• Journal of Environmental Health Sciences
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• v.46 no.3
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• pp.285-296
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• 2020

Objective: The objective of this study was to describe the characteristics of exposure to humidifier disinfectants (HDs) and their association with the presence of a person who experienced the adverse health effects in general households in Korea. Methods: During the month of December 2016, a nationwide online survey was conducted on adults over 20 years of age who had experience of using HDs. It provided information on exposure characteristics and the experience of health effects. The final survey respondents consisted of 1,555 people who provided information on themselves and their household members during the use of HD. Exposure characteristics at the household level included average days of HD use per week, average hours of HD use per day, the duration within which one bottle of HD was emptied, average input frequency of HD, amount of HD (cc) per one time used, and active ingredients of HD products (PHMG, CMIT/MIT, PGH, or others). The risk of the presence of a person who experienced adverse health effects in the household was evaluated by estimating odds ratios (ORs) and 95% confidence intervals (CIs) adjusted for monthly income and region using a multiple logistic regression model. Subgroup analyses were conducted for households with a child (≤7 years) and households with a newborn infant during HD use. Results: The level of exposure to HD tended to be higher for households with a child or newborn infant for several variables including average days of HD use per week (P<0.0001) and average hours of HD use per day (P<0.0001). The proportion of households in which there was at least one person who experienced adverse health effects such as rhinitis, asthma, pneumonia, atopy/skin disease, etc. was 20.6% for all households, 25.3% for households with children, and 29.9% for households with newborn infants. The presence of a person who experienced adverse health effects in the household was significantly associated with average hours of HD use per day (P_trend<0.001), duration within which one bottle of HD was emptied (P_trend<0.001), average input frequency of HD (P_trend<0.001), amount of HD per one use (P_trend=0.01), and use of HDs containing PHMG (OR=2.23, 95% CI=1.45-3.43). Similar results were observed in subgroup analyses. Conclusion: Our results suggest that level of exposure to HD tended to be higher for households with a child or newborn infant and that exposure to HD is significantly associated with the presence of a person who experienced adverse health effects in the household.

• Tuberculosis and Respiratory Diseases
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• v.61 no.3
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• pp.233-238
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• 2006

Study objectives: To determine the factors associated with mortality after an in-hospital diagnosis of tuberculosis in a region with low levels of HIV coinfection. Methods: From January 2003 to December 2004, all subjects who were > 15 years of age and had received a diagnosis of tuberculosis were registered. The clinical, radiological and laboratory aspects of the patients who died (n=27) were compared with those of an age and gender matched control population(n=54). Logistic regression analyses were carried out, which included age, gender, hospital admission source, initial site of admission, dyspnea, general weakness and initial laboratory data. Results: The mean age of the patients was $60{\pm}16$ years and male patients outnumbered female patients. Univariate analysis identified hemoglobin, blood urea nitrogen, albumin, cholesterol, aspartate aminotransferase (AST), C-reactive protein and the risk factors for tuberculosis to be significantly associated with mortality. Among the characteristics of disease presentation and treatment, emergency department admission, intensive care unit, disease severity, general weakness and dyspnea at the time of admission were associated with mortality. Multiple regression analysis revealed the initial management in the intensive care unit and lower serum albumin to be independently associated with mortality. Conclusion: The markers of disease chronicity and severity appear to be associated with in-hospital mortality. Identifying potentially reversible factors such as malnutrition and respiratory failure suggests specific intervention that might lead to an improvement in the patients' outcomes.

• Health Policy and Management
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• v.2 no.1
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• pp.42-65
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• 1992

