• Clinical and Experimental Pediatrics
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• v.45 no.2
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• pp.256-260
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• 2002

Bone marrow necrosis is a rare complication of a variety of diseases affecting the marrow. The cause and incidence are unknown, and reports of treatment response are rare. We describe a case of relapsed acute mixed type leukemia with bone marrow necrosis. The patient was a 10 year old female diagnosed with acute mixed type leukemia four years ago. She had been on second remission state for 1 year, presented with severe back pain, tenderness in lower extremities, low-grade fever and general weakness. Her level of serum lactic dehydrogenase on admission was increased. Bone marrow aspiration from both posterior iliac crest showed marrow necrosis. Subsequent examination showed the same feature. Hip MRI showed heterogenous low signal intensity in both iliac bone on T-1 weighted image and heterogenous high signal intensity on T-2 wieghted image. Remission induction therapy was started but she expired on 59th hospital day due to the complication of sepsis.

• Tuberculosis and Respiratory Diseases
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• v.82 no.4
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• pp.311-318
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• 2019

Background: Although physical activity is known to be beneficial to lung function, few studies have been conducted to investigate the correlation between physical activity and lung function in dusty areas. Therefore, the purpose of this study is to investigate the correlation between physical activity and lung function in a Korean cohort including normal and COPD-diagnosed participants. Methods: Data obtained from the COPD in dusty areas (CODA) cohort was analyzed for the following factors: lung function, symptoms, and information about physical activity. Information on physical activity was valuated using questionnaires, and participants were categorized into two groups: active and inactive. The evaluation of the mean lung function, modified Medical Research Council dyspnea grade scores, and COPD assessment test scores was done based on the participant physical activity using a general linear model after adjusting for age, sex, smoking status, pack-years, height, and weight. In addition, a stratification analysis was performed based on the smoking status and COPD. Results: Physical activity had a correlation with high forced expiratory volume in 1 second ($FEV_1$) among CODA cohort (p=0.03). While the active group exhibited significantly higher $FEV_1$ compared to one exhibited by the inactive group among past smokers (p=0.02), no such correlation existed among current smokers. There was no significant difference observed in lung function after it was stratified by COPD. Conclusion: This study established a positive correlation between regular physical activity in dusty areas and lung function in participants.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.6
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• pp.46-58
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• 1999

The purpose of this research was to find out the state of the nursing performance of the home care nurses in Seoul in order to provide the data for the practical work guide. The data were collected from fifty home care nurses working in 22 institutions located in Seoul. The research tool used for this research was modified and tested by Song Jong-Rye(1999) which was originally modified the standard tool of American Nurses Association (1998) and was partly supplement and adjusted for this research. The reliability of this tool was Cronbach's $\alpha$=.0982. The collected data were statistically processed using SAS for t-test, ANOVA. $Scheff\'{e}$ test. Among the surveyees, 50% have been working as a home care nurse more than three years and 74.0% of them were married. And 52% have B.S degree with certification of home care nurse from the certification program for Home Care Nurses affiliated at nursing schools. Half of the home care nursing organizations were based on the general hospitals, and most(78%) of the responsible senior personnels of those organizations were nurses. The following results are drawn from this research. 1) The level of nursing performance by the task sectors General performance level of home care nurses was relatively high in grade of 3.06 from total 4.00. Among the task sectors. the ethical field scored the highest points, and the next were nursing intervention, professional training, and data gathering, and the research sector scored the lowest point. 2) The level of nursing performance by general features of home care nurses Statistically relevant correlation between performance according to the duration of working experience as a nurse(p=0.8951) and performance according to the duration of working as home care nurse(p=0.2263) did not emerge. Also, performance by marriage status(p=0.2218), education(p=0.5733), and taking the certification program for home card nurse(p =0.1560) has no statistically meaningful correlation. 3) The level of nursing performance by the type of home care nursing organizations There exists a significant difference(p=0.002) between performances by the types of organizations. Most of the responsible senior personnels of the home care nursing organization were nurses. The level of nursing performance of the home care nursing organization under nurse management was relatively higher than that of home care nursing organizations led by medical doctors or non-medical professional, but this was not proved as statistically meaningful(p =0.3617). 4) The level of nursing performance by task sectors according to the characteristic of home care nursing service organization There exists a significant difference between nursing performances by task sectors according to the characteristics of home care nursing organization(p=0.002). In case of model research center of one College of Nursing, the nursing performance in the sectors of organization, theory, and data gathering were lower than that of in hospital based home care nursing service. And in case of local home care centers, performances in sectors of organization, theory, data gathering, nursing intervention. professional training, and research sectors were significantly low. Based on the obtained results, overall performance of home care nurses can be appraised as relatively good. Especially, performances in sectors of the nursing intervention, nursing plan. and data gathering including the in direct nursing were recorded high scores. From this, it can be concluded that high quality of nursing is relatively practicing for home patients at these days. Since the high quality of nursing for patients was directly related to the level of nursing performances of home care nurses, it is required to improve practical performance level of them by making constant evaluation and running continual education program and supplementing curriculum for the sectors with low scores.

