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Effects of Concurrent Chemotherapy and Postoperative Prophylactic Paraaortic Irradiation for Cervical Cancer with Common Iliac Node Involvement (자궁경부암의 근치적 절제술 후 총장골동맥림프절 침범 시 동시항암화학치료와 예방적 대동맥주위림프절 방사선조사의 효과)

  • Han, Tae-Jin;Wu, Hong-Gyun;Kim, Hak-Jae;Ha, Sung-Whan;Kang, Soon-Beom;Song, Yong-Sang;Park, Noh-Hyun
    • Radiation Oncology Journal
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    • v.28 no.3
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    • pp.125-132
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    • 2010
  • Purpose: To retrospectively assess the advantages and side effects of prophylactic Paraaortic irradiation in cervical cancer patients with common iliac nodal involvement, the results for survival, patterns of failure, and treatment-related toxicity. Materials and Methods: From May 1985 to October 2004, 909 patients with cervical carcinoma received postoperative radiotherapy at the Seoul National University Hospital. Among them, 54 patients with positive common iliac nodes on pathology and negative Paraaortic node were included in the study. In addition, 44 patients received standard pelvic irradiation delivered 50.4 Gy per 28 fractions (standard irradiation group), and chemotherapy was combined in 16 of them. The other 10 patients received pelvic irradiation at a dose of 50.4 Gy per 28 fractions in addition to Paraaortic irradiation at 45 Gy per 25 fractions (extended irradiation group). In addition, all of them received chemotherapy in combination with radiation. Follow-up times for pelvic and Paraaortic irradiation ranged from 6 to 201 months (median follow-up time, 58 months) and 21 to 58 months (median follow-up time, 47 months), respectively. Results: The 4-year overall survival, disease free survival, and distant metastasis free survival in the standard irradiation group and extended irradiation group were 67.2% vs. 90.0% (p=0.291), 59.0% vs. 70.0% (p=0.568) and 67.5% vs. 90.0% (p=0.196), respectively. The most common site of first failure for the standard irradiation group was the paraaortic lymph node, while no paraaortic failure was observed in the extended irradiation group. Relatively, hematologic toxicity grade 3 or greater was common in the extended irradiation group (2/10 extended vs. 2/44 standard), while gastrointestinal toxicity of grade 3 or greater was lower (2/10 extended vs. 6/44 standard), and urologic toxicity of grade 3 or greater was observed in the standard irradition group only (0/10 vs. 3/44). Conclusion: Concurrent chemotherapy and prophylactic Paraaortic irradiation in patients with common iliac nodal involvement showed slightly improved clinical outcomes aside from increased hematologic toxicity, which was statistically insignificant. Considering the relatively small number of patients and short follow-up times, additional studies are needed to obtain more conclusive outcomes.

Prophylactic cranial irradiation in limited small-cell lung cancer : incidence of brain metastasis and survival and clinical aspects (예방적 두강내 방사선 조사후 소세포 폐암 환자의 뇌전이 빈도와 생존율에 대한 연구)

