• Title/Summary/Keyword: Boundary treatment

Search Result 518, Processing Time 0.031 seconds

Chronic pain control in patients with rheumatoid arthritis (만성통증 환자의 통증 조절)

  • Eun, Young
    • Journal of muscle and joint health
    • /
    • v.2 no.1
    • /
    • pp.17-40
    • /
    • 1995
  • Rheumatoid arthritis is the one of the chronic diseases, one of its major symptoms is a chronic pain. Despite developing medical treatment and surgical techniques, it is suggested that to control the pain is the goal of the treatment. But pain is an inner experience and even those closest to the patient cannot truly observe its progress or share in its suffering. The National Academy of Sciences Institute of Medicine's report on Pain and Disability concluded that there is no objective measure of pain-(exactly) no pain thermometer-nor can there ever be one, because the experience of pain is inseparable from personal perception and social influence such as culture. To explore chronic pain experience is to understand the process and property of the patient's perception of pain through the response to pain, the coping with pain, and the adaptation to pain. Therefore a qualitative study was conducted in order to gain an understanding of pain experience of patients with RA in korea. I used naturalistic inquiry as a research methodology, which had 5 axioms, the first is that realities are multiple, constructed, and holistic, the second is that knower and known are interactive, inseparable, the third is only time and context bound working hypotheses(idiographic statements) are possible, the forth is all entities are in a state of mutual simultaneous shaping, so that it is impossible to distinguish causes from effects and the last is that inquiry is value-bound. Purposive sampling was conducted as a sampling. 20 subjects who experienced pain over 10 years, lived in middle-sized city and big city in Korea, and 17 women and 3 men. The subject's age was from 32 to 62 (average 48.8), all were married, living with their spouse and children, except two-one divorced and the other widow before they became ill. I collected data using In depth structured interview. I had interviews two or three times with each subject, and the interviews were conducted at each subject's home. Each interview lasted about two hours an average. A recording was taken with the consent of the subject. I used inductive data analysis-such as unitizing and categorizing. unitizing is a process of coding, whereby raw data are systematically transformed and aggregated into units. Categorizing is a process wherby previously unitized data are organized into categories that provide descriptive or inferential information about the context or setting from which the units were derived. This process is used constant comparative method. The pain controlling process is composed of behavior of pain control. The behaviors of pain control are rearranging of ADL, hiddening role conflict, balancing treatment, and changing social relation. Rearranging of ADL includes diet management, sleep management, and the adjustment of daily life activities. The subjects try to rearrange their daily activities by modified style of motions, rearranging time span & range of activities, using auxillary facilities, and getting help in order to keep on the pace of daily life. Hiddening role conflict means to reduce conflicts between sick role and their role as a family member. In this process, the subjects use two modes, one is to control the pain complaints, and the other is to internalize the value which is to stay home is good for caring her children and being a good mother. To control pain complaints is done by 'enduring', 'understanding' the other family members, or making them undersood in order to reduce pain. Balancing treatment is composed of two aspects. One is to keep the pain within the endurable level, the other is to keep in touch with medical personnel in order to get the information of treatment and emotional support. Changing social relation is made by information seeking and sharing, formation of mutual support relation, and finally simplification of social relationships. The subjects simplify their social relationships by refraining from relations with someone who makes them physically and psychologically strained. In particular the subjects are apt to avoid contact with in-laws, and the change of relation to in-laws results in lessening the family boundary. In the course of this process, they confront the crisis of family confict result in family dissolution. This crisis is related to the threat of self-existence. Findings from this study contribute to understanding the chronic pain experience. To advance this study, we should compare this result with other cases in different cultural contexts. I think to interpret these results, korean cultural background should be considered. Especially the different family concept, more broader family members and kinship network, and the traditional medical knowledge influences patients' behavior.

