Journal of the Korea Academia-Industrial cooperation Society
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v.20
no.10
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pp.243-249
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2019
This study examined the patient's advantage and respect self-decision to protect human dignity and values, who are on the pathway of the hospice palliative care and death process. The study subjects were the elderly who had signed the advance medical directives at C Christian religious facilities in S region. The survey period was started on July 1st, 2019 and lasted for ten days. The study resulted in four topics and eight sub-topics on the motivation for preparing advanced medical directives. The four topics were 'for children', 'fear of pain', 'want to clear my life', 'felt the necessity', and the sub-topics were 'don't want to make a burden to children', 'don't want to make a worry of medical expenses', 'fear of pain', 'have experience of taking caring of painful death process', 'relaxed mind', 'importance of self-decision', 'have known it before but now decided', and 'it is the new information and decided'. This research is meaningful in that it can form the basis for improving well-dying education programs for the good death of the elderly and supplementing effective systems for preparing advance medical directives.
As 3D printing technology is used in the medical field, interest in metal materials is increasing. The Department of Radiation Oncology uses a shielding block to shield the patient's normal tissue from unnecessary exposure during electron beam therapy. However, problems such as handling of heavy metal materials such as lead and cadmium, reproducibility according to skill level and uncertainty of arrangement have been reported. In this study, candidate materials that can be used for metal 3D printing are selected, and the physical properties and radiation dose of each material are analyzed to develop a customized shielding block that can be used in electron beam therapy. As candidate materials, aluminum alloy (d = 2.68 g/cm3), titanium alloy (d = 4.42 g/cm3), and cobalt chromium alloy (d = 8.3 g/cm3) were selected. The thickness of the 95% shielding rate point was derived using the Monte Carlo Simulation with the irradiation surface and 6, 9, 12, and 16 energies. As a result of the simulation, among the metal 3D printing materials, cobalt chromium alloy (d = 8.3 g/cm3) was similar to the existing shielding block (d = 9.4 g/cm3) in shielding thickness for each energy. In a follow-on study, it is necessary to evaluate the usefulness in clinical practice using customized shielding blocks made by metal 3D printing and to verify experiments through various radiation treatment plan conditions.
Seo, Yu Bin;Kim, Young Keun;Lee, Jacob;Song, Wonkeun
Korean Journal of Healthcare-Associated Infection Control and Prevention
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v.21
no.2
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pp.50-56
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2016
Background: Alternatives to carbapenem are increasingly needed to decrease the usage of carbapenem. We evaluated the possibility of using non-carbapenem antibiotics against urinary tract infections (UTI) caused by extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE). Methods: This retrospective study was performed at 2 university hospitals between October 2010 and December 2012. All diagnosed adult cases of ESBL-PE UTI were identified from the microbiological database. The subjects were divided into 3 groups based on the empirical antibiotic classes and susceptibility: carbapenem (C) group, susceptible non-carbapenem (SNC) group, and non-susceptible non-carbapenem (NSNC) group. Results: A total of 84 patients were eligible for analysis. For empirical therapy, 41, 23, and 20 patients were included in the NSNC, SNC, and C empirical groups, respectively. During the empirical therapy, 7 patients (17.1%) in the NSNC group, 18 patients (78.3%) in the SNC group, and 19 patients (78.3%) in the C group experienced clinical improvement. No significant difference was observed between the SNC and C empirical groups (P=0.192). Severe sepsis or shock was the predictor of empirical SNC treatment failure (P=0.048). There was a tendency to use carbapenem as a definite therapy in cases of NSNC. In contrast, empirical SNC was maintained as a definite therapy. Conclusion: SNC could be considered as an alternative to carbapenems for treating ESBL-PE UTI. This strategy might decrease the usage of carbapenem without clinical deterioration. However, it should be noted that SNC therapy may fail in the case of severe sepsis or shock.
Purpose: Ingested foreign bodies present a common clinical problem. It is well known that most of them pass uninterrupted through the gastrointestinal tract. We evaluated the role of endoscopy and Foley catheter for removal of foreign bodies in the gastrointestinal tract. Methods: We investigated retrospectively 60 cases with foreign bodies in the gastrointestinal tract. They had been treated at Wonju Christian Hospital, Yonsei University of Korea, from January, 1996 through December, 1999. Results: The age of the patients ranged from 7 months to 13 years. Patients under 5 years were 57 cases (97%) and there was no significant difference in sex (M : F=1.07 : 1). 45 cases of the patients had no symptom. The most common foreign bodies were coins (43 cases). The most common location was esophagus (31 cases). The number of foreign body removal using flexible endoscopy and Foley catheter was 22 (36.7%) and 18 (30.0%) cases, respectively. In 18 cases (30.0%), foreign bodies passed spontaneously. Only 1 case (1.7%), curtain pin impaction at ileocecal region, required surgery. Conclusion: Early foreign body removal from esophagus and stomach is recommended to lessen the morbidity and complication. Fluoroscopic foley catheter technique and flexible endoscopy for removal of esophageal foreign bodies in children is safe and effective.
