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A Study on the Degree of Physical, Psychological and Social Adaptation of CVA Patients (뇌졸중(腦卒中) 환자(患者)의 신체적(身體的).심리적(心理的).사회적(社會的) 적응도(適應度)에 관(關)한 연구(硏究))

  • Hwang Hyun-Sook;Park Kyung-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.3 no.2
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    • pp.213-233
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    • 1996
  • This study was made on 274 apoplectics patients who received the rehabilitation therapy and tests on physical, psychological and social adaptations as outpatients in 23 general hospitals in the Seoul and Kyungi area. The basic data on degree of improvement of apoplectic patients studied from rehabilitation therapy. Data was collected over a period of 63 days, from February 21st till April, 23, 1996. The assigned physical therapist conducted direct interviews with patients after he answered the distributed questionnaires for each individual patient. The colleted data was processed by the $SPCC/C^+$ method. The results of the tests conducted to meascne the the degree of ADL dependency, depression and social activity corresponding to the physical, psychological, and social adaptation. The details are ; 1) The test to meascne the degree of ADL dependency, corresponding to the study of physical adaptation of CVA patients, indicated a mean score of 2.57(ideal score is 1.0) with a standard deviation of ${\pm}0.75$. The worst score was 3.95 while the best score was a perfect 1.0, representing a severe range of dependency. The distribution was centered with a median of 2.65 and a mode of 2.68. 2) The test to meascne the degree of depression which corresponds to the level of psychological adaptation yielded a mean of 2.99 which is higher than the normal limit of 2.45. The standard deviation was ${\pm}0.52$ and the worst score and the best score were 4.35 and Respectirdy. The distribution was centered with a median of 3.00 and a mode of 3.00. 3) The test to meascne the degree of social activities for the level of social adaptation indicated a very low mean score of 26.52 (perfect score is 144), with the standard deviation of ${\pm}16.23$. Some patients scored as high as 100, but others scored as low as 3. The distribution of social activities at a very low level was shifted to the left with a median of 24.00 and a mode of 20.00. 4) Factors influencing the level of physical, psychological and social adaptation are as follows : Factors significantly influencing the level of physical adaptation measured by ADL dependency are age, personal guardian, payer of medical expenses, and paralysis of the right arm, right leg and facial paralysis. Factors significantly influencing the level of psychological adaptation measured by the degree of depression, are age, marital status, education, medical history of individual and family, speech impediment, and facial paralysis. Factors significantly influencing the level of social adaptation measured by the degree of social activity are age, marital status, education, employment status, and the burden of medical expense. 5) The Corelationship is significant(9.00), between ADL dependeing as degree of physical adaptation and depreseion as degree of psychologial adaptation. ADL dependency is proportional to depression. But social activity is inversely protional to ADL dependeny and depression. In conclusion, the increased care for physical function of the patients is not the only necessary means to better facilitate the appropriate adaptation of CVA patients. The introduction of a solid rehabilitation program for psychological and social adaptation will also play the integral part of the treatment of CVA patients.

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Study the impact on job satisfaction in the care facility of the empowerment of the members of the organization (요양시설의 조직구성원의 임파워먼트가 직무만족에 미치는 영향에 관한 연구)

