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Isolated Volume Response to a Bronchodilator and GOLD Classification in Patients with COPD (만성 폐쇄성 폐질환 환자에서 기관지확장제의 사용에 따른 단독 폐용적 반응 (isolated volume response)과 GOLD 분류와의 관계)

  • Hur, Gyu Young;Lee, Seung Hyeun;Jung, Jin Yong;Kim, Se Joong;Lee, Kyoung Ju;Lee, Eun Joo;Jung, Hye Cheol;Lee, Sung Yong;Lee, Sang Yeub;Kim, Je Hyeung;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung-Ho;Yoo, Se Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.1
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    • pp.23-29
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    • 2005
  • Background : Chronic obstructive lung disease is characterized by smoke-related, gradually progressive, fixed airflow obstructions. However, some studies suggested that a reversible bronchial obstruction is common in chronic obstructive lung disease. Such reversibility persists despite the continued treatment with aerosolized bronchodilators and it appears to be related to the diminution in symptoms. The isolated volume response to a bronchodilator is defined as a remarkable increase in the FVC in response to the administration of a bronchodilator whereas the $FEV_1$ remains unchanged. This has been suggested in patients with severe emphysema. Therefore, the aim of this study was to determine the relationship between the response to a bronchodilator and the severity of an airflow obstruction in COPD patients using the GOLD classification. Methods : This study examined 124 patients with an airway obstruction. The patients underwent spirometry, and the severity of the airflow obstruction was classified by GOLD. The response groups were categorized by an improvement in the FVC or $FEV_1$ > 12%, and each group was analyzed. Results : Most subjects were men with a mean age of $65.9{\pm}8.5$ years. The mean smoking history was $41.26{\pm}20.1$ pack years. The isolated volume response group had relatively low $FEV_1$ and FVC values compared with the other groups. (p<0.001) Conclusion : In this study, an isolated volume response to a bronchodilator is a characteristic of a severe airway obstruction, which is observed in patient with a relatively poorer baseline lung function.

Factors Affecting Intention to Experience of 6th Industry (6차 산업 체험 의향에 영향을 미치는 요인에 관한 연구)

  • Choi, Yang-ae
    • Journal of Venture Innovation
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    • v.3 no.1
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    • pp.117-142
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    • 2020
  • The purpose of this study is to explore the factors affecting the 6th industry experience by Schmitt experience model. The newly introduced variables are the cognitive experience, emotional experience, and social experience that are reconstructed based on Schmitt's experience theory and gender, family as a moderrating variable and trust as a mediation variable. In addition to experience intention. The hypothesis was set as follows. the experience factors that are the cognitive factor, the emotional factor, and the social factor will have a positive(+) influence on the intention to experience. Mooring factors will have a negative(-) effect on intention to experience. For statistical analysis, SPSS 24 and AMOS 23 statistical packages were used to test the research hypothesis. The research was based on 320 questionnaire data and tested by 314 valid responses were analyzed. As a result of the research, First, cognitive, emotional, and social factors had positive(+) effects on experience intention. Among the factors that directly affect the experience intention, the magnitude of influence appeared in the order of cognitive factors > social factors > emotional factors > mooring factors. Second, mooring factors have negative(-) effects on experience intention. Third, Trust has been partially influenced by factors of attraction, cognitive, emotional, and social. Fourth, there are significant statistical differences between men and women in cognitive and mooring factors in the path differences. Fifth, Social factors and mooring factors differed significantly in the composition of the household. Social factors with significant differences in path analysis have also been statistically demonstrated. The results of this study are academically verified that the cognitive, emotional, and social factors have an important influence on the experience intention in the 6th industry experience and the Schmitt's experience model proposed in this study is useful framework of analysis. In practical terms, it could provide implications for what factors should be strategically and marketingly focused to activate the 6th industry experience.

