• Journal of Preventive Medicine and Public Health
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• v.31 no.2 s.61
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• pp.323-334
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• 1998

To investigate determinants of health care utilization of the physically disabled over 20 years old in age living in Taegu city, a self-administered questionnaire survey was carried out for 337 disabled persons with chronic illness from April to July, 1997. Health care utilization .ate was 81.9%(69.1% for hospital or clinic and 12.8% for pharmacy). Marital status, job, health concern, and response to illness showed statistically significant relationship with health care utilization(p<0.05). By path analysis, job, economic status, medical security type and response to illness had a significant direct effect on health care utilization(p<0.05), however, health concern and regular source of care had an indirect effect. The reasons of no health utilization were due to economic problem(31.1%), no symptom(18.0%), inconvenience to seek care or no accompanying persons to be helped(14.8%), unseriousness of the severity of the illness(14.8%), too busy to be treated or no free time(8.2%), hopeless prognosis to be treated(6.6%) in order. In conclusion, it is recommended that the program for expanding medicaid, improving socioeconomic status by getting a job and health education to increase the health concern toward physically disabled should be implemented to increase health care utilization rate.

• Childhood Kidney Diseases
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• v.15 no.2
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• pp.163-171
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• 2011

Purpose : To evaluate the prevalence of vesicoureteral reflux (VUR) according to the timing of voiding cystourethrography (VCUG) in infantile urinary tract infection (UTI). Methods : The data of 134 infants (1-12 months) with renal cortical defect in $^{99m}Tc$-2, 3-dimercaptosuccinic acid ($^{99m}Tc$-DMSA) scan with a diagnosis of UTI in two hospitals from 2000 to 2010 were retrospectively analyzed. The VCUG was performed after 2 weeks from the diagnosis of UTI in Group I (n=68), and the VCUG was performed within 2 weeks from the diagnosis of UTI in Group II (n=66). Results : There were no significant differences between the two groups in the duration of fever, white blood cell count, C-reactive protein levels, and abnormalities in ultrasonography (P>0.05). There was no significant difference between the two groups in the prevelence of VUR, bilateral VUR, and severe VUR. VCUG-induced UTI was detected 16 (23.5%) of patients in whom the procedure was performed 2 weeks after the diagnosis, and none of VCUG-induced UTI occurred in those in whom the procedure was performed 2 weeks within the diagnosis. Conclusion : We conclude that the prevalence of VUR according to the timing of VCUG did not differ between the two groups in infantile UTI with renal cortical defect in DMSA scan. We also found that performing VCUG with antibiotics can decrease risk of VCUG-induced UTI.

• Childhood Kidney Diseases
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• v.15 no.2
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• pp.138-145
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• 2011

Purpose : To test whether the expression of ${\beta}$-catenin, a component of podocyte as a filtration molecule, would be altered by puromycin aminonucleoside (PAN) in the cultured podocyte in vitro. Methods : We cultured rat glomerular epithelial cells (GEpC) with various concentrations of PAN and examined the distribution of ${\beta}$-catenin by confocal microscope and measured the change of ${\beta}$-catenin expression by Western blotting and reverse transcriptase-polymerase chain reaction (RT-PCR). Results :We found that ${\beta}$-catenin relocalized from peripheral cytoplasm to inner cytoplasm, therefore, intercellular separations were seen in confluently cultured cells by high concentrations of PAN in immunofluorescence views. In Western blotting of GEpC, PAN ($50{\mu}g/mL$) decreased ${\beta}$-catenin expression by 34.9% at 24 hrs and 34.3% at 48 hrs, compared to those in without PAN condition (P<0.05). In RT-PCR, high concentrations ($50{\mu}g/mL$) of PAN also decreased ${\beta}$-catenin mRNA expression similar to protein suppression by 25.4% at 24 hrs and 51.8% at 48 hrs (P<0.05). Conclusion : Exposure of podocytes to PAN in vitro relocates ${\beta}$-catenin internally and reduces ${\beta}$-catenin mRNA and protein expression, which could explain the development of proteinuria in experimental PAN-induced nephropathy.

