• Title/Summary/Keyword: Confidence

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The Association of CHADS-P2A2RC Risk Score With Clinical Outcomes in Patients Taking P2Y12 Inhibitor Monotherapy After 3 Months of Dual Antiplatelet Therapy Following Percutaneous Coronary Intervention

  • Pil Sang Song;Seok-Woo Seong;Ji-Yeon Kim;Soo Yeon An;Mi Joo Kim;Kye Taek Ahn;Seon-Ah Jin;Jin-Ok Jeong;Jeong Hoon Yang;Joo-Yong Hahn;Hyeon-Cheol Gwon;Woo Jin Jang;Hyuck Jun Yoon;Jang-Whan Bae;Woong Gil Choi;Young Bin Song
    • Korean Circulation Journal
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    • v.54 no.4
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    • pp.189-200
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    • 2024
  • Background and Objectives: Concerns remain that early aspirin cessation may be associated with potential harm in subsets at high risk of ischemic events. This study aimed to assess the effects of P2Y12 inhibitor monotherapy after 3-month dual antiplatelet therapy (DAPT) vs. prolonged DAPT (12-month or longer) based on the ischemic risk stratification, the CHADS-P2A2RC, after percutaneous coronary intervention (PCI). Methods: This was a sub-study of the SMART-CHOICE trial. The effect of the randomized antiplatelet strategies was assessed across 3 CHADS-P2A2RC risk score categories. The primary outcome was a major adverse cardiac and cerebral event (MACCE), a composite of all-cause death, myocardial infarction, or stroke. Results: Up to 3 years, the high CHADS-P2A2RC risk score group had the highest incidence of MACCE (105 [12.1%], adjusted hazard ratio [HR], 2.927; 95% confidence interval [CI], 1.358-6.309; p=0.006) followed by moderate-risk (40 [1.4%], adjusted HR, 1.786; 95% CI, 0.868-3.674; p=0.115) and low-risk (9 [0.5%], reference). In secondary analyses, P2Y12 inhibitor monotherapy reduced the Bleeding Academic Research Consortium (BARC) types 2, 3, or 5 bleeding without increasing the risk of MACCE as compared with prolonged DAPT across the 3 CHADS-P2A2RC risk strata without significant interaction term (interaction p for MACCE=0.705 and interaction p for BARC types 2, 3, or 5 bleeding=0.055). Conclusions: The CHADS-P2A2RC risk score is valuable in discriminating high-ischemic-risk patients. Even in such patients with a high risk of ischemic events, P2Y12 inhibitor monotherapy was associated with a lower incidence of bleeding without increased risk of ischemic events compared with prolonged DAPT.

Association between physical activity and periodontitis according to depression among Korean adults (한국 성인의 우울증 여부에 따른 신체활동과 치주질환 간 관련성)

  • Hye-Rim Jeon;Soo-Myoung Bae;Hyo-Jin Lee
    • Journal of Korean Dental Hygiene Science
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    • v.7 no.1
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    • pp.69-81
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    • 2024
  • Background: This study aimed to investigate the association between physical activity and periodontitis based on depression status in a representative sample of Korean adults. Methods: A total of 12,689 subjects who participated in the 7th Korea National Health and Nutrition Examination Survey (2016-2018) were examined. Depression was defined as a PHQ-9 score ≥ 10. Periodontal status was assessed using the community periodontal index, with periodontitis defined as a code ≥ 3. Physical activity categories were divided into a physical activity group and a non-physical activity group, considering the number of days and minutes spent on moderate and vigorous activities. Moderate activity was defined as causing slight breathlessness or a slightly elevated heart rate, while vigorous activity was defined as causing significant breathlessness or a rapid heart rate. Multivariable logistic regression analyses were adjusted for sociodemographic variables (age, sex, education level, and household income), oral and general health behaviors (use of floss and interdental proximal brush, current smoking), and systemic health status (diabetes and hypertension). All analyses utilized a complex sampling design, and subgroup analysis was performed to estimate associations stratified by depression (PHQ-9 ≤ 9 and ≥ 10). Results: Multivariable regression analysis revealed that among participants with depression, those who did not engage in physical activity were 2.65 times more likely to have periodontitis (odds ratio = 2.65, 95% confidence interval = 1.17-6.01). Conclusion: The study findings suggest that individuals who participate in any form of physical activity may be significantly less likely to develop periodontitis, particularly within the group experiencing depression.

