• Journal of Environmental Health Sciences
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• v.46 no.3
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• pp.267-275
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• 2020

Objectives: The causes of dementia have been reported in various ways, but there has been little research on the interrelationship between heavy metals and dementia, and the results also show little consistency. Therefore, it is imperative to compare the levels of heavy metal exposure between the dementia-suffering group and a control group to confirm the correlation between the level of heavy metal exposure and the likelihood of dementia. Methods: In order to assess the dementia level of the elderly, the Global Deterioration Scale (GDS) and Mini Mental State Examination (MMSE) were applied. To analyze the concentration of heavy metals in the blood, blood was collected from the veins of study subjects and measured using Inductively Coupled Plasma-mass spectrometry (ICP-MS). Results: There was a statistically significant correlation between lead and manganese concentrations in the blood and the MMSE and GDS. It was found that there was a statistically significant correlation between cadmium concentration in the blood and the GDS, but the MMSE was less relevant. It was found that the blood mercury concentration and the MMSE and GDS were less relevant. The lead concentration in the blood was 0.95±0.74 ㎍/dL in the dementia patient group and 0.33±0.22 ㎍/dL in the normal group, while cadmium was 0.69±0.37 ㎍/L in the dementia group and 0.18±0.10 ㎍/L in the normal group. Mercury was 0.81±0.31 ㎍/L in the dementia group and 1.16±0.80 ㎍/L in the normal group. Manganese was 6.83±2.01 ㎍/L in the dementia group and 4.78±1.59 ㎍/L in the normal group. All of these show statistically significant differences. Conclusions: As the concentration of lead, cadmium and manganese in the blood increases, the MMSE scores and GDS scores were found to worsen, and it was confirmed that there is a correlation between heavy metal exposure and cognitive degradation.

• The Journal of Korea Institute of Information, Electronics, and Communication Technology
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• v.9 no.4
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• pp.428-438
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• 2016

The aim of this study, in order to reduce the support burden of dementia primary caregiver, within the framework of long-term care insurance system to present its founding model for the development of new services. Previous research as analytical materials and based on the CARE study between 2012 to 2013. Primary caregiver burden of patient are both physical, psychological and economic aspects as well as difficulties in many aspects and had influence on many factors such as age, care burden, economic, health, and social support. It also came high-risk primary caregiver suffer from depression. This primary caregiver to take advantage of the elderly long-term care insurance system implemented at the time of the institutional support necessary for since 2008, presented additional services in this study. Of increasing the small sizes day care center (tentative name) to open an as established in the settlements at a scale of less than nine, within 5 minutes from the residence, limited dementia by expertise in the disease home care services scale model of the current system service It was to improve the quality of existing shares, small group sizes for day care centers and community life apart.

• Radiation Oncology Journal
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• v.13 no.1
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• pp.19-26
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• 1995

Purpose : Surgery is the treatment of choice for resectable non-small cell lung cancer. For patients who are medically unable to tolerate a surgical resection or who refuse surgery, radiation therapy is an acceptable alternative. A retrospective analysis of Patients with stage I non-samll cell lung cancer treated with curative radiation therapy was performed to determine the results of curative radiation therapy and patterns of failure, and to identify factors that may influence survival. Materials and Methods : From 1986 through 1993, 39 Patients with T2N0M0 non-small cell lung cancer were treated with curative radiation therapy at department of radiation oncology, Kyungpook national university hospital. All Patients were not candidates for surgical resection because of either Patient refusal (16 patients), poor pulmonary function (12 patients), old age (7 patients), Poor Performance (2 patients) or coexisting medical disease (2 patients). Median age of patients was 67 years. Histologic cell type was squamous cell carcinoma in 36, adenocarcinoma in 1, large cell carcinoma in 1 and mucoepidermoid carcinoma in 1. All patients were treated with megavoltage irradiation and radiation dose ranged from 5000cgy to 6150cGy with a median dose of 6000cGy. The median follow-up was 17 months with a range of 4 to 82 months, Survival was measured from the date therapy initiated. Results : The overall survival rate for entire Patients was $40.6\%$ at 2 years and $27.7\%$ at 3 years, with a median survival time of 21 months. The disease-free survival at 2 and 3 years was $51.7\%$ and $25.8\%$, respectively. Of evaluable 20 patients with complete response, 15 patients were considered to have failed. Of these, 13 patients showed local failure and 2 patients failed distantly. Response to treatment (p=0.0001), tumor size (p=0.0019) and age (p=0.0247) were favorably associated with overall survival. Only age was predictive for disease-free survival (p = 0.0452). Conclusion : Radiation therapy is an effective treatment for small (less than 3cm) tumors, and should be offered as an alternative to surgery in elderly or infirm patients. Since local failure is the prominent Patterns of relapse, potential methods to improve local control with radiation therapy are discussed.