  • Suh, Jae-Chul;Kim, Myung-Hoon;Park, Hee-Sun;Kang, Dong-Won;Lee, Kyu-Seung;Ko, Dong-Seok;Kim, Geun-Hwa;Jeong, Seong-Su;Cho, Moon-June;Kim, Ju-Ock;Kim, Sun-Young
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.3
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    • pp.323-331
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    • 2000
  • Purpose: Brain metastases are present in approximately 10-16% of small cell lung cancer patients at diagnosis. Brain metastasis is an important clinical problem associated with increasing the survival rate, with a cumulative incidence of up to 80% in patients surviving 2 years. Prophylactic cranial irradiation(PCI) reduces the incidence of brain matastasis and may prolong survival in patients with limited small-cell lung cancer who achieved complete remission. This study was performed to analyze the incidence of brain metastasis, survival and clinical aspects after PCI in patients with limited small-cell lung cancer who achieved complete remission. Methods : Between 1989 and 1999, forty-two patients with limited small-cell lung cancer who achived achieved complete remission after therapy were enrolled into this study retrospectively. All patients received etoposide and cisplatin(VPP) alternating with cytoxan, adriamycin, and vincristine(CAV) every 3 weeks for at least 6 cycles initially. All patients received thoracic radiotherapy: concurrent(38.1%) and sequential(61.9%). All patients received late PCI. Results : Most patients(88.1%) were men, and the median age was 58 years. The median follow-up duration was 18.1 months. During the follow-up period, 57.1% of the patients developed relapse. The most frequent site of relapse was chest(35.7%), followed by brain(14.3%), liver(11.9%), adrenal gland(44%), and bone(2.2%). With the Kaplan-Meier method, the average disease-free interval was 1,090 days(median 305 days). The average time to development of brain relapse after PCI and other sites relapse(except brain) were 2,548 days and 1,395 days(median 460 days), respectively. The average overall survival was 1,233 days(median 634 days, 21.1 months), and 2-year survival rates was 41.7%. The average overall survival in the relapse group was 642 days(median 489 days) and in the no relapse group was 2,622 days(p<0.001). The average overall survival in the brain relapse group was 928 days(median 822 days) and in the no brain relapse group was 1,308 days(median 634 days)(p=0.772). In most patients(85.7%), relapse(except brain) or systemic disease was the usual cause of death. Brain matastasis was the cause of death in 14.3% of the cases. Conclusions : We may conclude that PCI reduces and delays brain metastasis in patients with limited small cell lung cancer who achieved complete remission. We found decreased survival in relapse group but, no significant survival difference was noted according to brain matastasis. And relapse(except brain) or systemic disease was the usual cause of death. In order to increase survival, new treatment strategies for control methods for relapse and systemic disease are required.

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Postmastectomy Radiotherapy and Chemotherapy in Patients with Breast Cancer (유방절제술을 시행한 유방암 환자에서 방사선과 항암제 치료성적)

  • Ahn Sung-Ja;Chung Woong-Ki;Nam Taek-Keun;Nah Byung-Sik;Song Ju-Young;park Seung-Jin
    • Radiation Oncology Journal
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    • v.22 no.1
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    • pp.17-24
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    • 2004
  • Purpose: To evaluate the treatment outcomes after postmastectomy radiotherapy (PMRT) and chemotherapy in patients with breast cancer. Materials and Methods: The PMRT were retrospectively analyzed in 83 patients with stage II-III female breast cancer treated between 1989 and 1995. The median age was 46 years (range, 23-77): Seventy-seven patients had modified radical mastectomies, 5 radical mastectomies and 1 simple mastectomy. Three patients ($4\%$) had pathologically negative axillae, and the remaining 80 ($96\%$) had positive axillae. Eleven, 23, 44 and 5 patients had pathological stages IIA, IIB, IIIA, and IIIB, retrospectively. Eighty ($96\%$) patients were treated with hockey-stick fields. The median dose of PMRT was 50.4 ey, in 1.8 Gy fractions. Adjuvant systemic chemotherapy was given to 74 patients ($89\%$). CMF-based or doxorubicin-containing regimens were given to 54 patients ($55\%$). The median follow-up time was 82 months (range, 8-171) after the mastectomy. Results: The 5 and 10-year overall survival rates for all patients were 65 and $49\%$, respectively. The univariate and multivariate analyses of the factors affecting the overall survival revealed the stage to be the most significant prognostic factor (p=0.002), followed by the combination of chemotherapy. Thirteen patients $16\%$ developed a LRF, at an interval of 4-84 months after radiotherapy, with a median of 20 months. The only significant prognostic factor affecting LRF was the combination of chemotherapy, in both the univariate and multivariate analyses. With respect to the sequence of chemoradiation, the sequence had no saatistical significance (p=0.90). According to the time interval from mastectomy to the onset of radiotherapy, the LRFR of the patients group treated by RT within or after 6 month postmastectomy 6 months were 14 vs. $27\%$ respectively (p=0.24). One third of the pa41en1s (26/83) developed distant metastasis, in 2-92 months, after radiotherapy, with a median of 21 months. The most commonly involved site was bone in 13 cases. The pathological staging was the only significant prognostic factor in both the univariate and multivariate analyses that affected distant failure. Radiological finding of radiation pneumonitis on a simple chest x-ray was shown in $20\%$ (17/83), with a time interval ranging from 2 to 7 months post-radiotherapy, with a median of 3 months. The stable lung fibrosis settled in 11 patients ($65\%$). Conclusion: It was concluded through this analysis that the combination of PMRT with in chemotherapy resulted in better overall survival and local control than PMRT alone in patients needing PMRT.

