• Title/Summary/Keyword: Korean national guidelines

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The Clinical Characteristics, Diagnosis, Treatment, and Outcomes of Patients with Tuberculosis at a Private University Hospital in Korea (국내 한 민간종합병원에서 결핵 환자의 진료 실태)

  • Jung, Young Ju;Park, I-Nae;Hong, Sang Bum;Oh, Yeon-Mok;Lim, Chae-Man;Lee, Sang Do;Koh, Younsuck;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Shim, Tae Sun
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.2
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    • pp.194-204
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    • 2006
  • Background : Even though tuberculosis (TB) is still a major public concern in Korea, there is little data on the management of TB patients and its outcomes in the private sector. This study evaluated the status of TB treatment in the private sector. Methods : Sixteen-hundred-sixty-six TB patients who were notified in a private university hospital from 2001 to 2002 were enrolled in this study. The patients were divided into pulmonary ($TB_P$), extrapulmonary ($TB_E$), and combined ($TB_{P+E}$) groups, and were also divided into initial and retreatment groups. The clinical characteristics, diagnostic methods, treatment regimens, and outcomes were analyzed and compared. Results : The mean age of the 1,666 patients was 48.9 years and the male-to-female ratio was 1.3:1. The number of patients in the initial and retreatment groups of $TB_P$, and those of ($TB_E+TB_{P+E}$) were 809, 276, 480, 101, respectively. A bacteriological study was performed in 92.0% of cases, and a positive culture was confirmed in 58.1% and 31.7% of patients with TBP and ($TB_E+TB_{P+E}$), respectively (p<0.05). The AFB smear was positive in 45.4 % of the $TB_P$ patients. PCR was carried out in 60.4% of the ($TB_E+TB_{P+E}$) group. The MDR was detected in 14.0% of isolates. Overall, the treatment completion, default, and death rates were 70.2%, 13.5% and 1.9%, respectively. Conclusion : Even though the management of TB patients in a private hospital was satisfactory in terms of the national guidelines, the high default rate was is still a problem. Efforts to decrease the default rate either independently or in cooperation with the public sector will be needed.

Clinical Value of a Desktop Spirometer (HI-801) for Spirometry Screening (선별 검사를 위한 탁상용 폐활량기 (HI-801)의 임상적 유용성에 관한 고찰)

  • Choi, Hye Sook;Choi, Cheon Woong;Park, Myung Jae;Kang, Hong Mo;Yoo, Hong Ji
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.4
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    • pp.276-283
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    • 2007
  • Background: A national health care initiative recommends routine spirometry screening of all smokers over age 45 or patients with respiratory symptoms. In response to the recommendation, new, simple, and inexpensive desktop spirometers for the purpose of promoting widespread spirometric screening were marketed. The performance of these spirometers was evaluated in vivo testing with healthy subjects. However, the clinical setting allows spirometric assessment of various pathologic combinations of flow and volume. Objective: The aim of this study was to compare the accuracy of a desktop spirometer to a standard laboratory spirometer, in a clinical setting with pathologic pulmonary function. Method: In a health check-up center, where screening pulmonary funct test was performed using the HI-801 spirometer. Subjects who revealed the ventilation defect in screening spirometry, performed the spirometry again using the standard Vmax spectra 22d spirometer in a tertiary care hospital pulmonary function laboratory. Pulmonary function test with both spirometer was performed according to the guidelines of the American Thoracic Society. Results: 109 patients were enrolled. Pulmonary function measurements (FVC, $FEV_1$, PEFR, FEF25%-75%) from the HI-801 correlated closely (r=0.94, 0.93, 0.81, 0.84, respectively) with those performed with the Vmax spectra 22d and showed the good limits of agreement and differences between the 2 devices; FVC +0.35 L, $FEV_1$ +0.16 L, PEFR +1.85 L/s, FEF25%-75%-0.13 L/s. With the exception of $FEV_1$, FEF25%-75%, these differences were significant(p<0.05) but small. Conclusion: The HI-801 spirometer is comparable to the standard laboratory spirometer, Vmax spectra 22d, with high accurary for $FEV_1$ and FVC and acceptable differences for clinical use.