Malignant Melanoma (악성 흑색종)

  • Rhee, Seung-Koo;Kang, Yong-Koo;Park, Won-Jong;Chung, Yang-Guk;Lee, Hyuk-Je
    • The Journal of the Korean bone and joint tumor society
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    • v.7 no.1
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    • pp.13-19
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    • 2001
  • Background : The incidence of malignant melanoma is currently increasing at a rate greater than any other cancer occuring in human. At this time, early diagnosis and surgical excision were the mainstay of treatment for patients with malignant melanoma. We reviewed the results of average 4 years of follow-up after surgical excision of total 16 cases of malignant melanoma since 1985. Materials and Methods : There were 16 patients (mean age 58.5 years, 5 men, 11 women). The site of the primary lesion was foot and toe (6), back (3), hand (2), thigh (2), shoulder (1), lower abdomen (1) and lip (1). The lymph node was involved at 9 patients. The histologic diagnosis was made with H-E, S-100 stain, and HMB-45 stain as a special stain. Results : Histologically, there were Clark's stage I for 3 patients, II in 4, III in 2, IV in 3, and stage V in 4 patients. The wide excision only greater than 2cm margin was performed for 4 patients. The wide excision and lymph node dissection were performed for 4 patients. The amputation was only performed for 3 patients, and the amputation and lymph node dissection were performed for 5 patients. After surgical excision, chemotherapy was done with Taxol for each 2 patients of stage IV and V. After long term follow-up for mean 4 years, 4 patients died related with melanoma, 1 patient was recurred, and 11 patients were cured. Conclusion : The incidence of malignant melanoma was rare in Korea, but early involvement of lymph node at initial diagnosis was found in many cases (9/16, 56%). And then, early detection and appropriated excision as well as careful dissection of adjacent lymph nodes will offer the patient the best chance for cure.

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Health-Related Behaviors and Nutrient Intake of Police Officers Based on the Level of Job Stress (일부 지역 경찰공무원의 직무스트레스 정도에 따른 건강관련 형태 및 영양소 섭취량에 관한 연구)

  • Joo, Hye-Eun;Sohn, Cheong-Min
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.39 no.4
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    • pp.518-525
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    • 2010
  • The purpose of the study was to examine health-related behaviors and nutrient intake in relation to job stress level of police officers. Total of 166 police officers working in Jeonbuk area participated in the study. The study was conducted from February to March, 2009. Subjects were given self-administered questionnaire on their general health status, dietary and health-related habits. Nutrient intake was assessed by semi-quantitative food frequency questionnaire. Subjects were divided into four groups (very low, low, high, very high) by their job stress level scores. Main concerns of job stress were from 'job demand', 'organizational system' and 'lack of reward'. More than 95% of the subjects were confident of their health status. Health habits, such as drinking, smoking and exercising, were better than that of average Korean men. There were significant differences in dietary habits in relation to job stress level. Lower job stress group showed lower rate of skipping breakfast (p<0.01), more affordable meal time (p<0.05) and better snacking habits (p<0.001). Sweet food preference was higher in lower job stress group (p<0.05). The average calorie intake was $2063\pm532.7$ (88.5% of EER) and there was no significant difference in nutrient intake among job stress levels. However, mean intake of calcium and vitamin $B_2$ was less than 75% of %DRI in higher job stress group. Therefore, further support in nutritional counseling programs to improve dietary behaviors and health habits and to reduce job concerned stress of the police officers will be necessary.