To survey the specialties or sujects of practice displayed by the private practitioners the authors visited 691 clinics in Taegu from April 1 to May 18, 1991, At the same time, a mail questionnaire was administered to ask the number of displayed subjects of practice, and the reasons for displaying the subjects, reasons for not displaying in case of no specialty was displayed, composition of patients, and role as a specialist. The questionnaire was returned by 308(44.6%) practitioners. The distributions of private practitioners by specialty were 13.9% for internal medicine (IM), 11.7% for pediatrics(Ped), 13.0% for obstetrics '||'&'||' gynecology(OBGY), 11.1% for general surgery(GS), 10.0% for family practice(FP), and 5.3% for general practitioner(GP). Ninety percent of the specialists have displayed their specialty in their offices. Among all the private practitioners, 61.9% of them have displayed their subjects of practice and 23.7% have shown telephone number. Among private practitioners who displayed the subjects of practice, 80.6% have signs of 'subjects of practice'. Mean number of the displayed subjects of practice for the all private practitioners is 1.20, and 1.93 for the private practitioners who displayed subjects of practice. FP and GS have displayed their subjects of practice in 91.2% and 87.0% respectively and OBGY have displayed in 32.2%, the lowest percentage among all the soecuaktues. IM specialists displays pediatrics as a major subject of practice in 72.1% the pediatricians display IM in 88.9% the OBGYs display pediatrics in 77.8%, and the GSs display IM in 51.9%. Most commonly displayed subjects of practice are Ped and IM. Sixty-five percent of the private practitioners answered that they don't display their specialties because their clinics are "primary health care facility". The reasons for displaying the subjects of practice and its relevance with their own specialty(45.6%), and the difficulty in clinic management only with the patients for their own specialty(36.9%). The proportion of clinics whose patients of other specialty are than their own specialty accounted less than 10% was 52.8% and that accounted more than 51% was 16.0%. Specially, 51.4% of GS specialists cared more than 51% of patients of other specialty area than their own specialty. Most of the patients of IM, Ped, and OBGY specialists are the patients of their own specialty. However, 56.8% of GS care more of IM patients and only 24.3% of them care mostly GS patients, The respondents to the mail questionnaire who stated that they can not play the role of specialist well are 30.5% and especially 72.9% of the GS specialists state so. The proportion of respondents who do not suffort the private practice of specialists is 71.1%. Among the surgical specialists, 82.7% of them rarely perform operation. The reasons for not performing operation are insufficient insurance fee (76.9%), and risk of operation(58.0%), so as the OBGY specialists. Above finidngs suggest that most of the specialists, especially surgeons, in the private practice can not play their role as a specialist. It is necessary to develop a policy that facilitates the production of practice and the retention of the specialists in the hospitals.s.

• Journal of radiological science and technology
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• v.40 no.2
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• pp.187-195
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• 2017

Early diagnosis for upper facial trauma is difficult by using the standard Water's view (S-Water's) in general radiograph due to overlapping of anatomical structures, the uncertainty of patient positioning, and specific patients with obese, pediatric, old, or high-risk. The purpose of this study was to analyze appropriate exposure angles through a comparison of two different protocols (S-Water's vs. reverse Water's view (R-Water's)) by using a head phantom. A head phantom and general radiograph with 75 kVp, 400 mA, 45 ms 18 mAs, and SID 100 cm. Images of R-Water's were obtained by different angles in the range of $0^{\circ}$ to $50^{\circ}$, which adjusted an angle at 1 degree interval in supine position. Survey elements were developed and three observers were evaluated with four elements including the maxillary sinus, zygomatic arch, petrous ridge, and image distortion. Statistical significant analysis were used the Krippendorff's alpha and Fleiss' kappa. The intra-class correlation (ICC) coefficient for three observers were high with maxillary, 0.957 (0.903, 0.995); zygomatic arch, 0.939 (0.866, 0.987); petrous ridge, 0.972 (0.897, 1.000); and image distortion, 0.949 (0.830, 1.000). The high-quality image (HI) and perfect agreement (PA) for acquired exposure angles were high in range of the maxillary sinus ($36^{\circ}-44^{\circ}C$), zygomatic arch ($33^{\circ}-40^{\circ}$), petrous ridge ($32^{\circ}-50^{\circ}$), and image distortion ($44^{\circ}-50^{\circ}$). Consequently, an appropriate exposure angles for the R-Water's view in the supine position for patients with facial trauma are in the from $36^{\circ}$ to $40^{\circ}$ in this phantom study. The results of this study will be helpful for the rapid diagnosis of facial fractures by simple radiography.

• Journal of the Korean Institute of Landscape Architecture
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• v.46 no.5
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• pp.44-58
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• 2018