Development of Adjustable Head holder Couch in H&N Cancer Radiation Therapy (두경부암 방사선 치료 시 Set-Up 조정 Head Holder 장치의 개발)

  • Shim, JaeGoo;Song, KiWon;Kim, JinMan;Park, MyoungHwan
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.1
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    • pp.43-50
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    • 2014
  • In case of all patients who receive radiation therapy, a treatment plan is established and all steps of treatment are planned in the same geometrical condition. In case of head and neck cancer patients who undergo simulated treatment through computed tomography (CT), patients are fixed onto a table for planning, but laid on the top of the treatment table in the radiation therapy room. This study excogitated and fabricated an adjustable holder for head and neck cancer patients to fix patient's position and geometrical discrepancies when performing radiation therapy on head and neck cancer patients, and compared the error before and after adjusting the position of patients due to difference in weight to evaluate the correlation between patients' weight and range of error. Computed tomography system(High Advantage, GE, USA) is used for phantom to maintain the supine position to acquire the images of the therapy site for IMRT. IMRT 4MV X-rays was used by applying the LINAC(21EX, Varian, U.S.A). Treatment planning system (Pinnacle, ver. 9.1h, Philips, Madison, USA) was used. The setup accuracy was compared with each measurement was repeated five times for each weight (0, 15, and 30Kg) and CBCT was performed 30 times to find the mean and standard deviation of errors before and after the adjustment of each weight. SPSS ver.19.0(SPSS Inc., Chicago, IL,USA) statistics program was used to perform the Wilcoxon Rank test for significance evaluation and the Spearman analysis was used as the tool to analyze the significance evaluation of the correlation of weight. As a result of measuring the error values from CBCT before and after adjusting the position due to the weight difference, X,Y,Z axis was $0.4{\pm}0.8mm$, $0.8{\pm}0.4mm$, 0 for 0Kg before the adjustment. In 15Kg CBCT before and after adjusting the position due to the weight difference, X,Y,Z axis was $0.2{\pm}0.8mm$, $1.2{\pm}0.4mm$, $2.0{\pm}0.4mm$. After adjusting position was X,Y,Z axis was $0.2{\pm}0.4mm$, $0.4{\pm}0.5mm$, $0.4{\pm}0.5mm$. In 30Kg CBCT before and after adjusting the position due to the weight difference, X,Y,Z axis was $0.8{\pm}0.4mm$, $2.4{\pm}0.5mm$, $4.4{\pm}0.8mm$. After adjusting position was X,Y,Z axis was $0.6{\pm}0.5mm$, $1.0{\pm}0mm$, $0.6{\pm}0.5mm$. When the holder for the head and neck cancer was used to adjust the ab.0ove error value, the error values from CBCT were $0.2{\pm}0.8mm$ for the X axis, $0.40{\pm}0.54mm$ for Y axis, and 0 for Z axis. As a result of statistically analyzing each value before and after the adjustment the value was significant with p<0.034 at the Z axis with 15Kg of weight and with p<0.038 and p<0.041 at the Y and Z axes respectively with 30Kg of weight. There was a significant difference with p<0.008 when the analysis was performed through Kruscal-Wallis in terms of the difference in the adjusted values of the three weight groups. As it could reduce the errors, patients' reproduction could be improved for more precise and accurate radiation therapy. Development of an adjustable device for head and neck cancer patients is significant because it improves the reproduction of existing equipment by reducing the errors in patients' position.