A Clinical Study of Protruding Lesions That Arise at the Scar of an Endoscopic Mucosal Resection for an Early Gastric Carcinoma and a Gastric Flat Adenoma (위 편평선종 및 조기위암에서 내시경적 점막절제술 후 절제부위에서 발생한 융기형 병변에 관한 임상적 고찰)

  • Cheon Young Koog;Ryu Chang Beom;Ko Bong Min;Kim Jin Oh;Cho Joo Young;Lee Joon Seong;Lee Moon Sung;Jin So Young;Shim Chan Sup
    • Journal of Gastric Cancer
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    • v.1 no.1
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    • pp.55-59
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    • 2001
  • Purpose: Several studies of an endoscopic mucosal resection(EMR) have been reported, but reports about benign protruding lesions that arise at the scar of EMR for early gastric cancer (EGC) or a gastric adenoma are rare. The purpose of this study was to elucidate endoscopic and histological characteristics of benign protruding lesions which arise at the scar of an EMR for EGC and a gastric flat adenoma. Materials and Methods: In 101 lesions (73 gastric flat adenomas and 28 EGCs) from 96 patients, 16 lesions developed new protruding lesions that arose at the scar of the EMR. We retrospectively analyzed the endoscopic findings of initial and protruding lesions, and several other clinical factors (H. pylori infection, eradication therapy, and proton pump inhibitor (PPI) or H2-blocker use). Results: 1. The mean duration until detection of the protruding lesion was 8.9 months ($1.5\∼27$). Protruding lesions arose at the scar of the EMR in 1 of 28 EGCs ($3.6\%$) and from 15 of 73 gastric flat adenomas ($20.5\%$). All of the patients were men. 2. With respect to the endoscopic findings, the shapes of the protruding lesions were as follows: 10 Yamada (Y) I, 4 Y-II, 1 Y-III, and 1 flat lesion. Histological examination of the protruding lesions revealed regenerating hyperplasia in 5 lesions, intestinal metaplasia in 5, and both in 6. 3. The incidence of these lesions was higher in cases of tubular adenomas with focal high-grade dysplasia than in cases of tubular adenomas without dysplasia (p<0.05). 4. The incidence of H. pylori infection was higher in patients ($81.7\%$) who developed a protruding lesion than in those ($51.8\%$) who did not develop (p=0.029); also, the incidence of use of PPI was higher in those patients (p=0.045). However, eradication therapy for H. pylori and duration of use of PPI or H2-blocker showed no difference between groups. Conclusions: It may be possible that the potential hyperplasia that may reside in normal mucosa surrounding EGC or a gastric adenoma might awaken during the healing process of the EMR ulcer and develop to benign protruding lesions. And, H. pylori and PPI might also be related to the development of the protruding lesions.

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Clinical Features of Patients with Stage IV Gastric Cancer (4기 위암 환자의 임상적 특성)

  • Kim, Yoo Seok;Kim, Sung Soo;Min, Young Don
    • Journal of Gastric Cancer
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    • v.8 no.2
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    • pp.91-96
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    • 2008
  • Purpose: The early detection of gastric cancer and accuracy of preoperative staging has currently been on the increase due to the development of endoscopy and imaging techniques, but there are still many cases of advanced gastric cancer detected at the first diagnosis and there are also many cases of stage IV gastric cancer diagnosed after a postoperative pathological examination. Although the prognosis of stage IV gastric cancer is very poor, this study was performed to determine the value of the use of aggressive treatment determined after a clinical analysis. Materials and Methods: We retrospectively analyzed 150 patients that were diagnosed with stage IV gastric cancer among 1376 patients who underwent a laparotomy for gastric cancer from January 1994 to December 2006. Results: Of the 150 patients with stage IV gastric cancer who underwent a laparotomy, there were 104 men and 46 women. The mean patient age was 57.8 years (age range, 28~93 years). A subtotal gastrectomy or total gastrectomy was performed in 119 patients and 31 patients underwent an explorative laparotomy. The mean survival time of patients that underwent a gastrectomy and patients that did not undergo a gastrectomy was 722 days (range, 14~4,559 days) and 173 days (range, 16~374 days), respectively this result was statistically significant. When patients that underwent a gastrectomy were classified according to the TNM stage, the mean survival time of 33 patients with stage T4 disease was 534 days (range, 17~3,378 days) and the mean survival time of 63 patients with stage N3 disease was 521 days (range, 14~4,190 days), but there was no statistical significance. Chemotherapy was administered to 98 patients and 52 patients did not receive chemotherapy. The mean survival time of patients that received chemotherapy was 792 days (range, 36~4,559 days) and the mean survival time of patients that did not receive chemotherapy was 243 days (range, 14~2,413 days), with statistical significance. Conclusion: If there is no evidence of distant metastasis in stage IV gastric cancer, one can expect improvement of the survival rate by the use of aggressive treatment, including curative gastric resection with radical lymph node dissection and chemotherapy.