  • Kim, Chang-Tae;Gwak, Gyeong-Ja
    • Management & Information Systems Review
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    • v.31 no.4
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    • pp.57-82
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    • 2012
  • The purpose of the study is to suggest the measure for the improvement of job satisfaction and level of empowerment of sanatoriums' social workers by analyzing factors of empowerments' effect on the job satisfaction, and investigating level of empowerment and job satisfaction of social workers of sanatoriums for the elderly and the handicapped. The result of investigation and analysis on subjects of 420 social workers of sanatoriums for the elderly and the handicapped in Youngnam area for this is as follows: First, job characteristic that is empowerments' influence factor of sanatoriums' social workers is appeared in order of feedback, and function variety, and in organization characteristic is appeared in order of leadership, reward, and employee development. Second, level of empowerment that is recognized by sanatoriums' social workers is appeared a little higher than normal level and significance is appeared highest, and next are capability, self-determination ability, and influence. Third, features that showed significant difference with significance in general characteristic of sanatoriums' social workers were 'sex', 'marital status', and 'religion', and features that showed significant difference with capability were sex, age, marital status, academic background, and employment history. And features that showed significant difference with self-determination ability were sex, age, marital status, and employment history, and features that showed significant difference with influence were sex, age, employment history and types of facilities. Fourth, the whole average of job satisfaction of sanatoriums' social workers was 3.82 out of 5, which is generally high, features that showed significant difference statistically were age, marital status, academic background, employment history, and types of facilities. Thus, job satisfaction was appeared as high as 'more than age of thirty' in age, 'married' in marital status, 'under graduates of colleges' in academic background, and 'less than three years' in employment history. Fifth, as for factors that had influence on job satisfaction, the indirect effect with empowerment was appeared that had significant effect in organization characteristic, and had few effect in organization features. On these results, practical measures to increase job satisfaction of sanatoriums' social workers are as follows: First, political approach is required to standardize duty system(by various types of facilities and clients' characteristic) of social workers of sanatoriums for elderly and the handicapped, and help to do the role as professionals with giving better treatment and building self-respect by enough reward. Second, to suggest chances to perform the responsibility for the duty of the scenes by the regular supervision, establish regular supervision system of social workers of sanatoriums for the elderly and the handicapped, and the extension of duty to increase the functional varieties. Third, it is required to motivate to have self confidence for the work and to use potential ability with transforming leadership, and to have more chances of education for the self-development. To increase job satisfaction of sanatoriums' social workers who give direct services in sanatoriums for the elderly and the handicapped, more active and positive empowerment's level improvement is in need by improvement of empowerment for them.

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The Effect of Vitamin E on the Composition of inflammatory Cells in Alveoli after Paraquat Intoxication in Rats (Paraquat에 의한 급성 폐손상에서 Vitamin E처치가 기관지폐포 세척액내 세포조성에 미치는 영향)

  • Song, Kwang-Seon;Lee, Won-Yeon;Cho, Do-Yeun;Yong, Suk-Joong;Shin, Kye-Chul
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1332-1342
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    • 1997
  • Background : Acute pulmonary injury by paraquat are caused by multiple mechanisms including direct injury with oxygen free radicals and several mediators released from inflammatory cells. In order to clarify whether vitamin E could reduce tissue damages induced by intraperitoneal administration of paraquat and to investigate the pathogenetic mechanisms of paraquat-induced pulmonary injury, vitamin E as a free radical scavenger was administered. Method : Rats were divided into three groups (group 1 : control, group 2 : paraquat treated group, group 3 : paraquat and vitamin E treated group). Animals were sacrificed on day 1, day 2, day 3, and day 8 after the administration of saline, paraquat, or paraquat/vitamin E. Results : Treatment with vitamin E decreased the death rate of rats treated with paraquat. Comparing with control group ($1.37{\times}10^6/ml$), mean total cell counts recovered from the lavage fluid from animals treated with paraquat($1.65{\times}10^6/ml$) were increased(p=0.06). Magnitudes of increment of the total cell counts on the Day 8 in the vitamin E treated group were smaller than those of the animals treated with paraquat alone. The neutrophils began to appear in significant amounts in the lavage fluid on Day 8 after the administration of paraquat(37.0+12.7%). A significant decreasing neutrophil concentration at Day 8 was observed in the paraquat/vitamin E treated group(20.6+13.4%). Histologically the degree of pulmonary fibrosis was most prominent in the paraquat treated group while diffuse alveolar damage was continuously observed in the paraquat/vitamin E treated group and extensive interstitial lymphocytic infiltration was seen in the paraquat/vitamin E treated group. The paraquat/vitamin E treated group showed the less histologic changes. Conclusion : In this study vitamin E acting as a scavenger of neutrophil-derived free radicals and suppressant of lipid peroxidation, seemed to be the effective antioxidant in the inhibition of paraquat-induced pulmonary injury.