Cities face new challenges not only in natural disasters by climate change but also in social and economic fluctuations. With the existing simple reconstruction method, it is difficult to solve the overall problems that a city or region may face. As a new approach to cope with various changes, the concept of resilience is emerging. Resilience is also one of the themes of recent major urban design projects. Design with the concept of resilience is a new strategy that can deal with various changes of urban space, rather than a temporary trend. The purpose of this paper is to explore the design method by analyzing cases where the concept of resilience is employed. We aim to examine what kind of design strategies are needed for the resilience design and how this design process differ in character, as compared to general design projects. Cases for this study include the "Rebuild by Design" competition held in 2013 and the "Resilient by Design/Bay Area Challenge" competition held in 2017. This paper consists of literature reviews and case studies. The latter is divided into two aspects: content analysis based on the theory of resilience and characteristics of the design process. Cases are analyzed through literature reviews and process characteristics of resilience design in response to the general design process. The main categories for urban resilience used as the framework for analysis include: Urban Infrastructure, Social Dynamics, Economic Dynamics, Health and Wellbeing, Governance Networks, and Planning and Institutions. As a result, the aspects of resilience concepts considered and design strategies undertaken by each team were identified. Each team tried to connect all 6 categories to their design strategies, placing special value on the role of governance, a system that enables collaborative design and project persistency. In terms of the design process, the following characteristics were found: planning the whole project process in the pre-project phase, analyzing predictable socioeconomic risk factors in addition to physical vulnerabilities, aiming for landscape-oriented integrated design, and sustainable implementation strategies with specific operations and budget plans. This paper is meaningful to connect the concept of resilience, which has been discussed in various articles, to design strategy, and to explore the possibility of constructing a practical methodology by deriving the characteristics of the resilience design process. It remains a future task to research design strategies that apply the concept of resilience to various types of urban spaces, in addition to areas that are vulnerable to disasters.

• Women's Health Nursing
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• v.5 no.3
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• pp.389-409
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• 1999

This study was carried out to identify the differences between nursing needs and levels of satisfaction of postpartum women during the early postpartum period. The goal of this study was to obtain needed to develope the nursing quality for postpartum women. The subjects were 87 postpartum women who had vaginal delivery at 2 general hospital and 2 maternity hospital in the Ulsan City. The period for the data collection was from June 1 to 29, 1999. The data was gathered using an 98 items questionnaire which was a modified version of a questionnaire the developed by Y. J. Chun. Results found are as follows : 1. The general characteristics of the subjects : The majority of subjects were 25-29 yrs. (57.5%), high school and college graduates(96.5%), unemployed(75.9%), middle ranged economics(93.1%), had no religion(43.7%), male baby(52.9%), birth weight 3-3.5Kg(49.4%), wanted pregnancy(96.6%), no abortion history(50.6%), had antenatal care(89.7%), had prenatal education(32.2%), postnatal education(42.5%), intended breast feeding (46.0%), had resonable self confidence about self(20.7%), infant care(36.8%) and nuclear family pattern(82.3%). 2. The level of nursing needs of overall nursing care(3.93) and the levels of satisfaction(3.86) was relatively high. The nursing needs by category of nursing care, the highest need was in the emotional and psychological care(4.09), and the lowest need was in physical need(3.73). The satisfactions by category of nursing care, the highest satisfaction was in emotional and psychological care(4.11) and the lowest satisfaction was in education in self care(3.64). The significant differences between nursing needs and satisfactions were found on education in infant care(p=.005), and education in self care(p=.020). 3. Among items of physical care, 'accurate medication and treatment(4.21)', 'control of postpartum hemorrhage(4.13)', 'pain control and care of episiotomy wound (4.12)' and 'regular observation of postpartum conditions(4.09)' showed high nursing needs. 'Accurate medication and treatment(4.31)', 'regular observation of postpartum condition(4.24)', 'control of postpartum hemorrhage(4.22)' and 'pain control and care of episiotomy wound(4.12)' showed high satisfaction levels. 4. Among items of emotional and psychological care, 'personal treatment(4.32)', kind and faithful care(4.30)', 'detailed explanation on the treatment or nursing care(4.25)', 'adequate draping during the care and treatment(4.23)' and detailed explanation on a doubt(4.13)', showed high nursing needs, 'personal treatment(4.52)', 'kind and faithful care(4.45)', 'detailed explanation on a doubt(4.24)', 'detailed explanation on the treatment or nursing care(4.21)' and 'adequate draping during the care and treatment(4.18)' showed high satisfaction of nursing care. Difference between the level of nursing needs and satisfaction was significant except item of 'early contacts with their baby and breast feeding'. 5. Among items of environmental care, the highest level of need and satisfaction were on the items of 'neat bedding and clothes(4.05, 4.21)' and 'room cleansing or care of room(4.01, 4.28)'. Differences between the level of nursing care and satisfaction were 'room cleansing of care of room'. 6. Among items of educational needs on self care, 'sitz bath method(4.22)', 'high risk symptoms to immediate clinic visits(4.13)', 'the timing of tub bath(4.05)' and 'good secretion of breast milk(4.03)', showed high nursing needs, 'sitz bath method(4.22)' showed high satisfaction of nursing care. Differences between the level of nursing care and satisfaction were 'the timing of hair shampoo', 'the timing of tub bath', ' the method of pad change', 'postpartum exercise', 'good secretion of breast milk', 'maintenance of breast figure', 'contraindicated drugs in postpartum women', 'kegel exercise' and 'breast self examination'. 7. Among items of educational needs on infant care, 'immunization of infants(4.36)', 'symptoms of sickness to immediate clinic visits(4.28)'. 'safety and emergency care(4.28)', 'umbilical care(4.26)', 'feeding times and intervals(4.24)', 'normal growth and development of infant(4.24)' and 'infection control(4.22)', showed high level of nursing care, 'immunization of infants(4.21)', 'feeding times and intervals(4.17)', were high satisfaction items showed significant differences between the level of nursing care and satisfaction. 8. Relationship between nursing needs and levels of satisfaction among postpartum women were as follows : 1) Physical area : There were no significant differences in the level of nursing needs, but satisfaction levels were significantly different among 'working mothers', 'baby's weights', 'baby's sex', 'planning of feeding' and 'routes of receiving postpartum informations'. 2) Emotional and psychological area : The level of nursing needs were significantly different in the area of 'confidence in self care'. Satisfaction levels were significantly different among 'baby's sex', 'baby's weights', 'the confidence of infant care' and 'working mother'. 3) Environment area : There were on significant differences in the level of nursing needs, but satisfaction levels were significantly different among 'maternal age' and 'baby's weights'. 4) Education in self care : The level of nursing needs were significantly different among 'parity history' and 'type of family formation'. Satisfaction levels were significantly different among 'working mother', 'baby's sex', 'antenatal care', 'postpartum education', 'planning of feeding', 'routes of receiving postpartum informations'. 5) Education in infant care area : The level of nursing needs were significantly different among 'parity history'. Satisfaction levels were significantly different among 'baby's sex', 'receiving postpartum education or not' and 'working mother'.