Evaluation of a Community-Based Cancer Patient Management Program: Collaboration between a Hospice Center and Public Health Centers (병원 호스피스센터-보건소 연계를 통한 지역사회 재가암환자 관리 프로그램 평가)

  • Lee, Hae-Sook;Park, Sun-Hee;Chung, Young-Soon;Lee, Boo-Kyung;Kwon, So-Hi
    • Journal of Hospice and Palliative Care
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    • v.13 no.4
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    • pp.216-224
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    • 2010
  • Purpose: The purpose of this study was to evaluate a community-based cancer patient management program (CBPCMP) which was collaborated between a hospice center and public health centers. Methods: The CBPCMP proceeded on four steps; 1) Signing agreements with three public health centers, 2) Enrolling the domiciliary terminal cancer patients, 3) Providing home hospice service, and 4) Inquiring patient's level of satisfaction. From February 1 to December 31 in 2009, 43 terminal cancer patients were referred and provided with home hospice service. The hospice team made a total of 605 visits. Medical records for each visit and data from satisfaction surveys were analyzed. Results: 76.7% of patients were older than 60 years, and 90.7% of the patients were alert. The level of functional status for 76.7% of patients rated as lower than ECOG grade 1. 62.8% of the patients or their caregivers signed hospice service agreements. On the initial evaluation, the most frequent reasons for referral were general weakness (86.0%), followed by anorexia (72.1%). Nurses visited the patients' most frequently (371 visits), followed by volunteers (216 visits). Nurses provided emotional support and health promotion counseling on 95.1% and 22.9% of visits, respectively. The mean satisfaction score rated by patients and their family was 4.45 out of 5. Conclusion: This study tested CBPCMP in collaboration with hospice centers and public health centers. CBPCMP showed a possibility to improve the quality of end of life care. To insure the quality care, however, the guidelines for home hospice service should be developed.

Clinical characteristics of vitamin D deficiency rickets in infants and preschool children (비타민 D 결핍성 구루병 영.유아의 임상적 특징)

  • Huh, Kyoung;Woo, Mi Kyeong;Yoon, Jung Rim;Shim, Gyu Hong;Chey, Myoung Jae;Park, Mi Jung
    • Clinical and Experimental Pediatrics
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    • v.53 no.2
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    • pp.152-157
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    • 2010
  • Purpose : Vitamin D deficiency rickets is a significant public health problem that results from insufficient exposure to sunlight and inadequate vitamin D supplementation. The purpose of this study is to identify the clinical characteristics of vitamin D deficiency rickets in infants. Methods : Data of 35 infants diagnosed as vitamin D deficiency rickets at Sanggye-Paik Hospital, Seoul, Korea, from March 2007 to May 2009 were reviewed. Children with plasma 25-hydroxyvitamin D levels <15 ng/mL and 15-30 ng/mL were considered to have vitamin D deficiency and vitamin D insufficiency, respectively. Results : Thirty-five infants (22 boys, 13 girls) were diagnosed with rickets. Mean age at diagnosis was $7.4{\pm}7.1$ months (range: 0.1-29.8 months). Eighteen infants (51%) were vitamin D deficient and seventeen infants (49%) were insufficient. Twenty-eight of all (80%) diagnosed as subclinical rickets. Twenty-nine infants (83%) were below the age of 12months. Twenty infants (57%) had breastfed and ten infants (29%) had iron deficiency anemia. Nine of breastfed infants (45%) were vitamin D deficient and ten of their mothers were vitamin D insufficient. Overall, radiographic evidence of rickets was present in 93% of the cases. Radiographic sign of rickets was evident even in vitamin D insufficient state. Conclusion : It is important for the clinician to screen for subclinical vitamin D deficiency rickets in inadequately supplemented infants by pairing 25-hydroxyvitamin D levels with wrist radiographs. A nationwide epidemiological study of vitamin D deficiency rickets must be conducted and evidence-based national guidelines must be defined to prevent rickets.

