• 제목/요약/키워드: Disease burden

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Allogeneic Hematopoietic Stem Cell Transplantation in Juvenile Myelomonocytic Leukemia (연소형 골수단구성 백혈병에서의 동종 조혈 모세포 이식)

  • Yoo, Keon Hee;You, Dong Kil;Lee, Soo Hyun;Sung, Ki Woong;Cho, Eun Joo;Koo, Hong Hoe
    • Clinical and Experimental Pediatrics
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    • v.48 no.2
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    • pp.178-185
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    • 2005
  • Purpose : The purpose of this study was to evaluate the outcome of children with juvenile myelomonocytic leukemia(JMML) treated with allogeneic hematopoietic stem cell transplantation(allo-HSCT). Methods : Eleven JMML patients aged 8-39 months underwent allo-HSCT. The sources of grafts were unrelated donors(n=7), HLA-matched siblings(n=3) and an HLA 1-antigen mismatched familial donor. All patients had received chemotherapy ${\pm}13$-cis-retinoic acid(CRA) before transplant, and CRA was used, posttransplant, in six patients. Results : Only three patients were in complete remission(CR) at the time of transplantation. Initial chimeric status revealed complete donor chimerism(CC) in five patients, mixed chimerism(MC) in five and autologous recovery(AR) in one. One patient with MC having persistent splenomegaly eventually turned to CC and CR after rapid tapering of cyclosporine, combined with daily use of CRA. An AR case relapsed shortly after transplant but was rescued with second, unrelated cord blood transplantation. Ultimately, six patients are alive, event-free, with a median follow-up of 15.5 months posttransplant. All three deaths occurred in patients who failed to achieve CC, leading to disease progression. Conclusion : We suggest that graft-versus-leukemia effect play an important role and CRA a possible role in posttransplant leukemic involution in JMML. In patients whose leukemic burden is still high with MC after transplant, early tapering of immunosuppressants and introduction of CRA might provide a chance of a cure for some patients.

Comparison Study of the Pulmonary Function and Serum Carboxyhemoglobin Level Between the Traffic Policmen and Clerk Policemen (교통경찰과 비 교통경찰의 폐기능과 혈중 Carboxyhemoglobin 수치에 대한 비교연구)

  • Kim, Sung Min;Cheon, Gyu Rak;Kim, Young Wook;Kim, Joon Hyung;Lee, Ho Hak;Hong, Soon Chang;Lee, Seung Hee;Park, Sang Joon;Chung, Joon Oh;Kim, Yun Kwon;Kim, So Yon;Kim, Young Jung;Cho, Min Koo;Lee, Gwon Jun;Lee, Kyung In
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.6
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    • pp.560-569
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    • 2003
  • Background : A large number of pollutants such as sulfur dioxide, nitric oxide, carbon monoxide, particulate matter, and ozone influence on the body. These pollutants put a burden on the lung and the sequelae resulting from the oxidative stress are thought to contribute to the development of fibrotic lung disease, emphysema, chronic bronchitis and lung cancer. Also, carbon monoxide generated from the incomplete combustion of carbon-containing compounds is an important component of air pollution caused by traffic exhaust fumes and has the toxic effect of tissue hypoxia and produce various systemic and neurologic complications. The objective of this study is to compare the difference of pulmonary function and serum carboxyhemoglobin(CO-Hb) level between the traffic policemen and clerk policemen. Method : Three hundred and twenty-nine of traffic policemen, and one hundred and thirty clerk policemen were included between 2001 May and 2002 August. The policemen who took part in this study were asked to fill out a questionnaire which included questions on age, smoking, drinking, years of working, work-related symptoms and past medical history. The serum CO-Hb level was measured by using carboxyoximeter. Pulmonary function test was done by using automated spirometer. Additional tests, such as elecrocardiogram, urinalysis, chest radiography, blood chemistry, and CBC, were also done. Results : $FEV_1(%)$ was $97.1{\pm}0.85%$, and $105.7{\pm}1.21%$(p<0.05). FVC(%) was $94.6{\pm}0.67%$, and $102.1{\pm}1.09%$, respectively(p<0.05). Serum CO-Hb level was $2.4{\pm}0.06%$, and $1.8{\pm}0.08%$(p<0.05). After correction of confounding factors (age, smoking), significant variables were FVC(%), $FEV_1(%)$ and serum CO-Hb level(%)(p<0.05). Conclusion : Long exposure to air pollution may influence the pulmonary function and serum CO-Hb level. But, further prospective cohort study will be needed to elucidate detailed influences of specific pollutants on pulmonary function and serum carboxyhemoglobin level.