Studies of the Effects of Acupuncture Stimulation at Huatuo Jiaji(EX B2) Points on Axonal Regeneration of Injured Sciatic Nerve in the Rats (화타협척혈 침자극에 의한 손상 말초신경의 재생효과에 관한 연구)

  • Kim, Dae-Feel;Park, Young-Hoi;Keum, Dong-Ho
    • Journal of Korean Medicine Rehabilitation
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    • v.18 no.4
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    • pp.39-61
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    • 2008
  • Objectives : The present study was performed to investigate whether acupuncture stimulation in the rats affected regeneration properties of the injured sciatic nerve. A differential effect of acupuncture stimulation on the one point near the spinal nerve root controlling sciatic nerve activity and the other point in the peripheral area subordinated by injured nerve was compared. Materials and Methods: Rat sciatic nerves were injured by crush, and the effects on axonal regeneration on injured sciatic nerves were evaluated by acupuncture stimulation at two different regions. In proximal acupuncture stimulation group, acupuncture stimulation was performed on Huatuo Jiaji(EX B2) points located from L5 to S1 vertebral levels to stimulate the nearest spinal nerve root that innervates sciatic nerves. In distal acupuncture stimulation group, acupuncture stimulation was performed on Zusanli(ST 36) and Weizhong(BL 40) points to stimulate at peripheral area dominated by injured sciatic nerves. Acupuncture stimulation was given every other days for 1 or 2 weeks. Sciatic nerve tissues collected from acupuncture stimulation experimental groups, injury control group, and intact animal group were used for protein analysis by Western blotting or Hoechst nuclear staining. To determine axonal regeneration, Dil fluorescence dye was injected into the sciatic nerve 0.5 cm distal to the injury site in individual animal groups and Dil-labeled cells by retrograde tracing were measured in the DRG at lumbar 5 or in the spinal cord. DRG sensory neurons prepared from individual animal groups were used to measure the extent of neurite outgrowth and for immunofluorescence staining with anti-GAP-43 antibody. Results : Animal groups given proximal or distal acupuncture stimulation showed upregulation of GAP-43 and Cdc2 protein levels in the sciatic nerve at 7 days after injury. Cdk2 protein levels were strongly induced by nerve injury, but did not show changes by acupuncture stimulation. Phospho-Erk1/2 protein levels were elevated by acupuncture stimulation above those present in the injury control animals. These increase in regeneration-associated protein levels appeared to be related with increase cell proliferation in the injured sciatic nerves. Hoechst 33258 staining of sciatic nerve tissue to visualize nuclei of individual cells showed increased Schwann cell number in the distal portion of the injured nerve 7 and 14 days after injury and further increases by acupuncture stimulation particularly at the proximal position. Measurement of axonal regeneration by retrograde tracing showed significantly increased Dil-labeled cells in proximal acupuncture stimulation group compared to distal acupuncture stimulation group and injury control group. Finally, an evaluation of axonal regeneration by retrograde tracing showed increased number of Dil labeled cells in the DRG at lumbar 5 or in the ventral horn of the spinal cord at lower thoracic level at 7 days after nerve injury. Conclusions : The present data show that the proximal acupuncture stimulation at Huatuo Jiaji(EX B2) points governing injured sciatic nerves was more effective for axonal regeneration than the distal acupuncture stimulation. Further studies on functional recovery or associated molecular mechanisms should be critical for developing animal models and clinical applications.

Lung Clearance of Inhaled $^{99m}Tc$-DTPA by Urine Excretion Ratio (소변내 방사능배설량비를 이용한 $^{99m}Tc$-DTPA 폐청소율에 관한 연구)