• Investigative Magnetic Resonance Imaging
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• v.12 no.2
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• pp.131-141
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• 2008

Purpose : To investigate the feasibility and accuracy of Proton Resonance Frequency (PRF) shift based magnetic resonance (MR) temperature mapping utilizing the self-developed center array-sequencing phase unwrapping (PU) method for non-invasive temperature monitoring. Materials and Methods : The computer simulation was done on the PU algorithm for performance evaluation before further application to MR thermometry. The MR experiments were conducted in two approaches namely PU experiment, and temperature mapping experiment based on the PU technique with all the image postprocessing implemented in MATLAB. A 1.5T MR scanner employing a knee coil with $T2^*$ GRE (Gradient Recalled Echo) pulse sequence were used throughout the experiments. Various subjects such as water phantom, orange, and agarose gel phantom were used for the assessment of the self-developed PU algorithm. The MR temperature mapping experiment was initially attempted on the agarose gel phantom only with the application of a custom-made thermoregulating water pump as the heating source. Heat was generated to the phantom via hot water circulation whilst temperature variation was observed with T-type thermocouple. The PU program was implemented on the reconstructed wrapped phase images prior to map the temperature distribution of subjects. As the temperature change is directly proportional to the phase difference map, the absolute temperature could be estimated from the summation of the computed temperature difference with the measured ambient temperature of subjects. Results : The PU technique successfully recovered and removed the phase wrapping artifacts on MR phase images with various subjects by producing a smooth and continuous phase map thus producing a more reliable temperature map. Conclusion : This work presented a rapid, and robust self-developed center array-sequencing PU algorithm feasible for the application of MR temperature mapping according to the PRF phase shift property.

• Neonatal Medicine
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• v.15 no.2
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• pp.151-159
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• 2008

Purpose : This study determined the prenatal and postnatal factors associated with complications and prognosis in premature infants with leukemoid reaction. Methods : We retrospectively reviewed the medical records of premature infants with gestational ages <37 weeks and low birth weights (<2,500 g) who were admitted immediately after birth to the neonatal intensive care unit at the Dongguk University Ilsan Hospital between June 2005 and July 2006. A leukemoid reaction was defined as an absolute neutrophil count (ANC) >30,000/$mm^3$. The infants who had leukemoid reaction comprised the study group, while the remainder of infants made up the control group. The relationships between maternal and neonatal variables and ANC were studied. Results : Leukemoid reaction was detected in 3.1% of the study infants (8 of 252). Factors more frequently associated with infants with leukemoid reaction were as follows: maternal chorioamnionitis, high levels of maternal and infant C-reactive protein, gestational age <37 weeks, birth weight <2,500 g, low Apgar score, prolonged ventilator support, and a high incidence of bronchopulmonary dysplasia (BPD). However, there were no significant differences with respect to the antenatal usage of steroids, the incidences of patent ductus arteriosus, necrotizing enterocolitis, intraventricular hemorrhage, retinopathy of prematurity, and mortality between the two groups. Conclusion : Leukemoid reaction in premature infants was associated with chorioamnionitis and high levels of serum C-reactive protein in mothers and infants, and BPD in infants. These findings suggest that leukemoid reaction is secondary to inflammation caused by infection.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.1
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• pp.26-34
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• 2009

Purpose: The purpose of this study was to find out what clinicopathologic or immunohistochemical parameter that may affect FDG uptake of primary tumor in PET/CT scan of the gastric carcinoma patient. Materials and Methods: Eighty-nine patients with stomach cancer who underwent pre-operative FDG PET/CT scans were included. In cases with perceptible FDG uptake in primary tumor, the maximum standardized uptake value (SUVmax) was calculated. The clinicopathologic results such as depth of invasion (T stage), tumor size, lymph node metastasis, tumor differentiation and Lauren's classification and immunohistochemical markers such as Ki-67 index, expression of p53, EGFR, Cathepsin D, c-erb-B2 and COX-2 were reviewed. Results: Nineteen out of 89 gastric carcinomas showed imperceptible FDG uptake on PET/CT images. In cases with perceptible FDG uptake in primary tumor, SUVmax was significantly higher in T2, T3 and T4 tumors than T1 tumors ($5.8{\pm}3.1$ vs. $3.7{\pm}2.1$, p=0.002). SUVmax of large tumors (above or equal to 3 cm) was also significantly higher than SUVmax of small ones (less than 3 cm) ($5.7{\pm}3.2$ vs. $3.7{\pm}2.0$, p=0.002). The intestinal types of gastric carcinomas according to Lauren showed higher FDG uptake compared to the non-intestinal types ($5.4{\pm}2.8$ vs. $3.7{\pm}1.3$, p=0.003). SUVmax between p53 positive group and negative group was significantly different ($6.0{\pm}2.8$ vs. $4.4{\pm}3.0$, p=0.035). No significant difference was found in presence of LN metastasis, tumor differentiation, Ki-67 index, and expression of EGFR, Cathepsin D, c-erb-B2 and COX-2. Conclusion: T stage of gastric carcinoma influenced the detectability of gastric cancer on FDG PET PET/CT scan. When gastric carcinoma was perceptible on PET/CT scan, T stage, size of primary tumor, Lauren's classification and p53 expression were related to degree of FDG uptake in primary tumor.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.1
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• pp.40-47
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• 2009