  • PDF

Physician's Responsibilities in Medical Dispute (의료분쟁(醫療紛爭)에 있어서 의사(醫師)의 주의의무(注意義務))

  • Lee, Joon-Sang;Choi, Baik-Hi
    • Journal of Preventive Medicine and Public Health
    • /
    • v.15 no.1
    • /
    • pp.17-31
    • /
    • 1982
  • A physician assumes toward his patient the obligation to use such reasonable care and skill as is commonly possessed and exercised by physicians in the same general line of practice in the same or similar localities and to use his best judgment at the times. Medical disputes between physicians and patients are, ever more increased in these days as human body, happens to cause a variety of changes in body unlike the function of machine. Such increased trends of medical disputes became a problem in common across the word under the influence of affluent living standard, high consciousness of life value and right by today's people. The aim of this dissertation is oriented to forming a physician's responsibilities in medicalcare accidents arising between physicians and patients. A general physician, for example, has not been negligent merely because, a specialist might have treated the patient with greater skill and knowledge. However, the fact that a physician may have acted to the best of his ability will not avoid legal problems for damages resulting from substandard treatment, that is the degree of care and skill which is to be expected of the ordinary practitioner in his field of practice. The duty of a physician who is, or holds himself out to be, a specialist is greater in the field of his specialty than one who is a general physician. A patient's consent to routine medical procedures is implied from the fact that patient comes to the physician with a medical problem and voluntarily submits to the procedures. For the more serious medical procedures and for major operations, however, it is preferable for the physician to have the patient's consent in writing, to facilitate proof of the consent in the event of a dispute or litigation. Suppose that mistakes on the part of physicians are likely to be blamed in all cases of malpractice. Then it will create a sort of shrinkage in activities of medical treatment. There should be some limitation on excessive application of 'The thing speaks for itself' on mistakes by physicians and availablity of cause and effect. It is a matter of complicity as well as a matter of importance to draw a definite boundary on responsibilities of physician. A series of further research on this particular aspect is strongly urged.

  • PDF

Cesium Release Behavior during the Thermal Treatment of High Bum-up Spent PWR Fuel (고연소도 경수로 사용후핵연료의 열처리에 따른 세슘 방출거동)

  • Park, Geun-Il;Cho, Kwang-Hun;Lee, Jung-Won;Park, Jang-Jin;Yang, Myung-Seung;Song, Kee-Chan
    • Journal of Nuclear Fuel Cycle and Waste Technology(JNFCWT)
    • /
    • v.5 no.1
    • /
    • pp.53-64
    • /
    • 2007
  • The dynamic release behavior of Cs from high burn-up spent PWR fuel was experimentally performed under the conditions of a thermal treatment process such as voloxidation and sintering conditions. In voloxidation process, influence of the oxidation and reduction atmosphere on the Cs release characteristic using fragment type of spent fuel heated up to $1,500^{\circ}C$ was compared. In sintering process, temperature history effect on Cs release behavior was evaluated using green pellet under 4% $H_2/Ar$ environment. Temperature range for complete Cs release from spent fuel fragment under voloxidation condition was about $800^{\circ}C{\sim}1,200^{\circ}C$, but that of green pellet under the reduction atmosphere was $1,100^{\circ}C{\sim}1,400^{\circ}C$. Key parameters on Cs release behavior from spent fuel was powder formation as well as the diffusion rate of Cs compound to grain boundary and fuel surface.

  • PDF

A Study on the Viscosity Characteristics of Dewatered Sewage Sludge according to Thermal Hydrolysis Reaction (열가용화 반응에 의하여 탈수된 하수슬러지의 점도 특성에 관한 연구)