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Clinicopathological Features and Prognostic Factors for Patients with Clinical T4 Gastric Cancer that Underwent Combined Resection of Invaded Organs (위암의 주위 장기 침윤으로 합병 절제를 실시한 환자의 병리학적 병기 및 예후)

  • Byun, Gun-Young;Park, Joong-Min;Kim, He-Il;Kim, Jong-Han;Park, Sung-Soo;Kim, Seong-Ju;Mok, Young-Jae;Kim, Chong-Suk
    • Journal of Gastric Cancer
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    • v.7 no.3
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    • pp.117-123
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    • 2007
  • Purpose: The surgical treatment of gastric cancer that invades adjacent organs is a radical gastrectomy with combined resection including the adjacent organs or a palliative operation by performing either a gastrojejunostomy or gastrectomy. However, since it is impossible to determine the exact stage of the cancer, either T or N, in the case of palliative surgery, it is inappropriate to predict patient prognosis. This study analyzes the prognoses for patients whose final TNM stages are determined by a combined resection performed due to macroscopical infiltration into the adjacent organs. Materials and Methods: Of 2,452 patients that underwent surgery for gastric cancer at our hospital from 1983 to 2002, we evaluated 102 patients where a combined resection was performed because direct infiltration into the adjacent organs was discovered. Results: Univariate analysis showed that the survival rate differed by the depth of invasion into the gastric walls, the degree of lymph node metastasis, distant metastasis, pathological TNM stage, surgical curability, the location of tumor, and histological differentiation. By multivariate analysis, it was found that the surgical curability, the location of the tumor and the degree of lymph node metastasis were independent prognostic factors. Conclusion: It is suggested that even when infiltration into adjacent organs is suspected, radical surgery should be performed as to allow a prediction of prognosis through an exact determination of disease stage, and to improve the survival rate.

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Effect of Organic Matter and Moisture Content on Reduction of Cr(VI) in Soils by Zerovalent Iron (영가철에 의한 토양 Cr(VI) 환원에 미치는 유기물 및 수분함량 영향)

  • Yang, Jae-E.;Lee, Su-Jae;Kim, Dong-Kuk;Oh, Sang-Eun;Yoon, Sung-Hwan;Ok, Yong-Sik
    • Korean Journal of Environmental Agriculture
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    • v.27 no.1
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    • pp.60-65
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    • 2008
  • Current soil remediation principles for toxic metals have some limitations even though they vary with different technologies. An alternative technology that transforms hazardous substances into nonhazardous ones would be environmentally beneficial. Objective of this research was to assess optimum conditions for Cr(VI) reduction in soils as influenced by ZVI(Zero-Valent Iron), organic matter and moisture content. The reduction ratio of Cr(VI) was increased from 37 to 40% as organic matter content increased from 1.07 to 1.75%. In addition, Cr(VI) concentration was reduced as soil moisture content increased, but the direct effect of soil moisture content on Cr(VI) reduction was less than 5% of the Cr(VI) reduction ratio. However, combined treatment of ZVI(5%), organic matter(1.75%) and soil moisture(30%) effectively reduced the initial Cr(VI) to over 95% within 5 days and nearly 100% after 30 days by increasing oxidation of ZVI and concurrent reduction of Cr(VI) to Cr(III). The overall results demonstrated that ZVI was effective in remediating Cr(VI) contaminated soils, and the efficiency was synergistic with the combined treatments of soil moisture and organic matter.

A Study of Industrial Patients from Selected General in the Kyung Pook and Taegu City areas (일부지역 산업재해환자 실태 조사 연구 -대구${\cdot}$경북지역 일부 종합병원 중심으로-)