Factor Influencing Unmet Healthcare Needs among People with Disabilities (장애인의 미충족의료 경험에 영향을 미치는 요인)

  • Bo Hui Park;Kyoung Eun Yeob;Eun Hye Choi;So Young Kim;Jong Hyock Park
    • Health Policy and Management
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    • v.34 no.3
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    • pp.271-281
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    • 2024
  • Background: The unmet healthcare needs (UHNs) of people with disabilities (PWD) are not only detrimental to their quality of life but also can lead to serious health outcomes including death. A variety of factors including socioeconomic, personal, and environmental factors affect UHNs for PWD. Previous studies focused on individual socioeconomic and disability characteristics as influencing factors. Our studies included environmental factors that have a significant impact on the use of healthcare service by PWD. Methods: We analyzed the UHNs status and influencing factors among 4,326 adults with disabilities using the Korea Disability Life Data. Chisquare analysis identified differences in UHNs by general, disability, and environmental characteristics. Logistic regression determined factors affecting UHNs. Results: Those with low educational level (adjusted odds ratio [aOR], 1.229; 95% confidence interval [CI], 1.024-1.475), those with low income level (aOR, 1.416; 95% CI, 1.015-1.976), those who enrolled in private insurance (aOR, 1.234; 95% CI, 1.018-1.496), those who need help with daily living (aOR, 1.298; 95% CI, 1.059-1.592), those who did not go out (OR, 1.566; 95% CI, 1.274-1.924), those who use taxis (aOR, 1.407; 95% CI, 1.047-1.891) or call taxi for people with disabilities when going to the hospital (aOR, 1.370; 95% CI, 1.001-1.875), the communication disabled (aOR, 1.304; 95% CI, 1.029-1.651), those with poor subjective health status (aOR, 1.248; 95% CI, 1.043-1.494), those who felt the explanation of treatment results was insufficient (aOR, 4.035; 95% CI, 1.365-11.927), hose dissatisfied with healthcare services (aOR, 3.515; 95% CI, 2.741-4.508) were more likely to experience UHNs. Conclusion: Effective healthcare service provision for PWD requires not only financial assistance but also social support, along with education for healthcare staff, policies that consider the characteristics of disabilities.

Evaluation of Error Factors in Quantitative Analysis of Lymphoscintigraphy (Lymphoscintigraphy의 정량분석 시 오류 요인에 관한 평가)

  • Yeon, Joon-Ho;Kim, Soo-Yung;Choi, Sung-Ook;Seok, Jae-Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.2
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    • pp.76-82
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    • 2011
  • Purpose: Lymphoscintigraphy is absolutely being used standard examination in lymphatic diagnosis, evaluation after treatment, and it is useful for lymphedema to plan therapy. In case of lymphoscintigraphy of lower-extremity lymphedema, it had an effect on results if patients had not pose same position on the examination of 1 min, 1 hour and 2 hours after injection. So we'll study the methods to improve confidence with minimized quantitative analysis errors by influence factors. Materials and Methods: Being used the Infinia of GE Co. we injected $^{99m}Tc$-phytate 37 MBq (1.0 mCi) 4 sylinges into 40 people's feet hypodermically from June to August 2010 in Samsung Medical Center. After we acquired images of fixed and unfixed condition, we confirmed the count values change by attenuation of soft tissue and bone according to different feet position. And we estimated 5 times increasing 2 cm of distance between $^{99m}Tc$ point source and detector each time to check counts difference according to distance change by different feet position. Finally, we compared 1 and 6 min lymphoscintigraphy images with same position to check the effect of quantitative analysis results owing to difference of amounts of movement of the $^{99m}Tc$-phytate in the lymphatic duct. Results: Percentage difference regarding error values showed minimum 2.7% and maximum 25.8% when comparing fixed and unfixed feet position of lymphoscintigraphy examination at 1 min after injection. And count values according to distance were 173,661 (2 cm), 172,095 (4 cm), 170,996 (6 cm), 167,677 (8 cm), 169,208 counts (10 cm) which distance was increased interval of 2 cm and basal value was mean 176,587 counts, and percentage difference values were not over 2.5% such as 1.27, 1.79, 2.04, 2.42, 2.35%. Also, Assessment results about amounts of movement in lymphatic duct within 6 min until scanning after injection showed minimum 0.15%, and maximum 2.3% which were amounts of movement. We can recognize that error values represent over 20% due to only attenuation of soft tissue and bone except for distance difference (2.42%) and amounts of movement in lymphatic duct (2.3%). Conclusion: It was show that if same patients posed different feet position on the examination of 1 min, 1 hour and 2 hours after injection in the lymphoscintigraphy which is evaluating lymphatic flow of patients with lymphedema and analyzing amount of intake by lymphatic system, maximum error value represented 25.8% due to attenuation of soft tissue and bone, and PASW (Predictive Analytics Software) showed that fixed and unfixed feet position was different each other. And difference of distance between detector and feet and change of count values by difference of examination beginning time after injection influence on quantitative analysis results partially. Therefore, we'll make an effort to fix feet position and make the most of fixing board in lymphoscintigraphy with quantitative analysis.