• Journal of Korea Water Resources Association
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• v.53 no.2
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• pp.107-119
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• 2020

This study analyzed past drought characteristics based on the observed rainfall data and performed a long-term outlook for future extreme droughts using Representative Concentration Pathways 8.5 (RCP 8.5) climate change scenarios. Standardized Precipitation Index (SPI) used duration of 1, 3, 6, 9 and 12 months, a meteorological drought index, was applied for quantitative drought analysis. A single long-term time series was constructed by combining daily rainfall observation data and RCP scenario. The constructed data was used as SPI input factors for each different duration. For the analysis of meteorological drought observed relatively long-term since 1954 in Korea, 12 rainfall stations were selected and applied 10 general circulation models (GCM) at the same point. In order to analyze drought characteristics according to climate change, trend analysis and clustering were performed. For non-stationary frequency analysis using sampling technique, we adopted the technique DEMC that combines Bayesian-based differential evolution ("DE") and Markov chain Monte Carlo ("MCMC"). A non-stationary drought frequency analysis was used to derive Severity-Duration-Frequency (SDF) curves for the 12 locations. A quantitative outlook for future droughts was carried out by deriving SDF curves with long-term hydrologic data assuming non-stationarity, and by quantitatively identifying potential drought risks. As a result of performing cluster analysis to identify the spatial characteristics, it was analyzed that there is a high risk of drought in the future in Jeonju, Gwangju, Yeosun, Mokpo, and Chupyeongryeong except Jeju corresponding to Zone 1-2, 2, and 3-2. They could be efficiently utilized in future drought management policies.

• Journal of Gastric Cancer
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• v.6 no.2
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• pp.109-113
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• 2006