  • Huh, Choon-Bok
    • The Journal of Korean Physical Therapy
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    • v.3 no.1
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    • pp.151-174
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    • 1991
  • The purpose of this study is to research the actual conditions of industrial accident patients and to produce worker satisfaction and a rational and effective counter measure plan. Direct interviews with 179 cases (in and out patients) were carried out during a three month period from April to July 1990, at six hospitals : two general hospitals Sun Lin and Sung Mo in Po Hang, and four general hospitals in Taegu : Kyung pooh University Hospital, Dong San Medical Center, Young Nam Medical Center and Catholic Hospital. The results of this study are summarized as fellows : 1. Among the 179 cases, $51.6\%$ were male and $48.4\%$ were female. The two largest age groups were 30-39, $31.8\%$ and 20-29, $27.4\%$. Among the 179 cases, $51.6\%$ were married, the largest family number was 2 to 3, $41.1\%$ and 4 to 5, $25.6\%$. Educationally, graduation from high school was the largest group, $46.4\%$ among ,the patients, followed by middle school and primary school. The largest group income level was from 40-69 만원, $45.2\%$. The largest group of patients who worked over 50 hrs. a week was $52.0\%$. The largest group of patients who worked less than 1 year was $44.7\%$, of the patients in work places of less than 100 people, $60.3\%$ were injured and in work places of 100-299 people, $20.1\%$ were injured. In manufacturing, the largest group injured was $55.3\%$, the next group was transport, storage, communication. The largest group of production workers injured was $40.2\%$. 2. The cause of injury in the largest group was facility problems, $33.5\%$. The next group was unsafe habits, $30.2\%$ ; a lack of safety knowledge, $17.9\%$ ; and insufficient supervision, $12.3\%$. The 30-39 year age group head the highest number of injuries, $40.4\%$ ; work places with more than 10 years of work, $44.4\%$ ; work places with more than 1000 people, $56.3\%$ and mining accidents, $80.0\%$. Among. these groups the highest cause of injury was due to facility problems. 3. The accident pattern showed machinery injuries $28.5\%$ as the largest group, followed by falls & falling objects $17.3\%$, fire & electric $15.1\%$, strucke by an object $14.5\%$, followed by overaction and vehicular accidents. The accident pattern showed $46.4\%$ among workers over the 50 year age group, workers in the 5-10 year group, $50.0\%$ ; places employing more than 1000 workers, $35.3\%$ ; construction $73.7\%$, and construction workers $57.1\%$, among these fall & falling objects caused the greatest number of injuries. 4. The largest group of injuries was fractures $54.8\%$, trauma $14.5\%$, amputation $11.7\%$, open wound, and burns. The largest number of fractures occurred in people in the 30-39 year age group, $63.2\%$ : over 10 years of work, $55.0\%$ ; in work places of 300-490 people, $63.6\%$ ; construction $63.2\%$ and general workers $57.2\%$. 5. The largest group of injuries was upper extremity $45.3\%$, lower extremity $24.0\%$, trunk $18.5\%$ and head or neck $12.2\%$. Of these groups, upper extremity injuries were the highest in those less than 20 years old $75.0\%$, less than 1 year or work $59.5\%$, in work places of 500-999 people $60.0\%$, manufacturing $56.6\%$ and production workers $55.6\%$. 6. Periods of injury showed 34 people injured in September, to be the largest followed by October, 32 ; August, 22 people : July, 19 people and the lowest December, 2 people. During the week, Friday had the largest group injured, 35 people ; followed by Saturday, 26 people and the lowest was Wednesday, 17 people, During the day 1400 hours had the largest group injured, 38 people ; followed by 800 hours, 31 people. 7. On a basis of 5 as the highest mark, the average, according to worker satisfaction showed facility safety 3.55, work environment 3.47, income 3.44, job 3.21 and treatment 2.98. 8. The correlation between general characteristics and injury showed that age was directly correlated to the duration of work (r=2591) p<0.01, age was directly correlated to industry (r=2311) p<0.01, and the duration was directly correlated to occupation (r=4372) p<0.001.