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Validity of Nursing Diagnoses Related to Difficulty in Respiratory Function (호흡기능장애와 관련된 간호진단의 타당도 조사)

  • 김조자;이원희;유지수;허혜경;김창희;홍성경
    • Journal of Korean Academy of Nursing
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    • v.23 no.4
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    • pp.569-584
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    • 1993
  • This study was done to verify validity of nursing diagnoses related to difficulty in respiratory function. First, content validity was examined by an expert group considering the etiology and the signs / symptoms of three nursing diagnoses - ineffective airway clearance, ineffective breathing pattern, impaired gas exchange. Second, clinical validity was examined by comparing the frequencies of the etiologies and signs / symptoms of the three nursing diagnoses in clinical case studies with the results of the content validity. This study was a descriptive study. The sample consisted of 23 experts (professors, head nurses and clinical instructors) who had had a variety of experiences using nursing diagnoses in clinical practice, and 102 case reports done by senior student nurses of the college of nursing of Y-university. These reports were part of their clinical practice in the ICU. The instrument used for this study was a checklist for etiologies and signs and symptoms based on the literature, Doenges and Moorhouse (1988), Kim, McFarland, McLane (1991), Lee Won Hee et al. (1987), Kim Cho Ja et at. (1988). The data was collected over four month period from May 1992 to Aug. 1992. Data were analyzed using frequencies done with the SPSS / PC+ package. The results of this study are summarized as follows : 1. General Characteristics of the Expert Group A bachelor degree was held by 43.5% and a master or doctoral degree by 56.5% of the expert group. The average age of the expert group was 35.3 years. Their average clinical experience was 9.3 years and their average experience in clinical practice was 5.9 years. The general characteristics of the patients showed that there were more women than men, that the age range was from 1 to over 80. Most of their medical diagnoses were diagnoses related to the respiratory. system, circulation or neurologic system, and 50% or more of them had a ventilator with intubation or a tracheostomy. The number of cases for each nursing diagnoses was : · Ineffective airway clearance, 92 cases. · Ineffective breathing pattern, 18 cases. · Impaired gas exchange, 22 cases. 2. The opinion of the expert group as to the classification of the etiology, and signs and symptoms of the three nursing diagnoses was as follows : · In 31.8% of the cases the classification of etiology was clear. · In 22.7%, the classification of signs and symptoms was clear. · In 17.4%, the classification of nursing interventions was clear. 3. In the expert group 80% or mere agreed to ‘dysp-nea’as a common sign and symptom of the three nursing diagnoses. The distinguishing signs and symptoms of (Ineffective airway clearance) were ‘sputum’, ‘cough’, ‘abnormal respiratory sounds : rales’. The distinguishing sings and symptoms of (Ineffective breathing pattern) were ‘tachypnea’, ‘use of accessory muscle of respiration’, ‘orthopnea’ and for (Impaired gas exchange) it was ‘abnormal arterial blood gas’, 4. The distribution of etiology, and signs and symptoms of the three nursing diagnoses was as follows : · There was a high frequency of ‘increased secretion from the bronchus and trachea’ in both the expert group and the case reports as the etiology of ineffective airway clearance. · For the etiologies for ineffective breathing pat-tern, ‘rain’, ‘anxiety’, ‘fear’, ‘obstructions of the tract, ca and bronchus’ had a high ratio in the ex-pert group and ‘decreased expansion of lung’ in the case reports. · For the etiologies for impaired gas exchanges, ‘altered oxygen -carrying capacity of the blood’ and ‘excess accumulation of interstitial fluid in lung’ had a high ratio in the expert group and ‘altered oxygen supply’ in the case reports. · For signs and symptoms for ineffective airway clearance, ‘dyspnea’, ‘altered amount and character of sputum’ were included by 100% of the expert group. ‘Abnormal respiratory. sound(rate, rhonchi)’ were included by a high ratio of the expert group. · For the signs and symptoms for ineffective breathing pattern. ‘dyspnea’, ‘shortness of breath’ were included by 100% of the expert group. In the case reports, ‘dyspnea’ and ‘tachypnea’ were reported as signs and symptoms. · For the sign and symptoms for impaired gas exchange, ‘hypoxia’ and ‘cyanosis’ had a high ratio in the expert group. In the case report, ‘hypercapnia’, ‘hypoxia’ and ‘inability to remove secretions’ were reported as signs and symptoms. In summary, the similarity of the etiologies and signs and symptoms of the three nursing diagnoses related to difficulty in respiratory function makes it difficult to distinguish among them But the clinical validity of three nursing diagnoses was established through this study, and at last one sign and symp-tom was defined for each diagnosis.