• The Korean Nurse
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• v.32 no.1
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• pp.61-76
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• 1993

This study was done in order La provide basic data to a Fee System for hospital based Home Health Care services in Korea in the future. It was done by investigating activities provided to possible Home Health Care clients who could be discharged early from genera] hospitals and then estimating the nursing care fee according to each nursing activity based upon the time used for activity. The subjects of the study were selected by convenience sampling and consisted of 35 clients who might be clients for Home Nursing Care and were presently admitted to a medical- surgical ward of Y University Medical Center located in Seoul, Korea. The data collection period was from September 1, 1991 to September 30, 1991. The research in strum nets utilized for the study were a client selection criterial for Home Health Care developed by Choo(l991) and a check-list of nursing activity developed by researcher. The results of the study were as follows : 1. There were 44 different nursing activities provided in the seven days but the time was calculated for only 25 of the nursing activities. 2. Fees for the 25 different nursing activities were calculated by multipling the median of the average wage of a staff nurse having five years experience in an A grade general hospital to the Lime of the nursing activity. The results were compared with the insurance fee which the government recognized as an appropriate fee for that activity. The nursing activities with a lower calculated fee than the insurance fee were suction, catheterization, exercise education and dressing change. The nursing activities with a higher calculated fee than the government recognized fee were 1M injection and vital sign check. 3. There was a range of 1-15 nursing activities provided daily to the client. For the average number of nursing activities per day of 6.26 events the nursing care fee was calaulated at W 6136 per day. 4. Based upon the results of the study, a recommentdation for a Home Health Care fee per visit based on the nursing activities provided could be formulated for a Home Health Care fee system. It could be formulated as following: 1) Home health Care fee per visit $=[(direct{\;} nursing{\;}fee(direct{\;}nursing{\;}care{\;}time{\;}per{\;}activity{\;}{\times}{\;}average{\;}nursing{\;}wage)+indirect fee]{\times}average$ nursing activity per visit]+management fee+ materials fee+a travel fee In this way a nursing fee could be calculated based upon the result of the study of the nursing fees per visit. 2) Nursing activity fees per visit. = $([direct nursing{\;}care{\;}fee+indirect{\;}nursing{\;}fee]{\times}average$ number of nursing activities provided per visit] (W 6, 136) + travel fee(\ 5, 542) +management fee material $fee({\alpha})\{\;}16, 436+{\alpha}$ The nursing fee per visit as calculated in this research of $\{\;}15, 0000+{\alpha}$ could be adjusted according to the patient's condition or the use of high technology nursing care or according to the amount of time spent for travel. The nursing care fee per visit presented in this study can be validated through a Home Health Care demonstration project.

• Journal of Korean society of Dental Hygiene
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• v.9 no.1
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• pp.169-180
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• 2009

This study grasped recognition on a system of long-term care insurance for the elderly targeting dental professionals who are working at dental hospitals and clinics where are located in Daejeon Metropolitan City. It developed and utilized materials available for educating the care staff in a system of long-term care insurance for the elderly and the dental professionals who participate in the oral hygiene service. It carried out the effective duty performance for the elderly in a situation of long-term care protection. Thus, the purpose of this study was to contribute to the early settlement in a system of long-term care insurance for the elderly. The following conclusions were obtained as a result of having carried out self-administered questionnaire research targeting 238 people from August 1 to August 30 in 2008. 1. In the general characteristics of the research subject, the present working place was indicated to be 22.7% for dental hospital, 71.8% for dental clinic, and 5.5% for others. As for the main duty field, the medical treatment & cooperative duty was indicated to be the highest with 61.8%, and was statistically significant(p=0.000). 2. The necessity for a system of long-term care insurance for the elderly was indicated to be 77.7% for 'necessary' and 1.7% for 'unnecessary,' and was statistically significant(p=0.016). 3. In the item of dividing the service of long-term care insurance for the elderly, the dental hygienists showed higher recognition than non-dental hygienists, and indicated significant difference(p=0.010). 4. As for recognition on a system of long-term care insurance for the elderly in dental professionals who responded as saying of 'knowing name and contents' about a system of long-term care insurance for the elderly, the recognition level was high in recognition of subjects' age(p=0.000), division in services(p=0.012), contents in at-home care service(p=0.000), execution in oral-hygiene service(p=0.004), procedure of using the long-term care insurance for the elderly(p=0.016), item of judging grade of long-term care insurance for the elderly(p=0.013), medical charge by service according to judging grade of long-term care insurance for the elderly(p=0.015), burden of cost for a system of long-term care insurance for the elderly(p=0.011), qualification of care staff(p=0.002), and contents of oral-hygiene service(p=0.027), and showed significant difference. 5. The service of long-term care insurance for the elderly and the oral-hygiene service indicated the statistically significant correlation. Accordingly, all of dental professionals need to make a desperate effort to improve dental professionals' knowledge on a system of long-term care insurance for the elderly enough to be required a system of long-term care insurance for the elderly. The more systematic and standardized professional education and materials are thought to be needed to be developed aiming at the success in oral-hygiene service within a system of long-term care insurance for the elderly, by strengthening professionalism in dentists and dental hygienists.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.13 no.2
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• pp.95-98
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• 2017