Purpose: Various minimally invasive surgical techniques, such as an endoscopic mucosal resection and a laparoscopic gastrectomy, are becoming common practice for some cases of early gastric cancer (EGC) defined in terms of the depth of invasion being limited to the mucosa or submucosa. However, there are rare cases of early gastric cancer with massive lymph-node metastasis. Materials and Methods: From 6 university hospitals of Korea, 2,772 EGC cases were resected during the various period of analysis (1,432 cases of mucosal cancer and 1,340 of submucosal cancer). Results: As control data, we used the data from a single institute, CHA University Hospital. There were nine cases of early gastric cancer (9/2,772, 0.32%) with N3 lymph node metastasis defined by more than 15 lymph nodes being metastasized according to the UICC-TNM classification (pT1N3, stage IV). Two cases were mucosal cancer (2/1,432, 0.1 4%), and seven cases were submucosal cancer (7/1,340, 0.52%). Metastasized lymph nodes varied in number from 18 to 52. There were three male and six female patients with a mean age of 57. This is a totally reversed sex ratio compared to the usual gastric cancer or EGC. Among the total of 9 EGC patients, there were 5 who had superficial spreading carcinomas with surface areas larger than $25\;cm^2$. This is a significantly higher proportion compared to the general EGC population. When we compared the tumor size according to the LN status, the N3 group was definitely larger than the other groups. 78% of the pT1N3 cases showed lymphatic invasion, which is very high compared to the 4.7% in general EGC cases. Among the 9 cases, 6 patients had too short a follow-up period to evaluate the correct prognosis, but there was one patient with a non-curative resection and two patients with early recurrence. Although the sample size is small and the follow-up period is short, we can expect a very poor prognosis when we consider the common prognosis of EGC that is widely known and accepted. Conclusion: From these results, we can a conclude that the risk factors for pT1N3 gastric cancer are female patients, submucosal invasion, larger tumor size, and lymphatic invasion. However rare, the existence of pT1N3 gastric cancer needs to be taken into consideration, especially during the diagnosis. Furthermore, minimally invasive treatment for EGC needs to be chosen with great precaution. Since the prognosis of pT1N3 gastric cancer is expected to be poor, aggressive adjuvant chemotherapy may be necessary. (J Korean Gastric Cancer Assoc 2006;6:109-113)

• The Korean Journal of Nuclear Medicine Technology
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• v.20 no.1
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• pp.42-46
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• 2016

Purpose Mammography is the most widely used scan for the early diagnosis since it is possible to observe the anatomy of the breast. however, The sensitivity is markedly reduced in high-risk patients with dense breast. Molecular Breast Imaging (MBI) sacn is possible to get the high resolution functional imaging, and This new neclear medicine technique get the more improved diagnostic information through It is useful for confirmation of tumor's location in dense breast. The purpose of this study is to evaluate the usefulness of MBI for tumor diagnosis in patients with dense breast. Materials and Methods We investigated 10 patients female breast cancer with dense breast type who had visited the hospital from September 1st to Octorber 10th, 2015. The patients underwent both MBI and Mammography. MBI (Discovery 750B; General Electric Healthcare, USA) scan was 99mTc-MIBI injected with 20 mCi on the opposite side of the arm with the lesions, after 20 minutes, gained bilateral breast CC (CranioCaudal), MLO (Medio Lateral Oblique) View. Mammography was also conducted in the same posture. MBI and Mammography images were compared to evaluate the sensitivity and specificity of each case utilizing both image and two images in blind tests. Results The results of the blind test for breast cancer showed that the sensitivity of Mammography, MBI scan was 63%, 89%, respectively, and that their specificity was 38%, 87%, respectively. Using both the Mammography and MBI scan was Sensitivity 92%, specificity 90%. Conclusion This research has found that, The tumor of dense tissue that can not easily distinguishable in Mammography is possible to more accurate diagnosis since It is easy to visually evaluation. But MBI sacn has difficulty imaging microcalcificatons, If used in conjunction with mammography it is thought to give provide more diagnostic information.

• Journal of the Korean Arthroscopy Society
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• v.10 no.2
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• pp.148-152
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• 2006

Purpose: The purpose of this study was to investigate the distribution of the diameter of four strand autologous hamstring tendon and to identify the factors related to the diameter. Materials and Methods: Between December 2004 and July 2006, 66 patients underwent anterior cruciate ligament reconstruction using autologous hamstring tendon. Sixty one patients were male and the other 5 patients were female. Both semitendinosus and gracilis tendon were harvested in every case. Harvested two tendons were folded once together to create a four strand double loop graft and were passed through cylindrical sizer to measure their diameter. Parameters such as sex, age, height and weight were analyzed for their correlation with the diameter of the graft. Results: The diameter of the graft ranged from 6 mm to 10 mm. The graft with the diameter of 8 mm was most common and the average diameter of all the grafts was $7.85{\pm}0.92mm$. Seven patients (10.6%) had a graft with the diameter of 6 mm, which is considered too thin to be ideal one. No statistically significant correlation was found between age of the patient and the diameter of the graft. However, the diameter of the graft was significantly correlated with sex, height and weight of the patient. Female patients had a significant tendency to have thinner hamstring tendons. Both small height and light weight of the patients were correlated with thinner hamstring tendons significantly. Conclusion: Sex, height and weight of the patients were the factors that had a statistically significant correlation with the diameter of the graft. Being aware of the risk factors related with harvesting exceedingly thin hamstring tendon prior to anterior cruciate ligament reconstruction, one can utilize wide range of options in selecting an optimal graft.