Formation of ${\beta}$-amyloid $(A{\beta})$ fibrils has been identified as one of the major characteristics of Alzheimer's disease (AD). Inhibition of $A{\beta}$ fibril formation in the CNS would be attractive therapeutic targets for the treatment of AD. Several small compounds that inhibit amyloid formation or amyloid neurotoxicity in vitro have been known. Citrate has surfactant function effect because of its molecular structure having high anionic charge density, in addition to the well-known antibacterial and antioxidant properties. Therefore, we hypothesized that citrate might have the inhibitory effect against $A{\beta}$ fibril formation in vitro and have the protective effect against $A{\beta}$-induced neurotoxicity in PC12 cells. We examined the effect of citrate against the formation of $A{\beta}$ fibrils by measuring the intensity of fluorescence in thioflavin-T (Th-T) assay of between $A{\beta}_{25-35}$ groups treated with citrate and the control with $A{\beta}_{25-35}$ alone. The neuroprotective effect of citrate against $A{\beta}$-induced toxicity in PC12 cells was investigated using the WST-1 assay. Fluorescence spectroscopy showed that citrate inhibited dose-dependently the formation of $A{\beta}$ fibrils from ${\beta}$-amyloid peptides. The inhibition percentages of $A{\beta}$ fibril formation by citrate (1, 2.5, and 5 mM) were 31%, 60%, and 68% at 7 days, respectively in thioflavin-T (Th-T) assay. WST-1 assay revealed that the toxic effect of $A{\beta}_{25-35}$ was reduced, in a dose-dependent manner to citrate. The percentages of neuroprotection by citrate (1, 2.5, and 5 mM) against $A{\beta}-induced$ toxicity were 19%, 31 %, and 34%, respectively. We report that citrate inhibits the formation of $A{\beta}$ fibrils in vitro and has neuroprotective effect against $A{\beta}$-induced toxicity in PC12 cells. Neuroprotective effects of citrate against $A{\beta}$ might be, to some extent, attributable to its inhibition of $A{\beta}$ fibril formation. Although the mechanism of anti-amyloidogenic activity is not clear, the possible mechanism is that citrate might have two effects, salting-in and surfactant effects. These results suggest that citrate could be of potential therapeutic value in Alzheimer's disease.
The Journal of the Society of Korean Medicine Diagnostics
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v.10
no.1
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pp.153-165
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2006
Objectives: The purpose of this study is to obtain basic data about medical consumer's behavior by the examination of the demographic characteristics, experience of medical service and attitude toward traditional medicine based on the outpatients of oriental medicine clinic. Methods: The participants of this study are outpatients in 5 oriental medicine clinics located in the metropolitan area. The resources were collected from the self-administration questionnaire survey. 202 samples were collected. The SPSS 13.0 for windows was used for statistical analysis: One-way ANOVA, $x^2-test$, correlation analysis were used to verify the results. Results & Conclusions: The results from this study are as follow. 1, The group which are in low-ade educational background and income selected traditional medicine for the promotion of health. In this group, traditional medicine was consumed with higher purchasing frequency and more satisfaction and considered more safe and effective, on the other hand western medicine was consumed with lower frequency. People In this group highly evaluated the kindness of oriental medicine doctor and more interested in health. 2. The group which selected traditional medicine for the treatment of disease more frequently consumed traditional medicine. People In this group highly evaluated the efficacy and economical efficiency of traditional me야cine and the kindness of oriental medicine doctor. 3. The group which selected traditional medicine for the management of disease iess : frequently consumed western medicine. People In this group highly evaluated the efficacy of traditional medicine. 4. Purchasing frequency on traditional medicine was higher in the 50year above group than $30{\sim}39year$, 29year and below group.(P<0.1) 5. Purchasing frequencyy on traditional medicine slightly correlated with the satisfaction of traditional medicine and the kindness of oriental medicine doctor. The satisfaction of traditional medicine strongly correlated with the kindness of oriental medicine doctor. 6. The efficacy of traditional medicine and the kindness of oriental medicine doctor were highly evaluated in the $10{\sim}19times$ experience group and 20times above experience group than $1{\sim}4times$ experience group.