Purpose: Differentiated thyroid cancer (DTC) has variable degree of F-18 FDG avidity. The purpose of this study was to evaluate the relationship between F-18 FDG uptake and pathological or immunohistochemical features of DTC. Materials and Methods: DTC patients who underwent both pre-operative F-18 FDG PET/CT scan and surgery were included in the study. Maximum standardized uptake values (SUVmax) of primary tumor were calculated. If the primary tumor showed no perceptibly increased F-18 FDG uptake, region of interest was drawn based on finding of a portion of the PET/CT images. Pathological and immunohistochemical markers such as presence of lymph node (LN) metastasis and underlying thyroiditis, tumor size, Ki-67 labeling index, expressions of EGFR, COX-2, and Galectin-3 were evaluated. Results: Total of 106 patients was included (102 papillary carcinomas, 4 follicular carcinomas). The mean SUVmax of the large tumors (above 1 cm) was significantly higher than the mean SUVmax of small (equal to or less than 1 cm) ones ($7.8{\pm}8.5$ vs. $3.6{\pm}3.1$, p=0.004). No significant difference in F-18 FDG uptake was found according to the presence or absence of LN metastasis and underlying thyroiditis, or the degree of Ki-67 labeling index, expression of EGFR, COX- 2 and Galectin-3. Conclusion: In conclusion, the degree of F-18 FDG uptake in DTC was associated with the size of primary tumor. But there seem to be no relationship between F-18 FDG uptake of DTC and expression of Ki-67, EGFR, COX-2 and Galectin-3.

• Therapeutic Science for Rehabilitation
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• v.9 no.1
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• pp.69-78
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• 2020

Objective : The purpose of this study was to conduct a comprehensive survey of children's play in parents of disabled and non-disabled children prior to commencing school. This study aimed to further understanding play recognition and to present a specific direction of play necessary to each parent. Methods : A questionnaire based on prior studies was sent to 700 people who had previously agreed to the take part. A total of 596 questionnaires were analyzed. Uncollected and insincere surveys, of which 106 were questionnaires for parents of disabled children, were exclused from analysis. The SPSS Window 23 program was used for data analysis and frequency analysis and the independent sample T test were performed. Results : Disabled children's parents perceived playing with their children as more important than that of non-disabled children's parents(p<0.01). There was no statistical difference between disabled children and non-disabled children's parents, but there were some differences(p=0,053). Both disabled and non-disabled children had more time to participate with their mothers than with their fathers. Mothers with disabilities had more time to play however, fathers with no disabilities had more time. Both disabled and non-disabled children's parents had the most "ordinary" frequency of buying toys and there was very littele difference between the 2 groups. Both disabled and non-disabled children's parents primarily used the internet to acquire play information, and consideration when buying fun was followed by interest inducement, development level and safety. Conclusion : Through this study, it was possible to compare the status of play recognition and participation by parents of children with or without disabilities. Based on this study, parents will be able to find out what they really need to play and will be provided as a basis for future play studies for children.