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Immunogenicity and Safety of a Haemophilus influenzae Type b Polysaccharide-Tetanus Toxoid Conjugate Vaccine (PRP-T: HiberixTM) in Korean Infants (우리나라 영아에서 PRP-T(HiberixTM)백신의 면역원성 및 안전성에 대한 연구)

  • Chung, Eun Hee;Kim, Yae Jean;Kim, Yun Kyung;Kim, Dong Ho;Seo, Jeong Wan;Lee, Hoan Jong
    • Pediatric Infection and Vaccine
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    • v.10 no.1
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    • pp.71-80
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    • 2003
  • Purpose : Four kinds of Haemophilus influenzae type b protein conjugate vaccines, PRPD, PRP-T, PRP-OMP and PRP-CRM197, have been developed, and PRP-T vaccines are currently produced by two manufacturer, $ActHib^{(R)}$ by Aventis and $Hiberix^{TM}$ by GlaxoSmith-Kline Biologicals. The purpose of this study is to evaluate the immunogenicity and safety of $Hiberix^{TM}$ in Korean infants. Methods : Seventy-three healthy infants(43 male infants) were recruited for this study after parental informed consent was obtained. Each infant was vaccinated at 2, 4 and 6 months of age with the study vaccine. At each visit, infants were also immunized with DTaP, trivalent oral polio vaccine and hepatitis B vaccine when indicated. The serum anti-PRP antibody was measured at prevaccination, 2 month later after the 2nd dose, and 1 month later after the 3rd dose by the ELISA method. The local and systemic adverse reactions of vaccination were monitored for 3 consecutive days after each immunization. Immunogenicity of vaccine was evaluated in infants who received all the scheduled immunization and the adverse reactions were evaluated for infants who received at least one dose of the study vaccine. Results : Among seventy three infants, enrolled in this study; sixty three(37 male infants) completed all the scheduled immunizations. The geometric mean titer(GMT) of anti-PRP antibodies at prevaccination was 0.17 ${\mu}g/mL$(95% confidence interval[CI]; 0.13~0.22). The GMT of anti-PRP antibodies increased to 4.14 ${\mu}g/mL$(95% CI; 2.65~6.48) at 2 month later after the 2nd dose of PRP-T and 14.65 ${\mu}g/mL$(95% CI; 10.83~19.81) at 1 month later after the 3rd dose. Anti-PRP antibody ${\geq}0.15$ ${\mu}g/mL$, was observed in 98.4%(95% CI; 91.8~100) after 2 doses and 100%(95% CI; 100~100) after 3 doses. Anti-PRP antibody ${\geq}1.0$ ${\mu}g/mL$, was obtained in 77.8%(95% CI; 67.5~88.0) after 2 doses, and 98.4%(95% CI; 95.3~100) after 3 doses. Most of the adverse reaction after vaccination were mild. Irritability, the most common systemic reaction, was observed in 45.5%, followed by drowsiness(30.5%), poor feeding(26.7%) and fever(5.6%). Among the local reactions tenderness was observed in 7.9%, redness(${\geq}5$ mm) in 2.8% and swelling(${\geq}5$ mm) in 1.8%. Conclusion : The PRP-T vaccine used in this study was highly immunogenic and safe in Korean young infants. The finding that high GMT and high frequency of infants with a protective titer achieved after 2 doses is consistent with the previous studies which were done with a PRP-T vaccine of other manufacturer. This study suggests that the immunization schedule of PRP-T vaccine for Korean infants may need re-evaluation.