• Journal of Chest Surgery
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• v.30 no.5
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• pp.501-505
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• 1997

It was reported that use of aprotinin in elderly patients undergoing hypothermic circulatory arrest was associated with an increased risk of renal dysfunction, and myocardial infarction as a result of intravascular coagulation. We reviewed 20 patients who received high-dose aprotinin under deep hypothermic circulatory arrest with(NP group, n= 11) or without selective cerebral perfusion(SP group, n=9). The activated clotting time was exceeded 750 seconds in all but 1 patient. After opening aortic arch, retrograde low flow perfusion was maintained through femoral artery to prevent air embolization to the visceral arteries. Four patients among 20 died during hospitalization'due to bleeding, coronary artery dissection pulmonary hemorrhage and multiple cerebral infarction. Postoperatively, cerebrovascular accidents occurred in two patients; one with preoperative carotid artery dissection and the other with unknown multiple cerebral infarction. In conclusion, use of aprotinin in young patients undergoing hypothermic circulatory arrest did not increase the risk of renal dysfunction or intravascular coagulation if ACT during circulatory arrest is maintained to exceed 750 seconds with low-flow perfusion.

• Journal of Preventive Medicine and Public Health
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• v.41 no.5
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• pp.287-294
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• 2008

Objectives : To estimate the economic burden of osteoporotic vertebral fracture (VF) from a societal perspective. Methods : From 2002 to 2004, we identified all National Health Insurance claims records for women ${\geq}50$ years old with a diagnosis of VF. The first 6-months was defined as a "clearance period," such that patients were considered as incident cases if their first claim of fracture was recorded after June 30, 2002. We only included patients with ${\geq}$ one claim of a diagnosis of, or prescription for, osteoporosis over 3 years. For each patient, we cumulated the claims amount for the first visit and for the follow-up treatments for 1 year. The hospital charge data from 4 hospitals were investigated to measure the proportion of the non-covered services. Face-to-face interviews were conducted with 106 patients from the 4 study sites to measure the out-of-pocket spending outside of hospitals. Results : During 2.5 years, 131,453 VF patients were identified. The patients had an average of 3.38 visits, 0.40 admissions and 6.36 inpatient days. The per capita cost was 1,909,690 Won: 71.5% for direct medical costs, 20.6% for direct non-medical costs and 7.9% for indirect costs. The per capita cost increased with increasing age: 1,848,078 Won for those aged 50-64, 2,084,846 Won for 65-74, 2,129,530 Won for 75-84and 2,121,492 Won for those above 84. Conclusions : Exploring the economic burden of osteoporotic VF is expected to motivate to adopt effective treatment options for osteoporosis in order to prevent the incidence of fracture and the consequent costs.

• Journal of Korean society of Dental Hygiene
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• v.12 no.2
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• pp.379-389
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• 2012

Objectives : The purpose of this study was to improve the practice level on dental hygienists'infection prevention by examining the actual condition of dental hygienists'infection control and analyzing factors of having influence upon this. Methods : A questionnaire survey was carried out from July 18, 2011 to August 26 targeting dental hygienists who work at medical institutions where are located in Daegu, Busan and Ulsan Metropolitan Cities and Gyeongsangnam buk-do. After then, the following conclusions were obtained. Results : 1. As a result of surveying practice by item in the practice level of infection prevention, the items with high practice level in the management of infectious diseases were surveyed to be 12 months(89.6%) for health-checkup cycle and to be having experience of vaccination(78.0%) for hepatitis type B. The items with high practice level in the management and practice of washing hands were indicated to be in order of regularly paper towel(87.7%) and hands cleaning after regular medical examination(80.5%). In the item of the practice on wearing and managing individual protection equipment, regularly wearing(93.1%) rubber globes given washing implements was indicated to be high. 2. As a result of analyzing working career, working institution, working region, and practice level of infectious-disease management, the appearance of fulfilling infection control guidelines at medical institution and the experience of education for infection control were indicated to have difference depending on working institution. Regularly health checkup was indicated to have difference depending on respondents' working career and working institution. 3. The whole average in the practice level of infection prevention according to working career, working institution, and working region was indicated to be 2.55 out of 3-point perfection. 4. Wearing latex gloves was indicated to have statistically significant difference depending on working institution(p<0.001) and working region(p<0.001). The exchange of latex gloves every patient and the use of paper apron had statistically significant difference depending on working region(p<0.001). 5. As a result of comparing the frequency of using protection equipment for preventing infection according to the management of infectious diseases, the statistically significant difference was shown depending on the appearance of infection control guidelines at medical institution(p<0.001), the appearance of having experience of health checkup(p<0.01), and the appearance of having experience of vaccination for hepatitis type B(p<0.05). Conclusions : The above-mentioned findings showed that the denture satisfaction of the denture-wearing senior citizens was linked to their subjective oral health awareness. Therefore it will be possible to improve denture-wearing elderly people's quality of life when oral health plans geared toward boosting their denture satisfaction are carried out.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.1
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• pp.497-505
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• 2018

