• Title/Summary/Keyword: Primary Healthcare

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Evaluation and Verification of the Attenuation Rate of Lead Sheets by Tube Voltage for Reference to Radiation Shielding Facilities (방사선 방어시설 구축 시 활용 가능한 관전압별 납 시트 차폐율 성능평가 및 실측 검증)

  • Ki-Yoon Lee;Kyung-Hwan Jung;Dong-Hee Han;Jang-Oh Kim;Man-Seok Han;Jong-Won Gil;Cheol-Ha Baek
    • Journal of the Korean Society of Radiology
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    • v.17 no.4
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    • pp.489-495
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    • 2023
  • Radiation shielding facilities are constructed in locations where diagnostic radiation generators are installed, with the aim of preventing exposure for patients and radiation workers. The purpose of this study is seek to compare and validate the trend of attenuation thickness of lead, the primary material in these radiation shielding facilities, at different maximum tube voltages by Monte Carlo simulations and measurement. We employed the Monte Carlo N-Particle 6 simulation code. Within this simulation, we set a lead shielding arrangement, where the distance between the source and the lead sheet was set at 100 cm and the field of view was set at 10 × 10 cm2. Additionally, we varied the tube voltages to encompass 80, 100, 120, and 140 kVp. We calculated energy spectra for each respective tube voltage and applied them in the simulations. Lead thicknesses corresponding to attenuation rates of 50, 70, 90, and 95% were determined for tube voltages of 80, 100, 120, and 140 kVp. For 80 kVp, the calculated thicknesses for these attenuation rates were 0.03, 0.08, 0.21, and 0.33 mm, respectively. For 100 kVp, the values were 0.05, 0.12, 0.30, and 0.50 mm. Similarly, for 120 kVp, they were 0.06, 0.14, 0.38, and 0.56 mm. Lastly, at 140 kVp, the corresponding thicknesses were 0.08, 0.16, 0.42, and 0.61 mm. Measurements were conducted to validate the calculated lead thicknesses. The radiation generator employed was the GE Healthcare Discovery XR 656, and the dosimeter used was the IBA MagicMax. The experimental results showed that at 80 kVp, the attenuation rates for different thicknesses were 43.56, 70.33, 89.85, and 93.05%, respectively. Similarly, at 100 kVp, the rates were 52.49, 72.26, 86.31, and 92.17%. For 120 kVp, the attenuation rates were 48.26, 71.18, 87.30, and 91.56%. Lastly, at 140 kVp, they were measured 50.45, 68.75, 89.95, and 91.65%. Upon comparing the simulation and experimental results, it was confirmed that the differences between the two values were within an average of approximately 3%. These research findings serve to validate the reliability of Monte Carlo simulations and could be employed as fundamental data for future radiation shielding facility construction.

Immunogenicity, Reactogenicity and Safety of a Combined DTPa-IPV Vaccine Compared with Separate DTPa and IPV Vaccines in Healthy Korean Infants (한국의 건강한 영아를 대상으로 DTPa-IPV 혼합백신을 접종한 경우와 DTPa 백신과 IPV 백신을 각각 투여하였을 경우의 면역원성, 반응원성 및 안전성)

