• Radiation Oncology Journal
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• v.15 no.3
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• pp.225-231
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• 1997

Purpose : Radiation therapy in combination with surgery has an important role in the therapy of the head and neck cancer We conducted a prospective study for patients with head and neck cancer treated with surgery and radiation to evaluate the effect of therapies on the thyroid gland, and to identify the factors that might influence the development of hypothyroidism. Materials and Methods : From September 1986 through December 1994, 71 patients with head and cancer treated with surgery and radiation were included in this prospective study. Patients' age ranged from 32 to 73 years with a median age of 58 years. There were 12 women and 59 men. The primary tumor sites were larynx in 34 patients, hypopharynx in 13 patients, oral cavity in 12 patients, unknown primary of the neck in 6 patients, salivary gland in 3 patients, maxillary sinus in 2 patients, and oropharynx in 1 patient. Total laryngectomy with neck dissection was carried out in 45 patients and neck dissection alone in 26 patients. All patients were serially monitored for thyroid function (T3, T4, free T4, TSH, antithyroglobulin antibody and antimicrosomal antibody) before and after radiation therapy. Radiation dose to the thyroid gland ranged from 40.6Gy to 60Gy with a median dose of 50Gy The follow-up duration was 3 to 80 months. Results :The overall incidence of hypothyroidism was 56.3\%$);7 out of 71 patients $(9.9\%)$ developed clinical hypothyroidism and 33 patients $(46.4\%)$ developed subclinical hypothyroidism. No thyroid nodules, thyroid cancers, or hyperthyroidism was detected. Hypothyroidism developed earlier in patients who underwent total laryngectomy with neck dissection than in patients with neck dissection alone (P<0.05). The risk factor that significantly influenced the incidence of hypothyroidism was a combination of surgery (total laryngectomy with neck dissection) and radiation therapy (P=0.0000), Four of 26 patients $(15.4\%)$ with neck dissection alone developed hypothyroidism while 36 of 45 patients $(80\%)$ with laryngectomy and neck dissection developed hypothyroidism. Conclusion : The hypothyroidism following surgery and radiation therapy was a relatively common complication. The factor that significantly influenced theincidence of hypothyroidism was combination of surgery and radiation therapy. Evaluation of thyroid function before and after radiation therapy with periodic thyroid function tests is recommended for an early detection of hypothyroidism and thyroid hormone replacement therapy is recommended whenever hypothyroidism develops.

• Tuberculosis and Respiratory Diseases
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• v.71 no.5
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• pp.328-334
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• 2011

Background: Chronic obstructive pulmonary disease (COPD) is a major cause of chronic morbidity and mortality throughout the world and is the only major disease that is continuing to increase in both prevalence and mortality. The second Korean National Health and Nutrition Survey revealed that the prevalence of COPD in Korean subjects aged ${\geq}45$ years was 17.2% in 2001. Further surveys on the prevalence of COPD were not available until 2007. Here, we report the prevalence of spirometrically detected COPD in Korea, using data from the fourth Korean National Health and Nutrition Survey (KNHANES IV) which was conducted in 2007~2009. Methods: Based on the Korean Statistical Office census that used nationwide stratified random sampling, 10,523 subjects aged ${\geq}40$ years underwent spirometry. Place of residence, levels of education, income, and smoking status, as well as other results from a COPD survey questionnaire were also assessed. Results: The prevalence of COPD (defined as forced expiratory volume in 1 sec/forced vital capacity <0.7 in subjects aged ${\geq}40$ years) was 12.9% (men, 18.7%; women, 7.5%). In total, 96.5% of patients with COPD had mild-to-moderate disease; only 2.5% had been diagnosed by physicians, and only 1.7% had been treated. The independent risk factors for COPD were smoking, advanced age, and male gender. Conclusion: The prevalence of COPD was 12.9% in the KNHANES IV data. Most patients with COPD were undiagnosed and untreated. Based on these results, a strategy for early COPD intervention is warranted in high risk subjects.