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Factors associated with the bone mineral density in Korean adults: Data from the 2010-2011 Korean National Health and Nutrition Examination Survey (KNHANES) V (우리나라 성인남녀의 골밀도 관련요인: 국민건강영양조사 제 5기 1, 2차 년도(2010년, 2011년))

  • Kim, Kyung Sook
    • Journal of agricultural medicine and community health
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    • v.39 no.4
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    • pp.240-255
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    • 2014
  • Objective: The purpose of this study was to identify the correlates of bone mineral density of Korean adults. Methods: This study was based on the data from the 2010-2011 Korean National Health and Nutrition Examination Survey (KNHANES, 2010~2011) V. Among 8,473 subjects of the survey, who were adults 19 years old or over with bone mineral density data, the current study excluded those whose data include a missing study variable or the response of 'I don't know', and finally analyzed the data of 5,986 subjects (2,692 males and 3,294 females). This study employed the following statistical methods of analysis: t-test, analysis of variance (ANOVA), and hierarchical multivariate linear regression analysis. Results: In multivariate analysis, in the case of men, the significant associated factors in bone mineral density were age, education level, body mass index (BMI), waist circumference, total muscle mass, exercise, and weight control; in the case of women, the significant associated factors in bone mineral density were age, education level, economic activity, BMI, total muscle mass, exercise, weight control. fat intake, uptake female hormone, menopause, and age of menarche. Conclusion: For both sexes, the strongest modifiable factor in influencing bone mineral density was total muscle mass. Therefore, to prevent osteoporosis and promote health, active health education and interventions such as regular exercise for total muscle mass increase should be implemented from an early growth period.

The Effects of Health Promotion Initiatives with Community Participation and Parterships: The Case of Sabong-Myeon in Jinju City (지역사회참여와 파트너쉽에 기반을 둔 지역건강증진사업의 효과: 진주시 사봉면 사례)

  • Jeong, Baekgeun;Kim, Jang-Rak;Kang, Yune-Sik;Park, Ki-Soo
    • Journal of agricultural medicine and community health
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    • v.39 no.4
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    • pp.209-221
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    • 2014
  • Objectives: The objective of this study was to identify the effects of area-based health promotion initiatives with community participation and partnerships conducted in Sabong-Myeon, Jinju City for three years. Methods: We used data from the '2008 Sabong-Myeon Health Survey' and the '2011 Health Plus Happiness Plus Community Health Survey'. The study comprised 520 systematically sampled individuals, composed of 300 adults in 2008 and 200 adults in 2011. We compared some health behavior and mental health indicators as well as social capital levels between these two surveys. Results: The prevalences of smoking and walking exercise in 2011 were significantly higher than those in 2008. The prevalences of high risk alcohol consumption in men, stress perception, depressive symptoms experience, and suicide ideation were significantly lower than those in 2008. The proportion of people having a high level of social capital in 2011 was significantly higher than that in 2008, regardless of sex or marital status. However, the difference in the proportion was not statistically significant among people with a high educational background. Conclusions: This study suggested that the 3 years' implementation of area-based health promotion initiatives conducted in Sabong-Myeon might help to improve the mental health and social capital level of this community. The long-term health effects of area-based health promotion initiatives with community participation and partnerships need to be studied further, and lessons from these initiatives can be obtained by adapting proper evaluation methods.