  • Kim, Chang Hwi;Cha, Sung Ho;Shin, Son Moon;Kim, Chun Soo;Choi, Young Youn;Hong, Young Jin;Chey, Myoung Jae;Kim, Kwang Nam;Hur, Jae Kyun;Jo, Dae Sun;Kim, Sung Shin;Lee, Sang Lak;Song, Eun Song;Ramakrishnan, Gunasekaran;Ok, Jin Ju;Van Der Meeren, Olivier;Bock, Hans L.;Kim, Jung Soo
    • Pediatric Infection and Vaccine
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    • v.17 no.2
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    • pp.156-168
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    • 2010
  • Purpose : To compare immunogenicity and reactogenicity of a combined diphtheria-tetanus-acellular pertussis-inactivated poliovirus vaccine (DTPa-IPV, $Infanrix^{TM}$ IPV, GlaxoSmithKline Biologicals) with co-administration of commercially available DTPa and IPV vaccines at separate injection sites (DTPa+IPV). Methods : A total of 458 infants aged 8-12 weeks were randomized to receive three-ose primary vaccination at 2, 4 and 6 months with DTPa-IPV or DTPa+IPV. Blood samples were collected pre and post vaccination for measurement of immune responses. Reactogenicity was assessed following each dose using diary cards. Results : One month post-dose 3, seroprotection rates for anti-diphtheria, anti-tetanus and anti-poliovirus types 1, 2 and 3 were ${\geq}99.5%$ and vaccine response rates to pertussis antigens were at least 98.6% in both DTPa-IPV and DTPa + IPV groups. Non-inferiority between the groups was demonstrated based on pre-defined statistical criteria. Incidences of both local and systemic symptoms were within the same range across both groups with grade 3 symptoms reported following no more than 4.3% of DTPa-IPV doses and 4.5% of DTPa + IPV doses. Two serious adverse events (both pyrexia) after DTPa-IPV administration were considered vaccine-related. Both infants recovered fully. Conclusion : Combined DTPa-IPV vaccine was immunogenic and well tolerated when used as a three-dose primary vaccination course in Korean infants. DTPa-IPV could be incorporated into the Korean vaccination schedule, reducing the number of injections required to complete primary immunization.

Electroencephalographic Changes Induced by a Neurofeedback Training : A Preliminary Study in Primary Insomniac Patients (뉴로피드백 훈련에 의한 뇌파 변화 연구 : 일차성 불면증 환자에 대한 예비 연구)

  • Lee, Jin Han;Shin, Hong-Beom;Kim, Jong Won;Suh, Ho-Suk;Lee, Young Jin
    • Sleep Medicine and Psychophysiology
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    • v.26 no.1
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    • pp.44-48
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    • 2019
  • Objectives: Insomnia is one of the most prevalent sleep disorders. Recent studies suggest that cognitive and physical arousal play an important role in the generation of primary insomnia. Studies have also shown that information processing disorders due to cortical hyperactivity might interfere with normal sleep onset and sleep continuity. Therefore, focusing on central nervous system arousal and normalizing the information process have become current topics of interest. It has been well known that neurofeedback can reduce the brain hyperarousal by modulating patients' brain waves during a sequence of behavior therapy. The purpose of this study was to investigate effects of neurofeedback therapy on electroencephalography (EEG) characteristics in patients with primary insomnia. Methods: Thirteen subjects who met the criteria for an insomnia diagnosis and 14 control subjects who were matched on sex and age were included. Neurofeedback and sham treatments were performed in a random order for 30 minutes, respectively. EEG spectral power analyses were performed to quantify effects of the neurofeedback therapy on brain wave forms. Results: In patients with primary insomnia, relative spectral theta and sigma power during a therapeutic neurofeedback session were significantly lower than during a sham session ($13.9{\pm}2.6$ vs. $12.2{\pm}3.8$ and $3.6{\pm}0.9$ vs. $3.2{\pm}1.0$ in %, respectively; p < 0.05). There were no statistically significant changes in other EEG spectral bands. Conclusion: For the first time in Korea, EEG spectral power in the theta band was found to increase when a neurofeedback session was applied to patients with insomnia. This outcome might provide some insight into new interventions for improving sleep onset. However, the treatment response of insomniacs was not precisely evaluated due to limitations of the current pilot study, which requires follow-up studies with larger samples in the future.

Studies on Anti-Wrinkle and Whitening Effects of Liposomes Containing Acerola Extract Mixture (아세로라 추출물 혼합 리포좀의 주름, 미백 효과에 대한 연구)