• Journal of Nutrition and Health
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• v.48 no.6
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• pp.507-518
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• 2015

Purpose: The aim of this study was to examine the association of food security with the total and individual flavonoid intakes among Korean adults. Methods: Study subjects were 13,454 men and 19,563 women aged 19 years and older who participated in the 2007~2012 Korea National Health and Nutrition Examination Survey. Subjects were classified into food-secure and food-insecure groups using the answers to a self-reported question on food sufficiency of subjects' household. The total and individual flavonoid intakes were calculated by linking 24-h dietary recall data of subjects with a flavonoid database. Mean differences in dietary outcomes by food security status, and major food sources of total flavonoids were examined. Results: In this cross-sectional study, 5.8% of male adults and 6.6% of female adults were in food insecure households. Mean daily intakes of total flavonoids, flavonols, flavones, flavanones, flavan-3-ols, isoflavones, and proanthocyanidins were significantly lower in food-insecure groups than food-secure groups among both male and female adults. The differences were maintained in total flavonoids, flavones, flavanones, and flavan-3-ols after adjusting for total energy intake. Mean intakes of fruits and vegetables were significantly lower in food-insecure groups and the total flavonoid intake from fruits and vegetables was also significantly lower in food-insecure groups. The major food sources of total flavonoids were apples (20.7%), mandarines (12.0%), and tofu (11.5%) in the food-secure group, and apples (14.9%), tofu (13.3%), and mandarines (12.6%) in the food-insecure group. Conclusion: This study showed that food insecurity was associated with lower intakes of flavonoids and reduced intakes of fruits and vegetables in a representative Korean population.

• Journal of the Korean Society of Food Science and Nutrition
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• v.35 no.6
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• pp.690-697
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• 2006

This study has been carried out to estimate mean concentration and the daily intake of 2 artificial sweeteners (aspartame and sucralose) by analyzing food samples. Total number of samples was 755 and the number of samples detected for sweeteners was 33 (detection rate was 4.4%). Contribution rate to total estimated daily intake (%) of artificial sweeteners in food categories was high in candy for aspartame and sucralose. Total Estimated Daily Intakes $({\Sigma}EDI)$ for different age groups were high in $13{\sim}19$ years old for aspartame and $7{\sim}12$ years old for sucralose. Total estimated daily intakes $({\Sigma}EDI)$ of men and women were 5.10 mg/person/day and 4.88 mg/person/day, respectively. Total estimated daily intakes $({\Sigma}EDI)$ of artificial sweeteners were shown as follows; 3.75 mg/person/day for aspartame and 1.27 mg/person/day for sucralose, respectively and assuming a body weight of 55 kg. These values were ranged from $0.15{\sim}0.17%$ of acceptable daily intake (ADI) evaluated by FAO/WHO and $1.0{\sim}21.4%$ of theoretical maximum daily intake (TMDI), and therefore, judged to be safe.

• Journal of Chest Surgery
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• v.39 no.10 s.267
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• pp.759-764
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• 2006

Background: We analyzed post-operative angiography performed in symptomatic patients to evaluate the patency rates and the roles of grafts. Material and Method: We reviewed 52 (15%) coronary angiograms performed for recurrent angina after prior coronary artery bypass surgery from January 1995 to June 2005. A total of 345 patients underwent coronary artery bypass surgery during this period. There were 41 men and 11 women and the mean age was $64.07{\pm}15.58$ years. The median period from operation to re-angiogram was 68.5 months (range, 1 to 126 months). The numbers of grafts and peripheral anastomoses were 42 and 43 for internal thoracic artery (ITA), 14 and 20 for radial artery (RA), and 49 and 89 for saphenous vein. The mean number of anastomosis was 2.9 per patient, Result: The patency rates of ITA, RA and saphenous vein graft (SVG) were 37/43 (86%), 17/20 (85%) and 34/89 (38.2%). The patency rate of arterial grafts was significantly higher than that of SVG (p< 0.001) and the patency rate of the RA was comparable to that of ITA (p=0.942). The patency rate of sequential SVGs was higher than that of single SVG (40.3% vs 31.8%, p=0.478) and the patency rate of proximal segments in sequential anastomosis was higher than that in single anastomsis (55.6% vs 31.8%, p=0.097), but statistically not significant. Conclusion: Arterial grafts have markedly superior patency rates than SVGs, so consideration should be given to the vigorous use of arterial grafts. The patency rate of the RA was comparable to that of ITA.