  • Suh, G.Y.;Park, K.Y.;Jung, M.P.;Yoo, C.G.;Lee, D.S.;Kim, Y.W.;Han, S.K.;Jung, J.K.;Lee, M.C.;Shim, Y.S.;Kim, K.Y.;Han, Y.C.
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.4
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    • pp.357-366
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    • 1993
  • Background: Lung clearance of inhaled $^{99m}Tc$-DTPA reflects alveolar epithelial permeability and it had been reported as more sensitive than conventional pulmonary function tests in detecting lung epithelial damage. However, measuring lung clearance of inhaled $^{99m}Tc$-DTPA by gamma camera may not always reflect alveolar epithelial permeability exactly because it is influenced by mucociliary clearance depending on the site of particle deposition. Moreover, this method takes much time and patient's effort because he has to sit or lie still in front of the camera for a prolonged period. Most of the absorbed DTPA is excreted in urine within 24 hours and the amount of excreted DTPA in urine during the first few hours after inhalation is influenced by absorption rate which is correlated with the alveolar-epithelial permeability suggesting that the urinary excretion, especially in first few hours, may be an alternate index for lung clearance. The purpose of this study was to evaluate the usefulness of ratio of excreted $^{99m}Tc$-DTPA in 2 hour and 24 hour urine as an index of alveolar-epithelial damage. Methods: Pulmonary function tests including diffusing capacity and lung clearance of $^{99m}Tc$-DTPA measured by gama camera ($T_{1/2}$) and 2hr/24hr urine excretion ratio (Ratio) of inhaled $^{99m}Tc$-DTPA in 8 normal subjects and 14 patients with diffuse interstitial lung disease were compared. Results: 1) In the normal control, there was significant negative correlation between the $T_{1/2}$ and the Ratio (r=-0.77, p<0.05). In patients with diffuse interstitial lung disease, there also was significant negative correlation between $T_{1/2}$ and Ratio(r=-0.63, p<0.05). 2) In diffuse interstitial lung disease patients, the $T_{1/2}$ was $38.65{\pm}11.63$ min which was significantly lower than that of normal control, $55.53{\pm}11.15$ min and the Ratio was $52.15{\pm}10.07%$ also signifantly higher than that of the normal control, $40.43{\pm}5.53%$ (p<0.05). 3) There was no significant correlations between $T_{1/2}$ or Ratio and diffusing capactiy of lung in both patients and controls (p>0.05). Conclusion: These results suggests that 2hr/24hr urine excretion ratio of inhaled $^{99m}Tc$-DTPA is a useful simple bedside test in assessing alveolar epithelial permeability and that it may be used as an additive follow-up test in patients with diffuse interstitial lung disease complementing conventional pulmonary function tests.

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Clinical Study of Pulmonary Tuberculosis for Admitted Patients at National Masan Tuberculosis Hospital (국립마산결핵병원에 입원한 환자에 대한 폐결핵의 임상적 동태에 관한 연구)

  • Park, Seung-Kyu;Choi, In-Hwan;Kim, Chul-Min;Kim, Cheon-Tae;Song, Sun-Dae
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.241-250
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    • 1997
  • Objective : Although the prevalence of pulmonary tuberculosis has decreased progressively after the national control program for tuberculosis began, nowadays the number of MDRTB is increasing seriously. MDRTB tends to be poor responsive to current antituberculosis regimens. It is mainly due to poor compliance, high rate of side reaction of secondary drugs, and limitation in number of available drugs. The purpose of present study is to evaluate the clinical features of pulmonary tuberculosis patients admitted in one national tuberculosis hospital and to expose the problems pertaining to current remedies, to increase the treatment efficacy for pulmonary tuberculosis including MDRTB in the end. Method : Retrospective analysis of 336 pulmonary tuberculosis patients admitted in National Masan Tuberculosis Hospital was done. Contents of analysis were patients profile, the first diagnosed time and medical institutes, family history, residence, previous treatment history, chief complaints at the time of admission, lesion site on chest X -ray film, combined deseases, side reaction to antibuberculosis drugs, used drugs before admission and the results of drug sensitivity test. Results : The ratio between male and female was 4 : 1. Age showed relatively even distribution from 3rd to 6 th decades. 64.6% of the patients was diagnosed at public health center. Weight loss was the most common complaint at admission. Bilateral lesions on chest X-ray films were 59.8%. 130patients had combined desease, of which DM was the most common(37.7%). 95patients had family history, of which parents were the most common(41.7%). According to the time of first diagnosis, 31 patients were diagnosed before 1980, and after then the number of patients was increased by degrees. Residence overwhelmed in pusan and gyung-nam province. 258 patients got previous treatment history, of which 112 patients(43.4%) had more than 3 times and only 133 patients(51.6%)got regular medication. 97 patients used more than other 3 drugs in addition to INH, EMB, RFP and PZA before admission. 154 patients were informed with the results of drug sensitivity test. of which 77 patients had resistance to more than 5 drugs. Gastrointestinal problem was the most common in side reaction to drugs. Conclusion : In the case of weight loss of unknown cause, tuberculosis should be suspected. In first treatment, sufficient and satisfactory explanation for tuberculosis is necessary and treatment period should not be stict to 6 month-short term therapy. In retreatment, new drugs should not be added to used drugs even though drug sensitivity results show sensitivity to some of them. Proper time for surgical intervention should not be delayed.