  • Song, Hyoung Woon;Han, Seong Kuk;Kim, Choong Gon;Shin, Hyun Gon
    • Journal of the Korea Organic Resources Recycling Association
    • /
    • v.22 no.1
    • /
    • pp.27-34
    • /
    • 2014
  • demand for a low-cost treatment technology is high because the sewage sludge has an 80% or higher water content and a high energy consumption cost. This study apply the thermal hydrolysis reaction that consumes a small amount of energy for sludge treatment. The purpose of this study is to quantify the viscosity of sewage sludge according to reaction temperature. we measured continuously the torque of dewatered sludge by the reaction temperature. As the reaction temperature increased, the dewatered sludge is thermal hydrolysis under a high temperature and pressure. Therefore, the bond water in the sludge cells comes out as free water, which changes the dewatered sludge from a solid phase to slurry of a liquid phase. The results of the viscosity measurements according to the reaction temperature showed that the viscosity was very high at $270,180kg/m{\cdot}sec$ at a temperature of 293K, but rapidly decreased with increases in the reaction temperature to $12kg/m{\cdot}sec$ at a temperature of 400K and to $4kg/m{\cdot}sec$ at a temperature of 460K or higher, similar to the changes in the viscosity of water. And we was obtained the viscosity function of boundary condition for the optimal design of thermal hydrolysis reactor by numerical modeling based on the this results.

Hypolipidemic and Anti-oxidant Effects of Chunghyl Plus in Type II Diabetic Mice Model (제2형 당뇨 마우스 모델에서 청혈플러스의 항고지혈 및 항산화효과)

  • Choi, Koh Eun;Seol, In Chan;Kim, Yoon Sik;Cho, Hyun Kyoung;Yoo, Ho Ryong
    • Journal of Physiology & Pathology in Korean Medicine
    • /
    • v.30 no.3
    • /
    • pp.164-176
    • /
    • 2016
  • This study was perfomed to investigate the effects of Chunghyul-plus(CHP) on oxidative damage and hyperlipidemia in db/db mouse. After treatment with CHP, safety in cytotoxicity, heavy metal toxicity, production of reactive oxygen species(ROS), nitric oxide (N0) and proinflammatory cytokine IL-Ib, TNF-a, IL-6 in RAW 264.7 cells. Serum total cholesterol, LDL cholesterol, HDL cholesterol, triglyceride, insulin, GLP-1, glucose, food intake, body weight, organ weight, AST, ALT, ALP, BUN, creatine and histologic change of liver and aorta were measured in db/db mouse after oral administration of CHP. CHP showed safety in cytotoxicity and toxicity of liver and kidney for logn time administration. CHP increased the DPPH and ABTS radical scavenging activity. CHP showed significant inhibitory effect on reactive oxygen species (ROS), and showed inhibitory effect on nitiric oxide(NO) compared to control group. CHP decreased cytokine IL-6 production significantly, and decreased IL-1β and TNF-α compared to control group. CHP decreased body and organ weitht, intake food, and glucose levels compared to control group. CHP decreased total cholesterol and triglyceride significantly, and decreased LDL-cholesterol levels and increased HDL-cholesterol levels compared to control group. CHP decreased atherogenic index and cardiac risk factor significantly. CHP increased serum insulin and GLP-1 compared to control group. In histologic examination, lipophagy in the liver and aorta decreased in CHP treated mice and the cell was regular and boundary of vessel wall was clear compared to control group. These results suggest that CHP is effective in antioxidation activity and treatment and prevention of hyperlipidemia, atherosclerosis, diabetes, ischemic heart disease, stroke and other cardiocerebrovascular disease.

Study of the Optimize Radiotherapy Treatment Planning (RTP) Techniques in Patients with Early Breast Cancer; Inter-comparison of 2D and 3D (3DCRT, IMRT) Delivery Techniques (유방암 방사선치료 시 최적의 방사선치료계획기법에 대한 고찰)