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Evaluation of Peptide Nucleic Acid Probe-Based Fluorescence In Situ Hybridization for the Detection of Mycobacterium tuberculosis Complex and Nontuberculous Mycobacteria in Clinical Respiratory Specimens (임상 객담검체에서 Peptide Nucleic Acid Probe를 이용한 결핵과 비결핵 항산균의 구분)

  • Lee, Seung Hee;Kim, Shine Young;Kim, Hyung Hoi;Lee, Eun Yup;Chang, Chulhun L.
    • Annals of Clinical Microbiology
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    • v.18 no.2
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    • pp.37-43
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    • 2015
  • Background: Tuberculosis is globally the most important cause of death from single pathogen. Rapid and accurate identification of mycobacteria is essential for the control of tuberculosis. We evaluated a fluorescence in situ hybridization (FISH) method using peptide nucleic acid (PNA) probes for the differentiation of Mycobacterium tuberculosis complex (MTB) and nontuberculous mycobacteria (NTM) in direct smears of sputum specimens. Methods: The cross-reactivity of MTB- and NTM-specific PNA probes was examined with reference strains of M. tuberculosis ATCC 13950, Mycobacterium kansasii ATCC 12479, Mycobacterium fortuitum ATCC 6841, several clinical isolates of mycobacteria (Mycobacterium abscessus, Mycobacterium avium, Mycobacterium intracellulare, Mycobacterium gordonae and Mycobacterium chelonae), and 11 frequently isolated respiratory bacterial species other than mycobacteria. A series of 128 sputa (89 MTB culture positive, 29 NTM culture positive, and 10 under treatment culture negative) with grades of trace to 4+ were used to evaluate the performance of the method. Results: The MTB- and NTM-specific PNA probes showed specific reactions with the reference strains of MTB and M. kansasii and clinical isolates of mycobacteria except M. fortuitum ATCC 6841, and no cross-reactivity with other tested bacteria. The PNA probe-based FISH assay for detection of MTB had a sensitivity and specificity of 100%, respectively. The sensitivity and specificity of the NTM-specific PNA probe was 100%. The smear grades of the PNA FISH test were same as with those of the fluorescence AFB stain in 2+ or higher grade. Conclusion: Detection and differentiation based on PNA FISH is sensitive and accurate for detecting mycobacteria and for differentiating MTB from NTM in clinical sputum smears.

Reduction of Stem Inside-cavity and Improvement of Flower Quality in Chrysanthemum 'Baekma' by pH Stabilization and Foliar Spray of Ethephon (양액 pH 안정화와 에세폰 살포에 의한 국화 '백마'의 줄기동공 경감과 절화품질 향상)

  • Hwang, In Taek;Cho, Kyung Chul;Kim, Hee Gon;Ki, Gwang Yeon;Yoon, Bong Ki;Choi, Kyung Ju;Lim, Jin Hee;Choi, Sung Ryul;Shin, Hak Ki
    • FLOWER RESEARCH JOURNAL
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    • v.18 no.4
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    • pp.238-243
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    • 2010
  • This study was conducted to investigate effects of nutrient solution pH control agent and foliar spray of ethephon on the reduction of stem inside-cavity and improvement of flower quality in chrysanthemum 'Baekma'. Changes of pH in nutrient solution as affected by the kind of pH control agent showed more settled pattern in the plot of KOH treatment than in others. Plant growth and development such as cut flower length, leaf numbers, cut flower weight and petal number were the greatest in the plot of KOH. However, the size and area of stem cavity was large in KOH rather than $KHCO_3$. As changes in the absorbing patterns of mineral elements as affected by nutrient solution pH control agent in closed system, contents of total nitrate, phosphorus, potassium and calcium by $KHCO_3$ was absorbed into the plant less than KOH, so that it remained a lot of mineral element residues rather than KOH in closed system. Plant growth as affected by the foliar spray of ethephon showed growth retardation effect in the plot of solution diluted to 1 : 500 and growth promotion effect in the plot of solution diluted to 1 : 1,000 or 1 : 2,000. The number of petals was the best in the plot of foliar spray of ethephon solution diluted to 1 : 1,000 before flowering at 45 days showing 331 petals compared to control showing 302 petals. The size and area of stem cavity as affected the foliar spray of ethephon was smaller 1 mm and 7%, respectively, in the plot of solution diluted to 1 : 2,000 before flowering at 30 days than in control. Therefore, treating pH stabilization using KOH after floral initiation stage with the foliar spray of ethephon solution diluted to 1 : 2,000 before flowering at 30 days would help to reduce stem cavity size and improve flower quality in hydroponically grown chrysanthemum 'Baekma'.