• Therapeutic Science for Rehabilitation
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• v.9 no.1
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• pp.24-44
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• 2020

Objective : To develop an occupation-based bilateral upper extremity training protocol that can be effectively applied in a medical setting Methods : The research process using the delphi technique was carried out in 3 stages. The first stage was an open questionnaire development stage, The first draft is prepared through literature review and open questions were developed through preliminary research based on the draft. The second stage was the delphi survey. Based on the responses of the experts obtained through the open Delphi survey, the adequacy of the training protocol was shown on a Likert 5 point scale. The items were edited and deleted, reconstructed by analyzing the mean and standard deviation, stability, convergence degree, consensus, and content validity ratio through the questionnaire. The third step was the completion of the protocol. After discussions between researchers, the finalized protocol contents were reorganized to complete the occupation-based bilateral upper extremity training protocol for medical setting. Results : The final protocol consisted of 9 items across 3 areas in the occupation-based intervention selection domain and 81 items across 4 areas in the bilateral upper extremity training domain, intervention period, and evaluation. Conclusions : This study suggests an evidence-based method that collects the opinions of occupational therapists in order to use occupation-based activities as interventions in a situation that currently sees occupational therapy primarily performed in hospitals. It is also meaningful that the bilateral upper extremity training can be applied effectively in clinical situations by concretely presenting.

• Journal of agricultural medicine and community health
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• v.15 no.2
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• pp.97-106
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• 1990

1. Background Women's health and their involvement in health care are essential to health for everyone. If they are ignorant, malnourished or over-worked, the health &-their families as well as their own health will suffer. Women's health depends on broad considerations beyond medicine. Among other things, it depends upon their work in farming. their subordination to their families, their accepted roles, and poor hygiene with poorly equipped housing and environmental sanitation. 2. Objectives and Contents a. The health status of rural women : physical and mental complaints, experience of pesticides intoxication, Farmer's syndrome, experiences of reproductive health problems. b. participation in and attitudes towards housework and farming c. accessibility of medical care d. status of maternal health : fertility, family planning practice. induced abortion, and maternal care 3. Research method A nationwide field survey, based on stratified random sampling, was conducted during July, 1986. Revised Cornell Medical index(68 out of 195 items). Kawagai's Farmers Syndrome Scale, and self-developed structured questionnaires were used to rural farming wives(n=2.028). aged between 26-55. 4. Characteristics of the respondents mean age : 40.2 marital status : 90.8% married mean no. of household : 4.9 average years of education : 4.7 yrs. average income of household : \235,000 average years of residence in rural area : 36.4 yrs average Working hours(household and farming) : 11 hrs. 23 min 5. Health Status of rural women a. The average number of physical and mental symptoms were 12.4, 4.7, and the rate of complaints were 22.1%, 38.8% each. revealing complaints of mental symptomes higher than physical ones. b. 65.4% of rural women complained of more than 4 symptoms out of 9, indicating farmer's syndrome. 11.9 % experienced pesticide overdue syndrome c. 57.6% of respondents experienced women-specific health problems. d. Age and education of respondents were the variables which affect on the level of their health 6. Utilization of medical services a. The number of symptoms and complaints of respondents were dependent on the distance to where the health-care service is given b. Drug store was the most commonly utilized due to low price and the distance to reach. while nurse practitioners were well utilized when there were nurse practitioner's office in their villages. c. Rural women were internalized their subordination to husbands and children, revealing they are positive(93%) in health-care demand for-them but negative(30%) for themselves d. 33.0% of respondents were habitual drug users, 4.5% were smokers and 32.3% were alcohol drinkers. and 86.3% experienced induced-abortion. But most of them(77.6%) knew that those had negative effects on health. 7. Maternal Health Care a. Practice rate of contraception was 48.1% : female users were 90.9% in permanent and 89.6% in temporary contraception b. Induced abortions were taken mostly at hospital(86.3%), while health centers(4.7%), midwiferies(4.3%). and others(4.5%) including drug stores were listed a few. The repeated numbers of induced abortion seemed affected on the increasing numbers of symptoms and complaints. c. The first pre-natal check-up during first trimester was 41.8%, safe delivery rate was 15.6%, post-natal check-up during two months after delivery. Rural women had no enough rest after delivery revealing average days of rest from home work and farming 8.3 and 17.2. d. 86.6% practised breast feeding, showing younger and more educated mothers depending on artificial milk 8. Recommendations a. To lessen the multiple role over burden housing and sanitary conditions should be improved, and are needed farming machiner es for women and training on the use of them b. Health education should begin at primary school including health behavior and living environment. c. Women should be encouraged to become policy-makers as well as administrators in the field of women specific health affairs. d. Women's health indicators should be developed and women's health surveillance system too.