  • Kim, Young-Bum;Lee, Sang-Rok;Chung, Se-Young;Kwon, Young-Ho
    • The Journal of Korean Society for Radiation Therapy
    • /
    • v.18 no.1
    • /
    • pp.35-41
    • /
    • 2006
  • Purpose: A various find of radiotherapy treatment plans have been made to determine appropriate doses for breasts, chest walls and loco-regional lymphatics in the radiotherapy of breast cancers. The aim of this study was to evaluate the optimum radiotherapy plan technique method by analyzing dose distributions qualitatively and quantitatively. Materials and Methods: To evaluate the optimum breast cancer radiotherapy plan technique, the traditional method(two dimensional method) and computed tomography image are adopted to get breast volume, and they are compared with the three-dimensional conformal radiography (3DCRT) and the intensity modulated radiotherapy (IMRT). For this, the regions of interest (ROI) such as breasts, chest walls, loco-regional lymphatics and lungs were marked on the humanoid phantom, and the computed tomography(Volume, Siemens, USA) was conducted. Using the computed tomography image obtained, radiotherapy treatment plans (XiO 5.2.1, FOCUS, USA) were made and compared with the traditional methods by applying 3DCRT and IMRT. The comparison and analysis were made by analyzing and conducting radiation dose distribution and dose-volume histogram (DVH) based upon radiotherapy techniques (2D, 3DCRT, IMRT) and point doses for the regions of interest. Again, treatment efficiency was evaluated based upon time-labor. Results: It was found that the case of using 3DCRT plan techniques by getting breast volume is more useful than the traditional methods in terms of tumor delineation, beam direction and confirmation of field boundary. Conclusion: It was possible to present the optimum radiotherapy plan techniques through qualitative and quantitative analyses based upon radiotherapy plan techniques in case of breast cancer radiotherapy. However, further studies are required for the problems with patient setup reproducibility arising from the difficulties of planning target volume (PVT) and breast immobilization in case of three-dimensional radiotherapy planning.

  • PDF

National Survey of Injury and Poisoning on a Representative Sample Population of Koreans (우리나라 대표적(代表的) 표본인구(標本人口)의 연간(年間) 손상(損傷) 및 중독발생율(中毒發生率)과 역학적(疫學的) 특성(特性))