New Whitening Agent : Selina-4(14), 7(11)-dien-8-one (신규 미백제 : Selina-4(14), 7(11)-dien-8-one)

  • Kim, Cheong-Taek;Chang, Yun-Hee;Lee, Sang-Hwa;Kang, Sang-Jin;Cho, Wan-Goo
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.31 no.1 s.49
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    • pp.17-23
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    • 2005
  • We had previously reported that Selina (selina-4(14), 7(11)-dien-8-one) was isolated from methanol extract of Afractylodes rhizome and has strong whitening activity in B16 melanoma cells. In this report, we demonstrated its action mechanism in melan-a cells, non-tumorigenic melanocytes. We also investigated the clinical efficacy of cosmetic preparation containing Selina. Selina reduced the melanin synthesis of Melan-a cells by $50\%$ at a concentration of $10 {\mu}g/mL$ without any apparent cytotoxicity. We also found that the treatment of cells with Selina decreased tyrosinase activity by $60\%$ at a concentration of $10 {\mu}g/mL$ but Selina was not a direct inhibitor of tyrosinase activities. To elucidate the action mechanism of Selina, we investigated the changes in mRNA and protein level of tyrosinase, TRP-1 and TRP-2 using RT-PCR and western blotting, respectively. As a result, the mRNA and protein level of tyrosinase were markedly reduced at $10 {\mu}g/mL$ of Selina without any effect on TRP-1 and TRP-2. These results suggest that Selina exerts its whitening effect mainly through regulating expression of tyrosinase. A 7 week-clinical trial using formulation containing $0.2\%$ selina-4(14), 7(11)-dien-8-one with 20 volunteers resulted in statistically significant whitening effect (p < 0.05), without any adverse effect. Based on these results, Selina (selina-4(14), 7(11)-dien-8-one) can be s useful and safe ingredient for the cleanness and brightness of skin.

Chronic Hereditary Tyrosinemia Type I with Novel Mutation in FAH Gene (FAH gene novel mutation을 가진 만성형 Hereditary tyrosinemia 1형)

  • Yang, Sungmin;Choi, Hyo Won;Kang, Yun Koo;Lee, Jin-Sung;Namgoong, Mee Kyung
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.20 no.2
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    • pp.55-62
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    • 2020
  • A 22-month-old girl who had taken iron supplements due to iron deficiency anemia, presented bloody mucoid stool for one month. She had a bruise at the right periorbital area due to minor trauma and hepatosplenomegaly. Laboratory studies showed anemia, thrombocytopenia, elevated alkaline phosphatase (ALP), hypophosphatemia, decreased haptoglobin, hypocomplementemia, negative direct/indirect Coomb's test, normal vitamin D3 level and high PTHi. Wrist x-ray showed no signs of rickets. The abdominal ultrasound showed only accessory spleen. Tandem mass spectrometry was normal. During follow up, bloody stool regressed after seven days of withdrawal of iron supplement and cow milk, and the total CO2 level had been within 15-20 mEq/L with normal anion gap. NGS (next generation sequencing) panel test for evaluation of renal tubular acidosis showed negative results. After low dose steroid and vitamin D supplements under the impression of hypocomplementemic vasculitis, thrombocytopenia, C3/C4, decreased haptoglobin, and elevated ALP level became normal. At 57 months of age, laboratory findings showed elevated liver enzyme, ALP and gamma-glutamyl transferase again. And liver cirrhosis with splenomegaly and diffuse renal disease were reported with abdomen CT scan. Liver biopsy reported macro- and micronodular cirrhosis. Urine organic acid profile showed elevated succinylacetone level. Whole exome sequencing revealed novel compound heterozygous mutations (NM_00137.2:c.107T>C, NM_00137, 2:c.614T>C) in FAH gene and confirmed by Sanger sequencing. Consequently, the patient was diagnosed as chronic hereditary tyrosinemia type I. She started low phenylalanine/tyrosine diet and nitisinone treatment. Our case had presented symptoms very slowly, which is the first case of chronic tyrosinemia type I in South Korea.