The Journal of Korean Institute of Communications and Information Sciences
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v.38C
no.9
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pp.822-829
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2013
Hypertension is one of the most common clinical diseases, with an increasing prevalence globally. Hypertension triggers various harmful consequences and affects multiple organs. Life-long care may be required in some cases. According to the Korea Center for Disease Control and Prevention, the prevalence of hypertension is gradually increasing. A 2011 survey revealed that 28.9% of Korean adults had hypertension. The prevalence rates were slightly higher among men than women. Accurate measurement of blood pressure(BP) is crucial to classify patients, to identify BP-related risks, and to inform correct treatment. For accurate blood pressure measurement, the use of a cuff bladder size appropriate for the mid-upper arm circumference(MUAC) is essential. Incorrect sized cuff bladder is one of the main causes of equipment error affecting sphygmomanometer accuracy. When commercial sphygmomanometers were examined, the cuff bladders differed from the dimensions specified in the ISO 81060-1:2007 standards. Undercuffing is responsible for a spurious overestimation of BP in patients with large arms leading to overdiagnosis of hypertension, whereas overcuffing (that is, use of relatively large cuffs with small arms), may be responsible for an opposite problem, leading to erroneous underestimation of BP levels. The cuff bladder sizes recommended by the American Heart Association(AHA) are an arm circumference(AC) of 17-25 cm for small-sized adults, AC of 24-32 cm for adults, AC of 32-42 cm for normal-sized adults, and AC of 42-50 cm for obese adults. In contrast, the AC of Korean adults ranges from 23-31 cm, belonging to a single type of adult bladder. Three types of bladders are necessary for Korean adults with an AC of 23-31cm. Hospitals often use one or two differently-sized Western cuffs for adult patients, which can yield inaccurate BP determinations. Cuff bladders with dimensions based on anthropometric reference data obtained from Koreans will aid hospitals to measure BP more accurately.
The aim of this study is to examine effects of a yoga program for children on school stress of the elementary school children. To achieve this goal, total 10 students out of 231 in 6 classes among the third graders in M elementary school in B city were selected as subjects for this study. After regular school hours, they participated in a children's yoga program for 16 times for 45 minutes per session in the course of 8 weeks. An ethnographic interview was conducted to identify the effects of the program. During the initial stage of the children's yoga program, the participants were interviewed preliminarily. An analysis of areas and an analysis of classifications were made based on the initial interview results, and an area classification table was drawn on the school stress perceived by the elementary school children. After the yoga program ended, a follow up interview was made to apply an analysis of components by comparing changes in the school stress level due to a yoga effect. A research report was written through a cycle of addition and supplement in which the previous data analysis was complemented and corrected by new findings of the study. As a result of the ethnographic interview to analyze the school stress perceived by the elementary school children, and an examination of the changes in the school stress level, the children's yoga program proved to be significantly effective in reducing the school stress. However there were limitations to a certain degree in stress reduction. Details of such findings in each sub-category are as follow. First, as a result of the initial interview analysis, the school stress was classified broadly into 4 categories of study stress, friendship stress, teacher stress, and school environment stress. Second, the study stress as the first category of the school stress was classified into 3 sub-categories of homework, class, and exam stresses. In spite of minor differences among 3 sub-categories, the stress was reduced in general. Third, the friendship stress as the second category of the school stress was also classified into 3 sub-categories of bullying, alienation, and performing one's duty. There were minor differences among sub-categories, however stress reduction also appeared with the exception of the performing one's duty category which had relatively little effect from the yoga program. Fourth, regarding the teacher stress as the third school stress, a classification was made into 3 sub-categories of preference, penalty, and teaching method. Minor differences among the 3 sub-categories notwithstanding, stress reduction appeared with the exception of the teaching method stress which had relatively little effect from the yoga program. Fifth, the school environment stress as the fourth category of the school stress was classified into 2 sub-categories of school meals and facilities. Minor differences between the 2 categories notwithstanding, stress reduction appeared with the facilities stress having relatively little effect.