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The Effect of Common Features on Consumer Preference for a No-Choice Option: The Moderating Role of Regulatory Focus (재몰유선택적정황하공동특성대우고객희호적영향(在没有选择的情况下共同特性对于顾客喜好的影响): 조절초점적조절작용(调节焦点的调节作用))

  • Park, Jong-Chul;Kim, Kyung-Jin
    • Journal of Global Scholars of Marketing Science
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    • v.20 no.1
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    • pp.89-97
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    • 2010
  • This study researches the effects of common features on a no-choice option with respect to regulatory focus theory. The primary interest is in three factors and their interrelationship: common features, no-choice option, and regulatory focus. Prior studies have compiled vast body of research in these areas. First, the "common features effect" has been observed bymany noted marketing researchers. Tversky (1972) proposed the seminal theory, the EBA model: elimination by aspect. According to this theory, consumers are prone to focus only on unique features during comparison processing, thereby dismissing any common features as redundant information. Recently, however, more provocative ideas have attacked the EBA model by asserting that common features really do affect consumer judgment. Chernev (1997) first reported that adding common features mitigates the choice gap because of the increasing perception of similarity among alternatives. Later, however, Chernev (2001) published a critically developed study against his prior perspective with the proposition that common features may be a cognitive load to consumers, and thus consumers are possible that they are prone to prefer the heuristic processing to the systematic processing. This tends to bring one question to the forefront: Do "common features" affect consumer choice? If so, what are the concrete effects? This study tries to answer the question with respect to the "no-choice" option and regulatory focus. Second, some researchers hold that the no-choice option is another best alternative of consumers, who are likely to avoid having to choose in the context of knotty trade-off settings or mental conflicts. Hope for the future also may increase the no-choice option in the context of optimism or the expectancy of a more satisfactory alternative appearing later. Other issues reported in this domain are time pressure, consumer confidence, and alternative numbers (Dhar and Nowlis 1999; Lin and Wu 2005; Zakay and Tsal 1993). This study casts the no-choice option in yet another perspective: the interactive effects between common features and regulatory focus. Third, "regulatory focus theory" is a very popular theme in recent marketing research. It suggests that consumers have two focal goals facing each other: promotion vs. prevention. A promotion focus deals with the concepts of hope, inspiration, achievement, or gain, whereas prevention focus involves duty, responsibility, safety, or loss-aversion. Thus, while consumers with a promotion focus tend to take risks for gain, the same does not hold true for a prevention focus. Regulatory focus theory predicts consumers' emotions, creativity, attitudes, memory, performance, and judgment, as documented in a vast field of marketing and psychology articles. The perspective of the current study in exploring consumer choice and common features is a somewhat creative viewpoint in the area of regulatory focus. These reviews inspire this study of the interaction possibility between regulatory focus and common features with a no-choice option. Specifically, adding common