Due to hypodontia, poor oral hygiene, and significantly more prevalent periodontal disease, patients with Down syndrome show higher incidence of edentulism. Oral rehabilitation of such patients is imperative but challenging as high rates of prosthesis failure are reported due to malocclusion, high masticatory force, and parafunctional habits. As CAD/CAM(Computer-Aided Design and Computer Aided Manufacturing) is the recent trend in prosthodontics, this report discusses the application of CAD/CAM in a Down syndrome patient. A 25-year-old patient with Down syndrome was presented to the Department of Pediatric Dentistry, Yonsei University Dental Hospital for oral examination. 5 maxillary teeth were missing, 3 were fully impacted, and 4 had grade III mobility. The patient underwent general anesthesia for extraction of impacted and mobile teeth, implant surgery, and final impression for prosthesis. Afterwards, CAD/CAM was used to design and manufacture a 10-unit zirconia bridge. However the bridge was fractured after 18 months due to the patient's bruxism and high masticatory force. Final impression taking, bite registration, cast fabrication, cast scanning, and prosthesis designing were not needed as CAD/CAM data remained. Previous CAD/CAM design was used to remanufacture the zirconia bridge. Down syndrome patients have malocclusion, high masticatory force, and parafunctional habits which increase the possibility of prosthesis fracture. CAD/CAM is beneficial for Down syndrome patients as previous digital records can be utilized for prosthesis repair or remake. In detail, application of CAD/CAM in remanufacturing decreases patient's discomfort of impression taking, shortens and simplifies dental laboratory procedures, and reduces clinician's effort of taking detailed final impressions or accurate bite registration. In conclusion, oral rehabilitation using CAD/CAM provides not only satisfactory levels of comfort, stability, and esthetics, but also easier repair or remake compared to conventional prostheses.

• Journal of Chest Surgery
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• v.42 no.1
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• pp.9-13
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• 2009

Background: Hypoplastic left heart syndrome is uniformly fatal if this condition is not properly treated. We reviewed the surgical results of treating hypoplastic left heart syndrome, and we evaluated the hemodynamics and functional status of these patients after they underwent a Fontan operation. Material and Method: To assess the surgical results, we retrospectively reviewed the medical records of 6 (M/F=4/2) patients who underwent a staged operation, including a Norwood procedure, a bidirectional Glenn procedure and a Fontan procedure between October 1997 to May 2005. The mean age of the patients was $17.3{\pm}10.8$ days (range: 9~36 days) at the $1^{st}$ staged operation, $8.9{\pm}7.1$ months (4.6~23.3 months) at the $2^{nd}$ staged operation (the Bidirectional Glenn procedure) and $32.4{\pm}9.8$ months at the final staged operation (the Fontan procedure). During the $2^{nd}$ staged operation, one of the patients received tricuspid valve repair due to regurgitation. All the patients underwent an extracardiac Fontan procedure using Gore-Tex conduit (20 mm: 2 patients, 18 mm: 4 patients) and one of them required fenestration. Result: 21 patients underwented a Norwood procedure. There were 7 early deaths and 4 interstage deaths. Bidirectional cavopulmonary shunt was performed in 10 patients and the Fontan procedure was done in 6 (mortality: 1 patient, Flow up loss: 1 patient, Awaiting a Fontan procedure: 2 patients). After the Fontan procedure, there was no complication except for one case of post operative bleedings. All the patients had good ventricular function and 2 had grade I tricuspid regurgitation, as noted on their echocardiography. The average follow up period after the Fontan procedure was $19.6{\pm}14.9$ months (range: 1.5~39.1 month). All the patients had normal sinus rhythm and they were put on aspirin and cardiac medication. During follow up period, all the patients had a good functional status (NYHA functional class I). Conclusion: All the patients who suffered with hypoplastic left heart syndrome and who underwent a Fontan procedure achieved a good hemodynamic and functional status, even though there was a relatively high operative mortality rate after stage I Norwood palliation. Therefore, thise staged operation should be strongly recommended as an important surgical strategy for treating hypoplastic left heart syndrome.