Purpose: Laparoscopic gastric resection (LGR) is increasingly being used instead of open gastric resection (OGR) as the standard surgical treatment for gastric submucosal tumors. Yet there are few reports on which technique shows better postoperative outcomes. This study was performed to compare these two treatment modalities for gastric submucosal tumors by evaluating the postoperative outcomes. We also provide an analysis of the learning curve for LGR. Materials and Methods: Between 2003.4 and 2008.8, 103 patients with a gastric submucosal tumor underwent either LGR (N=78) or OGR (n=25). A retrospective review was performed on a prospectively obtained database of 103 patients. We reviewed the data with regard to the operative time, the blood loss during the operation, the time to the first soft diet, the postoperative hospital stay, the tumor size and the tumor location. Results: The clinicopatholgic and tumor characteristics of the patients were similar for both groups. There was no open conversion in the LGR group. The mean operation time and the bleeding loss were not different between the LGR group and the OWR group. The time to first soft diet (3.27 vs. 6.16 days, P<0.001) and the length of the postoperative hospital stay (7.37 vs. 8.88 days, P=0.002) were shorter in the LGR group compared to the OGR group. The tumor size was bigger in the OGR group than that in the LGR group (6.44 vs. 3.65 cm, P<0.001). When performing laparoscopic gastric resection of gastric SMT, the surgeon was able to decrease the operation time and bleeding loss with gaining more experience. We separated the total cases into 3 periods to compare the operation time, the bleeding losses and the complications. The third period showed the shortest operation time, the least bleeding loss and the fewest complications. Conclusion: LGR for treating a gastric submucosal tumor was superior to OGR in terms of the postoperative outcomes. An operator needs some experience to perform a complete laparoscopic gastric resection. Laparoscopic resection could be considered the first-line treatment for gastric submucosal tumors.
Kim, Kab-Choong;Yook, Jeong-Hwan;Choi, Ji-Eun;Cheong, Oh;Lim, Jeong-Taek;Oh, Sung-Tae;Kim, Byung-Sik
Journal of Gastric Cancer
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v.8
no.4
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pp.232-236
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2008
Purpose: Laparoscopic surgery for gastric cancer was introduced in the past decade because it was considered less invasive than open surgery, and this results in less postoperative pain, faster recovery and an improved quality of life. Several studies have demonstrated the safety and feasibility of this procedure. We examined the outcome of performing laparoscopic surgery for gastric cancer over the last two year. Materials and Methods: From April 2004 to December 2006, 329 patients with gastric adenocarcinoma underwent a laparoscopy-assisted distal gastrectomy with lymph node dissection. The data was retrospectively reviewed in terms of the clinicopathologic findings, the perioperative outcomes and the complications. Results: The total patient group was comprised 196 men (59.6%) and 133 women (40.4%). The mean BMI was 23.6 and the mean tumor size was 2.7 cm. The mean number of harvested lymph node was 22.7, and this was 18.6 before 30 cases and 23.1 after 30 cases, and the difference was significant (P=0.02). The mean operation time was 180.9 min, and this was than 287.9 min before 30 cases and 170.2 min after 30 cases. After 30 cases, there was a significant improvement of the operation time (P<0.01). The mean incision length after 30 cases was shorter than that before 30 cases (P<0.01). Postoperative complications occurred in 24 (7.3%) of 329 patients and there was no conversion to open surgery. Conclusion: Even though the LADG was accompanied by a difficult learning curve, we successfully performed 329 LADG procedures over the past 2 years and we believe that LADG is a safe, feasible operation for treating most early gastric cancers (EGC).
Purpose: Intra-abdominal fluid collection is one of the risk factors associated with postoperative morbidity or mortality for patients who undergo gastric cancer surgery. The aim of this study was to analyze the clinicopathological characteristics of the patients with postoperative intra-abdominal fluid collection and to identify the indications for inserting a percutaneous drain (PCD) in patients with intra-abdominal fluid collection. Materials and Methods: Among the 1,277 patients who underwent operations for gastric cancer at Seoul National University Hospital between April 2005 and July 2006, the data of 117 patients with an intra-abdominal fluid collection were reviewed. Results: The number of patients' with pathologic stage I, II, III and IV disease was 42 (36.8%), 23 (20.2%), 16 (14%) and 33 (28.9%), respectively. Forty-three patients (36.3%) underwent PCD insertion and the other 43 patients received conservative management. A univariate analysis of multiple clinical variables revealed that age, gender, diabetes, liver disease, lymph node dissection, the pathologic stage and the body mass index (BMI, $kg/m^2$) were not significantly associated with PCD insertion (P>0.05). However, the univariate analysis showed that two characteristics were associated with a significantly high incidence of PCD insertion: a diameter of an intra-abdominal fluid collection greater than 4 cm and infectious signs such as leukocytosis, fever and bacteremia. Conclusion: About two thirds of the intra-abdominal fluid collections after surgery for gastric cancer were managed with only conservative method without other morbidities of mortality. Surgeons should consider performing PCD insertion if the largest diameter of an intra-abdominal fluid collection is over 4 cm or if infectious signs are seen.