An Analysis on Health Promotion Behavior of Middle and High School Students (중등학교 학생의 건강증진 행태와 관련요인분석)

  • 김귀희;남철현
    • Korean Journal of Health Education and Promotion
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    • v.14 no.1
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    • pp.23-45
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    • 1997
  • This study was conducted from March 1, 1996 through June 30, in order to provide basic data for devising a policy for school health especially students health promotion and for developing of an education program. Middle school students were 1000, high school students were 2000 and a total of 3000 students were selected randomly among the boys/girls/middle/high schools which are in Seoul, Pusan, Taegu, Pohang, Suwon, Kyungsan, Milyang and a town or subcountry. The summary and conclusion are as follows. 1. In general characteristics of respondents, 51.8% were girl students, 33.7% were middle school students, 66.3% were high school students. 37.2% were living in a medium and small city, 89.1% were middle classes, 43.6% were having no religion, 27.3% were buddhists. 2. As a result of analyzing, exercise, nutrition, personal behavior, knowledge of health education and behavior level which are the factors promotion, exercise level were 3.61 of the perfect 9(40.1/100), nutrition level were 3.71(41.1/100), personal hygiene were 6.89(76.6/100), health education level were 5.1(58.9/100), all of the them are low level. 3. Judging from characteristics, in case of exercise behavior level, It was far higher in boy students than in girl students, in middle school students than in high school students. It was respectively higher than other groups in the second graders of middle school, in the first graders of high school, in the residents who live in a big city, in the high classes in the buddhists. 4. The students level against disease was average 9.11 of the perfect score 14(65.1/100). The level of disease consciousness was high in girl students by characteristics, in the second graders of high school by grades, in high school students than middle school students. 5. In health status, 55.4% were healthy, 7.9% were unhealthy. It was respectively higher than the other groups in boy students, in middle school students, in the residents who live in a big city, in high classes of life level, in buddihists, in higher education level of parents. 6. Judging from the factors of health status and health promotion and the degree of significance, there's a significant differences between exercise and dietary life as P〈0.001, in personal hygiene as P〈0.05, in health education an P〈0.01. 7. Knowledge on disease, health promotion behavior level were average 19.42 ± 4.01 of the perfect score 50(38.8/100) this score was too low. As for characteristics, the level between variables was statistically significant in the higher life level, in the higher parents education level, in the happier family. 8. Judging from health status, knowledge on disease, health behavior level, knowledge and health promotion behavior level significantly in the better health status, in the better school record. 9. As a result of the multiplex regression analyzing the factors which were under influence on health status, the variables like exercise, school record level, the degree of family happiness, nutrition, grades, the members of family influenced much and its persuasive power was 10.2%. The factors which are under the influence on the health promotion were exercise, satisfied degree of education, health status, the degree of family happiness, knowledge on disease, the usage of physical training, sex, the number of the family members, mother's education level. It’s explained power was 21.3%. promotion were high We should develop a text book and an education program to study exercise, nutrition(dietary life), personal hygiene, knowledge on disease and health systematically. As far as health education irrespective city and locality without considering the entrance exam for high school and university we should execute it continuously. To do this, it’s important to cultivate and secure qualified men of ability who can teach things related health promotion and the related subject, that is, health or health promotion subject should be established in middle and high school curriculum necessarily.

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