  • Kim, Su Jin;Oh, Won Jun;Kwon, Sung Pil;Nam, Gaewon
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.47 no.4
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    • pp.341-352
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    • 2021
  • Acerola is an excellent ingredient because of its high natural vitamin C content, but it is difficult to stabilize and has hardly been studied as a cosmetic material. Therefore, this study developed a mixed liposome preparation for stabilizing acerola extract. As a safety test, the skin irritation test was evaluated by BCOP assay and HET-CAM assay. We evaluated the inhibition of tyrosinase activity, the whitening effect of melanin production, and the wrinkle effect of prochloragentype-I C-peptide production, and confirmed the possibility of functional cosmetics. In addition, a cream of liposomes containing acerola extract mixture was developed to evaluate the clinical studies of skin wrinkles and whitening. BCOP assay, HET-CAM assay and human skin primary irritation test results of liposomes containing acerola extract mixture showed no irritation and were safe from skin and eye. The result of tyrosinase activity by 75.8% at 1,000 ㎍/mL. As a result of the melanogenesis inhibition test, liposome with acerola extract showed the melanin content by 46.2% at 1,000 ㎍/mL that does not effect the viability of the B16F10 cell line. The result of collagen production test using ELISA kit, liposomes containing acerola extract mixture showed collagen synthesis ability by 152.1% at 1,000 ㎍/mL that does not affect the viability of the HS68 cell line. But it did not showed any inhibition of collagenase (MMP-1) activity at all concentrations in the MMP-1 activity inhibition test in the HS68 cell line. We performed clinical studies for the whitening and skin-wrinkle activity of cream containing acerola extract mixes liposome, was showed that the melanin contents and wrinkle was statistically significant reduction. These results suggest that liposomes containing acerola extract mixture have safe natural material, and skin wrinkle, whitening effects allowing their application in cosmetics as a natural product.

Leucogen Tablets at 60 mg Three Times per Day are Safe and Effective to Control Febrile Neutropenia

  • Huang, Xin-En;Cao, Jie;Qian, Zhi-Ying;Xu, Xia;Shi, Lin;Wu, Xue-Yan;Liu, Jin;Wang, Lin
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.19
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    • pp.8495-8497
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    • 2014
  • Purpose: To investigate whether it is safe to use leucogen tablets 60 mg three times per day (180 mg for a day) and whether this regimen could reduce the incidence of febrile neutropenia caused by chemotherapy. Methods: This prospectively designed study focused on the safety and effectiveness of leucogen tablets 60mg three times per day for a group of cancer patients during chemotherapy for mainly lung or gastric cancers. The tablets were administered from 5 days before until the termination of chemotherapy. Neutropenia and other healthcare encounters were defined as events and occurrence was estimated for comparison. Results: We identified 39 patients receiving leucogen tablets 60mg three times per day, including 11 with gastric, 12 with lung and 16 with other sites of cancer. The mean age was 65 (29-75) years and there were 27 male and 12 female patients. The mean duration of leucogen tablets intake was 59 days. Eighteen patients were treated with taxane-based, 4 with irinotecan-based and 17 with other chemotherapy. The incidence of febrile neutropenia was 0%. Twelve patients were found severe neutropenia (grade III/IV), and the duration of severe neutropenia (grade III/IV) was 5 days. Treatment-emergent adverse events were attributable to complications of myelosuppressive chemotherapy or the primary disease (i.e., alopecia, nausea, asthenia, neutropenia, and severe hepatic renal dysfunction). No chemotherapy was delayed and no treatment related death was observed. Conclusions: This study suggested that leucogen tablets 60mg three times per day (180mg for a day) are safe and could be effective for preventing febrile neutropenia in patients with chemotherapy.

Clinical Nutrition Services of a Long-term Care Hospital in Korea (전국 요양병원에서의 임상영양서비스 실태 조사)

  • Um, Mi Hyang;Lyu, Eun Soon;Lee, Song Mi;Lee, Seung Min;Lee, Eun;Cha, Jin A;Park, Mi Sun;Lee, Ho Sun;Rha, Mi Yong;Park, Yoo Kyoung
    • Korean Journal of Community Nutrition
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    • v.20 no.3
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    • pp.220-235
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    • 2015
  • Objectives: The purpose of this study was to investigate how clinical nutrition services is provided at a long term care hospital in Korea and to investigate job satisfaction levels of the clinical dietitians. Methods: Survey questionnaire was sent to dietitians working at a long term care hospital in Korea. The participating hospitals (n=240) were randomly selected from 1,180 long- term care hospitals using a stratified sampling method. A total of 134 long term care hospital s and 223 dietitians completed the survey of clinical nutrition service s and job satisfaction questionnaires The job satisfaction questionnaire included 27 job satisfaction questions on task, stability vision, working conditions, and relationship areas. Results: The average nutritional screening rate was 17.9% and the rate of computerized nutritional screening system was 9.7% in the participating hospitals. Nutritional intervention rate was only 3.2% of all patients. KOIHA (Korea Institute for Healthcare Accreditation) accreditated hospitals showed only 50% performance rate of nutrition service evaluation area. This shows that after achieving KOIHA accredition, many hospitals do not emphasize the performance of nutritional services. The job satisfaction scores in all four areas ranged from 2/5 to 3/5, implying generally low job satisfaction level in hospital dietitians. Linear regression analysis results showed that the "hospital adequacy grade" type was a significant predictor of job satisfaction level for two areas (working conditions & relationship). Conclusions: There is a need to provide proper standardized clinical nutrition services as a primary treatment and we observed large variations in the quality of nutritional service s in long term care hospitals. Therefore, government and local hospitals have to work on implementing nutritional programs and policies for improved service and care.