  • Kim, Joung-Soon;Kim, Sung-Soo;Chang, Sung-Chill
    • Journal of Preventive Medicine and Public Health
    • /
    • v.27 no.3 s.47
    • /
    • pp.447-463
    • /
    • 1994
  • Despite the public health importance of injury and poisoning in terms of its high mortality and incidence, epidemiologic information to be utilized are scarce in Korea. This study was carried out in 1990 on a representative sample population (about 55,000 persons) along with the 6th National Tuberculosis Prevalence Survey in order to estimate the magnitude of injury and poisoning occurrence and to identify its epidemiologic characteristics which can be aided for establishing preventive strategy. Pre-tested and structured Questionnaire was used by trained interviewer to collect data including general information of the person, various information on the injury and poisoning during the past one year such as time and place of its occurrence, its nature and external causes, type of medical institute attended, duration of treatment and outcome of the accident occured. In analysis of the data collected incidence rates per 1000 persons by sex, age group and its nature as well as external causes, and relative frequencies were calculated. The result obtained are as followings; 1. The incidence rate per 1000 was 30 for both sexes, 39 for male and 22 for female, male being 1.8 times more frequent than female. Age adjusted incidences were not much different from the crude rates. Age group specific rate curve showed bimodal shape in both sexes, small peaks in preschool children and higher peaks in older ages. The incidence rate per 1000 people by area was highest in Jeon-bug province (57/1000) and the lowest in Daegu city(11/1000). 2. The place where the injuries occured were road in 46%, within the boundary of house in 25%, and working place in 12% The injuries and poisoning had occured more frequently during the months from March to August of the year than other months. 3. The relatively frequent injuries by its nature were contusion with intact skin surface (19%), fracture of upper limb (13%), open wound of head, neck and trunk (12%) and fracture of lower limb (11%) among males; contusion with intact skin surface (28%), sprains and strains of joints and adjacent muscle (14%), fracture of upper limb (10%) and fracture of lower limb (9%) among females. Higher incidence rate among males than females were fracture of skull (4.5 times), open wound and fractures of limbs ($2{\sim}3$ times). Age specific rate of injuries and poisoning by its nature showed increasing pattern by age in fractures of upper and lower limbs and sprains & strains of joints whereas the age group of 30's showed highest incidence in open wounds of upper limb. Fractures of radius and ulna in upper limb, fractures of tibia & fibula and ankle in lower limb were most frequent among fractures of upper and lower limbs. The frequent injuries among sprains and strains of joints and adjacent muscles were that of ankle, foot and back, and among open wound were that of head and fingers. 4. Relative frequency of injuries and poisoning by external causes showed following order : other accidents (25%), accidental falls (23%), motor vehicle accident (22%) and other road vehicle accident (14%) among males and accidental falls (37%), motor vehicle accident (24%) and other accident (18%) among females. The external causes revealing higher incidences among males than females, were other road vehicle accident (4.8 times), vehicle accident not elsewhere classifiable (4.4 times), accidental poisoning (4.4 times), accidents due to natural and environmental factors (2.8 times), and sucide & self-inflicted injuries (2.8 times). Age specific incidence by external causes for frequent injuries showed that incidence of other accident steadily increased from 10's till age 50's; motor vehicle traffic accident increased from age 20's and dropped after age 60's; on the other hand accidental fall increased strikingly by age. The most frequent external causes among motor vehicle traffic accidents was motor vehicle traffic accident involving collision with pedstrain (69%), pedal cycle accident (30%) and other road vehicle accident (71%) among other road vehicle accidents; falls on same level from slipping, tripping or standing (44%) and other falls from one level to another among accidental falls; accidents caused by machinary (32%) for male and striking against or struck accidentally by objects or person for female among other accidents. 5. Seventy nine percent of the injuries and poisonings were treated in general hospital or hospital/clinic. The duration of treatment ranged from a few days to 123 weeks; the majority(52%) took under 2 weeks, 36% for $3{\sim}8$ weeks and 4% over 21 weeks. 6. The accident resulted in full recovery of normal healthy state in 62%, residual functional defects in 21% and on process of treatment in 16%.

  • PDF

A Basis Study on the Optimal Design of the Integrated PM/NOx Reduction Device (일체형 PM/NOx 동시저감장치의 최적 설계에 대한 기초 연구)

  • Choe, Su-Jeong;Pham, Van Chien;Lee, Won-Ju;Kim, Jun-Soo;Kim, Jeong-Kuk;Park, Hoyong;Lim, In Gweon;Choi, Jae-Hyuk
    • Journal of the Korean Society of Marine Environment & Safety
    • /
    • v.28 no.6
    • /
    • pp.1092-1099
    • /
    • 2022
  • Research on exhaust aftertreatment devices to reduce air pollutants and greenhouse gas emissions is being actively conducted. However, in the case of the particulate matters/nitrogen oxides (PM/NOx) simultaneous reduction device for ships, the problem of back pressure on the diesel engine and replacement of the filter carrier is occurring. In this study, for the optimal design of the integrated device that can simultaneously reduce PM/NOx, an appropriate standard was presented by studying the flow inside the device and change in back pressure through the inlet/outlet pressure. Ansys Fluent was used to apply porous media conditions to a diesel particulate filter (DPF) and selective catalytic reduction (SCR) by setting porosity to 30%, 40%, 50%, 60%, and 70%. In addition, the ef ect on back pressure was analyzed by applying the inlet velocity according to the engine load to 7.4 m/s, 10.3 m/s, 13.1 m/s, and 26.2 m/s as boundary conditions. As a result of a computational fluid dynamics analysis, the rate of change for back pressure by changing the inlet velocity was greater than when inlet temperature was changed, and the maximum rate of change was 27.4 mbar. This was evaluated as a suitable device for ships of 1800kW because the back pressure in all boundary conditions did not exceed the classification standard of 68mbar.