• Journal of Society of Preventive Korean Medicine
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• v.5 no.2
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• pp.40-68
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• 2001

In this study, grade of subjective symptom appealed by laborer of Jeollabuk-do was evaluated using questionary regarding factor made effect on musculoskeletal disease and in addition, studied relationship with health promotion life style of them. Based on the result, relationship of general characteristics of musculoskeletal subjective symptom and life-style of the subjects was concluded as below. 1. General characteristics of study subjects were as following. Ratio of male was higher as 57.7% of male and 42.2% female and age distribution was 5.1% of 20s, 34.99% of 30s, 36.3% of 40s and 23.7% of 50s and therefore, $30{\sim}40$ aged groups showed highest ratio. Most subjects (74.9%) was married status and in case of education level, high-school graduate and dropout (23.3%) and over-college graduate (46.8%) showed highest distribution. $1{\sim}2$ Mil. KRW (29.5%) and $2{\sim}2.99$ Mil. KRW (21.2%) is the main income distribution and however there was high ratio of non-reply (29.0%). In case of employment period, $10{\sim}14$ years (15.3%) and over 15 years (29.6%) showed highest ratio and there were many non-reply (39.4%) and in addition, 67.6% replied as own house and 14.3% as lease on deposit base in question of residence type. 2. Subjects showed high ratio of subjective symptom appeal of 62.79% and many cases (50.23%) appealed 1 or 2 symptoms. Symptom by body region was 29.8% (waist), 27% (shoulder), 21.2% (knee), 15.5% (neck), 9.5% (ankle), 8.1% (wrist) and 5.0% (elbow) in order. In case of relationship with general characteristics, female comparing with male, non-residence of own house, subjects with lower education level and employment period of $10{\sim}14$ years showed higher appeal rate and kind of symptoms than others. Therefore, it was concluded that rate of musculoskeletal symptom appeal have close relationship with gender, level of living, education level, age and employment period. 3. In case of severe pain of upper body except waist and ankle, it was appealed in both or right side and it means that upper body pain is originated from right side and right region pain is transited to both region pain. In addition, there was 39.41% of non-reply to existence of right-left region pain and therefore, it was evaluated that, in may cases, there was no awareness of their own symptom condition even on subjective symptom. 4. Degree of pain was, as pain over middle level, evaluated as 2.79 on full mark of 4.0 and in order of waist (2.97), ankle (2.83), knee (2.82), wrist (2.82), neck (2.79), shoulder (2.70) and elbow (2.62). In addition, 71.97% appealed $2{\sim}3$ cases for the latest 1 week. Owing to subjective symptom, 54.95% drop into hospital or pharmacy, 10.32% made temporary retirement or absence, 7.99% transferred into more comfortable duty and $39.4{\sim}54%$ experienced one or more managing mentioned above. 5. Fulfillment of health promotion life style of subjects was evaluated on full mark of 4.0 and total score was 2.63. Average mark of each area was personal relationship (3.05), self-realization (2.92), stress management (2.63), health control (2.48), physical exercise (2.19) and nutrition management (2.19) and personal relationship was highest and physical exercise and nutrition management were lowest. As general characteristics influencing health promotion life style, gender, residence style and employment period showed significant difference. Male showed higher mark than female and showed higher mark in order of own house, others, lease on deposit base, monthly rent. Subjects with longer employment period showed higher mark with significant difference. 6. Accounting of factor influencing each area of health promotion life style, self-realization showed significance in marriage status, income, residence style and education level and health control in age, residence style and employment period. Physical exercise showed significant difference in gender, age, residence style and employment period and nutrition in gender, age, residence style and employment period. Stress management showed significant difference in residence style and employment period and however not in personal relationship. 7. Health promotion life style relating with existence and kind of pain showed significant difference in all area except personal relationship area. In absence of pain, there was statistically significant high score in all area even in total health promotion life style and all area. Accounting of kind of pain, cases of $1{\sim}2$ kinds of pain and $5{\sim}6$ kinds of pain showed relatively high score and it was lower than mark of subject stated absence of pain. 8. Subjects appeal symptom were classified by symptom region and difference of total and each areas were evaluated. General area (p=0.002), self-realization (p=0.012), health management (p=0.023), physical exercise (p=0.028), nutrition management (p=0.028) and stress control (p=0.001) showed statistically significant difference and not in personal relationship area. Especially, elbow, shoulder and neck area marked high and group appealed pain of knee, arm and elbow, foot and ankle marked low. Based on those results, subjective symptom should be accounted seriously in diagnosis of occupational musculoskeletal disease of laborer and among subjective symptom, general characteristics of gender, age, condition of living, education level and employment period make effect. Generally subject appeal symptom marked lower than subject without symptom appeal and it means that life management of subject appealing musculoskeletal pain make important role in management and treatment of occupational musculoskeletal disease.