features rather than omitting them may increase the no-choice option ratio in the choice setting only to prevention-focused consumers, but vice versa to promotion-focused consumers. The reasoning is that when prevention-focused consumers come in contact with common features, they may perceive higher similarity among the alternatives. This conflict among similar options would increase the no-choice ratio. Promotion-focused consumers, however, are possible that they perceive common features as a cue of confirmation bias. And thus their confirmation processing would make their prior preference more robust, then the no-choice ratio may shrink. This logic is verified in two experiments. The first is a $2{\times}2$ between-subject design (whether common features or not X regulatory focus) using a digital cameras as the relevant stimulus-a product very familiar to young subjects. Specifically, the regulatory focus variable is median split through a measure of eleven items. Common features included zoom, weight, memory, and battery, whereas the other two attributes (pixel and price) were unique features. Results supported our hypothesis that adding common features enhanced the no-choice ratio only to prevention-focus consumers, not to those with a promotion focus. These results confirm our hypothesis - the interactive effects between a regulatory focus and the common features. Prior research had suggested that including common features had a effect on consumer choice, but this study shows that common features affect choice by consumer segmentation. The second experiment was used to replicate the results of the first experiment. This experimental study is equal to the prior except only two - priming manipulation and another stimulus. For the promotion focus condition, subjects had to write an essay using words such as profit, inspiration, pleasure, achievement, development, hedonic, change, pursuit, etc. For prevention, however, they had to use the words persistence, safety, protection, aversion, loss, responsibility, stability etc. The room for rent had common features (sunshine, facility, ventilation) and unique features (distance time and building state). These attributes implied various levels and valence for replication of the prior experiment. Our hypothesis was supported repeatedly in the results, and the interaction effects were significant between regulatory focus and common features. Thus, these studies showed the dual effects of common features on consumer choice for a no-choice option. Adding common features may enhance or mitigate no-choice, contradictory as it may sound. Under a prevention focus, adding common features is likely to enhance the no-choice ratio because of increasing mental conflict; under the promotion focus, it is prone to shrink the ratio perhaps because of a "confirmation bias." The research has practical and theoretical implications for marketers, who may need to consider common features carefully in a practical display context according to consumer segmentation (i.e., promotion vs. prevention focus.) Theoretically, the results suggest some meaningful moderator variable between common features and no-choice in that the effect on no-choice option is partly dependent on a regulatory focus. This variable corresponds not only to a chronic perspective but also a situational perspective in our hypothesis domain. Finally, in light of some shortcomings in the research, such as overlooked attribute importance, low ratio of no-choice, or the external validity issue, we hope it influences future studies to explore the little-known world of the "no-choice option."