Tuberculin Survey to Estimate the Prevalence of Tuberculosis Infection of the Elementary Schoolchildren under High BCG Vaccination Coverage (고 비시지 접종률 상태에서 초등학생들의 투베르쿨린 조사를 통한 감염률 추정 조사)

  • Kim, Hee Jin;Oh, Soo Yeon;Lee, Jin Bum;Park, Yun Sung;Lew, Woo Jin
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.4
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    • pp.269-276
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    • 2008
  • Background: Although the prevalence of tuberculosis infections (PTBI) is one of the basic epidemiologic indices, no survey has been carried out since 1995 because the nation-wide tuberculosis prevalence survey was changed to a surveillance system. Subjects without a BCG scar are examined in a tuberculin survey. However, it is very difficult to select these subjects under high vaccination coverage. It is important to evaluate the impact of BCG vaccinations on the tuberculin response and estimate the PTBI regardless of the BCG vaccination status. Methods: A nation-wide, school-based cross-sectional tuberculin survey was carried out among first graders in elementary school in 2006. A total of 5,148 children in 40 schools were selected by quota sampling. Tuberculin testing with 0.1 ml of two tuberculin units of PPD RT23 was carried out on 4,018 children. The maximum transverse diameter of induration was measured 48 to 72 hours later. The presence of a BCG scar was checked separately. Results: There were no BCG scars in 6.3% of the subjects. The mean induration size of tuberculin testing was $3.7{\pm}4.4mm$, which included 1,882 (46.8%) subjects with an induration size of 0 mm. The PTBI was 10.9% (439 subjects) using a cut-off point of ${\geq}10mm$ (conventional method). The annual risk of tuberculosis infections (ARTI) was 1.9% when the mean age of the subjects was assumed to be 6 years. There was no difference in the PTBI according to the presence or absence of a BCG scar [11.2% vs 7.6% (OR: 1.54, 95% CI: 0.98~2.43)]. Using a mirror image technique with 16 mm as the cut-off point, the PTBI and ARTI had decreased to 2.4% and 0.4% respectively. Conclusion: PTBI and ARTI, as estimated by conventional methods, appear to be high among BCG vaccinated children. A mirror image technique is more suitable for estimating the indices in a country with an intermediate burden of tuberculosis than the conventional method.

Understanding of the Workers in the North Area of Ulsan on the Oral Health and Hygienic Status (울산시 일부 생산직 근로자의 구강보건 인식에 대한 조사연구)

  • Lee, Ga-Ryeong
    • Journal of dental hygiene science
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    • v.4 no.3
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    • pp.117-126
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    • 2004
  • For a month of September, 2004, a questionnaire regarding dental hygiene was distributed to 165 workers of Ulsan area. A total of 125 questionnaire were analyzed: 102 collected of the distributed 165 pieces, and 23 questionnaires reported by patients of a dental clinic in Dong-gu, Woolsan. The result is as follows; (1) Labor workers of Ulsan have thought that they are in good dental health, 44.1% of respondents, following by those who they believe they are in moderate health and those who they think are in poor condition. 89.0% of total workers have experienced dental treatment. (2) Regarding the location of dental treatment, 85.0% of respondents have pointed out dental hospitals and clinics, while 3.9% have indicated that they had treatment from unlicensed dentists. Specifically, workers in their 40s over have ever experienced dental treatment by unlicensed dentists. Those who think they are in poor dental condition have tended to have more dental treatment by unlicensed dentists. (3) Regarding the reason that they put off the treatment, 59.1% of respondents have indicated that they have no time to have the treatment, following by economic burden and the lack of confidence in dentists. When they have tooth aches or the gum ache, 60% of respondents have suggested that they endure the ache or take a medicine to alleviate the pain, showing a lower understanding of early dental treatment. (4) Regarding the reason why they are unwilling to go to dentists, respondents have revealed the anxiety against pain, 50.4%, following by the difficulty of scheduling and unsatisfied services. (5) 47.2% of respondents have brushed their teeth 3 times everyday, following by those who have done it 2 times a day and those one a day. Regarding how to brush the teeth, most of respondents have brushed their teeth in the upper, lower, and the both side, 61.4%. The younger respondents and those who think they are in good dental health have tended to brush their teeth up and down. (6) Regarding the cause of the gum disease, 67.7% of respondents have thought that it is caused by poor dental hygiene, following by natural occurrence due to age, hereditary nature, and physical predisposition. (7) 67.7% of respondents have experienced dental scaling, while 32.3% of them have had no experience in it. 53.5% of workers have thought that scaling may not be recommended since they have the teeth scaled periodically once they had dental scaling, a higher rate than 46.5% who think scaling is good for the gum health.