This study was conducted to investigate the characteristics of private health insurance subscribers and non-subscribers as they relate to severely ill patients, and to identify the factors of participation. The study was conducted using the National Health and Nutrition Examination Survey for 2015, and data were analyzed using SPSS ver. 23.0. The subjects were 417 patients with severe disease (cancer, heart disease, cerebrovascular disease) over 19 years of age. Crossover analysis was employed to identify differences between the state of private health insurance participation, while binary logistic regression analysis was used to confirm the factors affecting private health insurance subscription. Analysis of the effects of the subjects on the private health insurance participation rate revealed that the social and demographic characteristics were higher in younger individuals regardless of sex, residence, or marital status. Moreover, higher household income, regardless of the education level, was associated with a higher participation rate of health insurance target individuals compared to medical benefit target individuals. The private health insurance participation rate was low and the explaining power was 51.7%, regardless of subjective health awareness and walking practice. Therefore, efforts should be made to improve the living environment and support local governmental programs for the elderly, low income households, socially vulnerable groups with limited activities and groups with limited health behavior. It is also necessary to consider various health policies, such as providing government health education or programs to prevent severe illness.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.6
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• pp.2161-2168
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• 2010

The administration data of the national health insurance and health insurance bills were utilized in this study. The data of 485,953 patients who were at the age of 30 and up and used the out-patient departments of every medical institution located in some regions involving two southern and northern provinces once or more during a 184-day period from July to December, 2008. As a result of analyzing their Continuity of Ambulatory Care and factors affecting it, the following findings were given: The continuity of ambulatory care among the adult patients with hypertension in our country turned out to be on a high level(MMCI $0.96{\pm}0.13$, MFPC $0.96{\pm}0.12$). Given examining the outpatient medical-cure continuity level according to index, the averagely medical-cure continuity level was calculated to be high level with MMCI, $0.96{\pm}0.13$, and MFPC $0.96{\pm}0.12$. Thus, the tendency of visiting only one medical provider was high. The findings of the study illustrated that the average continuity of ambulatory care among the adult patients with hypertension in our country was on a high level, and it seemed that special care should be provided to patients with a low-level continuity of ambulatory care, such as women and elderly people aged 64 and over. The findings of the study are expected to serve as one of the barometers for the health care of patients with hypertension and for the performance of national hypertension management plans.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.5
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• pp.355-365
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• 2017

This study investigatedwhether occupational therapeutic craft activity improves cognitive function and hand function in patients with acute stroke, with the hope of providing clinically useful results for further studies. From March 2016 to November 2016, thirty acute patients with stroke at A general hospital and B rehabilitation hospital in Seoul and Gyeonggi-do, Korea were enrolled and randomly divided into two groups. One group was treated with occupational therapeutic craft activity,and the other general exercise. The subjects performed each activity for 30 minutestwice weekly, for four weeks. To test the effect of intervention, hand function was tested with the Box & Block Test and the Jebsen-Taylor Hand Function Test.Cognitive function measures were the NCSE and Trail-Making Test. Over the four weeks of treatment activities, in the occupational therapeutic craft activity group, hand function measures(p<.05) increased significantly,as did cognitive function measures(p<.05). This study shows that occupational therapeutic craft activity improves hand function and cognitive function effectively in patients with acute stroke. Occupational therapeutic craft activity programscan be based on this study to prepare intervention programs for further studies with acute stroke patients.

• Journal of Oral Medicine and Pain
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• v.35 no.1
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• pp.93-99
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• 2010

Herpes zoster (HZ) is the secondary manifestation of an earlier infection with the varicella-zoster virus in one or more dermatomes. As reactivation of the virus is linked to an age-related diminished virus-specific and cell-mediated immunity, HZ develops mainly in elderly people. Acute zoster is painful, but does not incur lasting morbidity. Reactivation of the varicella-zoster virus in the trigeminal nerve (Herpes zoster) occur with severe pain and rash in the oro-facial region. The acute pain decreases as the rash begins to heal. Postherpetic neuralgia(PHN), the most frequent complication of herpes zoster, is usually defined as pain in the involved dermatome that is still present 3 month after rash onset. The clinical characteristics of PHN are, eposodic stabbing pain, burning pain and allodynia, with hypoesthesia and/or dysesthesia. $Neurometer^{(R)}$(neuroselective sensory nerve conduction threshold: sNCT, Automated current perception threshold: CPT, neurotron incorporated. Baltimore, Maryland. 21209 U.S.A.) is convenient, rapid and noninvasive, and allows objective assessment of sensory disturbance. This case is about the postherptic neuralgia patient assessed with $Neurometer^{(R)}$. From this case, we reviewed the pathophysiology and the treatment of PHN and recommend the assessment of pain intensity with $Neurometer^{(R)}$ as quantitative and objective method.