A National Chronic Disease Management Model and Evaluation of Validity of Primary Care Physician(PCP) Model in Korea (우리나라 만성질환 관리를 위한 질환주치의 모형의 타당성 분석)

  • Chun, Ki-Hong;Paek, Kyung-Won;Lee, Soo-Jin;Park, Chong-Yon
    • Health Policy and Management
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    • v.19 no.3
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    • pp.92-108
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    • 2009
  • This study suggests a model for continuing and comprehensive management of hypertension or Type 2 diabetes mellitus (T2DM) in Korea. Moreover, this paper computed the contribution cost of hypertension or T2DM management using the healthcare medical cost, which could have occurred from stroke, myocardial infarction (MI), and end-stage renal disease (ESRD) that were successfully prevented from the effective hypertension or T2DM management. Additionally, these costs were compared with the cost of implementing the hypertension or T2DM management model suggested in this study. This study used the medical fee summary of the health insurance claims submitted to National Health Insurance Corporation by medical facilities for services provided during the period from January 1st 1999 to December 31st 2006. The prevalence rate with treatment referred to cases in which patients submitted their medical claims at least once during the period, along with an accordant diagnosis. The incidence rate with treatment referred to cases in which patients who never submitted claims for the accordant disease during the five years from 1999 to 2003 submitted claims for the accordant disease in 2004 and 2005. The relative risk of the occurrence of stroke, MI and ESRD was 11.0, 13.6, and 30.3, respectively. The attributable risk of hypertension or T2DM for stroke was 0.730, and that for MI and ESRD were 0.773 and 0.888, respectively. Based on these, the contribution cost of hypertension or T2DM is estimated to be 986.3 billion Korean Won(KRW) for stroke patients, 330.5 billion KRW for MI patients, and 561.7 billion KRW for ESRD patients as in 2005. Hence, the total contribution cost of hypertension or T2DM to stroke, MI, and ESRD is 1.878 trillion KRW. The estimate for operational costs included an annual expenditure of 50,000 KRW per each recipient and an annual subsidy of 0.22 million KRW per person for the 1.6 million low.income individuals with hypertension or T2DM to cover their out.of.pocket medical expenses. Under this assumption, it took approximately 0.6 trillion KRW to manage 5 million high.risk patients in the low. and mid.income range, coverings up to 50% of costs. In conclusion, considering the potential benefits of preventing stroke, MI, and ESRD, the costs seems to be reasonable.

Study of Quality of Life and Related Factors in Veterans with Physical Dysfunction (신체적 기능장애를 가진 국가유공자의 삶의 질 수준 및 관련 요인 연구)

  • Kwon, Chun-Suk;Kim, Suhn-Yeop;Jang, Hyun-Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.1
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    • pp.490-497
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    • 2015
  • The aim of this study was to examine the quality of life (QOL) and its related factors in veterans with physical dysfunction. The survey data was collected from 412 patients with physical dysfunction managed at five veterans' hospitals in Seoul, Pusan, Daegu, Gwangju, and Daejeon city. The baseline for the quality of life was measured using the SF-36 (Short-Form 36), activities of daily living was measured using a Modified Barthel Index (MBI), pain level was determined using Quadruple Visual Analogue Scale (QVAS), and the depression level was assessed using Korean version of the Geriatric Depression Scale: Short-Form (SGDS-K). The SF-36 scores showed a significant correlation with age (r=-0.132), self-rated current health status (r=-0.545), active daily living (r=0.514), pain level (r=-0.243), and depression level (r=-0.565) (p<0.05). The most influential variables on the QOL were the depression level (B=-.969, p<0.001), QVAS (B=-0.163, p<0.001), and MBI (B=0.140, p<0.001). The results of this study showed that that depression, pain and activities of daily living are significant predictors of the QOL in veterans with a physical dysfunction. Therefore, healthcare providers need to consider these parameters for interventions to improve the QOL in veterans with a physical dysfunction.