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Effects of Preoperative Radiotherapy for $T_2,\;T_3$ Distal Rectal Cancer ($T_2,\;T_3$ 하부직장암의 수술 전 방사선치료 효과)

  • Kang Ki Mun;Choi Byung Ock;Jang Hong Seok;Kang Young Nam;Chai Gyu Young;Choi Ihl Bohng
    • Radiation Oncology Journal
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    • v.20 no.3
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    • pp.215-220
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    • 2002
  • Purpose : Preoperative radiotherapy has been used to induce tumor regression and allow complete resection of rectal cancer with a sphincter preservation surgery. This study was performed to determine the effectiveness of preoperative radiotherapy for $T_2,\;T_3$ distal rectal carcinoma. Materials and Methods : From November 1995 to June 1997, fifteen patients with invasive distal rectal cancer were treated with preoperative radiotherapy followed by sphincter preservation surgery. Classification by preoperative T stage consisted of 7 $T_2$ and 8 $T_3$ tumors. Radiation therapy was delivered with 6 MV and 15 MV linear accelerator, at 1.8 Gy fractions for 5 days per week. Total radiation doses were 45 Gy to 50.4 Gy (median : 50.4 Gy). Sphincter preservation surgery was peformed $4\~6$ weeks after the completion of radiotherapy. Median follow-up was 22 months (range : $16\~37\;months$). Results : One patient $(6.7\%)$ had a complete pathologic response. Comparing the stage at the diagnostic workup with the pathologic stage, tumor downstaging of T stages occurred in 11 of 15 patients $(73.3\%)$ and $N_1$ stages occurred in 2 of 5 patients $(40\%)$. No patient developed progressive disease undergoing treatment. Two patients suffered local recurrence at 7 and 20 months, and one a distant metastasis at 30 months. No grade 3 or 4 toxicity was observed. Conclusion : Our experience suggests that preoperative radiotherapy followed by sphincter preservation surgery is well tolerated, and can significantly reduce the tumor burden for $T_2\;T_3$ distal rectal cancer.

Association of diet-related quality of life with dietary regimen practice, health-related quality of life, and gastrointestinal symptoms in end-stage renal disease patients with hemodialysis (혈액투석을 실행중인 말기 신부전 환자의 식사관련 삶의 질(Diet-Related Quality of Life)과 식사요법 실천도, 건강관련 삶의 질 및 위장관 증상과의 관련성 연구)