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Pulmonary Mycoses in Immunocompromised Hosts (면역기능저하 환자에서 폐진균증에 대한 임상적 고찰)

  • Suh, Gee-Young;Park, Sang-Joon;Kang, Kyeong-Woo;Koh, Young-Min;Kim, Tae-Sung;Chung, Man-Pyo;Kim, Ho-Joong;Han, Jong-Ho;Choi, Dong-Chull;Song, Jae-Hoon;Kwon, O-Jung;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.6
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    • pp.1199-1213
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    • 1998
  • Background : The number of immunocompromised hosts has been increasing steadily and a new pulmonary infiltrate in these patients is a potentially lethal condition which needs rapid diagnosis and treatment. In this study we sought to examine the clinical manifestations, radiologic findings, and therapeutic outcomes of pulmonary mycoses presenting as a new pulmonary infiltrate in immunocompromised hosts. Method : All cases presenting as a new pulmonary infiltrate in immunocompromised hosts and confirmed to be pulmonary mycoses by pathologic examination or by positive culture from a sterile site between October of 1996 and April of 1998 were included in the study and their chart and radiologic findings were retrospectively reviewed. Results : In all, 14 cases of pulmonary mycoses from 13 patients(male : female ratio = 8 : 5, median age 47 yr) were found. Twelve cases were diagnosed as aspergillosis while two were diagnosed as mucormycosis. Major risk factors for fungal infections were chemotherapy for hematologic malignancy(10 cases) and organ transplant recipients(4 cases). Three cases were receiving empirical amphotericin B at the time of appearance of new lung infiltrates. Cases in the hematologic malignancy group had more prominent symptoms : fever(9/10), cough(6/10), sputum(5/10), dyspnea(4/10), chest pain(5/10). Patients in the organ transplant group had minimal symptoms(p<0.05). On simple chest films, all of the cases presented as single or multiple nodules(6/14) or consolidations(8/14). High resolution computed tomograph showed peri-lesional ground glass opacities(14/14), pleural effusions(5/14), and cavitary changes(7/14). Definitive diagnostic methods were as follows : 10 cases underwent minithoracotomy, 2 underwent video-assisted thoracoscopic surgery, 1 underwent percutaneous needle aspiration and 1 case was diagnosed by culture of abscess fluid. All cases received treatment with amphotericin B with 1 case each being treated with liposomal amphotericin B and itraconazole due to renal toxicity. Lung lesion improved in 12 of 14 patient but 4 patients died before completing therapy. Conclusion : When a new lung infiltrate develops presenting either as a nodule or consolidation in a neutropenic patient with hematologic malignancy or in a transplant recipient, you should always consider pulmonary mycoses as one of the differential diagnosis. By performing aggressive work up and early treatment, we may improve prognosis of these patients.