Iconography and Symbols of the Gwandeokjeong Pavilion Murals in Jeju (제주 관덕정(觀德亭) 벽화의 도상과 표상)

  • Kang, Yeongju
    • Korean Journal of Heritage: History & Science
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    • v.53 no.3
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    • pp.258-277
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    • 2020
  • The purpose of this paper is to examine the paintings and symbols of the Jeju Guandeokjeong murals, Treasure No. 322. Gwandeokjeong Pavilion in Jeju is one of the oldest buildings in Jeju and was built in 1448 during the reign of King Sejong (世宗) of the Joseon Dynasty to serve as a training ground for soldiers. Unlike Gwandeokjeong Pavilions in other regions, Jeju's Gwandeokjeong Pavilion has a long history and is of cultural value due to its beautiful architecture. In addition, it contains various murals which are a further source of attention. There are four murals on the front and back of the two Lintels on the left and right sides of the building. Their contents include of 『The Three Kingdoms (三國志)』 and and on the back. Towards the right, is depicted, with on the back. Based on a replica of the murals from 1976, the plan, style, and age of the Gwandeokjeong Pavilion murals have been studied, together with their meanings. The contents of the mural are broadly divided into five parts, which are identified by the tacit signatures atop the screen, which provide such details as the painting titles. The paintings on the left and right sides of the center appear to inspire the spirit of the military's commerce in order to boost soldiers' morale, protect the country, and protect the people in line with the purpose of Gwandeokjeong Pavilion. The following and figuratively depict guidelines for the behavior and mindset of officials. In particular, is a painting concerned with concepts of longevity and an auspicious (吉祥), which shows how court paintings became popular as folk paintings at that time. The paintings of tangerines and other specialties of Jeju Island, the ritual paintings of Jeokbyeokdaejeon, and the expressions of Mt. Halla (漢拏山) and Oreum (오름) indicate the existence of Jeju artists that belonged to the Jeju government office at that time. The five themes and styles of the murals also show that the murals of Gwandeokjeong Pavilion were produced in the late 19th and early 20th centuries.

A Study on the Guideline Amounts of Sugar, Sodium and Fats in Processed Foods Met to Children's Taste (어린이 기호식품의 당, 나트륨 및 지방류의 영양기준안 설정에 관한 연구)

  • Choi, Young-Sun;Chang, Nam-Soo;Joung, Hyo-Jee;Cho, Sung-Hee;Park, Hye-Kyung
    • Journal of Nutrition and Health
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    • v.41 no.6
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    • pp.561-572
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    • 2008
  • Currently, Korea is facing dramatic nutrition transition among children, which may increase risk of degenerative diseases due to excessive intakes of fats, sugars and sodium. Promotion of eating healthier foods among children is difficult because the present nutrition label is not easily understood. Therefore, to promote healthier foods this study was aimed at developing guidance of standard amounts of high, medium and low levels of sugars, sodium, fats and other components contained in foods or drinks that are promoted to or formulated for consumption by children. Multipronged approach was used to collecting information, including key word searches in Medline and other databases, internet searches, reports from world organization, and contact of key individuals who work in organizations. We reviewed dietary reference intakes for Koreans, nutrient reference values, nutrient content claims of nutrition labeling, guideline daily amounts of United Kingdom, dietary guidelines and consumption data of nutrients, and selected components for labeling. And we decided goals of guideline daily amounts for children and nutrient criteria to underpin the high, medium and low content of each component. Then we collected data on processed foods sold at 12 middle schools and 11 high schools in Seoul, and classified processed foods into food category. Sales per one student per day were in the order of snacks, breads, and non-carbonated drinks. One hundred forty five mostly consumed products were selected and classified into criteria of high, medium and low total fat or sodium. Eighty five(58.6%) were classified into high fat food and only 11(7.6%) into high sodium food, in case that the base is chosen per 100 g or 100 mL. In conclusion, the nutrient criteria and choice of 100 g base, which we suggest in this study, need to be tested by simulation with more processed foods and refined in view of the practical issues suggested by stakeholders in future.