  • Lee, JinJu;Kim, Ji-Myung;Kim, Yuri
    • Journal of Nutrition and Health
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    • v.46 no.2
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    • pp.137-146
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    • 2013
  • The purpose of this study was to evaluate diet-related Quality of Life (QOL) and to analyze the relationship among diet-related QOL, dietary regimen practice, health-related QOL, and gastrointestinal symptoms in hemodialysis patients. Subjects were recruited from an artificial kidney center in Seoul. The self-report questionnaire consisted of socio-demographic characteristics, diet-related QOL, compliance with dietary regimen practice, health-related QOL, and gastrointestinal symptoms was distributed. Diet-related QOL includes a 'Quality of Life and Related to Dietary Change Questionnaire', 'Satisfaction Survey', and 'Dietary Impact Survey'. According to their responses, participants had experienced the greatest difficulty with 'Dietary Impact'. In particular, the mean score for general health was low. Association of dietary regimen practice showed a positive association with 'Cost' and 'Self-care' score. In addition, diet-related QOL showed positive correlation with health-related QOL, particularly in 'taste'. Scores for 'Taste', 'Convenience', and 'Dietary Impact' were lower for subjects with constipation compared to those of subjects without constipation. Scores for 'Taste' and 'Dietary Impact' were lower in subjects with irritable bowel syndrome compared to those of subjects without the syndrome (p < 0.05). Diet-related QOL showed a positive association with health-related QOL (p < 0.05), whereas it showed a negative association with constipation (p < 0.01). In conclusion, hemodialysis patients in Korea suffer from burden of dietary regimen practice and most scores for diet-related QOL and health-related QOL from patients with gastrointestinal symptoms were low. Therefore, appropriate nutrition education considering gastrointestinal symptoms is necessary for improvement of patients' QOL during dietary regimen practice.

Antibacterial and Intracellular Clearance Effect of Saururus chinensis Baill Water Extract against Salmonella typhimurium (삼백초 수용성 추출물의 Salmonella typhimurium 균에 대한 항균 및 숙주세포 내 사멸 효과 규명)

  • Kim, Dong-Hyeok;Lee, Jin-Ju;Lim, Jeong-Ju;Kim, Dae-Geun;Kim, Gon-sub;Lee, Hu-Jang;Min, Won-gi;Rhee, Man-Hee;Chang, Hong-Hee;Kim, Suk
    • Journal of agriculture & life science
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    • v.44 no.6
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    • pp.111-119
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    • 2010
  • Salmonella spp. are one of major pathogens for zoonosis in worldwide, and can replicate within host cells and generally cause enterocolitis and foodborne poisoning which represents a considerable public health burden. The present study was designated to investigate the safty for host cells, antibacterial effects of Saururus chinensis Baill water extract (SCWE) on pure culture and infection with Salmonella enterica serovar Typhimurium (S. typhimurium) in murine derived macrophage RAW 264.7 cells. The different treatment of SCWE concentration (1, 10 or $100{\mu}g/ml$) did not show any cytotoxic effect to RAW 264.7 cells for 24 h incubation. In determination of antibacterial activity of SCWE against S. typhimurium, bacterial viability was markedly decreased compared to SCWE-untreated control. In RAW 264.7 cells, SCWE significantly induced morphological change (p<0.05). In infection assay of S. typhimurium in RAW 264.7 cells pretreated with $100{\mu}g/ml$ of SCWE, which are non-cytotoxic concentration, bacterial uptake ability of macrophage was increased corresponding with morphological change, whereas bacterial survival rates within macrophage was markedly reduced comparing to that of SCWE-untreated control. Furthermore, nitric oxide (NO) production in SCWE-treated cells was slightly decreased until 24 h post infection. Taken together, these findings demonstrated that SCWE have the antibacterial activity for S. typhimurium and the protective effects against S. typhimurium infection through activating murine macrophage independent on NO, suggesting that SCWE were beneficial on the disease caused by intracellularly replicating pathogens as a safe alternatives of conventional chemotherapies.

A Study on the Establishment and Operation of a Regulatory Response Framework in connection with the Regulatory Strength of the Licensing Policy for New Medical Devices -Focusing on the Application of FMEA- (의료기기 신제품의 인허가정책 규제강도에 연계한 규제대응 프레임워크 수립 및 운영에 관한 연구 - FMEA 적용을 중심으로 -)