Purpose: The main target of 5-fluorouracil (5-FU) is thymidylate synthase (TS). A high TS expression has been identified as promoting resistance to 5-FU. For colorectal cancers, the response to 5-FU based adjuvant chemotherapy is different according to the microsatellite instability (MSI) status. The reports on the relationship between MSI and the TS expression in colorectal cancer have been inconsistent. No data is available for gastric cancer regarding the relationship between MSI and the TS expression. Therefore, we studied the relationship between MSI and the TS expression in gastric cancer. Materials and Methods: Ninety-nine consecutive patients who underwent radical gastrectomy for gastric cancer from January 2004 to May 2006 at Bundang CHA hospital were studied. MSI was assessed for five markers (BAT25, BAT26, D2S123, D5S346, and D17S250) by PCR and with using an ABI prism 3100 Genetic analyzer. The TS expression was analyzed by immunohistochemistry with using mouse anti-thymidylate synthase monoclonal antibody to the TS 106 clone. Results: Out of the ninety-nine patients, MSS/MSI-L was detected in 92 (92.1%) cases and 7 cases (7.1%) were MSI-H. A negative TS expression was found in 46 (46.5%) cases, a low TS expression was found in 33 (33.3%) and a high TS expression was found in 20 (20.2%). Out of 92 MSS/MSI-L patients, the number of patients with negative, low and high TS expressions were 46 (50%), 30 (32.6%) and 16 (17.4%), respectively. Out of the 7 MSI-H patients, the number of patients with negative, low and high TS expressions were 0 (0%), 3 (42.9%) and 4 (57.1%), respectively. The relationship between MSI-H and a high TS expression was statistically significant. Conclusion: Gastric cancer with MSI-H showed higher levels of a TS expression compared to the gastric cancer with MSS/MSI-L.
Based on the spatial and land price data of innovation cities and their periphery areas in Korea, this study examines the degree and timing of changes in land price in relation to projects concerning innovation city. The study result confirms that the current system is inconsistent with the principle of restitution of development gain and therefore, this study attempts to seek improvement measures so that the current system can better fit the principle. The analysis reveals that most innovation cities, excluding Sinseo-dong of Daegu and Ujeong-dong of Ulsan, recorded a statistically significant increase in land prices since 2005, compared to those of their neighboring areas. It can be said that the information related to projects concerning innovation city was reflected in the land price since 2005. However, the standard land price pursuant to Article 70 of the Land Compensation Act is the officially assessed land price released on 1st of January 2007, and this official land price was actually applied to the compensation process. Therefore, estimating the compensation amount for land expropriation based on this land price will contradict the principle of restitution of development gain. In other words, despite the fact that development-related information was already reflected in land prices of innovation cities from 2005 to the end of 2006, the compensation process were carried out without institutional arrangements or efforts to exclude such reflection. To solve this problem, this study makes two suggestions. First, it is necessary to cast aside the limitations of the official land price that can be retroactively applied in accordance with Paragraph 5 of Article 70 of the Land Compensation Act, and instead apply the land price which is the most latest but deemed to have no reflection of development gains. Based on this revised standard land price, if the compensation amount is corrected by the average inflation rate and the average rate of increase in land price during the period until the time of the recognized land price, the amount would better satisfy the principle of restitution of development gain. Second, it is necessary to clearly stipulate the standards of development gains being reflected on the land price by including it in the secondary legislation. Under the current system, it is highly likely that appraiser's arbitrary interpretation on development gains is included in the process of calculating the amount of compensation for land expropriation. In this regard, it is necessary to improve the standards on determining whether development gains are reflected based on the results of this academic research and the existing guidelines for appraisal of compensation for land expropriation published by the Korea Association of Property Appraisers.