• Radiation Oncology Journal
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• v.15 no.4
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• pp.297-303
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• 1997

Purpose : To evaluate the prognostic factors for disease-free survival and long-term results of radiotherapy for pituitary adenoma. Methods and Materials : The study involved a retrospective review of out-come in a series of 27 patients with pituitary adenoma, between 1984 and 1995 at Paik hospital. The study included 20 patients treated with surgery and postoperative radiotherapy and 7 with radiotherapy alone. The patients were followed for 12-146 months (median : 97 months). Seventeen were men and 10 were women. The numbers of functioning and nonfunctioning pituitary adenorna were 22 and 5 respectively and those of microadenoma and macroadenoma were 4 and 23 respectively. The radiation doses of 5040-5580cGy (median : 5040cGy) were deliverd over 5-7 weeks, using 4MV LINAC. The prognostic factors were analyzed by log-rank test. Results: For radiation therapy alone, the 5YSR was 100% and progression free survival rate was 85.8%, The tumor was controlled in 6/7 (85.8%). For surgery and postoperative radiotherapy. the 5YSR, progression free survival rate and local control rate were 95%, 84.8%, and 89.5% respectively. The parameters of tumor size, hormone secretion, radiation dose. radiotherapy field size were evaluated in a uni- and multivariate analysis and all the factors were not statisticaIty significant (P>0.05). Eleven of 12 (92%) with visual field defect experienced normalization or improvement, and 5 for 7 evaluabie patients with hyperprolactinoma achived normalization in 4 and decrement in S patients. Only 2 patients developed mild degree of Panhypopituitarism. Conclusion: The radiotherapy appears to be effective in controiling clinical symptoms and signs resulting from pituitary adenoma. Local control rate with radiotherapy alone or with surgery and postoperative radiotherauy was comparable. There was a trend toward high recurrence rate in Patients with nonfunctioning or prolactin secretion tumor and larger radiation field sizes.

• Journal of Korea Entertainment Industry Association
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• v.13 no.7
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• pp.307-319
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• 2019

This study aims to provide the basic materials for the development of leisure and tourism contents in connection with Osaek cableway for the revitalization of Osaek District. For such a purpose, the following policy directions were presented through the analysis of the present situation and conditions of Osaek District, the direction of development of leisure and tourism contents of Osaek District, etc. The first is increasing the participation of local residents and reinforcing their capabilities. The suggested promotion plans are ① establishing organizational system and strengthening support, ② reinforcing the capabilities of local residents and ③ constructing networks with external human resources. The second is setting the guidelines for contents development. It was proposed to prepare contents for leisure experience using the natural environment of Osaek District in response to the trend of increase of people who enjoy "contents using culture and arts" and leisure. The third is typological approach to contents. It was proposed to develop cultural contents with the theme of Osaek such as "Osaek Light Festival", "Osaek Concert", "Osaek Photo Exhibition" and "Osaek Good Men and Women Contest" for the promotion of the brand of the place name of Osaek and the creation of the "Picture Book Village" for the compilation of the history and culture of Osaek District with pictures. The fourth is securing marketing channels. For this, it was proposed to produce the website of Yangyang County or a website tentatively named as "Osaek-ri with Beautiful Osaek" and introduce an integrated travel product (transportation + lodging + foods + experience (hot spring, mineral water therapy, leisure experience, etc.) + purchasing local specialty products, etc.) composed of the leisure and tourism contents, transportation, lodging, foods, etc. of Osaek District through travel agencies. The final policy direction presented was phased implementation of the development and operation of the contents. Proposed policies include support of a consulting project to upgrade the organization of local residents; implementation of "Tourism Dure (Cooperative)" project for the solution of the problem of tourism in Osaek District by the residents themselves together using the space of culture and arts made by remodeling idle public and private facilities after benchmarking exemplary places; system improvement for the introduction of leisure and tourism contents appropriate for local conditions; and the establishment of a master plan for the introduction of various leisure and tourism contents in Osaek District.