Effects of Low-Dose Fractionated Total Body Irradiation on Murine Immune System (마우스에서 전신 저선량 분할 방사선 조사에 의한 면역학적 변화 평가)

  • Kim, Mi-Hyoung;Rhu, Sang-Young;Lim, Dae-Seog;Song, Jie-Young
    • Journal of Radiation Protection and Research
    • /
    • v.39 no.3
    • /
    • pp.134-141
    • /
    • 2014
  • Along with the wide use of radiotherapy in cancer treatment, there is growing interest in beneficial effect of low-dose irradiation (LDI) in cancer therapy. Therefore, we investigate how LDI affects immune responses in mice model. Total body irradiation (TBI) on C57BL/6 mice was given at low-dose rate of $1mGy{\cdot}min^{-1}$ using $^{137}Cs$ source at three times for consecutive three days. Hematological examination, total cell numbers of spleen, populations and characteristics of splenocytes were determined. Total numbers of RBC or platelet in irradiated mice showed no significant changes. WBC counts were decreased in a dose-dependent manner 2 days after TBI, however, these differences are gradually waned until 28 days. Dose-dependent decrease in the number of splenocytes of TBI mice at day 2 was also improved as time progressed. While the level of Foxp3 mRNA was decreased, the frequency of $CD4^+$ T cells and $CD69^+$ cells in spleen was increased at day 2 and 14. Fractionated low-dose TBI on mice exhibited normal body weight with no distinguishable behavior during whole experimental periods. These results suggest that some parameters of immune system could be altered and evaluated by fractionated low-dose TBI and be used to broaden boundary of low dose radiation research.

The Analysis on Causes of Areas with Public Appeals to the Ecosystem and Nature Map (생태·자연도 이의신청지역의 원인 분석)

  • Jung, Tae-Jun;Song, Il-Bae;Lee, Ji-Seon;Lee, Sung-Je;Cho, Kwang-Jin;Song, Kyo-Hong;Kim, Ki-Dong;Cha, Jin-Yeol;Cho, Jang-Sam;Leem, Hyosun;Joung, Hae-Joung
    • Journal of the Korean Society of Environmental Restoration Technology
    • /
    • v.20 no.1
    • /
    • pp.25-34
    • /
    • 2017
  • The objective of this study is to seek for improvement measures to make the Ecosystem and Nature Map by analyzing causes for grade changes and distributional characteristics of areas with public objections to the Ecosystem and Nature Map notified by e-official gazette from 2014 to June 2016. The receipt of public appeals has been recently increased from average 23 cases a year(2007-2013) to average 33 cases a year(2014-June 2016) while there were 42 areas with public appeals for less than the minimum area($62,500m^2$) for the evaluation of grade of the Ecosystem and Nature Map. Most of the public appeals focused on the 1st grade zone of the Ecosystem and Nature Map. Before grade changes by public appeals, the 1st grade zone of the Ecosystem and Nature Map were 76.0% of the whole areas with public appeals. However, after grade changes by public appeals, it was rapidly decreased to 25.2%, which means that a lot of the 1st grade zone with public appeals were lowered. In the results of analyzing the distributional characteristics of areas with public appeals, they were mostly distributed in lowland(less than 250m altitude), section with $10{\sim}20^{\circ}$ slope, and areas close to or within 100m from built-up area. Regarding areas with public appeals, the biggest time difference between the period of the existing research by National Ecosystem Survey and the period of notice after completing the treatment of public appeals was 18 years while areas showing 6-15 years of time difference were about 70%. Thus, there were huge differences in time of research and notice. Also, the biggest causes for grade changes were boundary errors caused by small-scale survey, and then followed by changes in evaluation of endangered species and occurrence of built-up area and damaged land. Analyzing areas with public appeals in each evaluation item of the Ecosystem and Nature Map, vegetation part was 73.0%, and endangered species area was 23.1% while topography and wetland was less.