  • Kim, Gyosu;Ru, Gyuha;Kim, Yeonhee
    • Journal of Technology Innovation
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    • v.28 no.4
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    • pp.1-26
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    • 2020
  • Due to the spread of Corona 19 around the world, Infectious Disease Medicine and New Medical Devices such as Diagnostic Agent are being rapidly developed and launched, and for the fast supply and demand of these, each country has eased import regulations or has implemented policies for fast approval(NIDS, 2020). On the other hand, New Developed Medical Devices that are not related to New Infectious Diseases, they are still entering the market through strict licensing and licensing regulations, such as delay and cancellation in the test inspection process, etc. Therefore, This Study specialized in the government-managed laws encountered when New Medical Devices enter the market, derive Factors influencing the Strength of Regulations, analyzes the Strength of Regulations, and proposes a Regulatory Response Framework. The Research Method was conducted by Literature Research, was applied by Failure Mode and Effects Analysis(FMEA) Method, Expert Interview(1st): Idea Collection, Expert Interview(2nd): Validation, and Priority through the Application Process of FMEA Method. A Method of Quantifying the Intensity of Regulation was proposed by multiplying the Impact of the Influencing Factors for each stage of regulation and the Burden Impact for each type of Regulatory Affairs to find the Importance of the Regulatory Factors and multiplying the Severity of the Regulatory Impact. The Implications are that major overseas countries and the Korean government are actively responding with Special Regulatory Policies and Mitigation Policies for fast licensing of New Developed Medical Devices in accordance with Corona 19. It is expected that the direction for improvement of regulations and measures to respond to regulations will be implemented so that a more proactive and preemptive response to the regulatory process of the licensing policy for New Devices can be achieved.

Qualitative Study on Experiences of Responding to COVID-19 of Therapists in Long-term Care Hospitals (요양병원 치료사의 코로나19 대응 경험에 대한 질적 연구)

  • Bae, Won-Jin;Park, Ju-Young
    • Journal of Korea Entertainment Industry Association
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    • v.15 no.4
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    • pp.337-347
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    • 2021
  • This study is a qualitative study conducted to provide basic data for therapists working in long-term care hospitals to improve their countermeasure strategies for new infectious diseases and improvement of the treatment room infection management system, and to help therapists understand their infection management work. Colaizzi's phenomenological research method was applied as the research method. Telephone interviews were conducted with nine occupational therapists and physical therapists working in nursing hospitals. The contents of the interview were recorded with the consent of the study subjects, and additional confirmation was received by email. The recorded content was analyzed after transcription, and the meaning and nature of the experience coping with COVID-19 were described. The content was organized into 6 themes, 17 main meaning and 49 meaning units. In accordance with the COVID-19 situation, the infection control system has been strengthened by reinforcing infection control education in nursing hospitals, practicing infection control, and supervising infection control outside business hours. It was found that the treatment environment was changed due to the restriction of treatment activities by practicing distancing in the treatment room, adjusting rest and meal times during working hours, and strengthening infection control. In addition, the therapist's role has been expanded and the paradigm of treatment has changed, such as considering the untact intervention, and they have experienced cohort quarantine, pre-tested for COVID-19, vaccinations, and side effects from COVID-19. However, due to the infection work, the therapist's work burden is increased, and the person is experiencing fear, depression, and work stress from the spread of COVID-19. They were also aware of the need for nursing hospital care personnel support, such as guaranteeing rest after vaccination and providing infection control tools and equipment. The results of this study are expected to be used as basic data for human and physical support for the development of infectious disease response strategy programs in nursing hospital treatment rooms and for infection control in nursing hospitals.

A bibliographic study on medical science ancient period (上古時代) and the era of the old-Korea (古朝鮮時代) (상고시대(上古時代)와 고조선시대(古朝鮮時代)의 의학(醫學)에 관(關)한 문헌적(文獻的) 고찰(考察))