Knowledge and Perceptions of Cancer and Cancer Prevention among Malaysian Traditional Healers: a Qualitative Study

  • Al-Naggar, Redhwan A.;Bobryshev, Yuri V.;Abdulghani, Mahfoudh Al-Musali Mohammed;Rammohan, Subramanian;Al-Jashamy, Karim
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.3841-3850
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    • 2012
  • Objective: The objective of this study was to explore the knowledge and perceptions of Malaysian tradition healers towards cancer and cancer prevention. Methodology: A total of 25 participants agreed to participate in this qualitative study during the period from $20^{th}$ July 2011 until $24^{th}$ of September 2011. The proposal of this study was approved by the Ethics Committee of Management and Science University (MSU). Once the participant agreed to be interviewed, date, time and place of the interviews were determined. Consent form was obtained from participants before the interview began. Participants were briefed about the study and its purpose, and after asking their permissions, their replies were recorded. The data was organized into themes and analyzed manually. Results: Twenty-five Malaysian traditional healers participated in this qualitative study. The age of participants ranged between 26 to 78 years old. The majority were in the age group of 31-60 years old, male, Chinese, degree holders with a monthly income ranging from 1,000-5,000 Ringgit Malaysia (RM) and were married (56%, 80%, 48%, 52%, 68%, 84% respectively). The majority defined cancer as having high cholesterol or abscess accumulation. A few of them defined cancer as a type of cell growth. The majority mentioned that food and unhealthy lifestyles are the primary causes of cancer. Surprisingly some of them mentioned that cancer is caused by interference by ghosts. Regarding the diagnosis of cancer, the majority mentioned that they refer their patients to modern physicians' medical report when it comes to diagnosing or treating patients with cancer. The most common cancers that many patients came to seek treatment were breast cancers, followed by colon cancers, liver and lung cancers. Conclusions: Despite good knowledgeabout the causes of cancer among traditional healers, misconceptions still exist. Insufficient knowledge about the definition of cancer was noted among the traditional healers. This urges immediate action by the Ministry of Health of Malaysia to set up a strict regulation and regular monitoring of the traditional healers nationally. Traditional and Complementary Medicine may be integrated into the healthcare system and need to have sustained cooperation for the benefit of patients since about 80% of patients use traditional medicines.

Pharmacological Functional Magnetic Resonance Imaging of Cloropidol on Motor Task (운동과제에 대한 클로피도그렐의 약리적 뇌자기공명영상)

  • Chang, Yong-Min
    • Investigative Magnetic Resonance Imaging
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    • v.16 no.2
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    • pp.136-141
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    • 2012
  • Purpose : To investigate the pharmacologic modulation of motor task-dependent physiologic responses by antiplatelet agent, clopidogrel, during hand motor tasks in healthy subjects. Materials and Methods: Ten healthy, right-handed subjects underwent three functional magnetic resonance (fMRI) sessions: one before drug administration, one after high dose drug administration and one after reaching drug steady state. For the motor task fMRI, finger flexion-extension movements were performed. Blood oxygenation level dependent (BOLD) contrast was collected for each subject using a 3.0 T VHi (GE Healthcare, Milwaukee, USA) scanner. $T2^*$-weighted echo planar imaging was used for fMRI acquisition. The fMRI data processing and statistical analyses were carried out using SPM2. Results: Second-level analysis revealed significant increases in the extent of activation in the contralateral motor cortex including primary motor area (M1) after drug administration. The number of activated voxels in motor cortex was 173 without drug administration and the number increased to 1049 for high dose condition and 673 for steady-state condition respectively. However, there was no significant difference in the magnitude of BOLD signal change in terms of peak T value. Conclusion: The current results suggest that cerebral motor activity can be modulated by clopidogrel in healthy subjects and that fMRI is highly senstive to evidence such changes.