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A Study of the Health Service Computerization State and the Occupational Nurses's Satisfaction Level on Computerization (산업간호현장의 보건업무 전산화시스템 활용현황과 산업간호사의 전산화 직무만족도 연구)

  • Jung, Hee Young;Park, Hyoung-Sook
    • Korean Journal of Occupational Health Nursing
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    • v.13 no.1
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    • pp.5-18
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    • 2004
  • This study aims to investigate the use state of the health service computerization system in the occupational nursing field and the occupational nursers' satisfaction level, and provide basic data to promote the development of the health service computerization system for the nursing field. For this study, a questionnaire was provided to 118 occupational nurses who belong to Busan and Gyeongnam branches of KAOHN(Korean Association of Occupational Health Nurses) for 2 months (from Dec. 1, 2002 to Jan. 31, 2003). A tool of Choi Yong-Heui(2000) was used to investigate the satisfaction level of using the health service computerization system. The collected materials were analyzed in real number and percentage, average and standard deviation, t-test and ANOVA by using the SPSS WIN 10.0 program. This study is summarized as follows: 1. The average age was $31.99{\pm}5.58$ old in this study. The married were 54.2%. Participants who graduated from a junior college was 76.9%. The average service period was $4.48{\pm}4.68$ years. In service types, 79.7% of participants served in a health care center. The average service period was $3.22{\pm}2.89$ years. The service place which had 1000 workers or more was 35.6%. 2. Only 20.3% of participants in this study had a computer use education. 3. The field who participants used mostly was communication/internet, $3.29{\pm}.85$ hours in average. 4. 97.1% of occupational fields had computers and peripheral devices: 71.4% in pentium computer, 42.8% in the hard disk capacity of 20-29GB, 60.0% in 15 inch monitors, 86.2% in printers, 18.1% in digital cameras, 12.4% in LAN, and 9.5% in scanners. 80.1% of the occupational fields which were objects of study could use communication. 5. The occupational fields which did not introduced the health service computerization system were 62.8%. The main cause was attributable to entrepreneurs' insufficient recognition 66.6%. 51.5% of the entrepreneurs did not have an introduction plan. 37.2% of participating companies had the health service computerization system. 56.4% of them introduced it since the year 2000. 81.6% of the introduction motivation aimed to the efficiency of health service. The most issue upon introduction was insufficient understanding of a person in charge - 25.6%. The in-house development of the system covered 56.4%. 61.5% of the participants accepted their demands from the first stage of development. The direct effect of computerization showed the increase of 25.9% in the quickness and continuity of service treatment, and 25.9% in the serviceability of statistical treatment. 6. 22.0% of the participants had a computerization system use education. 69.2% of them had a in-house education. An educational method by nurses who used the computerization system was 76.9%. 92.3% of the education was helpful for practical duties. 7. An analysis of the computer use by health service fields showed that the medicine management in a health management field was 15.9%. the work environment measuring management in a work environment filed was 32.9%. the employment. general and special examination management in a heal th management field was 61.1 %. the various reports management in an administrative field was 64%. the health education data preparation management in an educational field was 58.0%. and the medicine and expendables management in an equipment management field was 51.6%. An analysis of the computerization system use showed that the various statistical data manage in a health management field was 13.0%. the work environment measuring management in a health management field was 34.8%. the personal disease management in a health management field was 51.9%. the heal education data preparation management in an educational field was 54.5%. and the equipment management of health care centers in an equipment management field was 52.6%. 8. 31.6% of the participants wanted that health service computerization system would include the generals of health services. 42.4% of the participants thought that first of all. the aggressive interest and investment of employers were required to build the health service computerization system. 9. The participants' satisfaction level on the computerization system use was $3.51{\pm}.57$ points. An analysis by each factor showed $3.62{\pm}.68$ points in a service change factor. $3.15{\pm}.63$ points in a computer program use factor, and $3.45{\pm}.71$ points in a continuous computerization use factor. 10. An analysis of the computerization system use by general characteristics of participants showed that the married (p = .022) had the satisfaction level higher than the unmarried. 11. The satisfaction level of the computerization system use by participants' computer use ability tended to be higher in proportion to the increase of computer use abilities in spreadsheet (F=2.606. p=.048). presentation (F=3.62. p=.012) and communication/internet(F=2.885. p=.0321. Based on the study results mentioned above. I will suggest as follows : The nationwide enlargement and repetition study is required for occupational nurses who serve in occupational nursing fields. The computerization system in a health service field is inferior comparing with other fields. The computerization system standard by business types and characteristics should be prepared through employers's aggressive participation and national support. Therefore various statistical data which occurs in occupational fields will be managed systematically and efficiently. A regular and systematic computer education plan for occupational nurses in charge of health services in the filed is urgently required to efficiently manage and improve the health of on-site workers.