• Korean Journal of Culture and Social Issue
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• v.8 no.1
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• pp.103-139
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• 2002

Korean society has significantly changed with the onset of a dramatic economic crisis in 1998. From 2000, however, the Korean economy has recovered and currently Korea is enjoying a similar standard of living and economic growth as the pre-1998 levels. This study is a follow-up analysis, comparing the results examining the success attribution of Korean students and adults in 2001 with the results obtained before the economic crisis in 1997. Using the indigenous psychological approach, this study compares the similarities and differences in Korean students and adults' attribution of their personal success before and after the economic crisis. A total of 988 participants, consisting of 481 primary, junior high, senior high and university students and 507 adults (236 fathers and 271 mothers of the students) completed the questionnaire developed by Kim and Park (1998). The results indicate that students perceived their academic achievement and adults perceived successful family life as their most proud achievement. Successful family life included items such as academic success of children, healthy development of their children, and harmonious family life. The person who provided the most significant support for students were parents and for adults, it was their spouse. For students, the importance of friends' social support increased during the high school years. In terms of type of social support, emotional support was reported to be the most important for both students and adults. As for the reason for their success, majority of students and men reported self-regulation and for women, supportive family environment was reported as being the most important. Comparing 2001 results with the 1997 results, the importance of family increased after the economic crisis. Even with the dramatic economic crisis, however, some of the underlying pattern remain strong (such as importance of academic achievement for students, family life for adults, the importance of social support, especially emotional social support from family members, and believing that self-regulation would lead to success). The similar pattern of results obtain before and after the economic crisis indicate that the above results reflect a fundamental values and belief system deeply imbedded in Korean mentality.

• Research in Community and Public Health Nursing
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• v.14 no.4
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• pp.568-578
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• 2003

This study was conducted to estimate the effects of self-care program on knowledge and symptoms related hypertension self-care and physiological index in essential hypertensive patients aged between 35-74 year. The subjects for the experiment group and the control group of this study were 70 men and women selected through random sampling from adults at Sangju Red Cross Hospital in Gyeongsanbuk-do, and the experiment was carried out during the period from the 15th of September to the 30th of April in 2002. This study measured systolic and diastolic blood pressure (SBP, DBP, the mean value of the two measures) and total cholesterol (TC) and surveyed the subjects' diet and life style in relation to hypertension using a self-report questionnaire. In order to study the significance of the effects of self-care program, the author carried out t-test, paired t-test, ANCOVA, chi-square analysis and effectiveness index (EI) analysis. Results of the study are as follows: The experiment group got higher mean scores than the control group in the degree of low sodium intake and the degree of high calcium and high potassium intake, and the difference was statistically significant(P<0.05). The effectiveness index of the self-care program in smoking was 0.797 at the 1st posttest and 0.601 at the 2nd posttest, and in physical activities 0.600 at the 1st posttest and 0.849 at the 2nd posttest. The rate of regular antihypertensive drugs intake of the experimental group was higher than that of the control group. and the effectiveness index of the self-care program was 0.715. The mean score of the systolic blood pressure of the experimental group was lower than that of the control group, and the difference was statistically significant(P<0.05). In conclusion, these findings support usefulness of self-care programs in reducing systolic blood pressure and in promoting self-care related to diet and life style for treating and preventing hypertension.

• Journal of Home Health Care Nursing
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• v.3
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• pp.53-66
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• 1996

Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.