Effect of Planned Nursing Intervention on the Stress, the Maternal Role Strain, and the Maternal Role Performance of Mothers of Premature Infants (계획된 간호 중재가 미숙아 어머니의 스트레스, 모성 역할 긴장과 역할 수행에 미치는 영향)

  • Joung Kyoun -Hwa
    • Child Health Nursing Research
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    • v.5 no.1
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    • pp.70-83
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    • 1999
  • The birth of a premature infant is distressing for its parents. The parents of a premature infant experience stress according to the infant's physical appearance and behavior, the environment of the neonatal intensive care unit (NICU) , and the alteration in the parental role. Especially, a mother of a premature infant feels distressed even after the discharge of the infant : therefore, she has difficulties in maternal role performance. The main purpose of this study is to identify the effects of the planned infant care information program in order to lower the stress level for mothers of premature infants caused by the birth and hospitalization in NICU of premature infants, to reduce the maternal role strain, and to promote the maternal role performance after the infants' discharge. This study employed two methods of research at the same time : quasi -experimental non-equivalent pre and post test to compare : non-equivalent post test to compare. The total number of subjects was 19 who were assigned to the research program : 12 mothers of premature infants at the NICU at the Ch university hospital and 7 at the NICU at the Y general hospital located in Chounju city. The data were collected for 79 days from August 18 to November 5, 1998. The questionnaire method was applied for the data collection, and the measures used in this study were Parental Stressor Scale : NICU(Miles, 1993), the Maternal Role Strain Measures ( Hobbs, 1968 ; Steffensmeier, 1982) , and Self Confidence Scale (Pharis, 1978). Research procedure is as follows : after preliminary examination, the experimental subjects, the mothers of premature infants at the Nl CU at Ch university hospital were provided with slide films and information developed by the researcher based on existing documents and data. It took two 60-minute sessions a week for two weeks, and the mothers' stress level was measured using the same instrument twice one week and two week after the infants' hospitalization. The stress level of the contrast subjects, the mothers at Y general hospital was measured during the same period. The experimental subjects were provided with booklets on matters that require attention after the infants' discharge and on developmental project, and they were educated to play the maternal role in person for 2-3 hours a week : breast-feeding, burping a baby, and changing diapers. One week after the infants' discharge, the maternal role strain and the maternal role performance were examined in two groups of the subjects. The analysis of collected data was done using descriptive statistics including real numbers, percentages, averages, and standard deviations. Mann-Whitney test ; x² test ; Repeated Measures Analysis of Variance ; ANCOVA Spearman's rho correlation coefficients. The results on this study were as follows. (1) The examination of the same quality showed that there were no differences in the general and obstetrical characters between the two groups. However, in terms of the characters of premature infants. just right after their birth, the infants at the contrast group weighed more than those at the experimental group(U=16.5, p=.02), and the former was in mother's womb longer than the latter(U=15.5, p=.02). (2) The stress level of the mothers provided with the plannned nursing intervention program became lower as time passed compared to the others'(F=16.61, p=.00) Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the mothers' stress levels made a statistical difference 2 weeks after the infants' hospitalization depending on treatment (F=8.00, p=.01) (3) The maternal role strain of the mothers provided with the planned nursing intervention program was lower than the others'(U=2.0, p=.00). Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the maternal role strain levels made a statistical difference 2 weeks after the infants' hospitalization, depending on treatment(F=14.72, p=.00). (4) The maternal role performance level of the mothers provided with the planned nursing program was higher than the others'(U=.0, p=.00). Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the mothers' stress levels made a statistical difference 2 weeks after the infants' hospitalization, depending on treatment(F=8.00, p=.01). (5) The correlation between a mother's stress level 2 weeks after her infant's hospitalization, the maternal role strain and the maternal role performance were compared : the stress and the maternal role strain were statistically irrelevant to each other(r=.33, p=.12) : the stress was found to be in inverse proportion to the maternal role performance(r=-.53, p=.02). The maternal role strain was in inverse proportion to the maternal role performance as well(r=-.50, p=.00). In conclusion, for the mothers provided with the planned nursing intervention program, their stress level was getting lower as time passed during the infants' hospitalization, their maternal role strain reduced when they took care of their infants after their discharge, and their maternal role performance level was high compared to the other mothers. Besides, the lower the stress level of mothers of premature infants was during the infants' hospitalization, the higher the maternal role performance after their discharge was. The lower maternal role strain was, the higher the maternal role performance was as well. These results of the study suggested that the nursing intervention program for the mothers of premature infants developed by the researcher would be effectively applied to nursing practice, and it would be a foundation for the development of this kind of program.

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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.

The Effect of Ginkgo Biloba Extract on the Fractionsted Radiation Therapy in C3H Mouse Fibrosarcoma (Ginkgo Biloba Extract가 C3H 마우스 섬유육종의 분할 방사선치료에 미치는 영향)