An Analysis of Factors That Affect Image Quality Deterioration in The Potable X-ray Examination on using Digital Wireless Detector (디지털 무선 검출기를 이용한 이동형 X선검사에서 영상품질 저하의 요인분석)

  • Yu, Young-Eun;Lim, Cheong-Hwan;Ko, Joo-Young
    • Journal of radiological science and technology
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    • v.37 no.2
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    • pp.93-100
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    • 2014
  • Recently the development of portable digital wireless imaging system, which acquires digital radiation images by using wireless LAN telecommunications function in an easy and fast way, provides lots of convenience for people. Considering the characteristics of portable imaging tests on emergency and critical patients, this study aims to suggest guidelines for Digital wireless detector by evaluating the effect of de-centering of focus-grid and displacement of subject in detector on the quality of image. The equipments used for this study were Elmo-T6 Digital Mobile X-ray system (SIMAZU Corp.), el' Tor ($14{\times}17$ "Wireless detector), Grid (10:1) and Chest & head phantom. After acquiring post-processing image according to dose increase and de-centering image of grid-focus and head phantom displacement image, this study compared, analyzed and evaluated these images by using a digital image analysis program by Image J. In the change of images based on dose increase, images were rough in the dose of 0.5 mAs, while there was no difference among images in the proper dose of 1~2 mAs and, especially from 2.5 mAs, average value of pixels radically decreased, affecting contrast. Over 3 mAs, contrast dropped due to saturation phenomenon of lungs. As the result of analysis using Image J program, with the increase of displacement between focus-grid and head phantom, the frequency of low pixel value also increase, causing the outline of surface image to disappear, which in turn affects contrast. For better quality imaging, a radiographer must be aware before the time of test that the image quality can be changed based on the critical patient's posture, movement, respiration, displacement of X-ray tube and distance of imaging.

The Study about Developing More Rational Valuation Model to the Early Stage Companies (초기기업에 대한 정량적 가치평가 모델 구축에 관한 탐색적 연구)

  • Kang, Sang-Wook;Yang, Young-Seok;Yang, Soo-Hee
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.12 no.4
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    • pp.15-24
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    • 2017
  • The major goal of this paper falls on developing new rational valuation model, to help companies and investors in the early stage of growth as to preparing and negotiating valuation of investment, by applying new reasonable discount indexes of calculating Discount Cash Flow in valuation of the start-up which has been recognized the critical fatal flaws of DCF with them. There are three specific studies done in this paper. First, this paper found the solid and viable bases of rational discount indexes as to applying DCF in valuing companies in the early growth stage with reviewing the previous studies including Berkus method, Scorecard Method, and Risk factor Summation method classified the most effective tools of valuing pre-revenue generating companies. Second, this paper quoted and analyzed the previous models and studies, so called, 'DCF-Prime' of applying DCF method as to value companies in the early growth stage by taking all risk factors innate to the companies in the early growth stage as the discount rate Beta coefficient. Third, this paper propose more viable and solid valuation models, so called, 'DCF-Plus'of combing all validated valuation factors in Berkus, Scorecard, and Risk Factor Summation methods into applying separate discount bracket after DCF Valuation over the companies in the early growth stage instead of taking them as the factors of discount rate, beta coefficient, like the previous model of DCF-Prime. DCF-Plus mainly developed in this paper will not only provide more rational valuation bases as to investment negotiation between companies and investors in the early growth stage, but also providing more accountable guidelines to companies in the early growth as to prepare investment raising and accelerating their company's value by themselves.

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The Introduction of the Concept of "Original Form" to the Heritage Conservation and Management and the Establishment and Development of the Principle of "Maintaining the Original Form" (한국의 문화재 보존·관리에 있어서 원형개념의 유입과 원형유지원칙의 성립, 그리고 발달과정)

  • Lee, Su Jeong
    • Korean Journal of Heritage: History & Science
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    • v.49 no.1
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    • pp.100-119
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    • 2016
  • The concept of "original form" and the principle of "maintaining the original form" take center stage in conservation, management, and promotion of the domestic heritage. Introduced in the 20th century, there were little discussion or deliberation about the concept of "original form" therefore it remains a vague and somewhat abstract notion subject to individual interpretation. Without a specified practical meaning, "maintaining the original form" became the fundamental principle for heritage conservation and management in the 1999 version of the Cultural Heritage Protection Act, engendering difficulties in applying the principle in practice. Conceived as an important first step toward resolving the issues stemming from the indistinct concept of "original form," this paper explores the process through which the concept was introduced to Korea and then established and developed as a legal principle for heritage conservation, management, and promotion. While the examination of the related documents and various cases shows that the development of the concept of "original form" has centered on specific periods and architectural styles, this essay explicates that the notion "original form" is commonly used as a term referring to the form at the earliest possible temporality. It also explains that this view emanates from perceiving heritages not as multivalent objects, but as a material object that exclusively carries aesthetic and, more importantly, historical value, and that comes from the history awareness of the times. This essay suggests that the concept "original form" should be reestablished with full consideration of the diverse values of heritage and diverse forms through which heritage can be expressed. After reviewing the feasibility and practicality of the concept a set of concrete guidelines should be presented for application in practice.