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A Study on the Space Formation and Garden Characteristics of Garden Remains, Gao-Byeoleop for Restoration Design (가오별업(嘉梧別業)의 복원 설계를 위한 공간구성 및 정원 특성에 관한 연구)

  • Rho, Jae-Hyun;Kim, Soon-Ki
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.36 no.3
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    • pp.58-74
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    • 2018
  • This study aims to propose baseline data for designing restoration of Gaobyulup, researching space formation and characteristics of gardens of Gaobyulup, which located in the foot of Cheonmasan Mountain in Namyangju. Gaobyulup is a remain in retirement of Gyulsan Yu-Won Lee, a representative politician, administrator, and tea drinker in late Joseon Dynasty. The results of the research about the shape of Gaobyulup deducted through reference review, poetry and prose analysis, an on-the-spot survey and residents' interview are below: Lee, who used pseudonym as 'Gyulsan,' which menas Jongnamsan Mountain, yearned Mangcheonbyeoreop(輞川別業) by Yu Wang and retirement with a country house operation by Seogye Sedang Park. In the persuit of this ideal, he created and operated a country house in Gaogok of Yangju, which a family burial ground was located. Gaobyulup, which located in Gaogok in the lower part of Cheonmasan Mountain, was largely composed outer and inner gardens, and the area of house operation was started from a stone post of Gaobokji The inner garden of Gaobyulup was including major garden components like buildings, such as Sasihyanggwan, Obaekganjung, Imharyoe and Toesadam, and Chaewon near Haengrangchae, and Gwawon in an backyard. In addition, Younggwijung pavilion, which located 850m away from Gaobyulup, was the another country house inside the Byulup, thus Gaobyulup shows a duplex space formation. In the inner garden of Gaobyulup, there are Sasihyanggwan, which had functions of Sarangchae as library and depository of old paintings and calligraphic works, and Obaekganjung, a small Sarangchae which connected with Sasihyanggwan in the form of a transept. Yusanggoksuger located near Obaekganjung. Additionally, Imharyeo, a library with a tablet of Byeokryowon(??園), which located in the highest point in Byulup, has the functions of a reading room and a tea house. Many Taihu stones were located not only in Toesadam, a square-formed pond with lotus but also many places in the inner gardens. And rare garden plants were planted. These were closely related to the trend of horticulture for pleasure, wealth, and collecting old paintings and calligraphic works for pleasure of Lee. Meanwhile, the area of Younggwijung pavilion, located in Gaocheon stream fall from Byulup to Manhoiam, looks like Wooampok, a enjoying place of other personages, who use their pseudonym as "Oksan" or "Wooam" Lee identifies Wooampok as "Jesampok" and carved 'Gyulsan' s he declared this place is his operating area. Lee built Younggwijung pavilion and planted many peach trees for recreation of utopia. The stone letters of Byukpadongcheon, located in front of a bridge in the foreside of Younggwijung pavilion, seems another enchanted land created in Gaobokji inside. Lee carved Jeilsan in huge rock on the falls rear Manhoiam temple, which Lee did great role of foundation of the temple, so he identifies that this place was the end of the outer garden of Gaobyulup. This study tries to estimate traces of the country house in Gaogok through reference review and on-th-spot survey, and the results from this study are presumed based on site remains only conformed today. It needs to discover second scenary or stone carved letters between Jeilsan and Jesampok. Additionally, exact formation characteristics of Gaobyulup should be identified through excavation survey later. To do so, an interest and a major role of Namyangju-si must be equipped for future restoration of Gaobyulup.