  • Kwon, Hak Cheol;Park, Chan-Guk
    • Journal of Korean Medical classics
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    • v.3
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    • pp.218-247
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    • 1989
  • As mentioned above, I got the next conclusion since I had considered the medical contents of the ancient period(上古時代) and the era of the old-Korea(古朝鮮時代) through several bibliographic records. 1. There were Pung-baeg(風伯), Uh-sa(雨師), Un-sa(雲師) that were the names of the governmental officials during the ancient period of Whan-ung(桓雄). Among them, Uh-sa specially managed the treatment for diseases. When we think of the significance of Pung(風)-which means the winds, Uh(雨)-which means the rain, Un(雲)-which means of clouds, we will find out that the human life will be affected by all kinds of phenomena of the nature. So I can infer that ancestries could prevent and treat diseases with adjusting them tn the changes in the weather. 2. There were five government officials(五事) in the ancient period of Whan-ung(桓雄上古時代). They are Uh-ga(牛加), Ma-ga(馬加), Ku-ga(狗加), Cheo-ga(猪加) and Yang-ga(羊加), and had charges of five important duties. Among them, Cheo-ga was set to a charge of treatment for diseases. So we can notice that there existed people who treated for diseases professionally. When we think of the meanings of Uh(牛)-which intends cows or bulls. Ma(馬)-which intends horses, Ku(狗)-which intends dogs, Cheo(猪)-which intends wild boars and Yang(羊)-which intends sheep, we can see that livestocks would be raised at that time, and they came to have more chances to digest meat. Since the digestion of meat became to be a burden on the stomach and the intestines, it might cause a lot of indigestive troubles. 3. When I compared Tan-gun Pal-ga(檀君八加) with the Oh-ga(五加) in the ancient period of Whan-ung(桓雄上古時代), I could tell that the community of Tan-gun's period is more advanced and specialized than one of Whan-ung's. When I think of the next sentence ; "The Prince Imperial, Bu-u(夫虞) become to be a Ro-ga(鷺加), who treat for diseases professionally.", I am sure that the treatment for diseases was more importment than any other things, because he was the third son of Tan-gun(檀君). 4. According to Tan-gun(檀君) mythology, Whan-ung(桓雄) came down from the heaven of the pure Yang(純陽) to the earth and then changed into a man who had had more Yang(陽) than Yin(陰). And a bear came up from the underground(or the cave) to the ground and then changed into a women who had had more Yin(陰) than Yang(陽). So both of them became to hold together. This story implicated that ancestors had taken a serious view of each of them, namely the ancestors didn't give the ascendance to the one side of them, and made much account of the mutual harmony. So I am sure that this fact coincided with the basic theories of oriental medical science. To refer to two proverbs of Tan-gun mythology that are "Ki-Sam-Chil-Il(忌三七日)" which means caring for twenty one days, and "Pul-Gyon-Il-Gwang-Baeg-Il(不見日光百日)" which means keeping indoors for one hundred days, I can tell you that "twenty-one-day" involves the principle of the birth of life, and "one-hundred-day" contains a preparatory period or the period of death to bear another life. 5. From the medical stuff, such as wormwood(艾), garlic(蒜), or wonder-working herbage(靈草), that had been written at the bibliographic papers of the ancient period(上古時代) and the era of the old-Korea(古朝鮮時代), I consider that many people might get a lot of women's diseases, indigestive troubles, and other diseases that were caused by the weakness, but with using various spices, such as the leaves of water pepper(蔘), they could prevent the occurrance of all kinds of diseases previously. So I regard this treatment as the medicine from food. 6. One of the sayings at Nae-gyong(內經) is that "The stone accupuncture(砭石) came from the orient." We can see both "wonder-wor-king wormwood(靈草)" and "dried wormwood(乾艾)" in the several bibliographic papers of the ancient history of the old-Korea(朝鮮上古史). From these records, I can be convinced that ancestors would utilize the acupuncture(針) and the moxa cautery(灸) to cure a patient of a disease. 7. Even though someone claimed that the book, "medical science and chemistry(醫學化學)" and "medical treatment(醫學大方)" had had been written during the ancient period of the old-Korea(上古朝鮮時代), such a fact can't have been ascertained historical evidence. But it has been handed down that there existed the original phonetic alphabet, such as the "Ka-Im-To alphabet(加臨土文字)" at that time. The terms about the diseases, which had been occurred at the community of the old-Korea(古朝鮮地域), were recorded fragmentarily at other records after that time. The origin of confucianism came from the race of the eastern barbarians, and Tae-Ho-Pok-Hi(太嗅伏義) and the king. Sun(舜) came from the eastern barbarians, too. The divination of tortoise shells at the country of Un(殷) is another from which was developed at the eastern barbarians' fortune-telling of animal bones. From these facts, I can infer that, by all means, they might record the medical knowledge which had been stored for thousands of years while contacting with china directly.

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