A Study on the Present Condition and Improvement of Cultural Heritage Management in Seoul - Based on the Results of Regular Surveys (2016~2018) - (서울특별시 지정문화재 관리 현황 진단 및 개선방안 연구 - 정기조사(2016~2018) 결과를 중심으로 -)

  • Cho, Hong-seok;Suh, Hyun-jung;Kim, Ye-rin;Kim, Dong-cheon
    • Korean Journal of Heritage: History & Science
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    • v.52 no.2
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    • pp.80-105
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    • 2019
  • With the increasing complexity and irregularity of disaster types, the need for cultural asset preservation and management from a proactive perspective has increased as a number of cultural properties have been destroyed and damaged by various natural and humanistic factors. In consideration of these circumstances, the Cultural Heritage Administration enacted an Act in December 2005 to enforce the regular commission of surveys for the systematic preservation and management of cultural assets, and through a recent revision of this Act, the investigation cycle has been reduced from five to three years, and the object of regular inspections has been expanded to cover registered cultural properties. According to the ordinance, a periodic survey of city- or province-designated heritage is to be carried out mainly by metropolitan and provincial governments. The Seoul Metropolitan Government prepared a legal basis for commissioning regular surveys under the Seoul Special City Cultural Properties Protection Ordinance 2008 and, in recognition of the importance of preventive management due to the large number of cultural assets located in the city center and the high demand for visits, conducted regular surveys of the entire city-designated cultural assets from 2016 to 2018. Upon the first survey being completed, it was considered necessary to review the policy effectiveness of the system and to conduct a comprehensive review of the results of the regular surveys that had been carried out to enhance the management of cultural assets. Therefore, the present study examined the comprehensive management status of the cultural assets designated by the Seoul Metropolitan Government for three years (2016-2018), assessing the performance and identifying limitations. Additionally, ways to improve it were sought, and a DB establishment plan for the establishment of an integrated management system under the auspices of the Seoul Metropolitan Government was proposed. Specifically, survey forms were administered under the Guidelines for the Operation of Periodic Surveys of National Designated Cultural Assets; however, the types of survey forms were reclassified and further subdivided in consideration of the characteristics of the designated cultural assets, and manuals were developed for consistent and specific information technologies in respect of the scope and manner of the survey. Based on this analysis, it was confirmed that 401 cases (77.0%) out of 521 cases were generally well preserved; however, 102 cases (19.6%) were found to require special measures such as attention, precision diagnosis, and repair. Meanwhile, there were 18 cases (3.4%) of unsurveyed cultural assets. These were inaccessible to the investigation at this time due to reasons such as unknown location or closure to the public. Regarding the specific types of cultural assets, among a total of 171 cultural real estate properties, 63 cases (36.8%) of structural damage were caused by the failure and elimination of members, and 73 cases (42.7%) of surface area damage were the result of biological damage. Almost all plants and geological earth and scenic spots were well preserved. In the case of movable cultural assets, 25 cases (7.1%) among 350 cases were found to have changed location, and structural damage and surface area damage was found according to specific material properties, excluding ceramics. In particular, papers, textiles, and leather goods, with material properties that are vulnerable to damage, were found to have greater damage than those of other materials because they were owned and managed by individuals and temples. Thus, it has been confirmed that more proactive management is needed. Accordingly, an action plan for the comprehensive preservation and management status check shall be developed according to management status and urgency, and the project promotion plan and the focus management target should be selected and managed first. In particular, concerning movable cultural assets, there have been some cases in which new locations have gone unreported after changes in ownership (management); therefore, a new system is required to strengthen the obligation to report changes in ownership (management) or location. Based on the current status diagnosis and improvement measures, it is expected that the foundation of a proactive and efficient cultural asset management system can be realized through the establishment of an effective mid- to long-term database of the integrated management system pursued by the Seoul Metropolitan Government.