our initial concern was about where to draw line as of medical field and we defined medicine in more broad meaning. The book ${\ulcorner}$the Historical Records of the Three Kingdoms${\lrcorner}$ describes the world of mythology by way of medicine which is not clearly a conventional one. There appears records of birth of multiple offsprings 7 times in which cases are of triplets or more. Delivering multiple offsprings were rare phenomenon though such fertility was highly admired. This shows one aspect of ancient country having more population meant more power of the nation. Of those medical records conveyed in that book includes stories of childbirth such as giving birth to a son after praying, giving birth to Kim Yoo-shin after 20 months after mother's dream of conception, and a song longing for getting a laudable child. Plagues were prevalent throughout winter to spring season and one can observe various symptoms of plagues in the record. Of these epidemic diseases, cold type might have been more common than the heat one. Appearance of epidemic diseases frequently coincided with that of natural disasters that this suggests a linkage between plague and underlying doctrine on five elements' motion and six kinds of natural factors. There exists only a few names of diseases such as epidemic disease, wind disease, and syndrome characterized by dyspnea. Otherwise there appeared only afflictions that were not specified therefore it remains cluless to keep track of certain diseases of prevalence. Since this ${\ulcorner}$Historical Records of the Three Kingdoms'${\lrcorner}$ wasn't any sort of medical book, words and terms used were not technical kind and most were the ones used generally among lay people. Therefore any mechanisms of the diseases were hardly mentioned. Some of medicinal substances such as Calculus Bovis, Radix Ginseng, Gaboderma Luciderm, magnetitum were also in use in those days. 53 kinds of dietary supplies appears in the records and some of these might have been used as medicinal purpose. Records concerning dicipline of one's body includes activities such as hunting, archery, horseback riding etc. In Shilla dynasty there were positions such as professor of medicine, Naekongbong(內供奉), Kongbong's doctor(供奉醫師), Kongbong's diviner(供奉卜師). As an educational facility, medical school was built at the first year of King Hyoso's reign and it's curricula included various subjects as ${\ulcorner}$Shin Nong's Herbal classic${\lrcorner}$, ${\ulcorner}$Kabeul classic of acupuncture and moxbustion${\lrcorner}$, ${\ulcorner}$The Plain Questions of the Yellow Emperor's Classic of Internal Medicine${\lrcorner}$, ${\ulcorner}$Classic of Acupuncturer${\lrcorner}$, ${\ulcorner}$The Pulse Classic${\lrcorner}$, ${\ulcorner}$Classic of Channels and Acupuncture Points${\lrcorner}$ and ${\ulcorner}$Difficult Classic${\lrcorner}$. There were 2 medical professors who were in charge of education. To establish pharmacopoeia, 2 Shaji(舍知), 6 Sha(史), 2 Jongshaji(從舍知) were appointed. In Baekje dynasty, Department of Herb was maintained. Doing praying for the sake of health, doing phrenology also can be extended to medical arena. Those who survived over 100 years of age appear 3 times in the record, while 98 appears once. The earliest psychiatrist Nokjin differentiated symptoms to apply either therapies using acupuncture and drug or psychotherapy. There appears a case of rape, a case of burying alive with the dead, 8 cases of suicide that can characterize a prototype of forensic medicine. Deformity-related records include phrases as follow: 'there seems protrudent bone behind the head', 'a body which has two heads, two trunks, four arms.', 'a body equipped with two heads' In those times spa can be said to be used as a place for he리ing, convalescence, and relaxation seeing the records describing a person pretended illness and went to spa to enjoy with his friends. Priest doctors and millitary surgeons were in charge of the medical sevice in the period of the Three Kingdoms by the record written by Mookhoja(墨胡子) and Hoonkyeom(訓謙). Poor diet and regimen makes people more vulnerable to diseases. So there existed charity services for those poor people who couldn't live with one's own capacity such as single parents, orphans, the aged people no one to take care and those who are ill. The cause of affliction was frequently coined with human relation. There appeared the phenomenon of releasing prisoners and allowing people to become priests at the time of king's suffering. Besides, as a healing procedure, sutra-chanting was peformed. There appears 10 cases of death related records which varies from death by drowning, or by freezing, death from animals, death from war, death from wightloss and killing oneself at the moment of spouse's death and etc. There also exist certain records which suggest the knowledge of physiology and anatomy in those times. Since the taoist books such as ${\ulcorner}$Book of the Way and Its Power(老子道德經)${\lrcorner}$ were introduced in the period of Three Kingdoms, it can be considered that medicine was also influenced by taoism. Records of higher level of acupuncture, records which links the medicine and occult art of transformation existed. Although limited, we could figure out the medical state of ancient society.

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Multicenter clinical study of childhood periodic syndromes that are common precursors to migraine using new criteria of the International Classification of Headache Disorders (ICHD-II) (편두통의 전 단계인 소아기주기성증후군의 다기관 임상 연구: 국제두통질환분류 제2판 제1차 수정판 적용)

  • Park, Jae Yong;Nam, Sang-Ook;Eun, So-Hee;You, Su Jeong;Kang, Hoon-Chul;Eun, Baik-Lin;Chung, Hee Jung
    • Clinical and Experimental Pediatrics
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    • v.52 no.5
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    • pp.557-566
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    • 2009
  • Purpose : To evaluate the clinical features and characteristics of childhood periodic syndromes (CPS) in Korea using the new criteria of the International Classification of Headache Disorders (ICHD)-II. Methods : The study was conducted at pediatric neurology clinics of five urban tertiary-care medical centers in Korea from January 2006 to December 2007. Patients (44 consecutive children and adolescents) were divided into three groups (cyclic vomiting syndrome [CVS], abdominal migraine [AM], and benign paroxysmal vertigo of childhood [BPVC]) by recurrent paroxysmal episodes of vomiting, abdominal pain, dizziness, and/or vertigo using the ICHD-II criteria and their characteristics were compared. Results : Totally, 16 boys (36.4%) and 28 girls (63.6%) were examined (aged 4-18 yr), with 20 CVS (45.5%), 8 AM (18.2%), and 16 BPVC (36.4%) patients. The mean age at symptom onset was $6.3{\pm}3.6$ yr, $8.5{\pm}2.7$ yr, and $8.5{\pm}2.9$ yr in the CVS, AM, and BPVC groups, respectively, showing that symptoms appeared earliest in the CVS group. The mean age at diagnosis was $8.0{\pm}3.4$ yr, $10.5{\pm}2.6$ yr, and $10.1{\pm}3.2$ yr the CVS, AM, and BPVC groups, respectively. Of the 44 patients, 17 (38.6%) had a history of recurrent headaches and 11 (25.0%) showed typical symptoms of migraine headache, with 5 CVS (25.0%), 2 AM (25.0%), and 4 BPVC (25.0%) patients. Family history of migraine was found in 9 patients (20.4%): 4 in the CVS group (20.0%), 2 in the AM group (25.0%), and 3 in the BPVC group (18.8%). Conclusion : The significant time lag between the age at symptom onset and final diagnosis possibly indicates poor knowledge of CPS among pediatric practitioners, especially in Korea. A high index of suspicion may be the first step toward caring for these patients. Furthermore, a population-based longitudinal study is necessary to determine the incidence and natural course of these syndromes.