• Journal of Radiation Protection and Research
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• v.31 no.4
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• pp.219-235
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• 2006

Based on the fact that studies on the use of radiations have not been largely conducted reflected on the importance of the use of radiations, the survey was performed to investigate the attitude on the use of radiations for some university students who have a high level of knowledges among average persons in order to extract certain directions for the education program to provide right information. The survey was performed for 517 university students from Oct. 10 to Oct. 15, 2005. The results of this survey can be summarized as follows. 1. Students who have experienced in the radiation related education presented statical differences in the results according to the majoring and monthly incomes. 2. Regarding the survey on the attitude of the use of radiations, the item of 'I agree to build a general hospital or university hospital where I lives in' was presented as the highest points of $3.73{\pm}1.004$, and the lowest point was recorded in the item of 'I agree to build an atomic wastes treatment facility where I live in' as the point of $2.63{\pm}1.091$. 3. The level of attitudes on 'I agree to build an atomic power plant or atomic wastes treatment facility where I live in' presented lower levels than that of the attitude on 'I agree to build an atomic power plant or atomic wastes treatment facility in my country'. 4. The lowest level recorded in the level of attitudes on 'I agree to build an atomic wastes treatment facility where I live in 'presented a significant difference according to the sex and grade.

• IMMUNE NETWORK
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• v.6 no.1
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• pp.43-51
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• 2006

Background: The DR-$70^{TM}$ immunoassay is a newly developed cancer diagnostic test which quantifies the serum fibrin degradation products (FDP), produced during fibrinolysis, by antibody reaction. The purpose of this study was to evaluate the potential of DR-$70^{TM}$ Immunoassay in screening malignant tumor. Methods: Sample subjects were 4,169 adults, both male and female, who visited the health promotion center of a general hospital from March 2004 to April 2005 and underwent the DR-$70^{TM}$ immunoassay test and other tests for cancer diagnosis. The patient group was defined as 42 adults out of the sample subjects who were newly diagnosed with cancer during the same time period when the DR-$70^{TM}$ immunoassay test was performed. Final confirmation of a malignant tumor was made by pathological analysis. Results: The mean DR-$70^{TM}$ level was $0.83{\pm}0.65{\mu}g/ml$ (range: 0.00 (0.0001)${\sim}7.42{\mu}g/ml)$ in the control group (n=4,127) as opposed to $2.70{\pm}2.33{\mu}g/ml$ (range: $0.12{\sim}9.30{\mu}g/ml)$ in the cancer group (n=42), and statistical significance was established (p<0.0001, Student t-test). When categorized by the type of malignant tumor, all cancer patients with the exception of the subgroups of colon and rectal cancer showed significantly higher mean DR-$70^{TM}$ levels compared with the control group (p<0.0001, Kruscal-Wallis test). The receiver operating characteristic (ROC) curve analysis revealed ${\geq}1.091{\mu}g/ml$ as the best cut-off value. Using this cut-off value, the DR-$70^{TM}$ immunoassay produced a sensitivity of 71.4%, a specificity of 70.1%, a positive predictability of 69.4%, and a negative predictability of 69.2% (1). Conclusion: A significant increase in the mean DR-$70^{TM}$ value was observed in the cancer group (thyroidal, gastric, breast, hepatic and ovarian) com pared with the control group. In particular, the specificity and sensitivity of the DR-$70^{TM}$ immunoassay was relatively high in the subgroups of breast, gastric, and thyroidal cancer patients. There is need for further studies on a large number of malignant tumor patients to see how the DR-$70^{TM}$ level might be changed according to the differentiation grade and postoperative prognosis of the malignant tumor.