Purpose: The aim for this study was to investigate clinical manifestation of seasonal influenza A and B during the 2012 winter season in Wonju, South Korea. Their clinical and laboratorial characteristics and effect of oseltamivir were compared and analyzed. Methods: Children under the age of 18 years who visited the Wonju Severance Christian Hospital with fever or acute respiratory symptoms and who were diagnosed with influenza A or B by rapid antigen test from nasopharyngeal swab were selected for the study. The medical records of patients were retrospectively reviewed. Results: Influenza A was detected in 374 patients (83.7%), and influenza B in 72 (16.6%). The incidence of influenza A was highest in February (n=186), while that of influenza B was highest in March (n=36). The most common symptoms were fever (n=434, 97.1%) and cough (n=362, 81.0%). No significant differences were observed between influenza A and B in symptoms and laboratory data. Patients who had used oseltamivir within 2 days showed statistically lower admission rate, shorter admission duration, and lower incidence of pneumonia. Conclusion: This study found no statistical difference between influenza A and B, in symptoms, progression, and laboratory test, but those who were treated with oseltamivir given within 2 days of the onset of fever experienced more positive outcomes.
Ancient mirrors are generally made of bronze, and it is very rare to find cases of iron mirrors excavated domestically. In this study, the unidentified ferrous artifact was treated for conservation, and was identified as a mirror. In this process, the sample was taken and analyzed for microstructure, and the manufacturing technology was studied. Analysis involved optical microscope, micro-hardness tester, and SEM-EDS. As the result of analysis, iron mirror structure exist not almost non-metallic inclusions, and partially network cementite was observed. This appears to have been caused by reduced carbon content due to decarburizing the cast iron in the solid state mirror which was created by cast iron. The ledeburite structure of the casting has difficult to cut or polish because has great hardness by high carbon content. Thus, the cast iron mirror was decarburized at a temperature under $850^{\circ}C$ with CO or $CO_2$ blocked, which reduced the hardness of the iron mirror and made it possible to polish the mirror surface. This deformation of structure according to carbon content results from such manufacturing technology.
Journal of the korean academy of Pediatric Dentistry
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v.32
no.1
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pp.174-184
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2005
For the purpose of investigating the etiologic factors of early childhood caries in 18-month old infants which is an important period in pediatric dentistry, 234 infants of 18-month age and their first care-givers (mothers in most cases) who visited Ilsin Christian Hospital in Busan for the baby-care counseling and vaccination were examined. The oral examination was performed on the infants and their care-givers were individually interviewed about various items, and the data was statistically processed to yield the results as follows : 1. The prevalence rate of early childhood caries was 27.4%. 2. The percentage of the eldest child, the education level of the mother and monthly income were revealed lower in caries group infants. 3. The percentage of prolonged breast-feeding and the frequency of daily nursing was higher in early childhood caries group. 4. In early childhood caries group, the between-meal snacks were tend to be provided irregularly without predetermined time, and sugar containing snacks such as chocolates and candies were ranked in higher order whereas the fruits and milks were in lower ranks. 5. In early childhood caries group, the percentage of those performing the oral hygienic care was lower and the timing to start the toothbrushing was comparatively later. From the above results, it can be concluded that prolonged breast-feeding, poor snack habits and lower socioeconomic status act an important role in early childhood caries in 18-month old infants.
The purpose of this paper is to evaluate the image of the Styrofoam Wedge that can minimize the position change by supporting the wrist during the True PA and lateral examination of the wrist. In 50 people, the gap between the distal radius joint facet and the wrist bone was measured after the wrist True PA and lateral images were obtained using a general examination(vertical), tube angle(vertical:10°, lateral:20°) and Styrofoam Wedge(vertical). When joint spacing was measured in the True PA and lateral images of the wrist, general examination(5.54mm, 9.42mm), tube angle(2.05mm, 5.07mm) and Styrofoam Wedge(1.79mm, 5.46mm) were shown to be small. The smaller the joint spacing, the easier it is to observe that is open. Therefore, True PA and lateral imaging of the wrist Styrofoam Wedge can reduce the distortion of the image and thus acquire images of high diagnostic value. In addition, it may be possible to reduce the deviation caused by the change of patient's position during re-projection.
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