  • Kim, Jong-Hoon;Ha, Sung-Whan;Park, Charn-Il
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.155-164
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    • 2002
  • Purpose : A ginkgo biloba extract (GBE) has been known as a hypoxic cell radiosensitizer. Its mechanisms of action are increase of the red blood cell deformability, decrease the blood viscosity, and decrease the hypoxic cell fraction in the tumor. The aims of this study were to estimate the effect of GBE on fractionated radiotherapy and to clarify the mechanism of action of the GBE by estimating the blood flow in tumor and normal muscle. Materials and Methods : Fibrosarcoma (FSall) growing in a C3H mouse leg muscle was used as the tumor model. When the tumor size reached 7 mm in diameter, the GBE was given intraperitoneally at 1 and 25 hours prior to irradiation. The tumor growth delay was measured according to the various doses of radiation (3, 6, 9, 12 Gy and 15 Gy) and to the fractionation (single and fractionated irradiation) with and without the GBE injection. The radiation dose to the tumor the response relationships and the enhancement ratio of the GBE were measured. In addition, the blood flow of a normal muscle and a tumor was compared by laser Doppler flowmetry according to the GBE treatment. Results : When the GBE was used with single fraction irradiation with doses ranging from 3 to 12 Gy, GBE increased the tumor growth delay significantly (p<0.05) and the enhancement ratio of the GBE was 1.16. In fractionated irradiation with 3 Gy per day, the relationships between the radiation dose (D) and the tumor growth delay (TGD) were TGD $(days)=0.26{\times}D$ (Gy)+0.13 in the radiation alone group, and the TGD $(days)=0.30{\times}D$ (Gy)+0.13 in the radiation with GBE group. As a result, the enhancement ratio was 1.19 ($95\%$ confidence interval; $1.13\~1.27$). Laser Doppler flowmetry was used to measure the blood flow. The mean blood flow was higher in the muscle (7.78 mL/100 g/min in tumor and the 10.15 mL/100 g/min in muscle, p=0.005) and the low blood flow fraction (less than 2 mL/100 g/min) was higher in the tumor $(0.5\%\;vs.\;5.2\%,\;p=0.005)$. The blood flow was not changed with the GBE in normal muscle, but was increased by $23.5\%$ ( p=0.0004) in the tumor. Conclusion : Based on these results, it can be concluded that the GBE enhanced the radiation effect significantly when used with fractionated radiotherapy as well as with single fraction irradiation. Furthermore, the GBE increased the blood flow of the tumor selectively.

Health Management and Services of School-Nurse in Special Schools (특수학교의 보건관리)

  • Lee, Kyung Hee;Park, Jae Yong
    • Journal of the Korean Society of School Health
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    • v.4 no.2
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    • pp.176-192
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    • 1991
  • School nurses, in service of 102 special schools in Korea, were urveyed by mail questionnaires from February to March, 1991 and 77 of hem responded. Collected data were analyzed to establish the direction of health management in special school and to provide basic reference data for improving the quality of the management of school-nurses' services. The major findings are as follows: Out of special schools surveyed, 67.5% is private school and 83.2% is located in city. The average number of classes, students, and educational personnels per special school is 17.2, 194, and 28 respectively. The average age of school-nurses surveyed is 32.7. The proportion of graduates from the junior college and upward was 97.4%, the proportion of the married was 71.4%. Out of respondents, 71.4% has religion : 79.2% has past career in the fields of clinics or public health: 62.3% accompanishes independent services: 77.9% belongs to primary school. About 69% of nursing room in special schools surveyed is located at the first floor. Out of special school surveyed, 90.9% has no organization for school health programms: Only 18.2% entrusted everyone of school doctor, school dentist, and school pharmacists with school health. 46.8% of respondents didn't know about the annual budget for school health programmes. The average annual expenditure for school health programme per special school was 317,000F26. won and the purchase cost for medical supplies accounted for the larger part of them. The monthly average number of students utilizing school nursing room was 71 per school, annual utilization times of school nursing room was 4.4 per student and utilization due to injury was prevalent by 26.6% and there is some differences in using the school nursing room according to disabled area. Rate of referral to medical facilities was 1.4%. The leading reason of referral to medical facilities was high fever among those who have visual handicaps, fracture among those who have emotional disturbance, injury by trauma among others. Nine hundred fifty six students of students in special school surveyed have sufferd from epilepsy and prevalence rate of epilepsy was 6.4%. Only 22.6% of respondents replied that they had physical examination more than 2 times per year. Out of respnodents, 98.7% answered that they had health education and 67.1% of them ansered that they educated in a classroom, 98.7% of respondents emphasized need of sex education. Respondents put the most emphasis on the personal hygiene when they performed health education and they used broadcasting education in the area of visual handicaps, OHP or VTR in hearing handicaps, home correspondence or OHP VTR in other area importantly. About 47% of repondents answered that health education was the most difficult and they emphasized that definite guide on health management was requested. Respondents had self-confidence and high perfomance rate in most of school-nurses' services completely, but so they was not in area of evaluation of school health programmes, an examination of physical strength, evaluation of health education, management of school purification area, suture of wounds. In consideration of above findings, we may conclude that special education for school-nurse in special schools as well as improvement of definite guiding principles are requested to establish direction for health management in special schools and to improve the degree of quality for school-nurses' sevices in special schools.

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