Objectives : The change of sleep patterns commonly occurs in association with the pregnancy. This study was to investigate sleep habits during the course of normal pregnancy. Methods : Sleep habits questionnaire was administered to healthy women in their first trimester(TR1) of pregnancy and then the same questionnaire was repeatedly administered during their second(TR2) and third(TR3) trimesters. The following aspects were assessed : patterns of night sleep, daytime status, sleep posture, reasons for sleep alteration, and the experience of any particular parasomnias, as well as sleep problem-related treatment or medication. Data analysis was based on 26 women who maintaind good health throughout their pregnancy and completed the questionnaire three times. Results : In comparisons between each trimester and non-pregnant state, total night sleep time, daytime tiredness, and sleepiness were significantly increased in all trimesters. Sleep latency was significantly decreased in TR1 and TR2, but not in TR3. In addition, refreshed feeling on waking the following day was significantly decreased and the number of awakenings during night sleep was significantly increased in TR3, but not in TR1 and TR2. In comparisons between trimesters, there was a significant increase in sleep latency, daytime sleepiness and the number of awakenings during night sleep and a significant decrease in refreshed feeling on waking the following day in TR3 compared to TR1 and TR2. Over the course of pregnancy, the rate of lateral position during sleep was gradually increased and all the pregnant women took the lateral sleeping posture in TR3. The major reasons for sleep pattern alteration were nausea, vomiting and heartburn in TR1, urinary frequency, fetal movement and ache in hips in TR2, and urinary frequency, fetal movement, cramp in legs and backache in TR3. Conclusion : These findings are expected to be useful for educating pregnant women about sleep hygiene. In future studies, the underlying factors and mechanisms regarding sleep patterns during pregnancy will need to be clarified.
Journal of the Korea Academia-Industrial cooperation Society
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v.16
no.11
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pp.7978-7989
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2015
Dyslipidemia is a major risk factor for cardio-cerebrovascular disease. Although the prevalence among Korean adults is very high, its management is known to be poor. The aim of this study was to access the prevalence, awareness, treatment, and control rates of dyslipidemia according to treatment guideline rather than diagnostic criteria. The risk factors for cardio-cerebrovascular disease were evaluated to apply the appropriate risk-based threshold of the lipid treatment targets according to risk category. Analysis was done using nationally representative data (n = 16,263) collected from adults aged 20 years and older participating the Korea National Health and Nutrition Examination Survey (KNHANS) 2010-2012. The age-standardized prevalence rate of dyslipidemia according to treatment criteria was 34.1%. Of these prevalent cases, however, only 19.2% were aware; 9.5% treated; and 8.7% controlled. The age-standardized control rate among treated persons was 47.5%. Men had a significantly higher prevalence than women (39.7% vs. 28.8%), but a significantly lower rate of awareness, treatment, and control (16.0% vs. 22.3%, 7.7% vs. 11.3%, and 6.1% vs. 11.2%, respectively). As the higher risk category, the prevalence rate was higher but the control rate was lower. The prevalence of patients with diabetes was 82.5% when applying the treatment criteria (LDL-cholesterol level of ${\geq}100mg/dL$ and triglyceride level of ${\geq}200mg/dL$). However, only 11.9 % of these were controlled, whose LDL-cholesterol and triglycerides were lower than the treatment goals. Our findings suggest that effective strategies are required to decrease the gap between the prevalence of dyslipidemia and the following treatment. It would be worthwhile to strengthen the follow-up management of patients with dyslipidemia in the National Health Screening Program, especially in the high risk group of cardio-cerebrovascular disease.
The purpose of this study was to analyze recognition characteristics of science gifted students on the earth system based on their thinking style. The subjects were 24 science gifted students at the Science Institute for Gifted Students of a university located in metropolitan city in Korea. The students' thinking styles were firstly examined on the basis of the Sternberg's theory of mental self-government. And then, the students were divided into two groups: Type I group(legislative, judicial, global, liberal) and Type II group(executive, local, conservative) based on Sternberg's theory. Data was collected from three different type of questionnaires(A, B, C types), interview, word association method, drawing analyses, concept map, hidden dimension inventory, and in-depth interviews. The findings of analysis indicated that their thinking styles were characterized by 'Legislative', 'Executive', 'Anarchic', 'Global', 'External', 'Liberal' styles. Their preference were conducting new projects and using creative problem solving processes. The results of students' recognition characteristics on earth system were as follows: First, though the two groups' quantitative value on 'System Understanding' was very similar, there were considerable distinctions in details. Second, 'Understanding the Relationship in the System' was closely connected to thinking styles. Type I group was more advantageous with multiple, dynamic, and recursive approach. Third, in the relation to 'System Generalization' both of the groups had similar simple interpretational ability of the system, but Type I group was better on generalization when 'hidden dimension inventory' factor was added. On the system prediction factor, however, students' ability was weak regardless of the type. Consequently, more specific development strategies on various objects are needed for the development and application of the system learning program. Furthermore, it is expected that this study could be practically and effectively used on various fields related to system recognition.
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