• 제목/요약/키워드: Primary care

검색결과 1,580건 처리시간 0.03초

Interleukin-$32{\gamma}$ Transgenic Mice Resist LPS-Mediated Septic Shock

  • Kim, Sun Jong;Lee, Siyoung;Kwak, Areum;Kim, Eunsom;Jo, Seunghyun;Bae, Suyoung;Lee, Youngmin;Ryoo, Soyoon;Choi, Jida;Kim, Soohyun
    • Journal of Microbiology and Biotechnology
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    • 제24권8호
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    • pp.1133-1142
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    • 2014
  • Interleukin-32 (IL-32) is a cytokine and inducer of various proinflammatory cytokines such as $TNF{\alpha}$, IL-$1{\beta}$, and IL-6 as well as chemokines. There are five splicing variants (${\alpha}$, ${\beta}$, ${\gamma}$, ${\delta}$, and ${\varepsilon}$) and IL-$32{\gamma}$ is the most active isoform. We generated human IL-$32{\gamma}$ transgenic (IL-$32{\gamma}$ TG) mice to express high level of IL-$32{\gamma}$ in various tissues, including immune cells. The pathology of sepsis is based on the systemic inflammatory response that is characterized by upregulating inflammatory cytokines in whole body, particularly in response to gram-negative bacteria. We investigated the role of IL-$32{\gamma}$ in a mouse model of experimental sepsis by using lipopolysaccharides (LPS). We found that IL-$32{\gamma}TG$ mice resisted LPS-induced lethal endotoxemia. IL-$32{\gamma}$ reduced systemic cytokines release after LPS administration but not the local immune response. IL-$32{\gamma}TG$ increased neutrophil influx into the initial foci of the primary injected site, and prolonged local cytokines and chemokines production. These results suggest that neutrophil recruitment in IL-$32{\gamma}TG$ occurred as a result of the local induction of chemokines but not the systemic inflammatory cytokine circulation. Together, our results suggest that IL-$32{\gamma}$ enhances an innate immune response against local infection but inhibits the spread of immune responses, leading to systemic immune disorder.

중년여성의 강인성, 폐경지식과 폐경관리에 관한 연구 (A Study on Hardiness, Knowledge of Menopause, Menopausal Management among Middle Aged Women)

  • 신혜숙;권숙희
    • 여성건강간호학회지
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    • 제5권2호
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    • pp.247-261
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    • 1999
  • The purpose of this study was to figure out related factors to the self-reported climacteric symptoms and the relationship among the health promoting behaviors, climacteric symptoms and degree of Sanhujori, the Korean traditional postpartal care. A cross-sectional survey design was employed in this study. The subjects were 108 middle-aged women who were non-hystrectomized and ranged in age from 40 to 60 years. They were selected in seoul and Kyoung-ki province, Korea, Data were collected from Oct.25 Nov. 10, 1997 by a structured questionnaire. The instruments used for this study were the revised health Promotion Lifestyle(HPLP) developed by Walker, Sechrist & Pender, and revised Climacteric Symptoms Scale developed by Chi, Sung Ai. the data were analyzed by the SPSS/$PC^+$ program using t-test, ANOVA and Scheffe test as a post hoc and Pearson Correlation Coefficient. The results of the study were as follows ; 1. The mean score of health promoting behaviors was low($2.42{\pm}0.35$). There were statistically significant differences in the score of health promoting behaviors according to the educational background, family income, marital satisfaction, whether or not taking a restorative food and degree of Sanhujori, especially the period (t=-2.07, F=2.60~7.57, p<0.05). 2. The mean score of score self-reported climacteric symptoms was 1.69%;99% of middle-aged women had symptoms. There were statically significant differences in the score of middle -aged women's self-reported climacteric symptoms according to the age, number of children, educational background, occupation, family income, marital satisfaction, whether or not receiving hormon replacement therapy (HRT) or consultation by a professional, perceived health status and self evaluation of Sanhujori(t=-2.04~3.69, F=2.87~11.63, p<0.05). 3. women's degree of Sanhujori was a positive correlation with health promoting behaviors(r=0.34, p=0.00) and negative correlation with the degree of self-reported climacteric symptoms(r=-0.19,p=0.03). 4. The influencing factors to the climacteric symptoms were self actualization, interpersonal support, and perceived health status among the health promoting behaviors with 57% of variance($R^2$=0.57). 5. The middle-aged women's type of coping pattern for the climacteric symptoms was classified as active behavioral coping, spiritual & psychological coping, and negative coping. In conclusion, to intervene the middle aged women's climacteric symptoms and develop nursing strategies for their health, health promoting behavior, especially ; self actualization, interpersonal support, and perceived health status should be considered. And, as the primary prevention strategy for women's health during the period of childbearing and also middle age, especially for the climacteric symptoms, Sanhujori should be reconsidered.

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Hypofractionated Radiotherapy for Breast Cancers - Preliminary Results from a Tertiary Care Center in Eastern India

  • Nandi, Moujhuri;Mahata, Anurupa;Mallick, Indranil;Achari, Rimpa;Chatterjee, Sanjoy
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권6호
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    • pp.2505-2510
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    • 2014
  • Background: The standard radiotherapy (RT) fractionation practiced in India and worldwide is 50Gy in 25 fractions over 5 weeks to the chest wall or whole breast followed by tumour bed boost in case of breast conservation (BCS). A body of validated data exists regarding hypofractionation in breast cancer. We here report initial results for 135 patients treated at our center with the START-B type of fractionation. Materials and Methods: From May 2011 till July 2012, women with all stages of breast cancer (excluding metastatic), who had undergone BCS or mastectomy were planned for 40Gy in 15 fractions over 3weeks to chest wall/whole breast and supraclavicular fossa (where indicated) followed by tumour bed boost in BCS patients. Planning was done using Casebow's technique. The primary end point was to assess the acute toxicity and the cosmetic outcomes. Using cosmetic scales; patients were assessed during radiotherapy and at subsequent follow up visits with the radiation oncologist. Results: Of the 135 patients, 62 had undergone BCS and 73 mastectomy. Median age of the population was 52 years. Some 80% were T1&T2 tumours in BCS whereas most patients in mastectomy group were T3&T4 tumours (60%). 45% were node negative in BCS group whilst it was 23% in the mastectomy group. Average NPI scores were 3.9 and 4.9, respectively. Most frequently reported histopathology report was infiltrating ductal carcinoma (87%), grade III being most common (58%), and 69% were ER positive tumours, and 30% were Her 2 Neu positive. Triple negative tumours accounted for 13% and their mean age was young (43 yrs.) The maximum acute skin toxicity at the end of treatment was Grade 1 in 94% of the mastectomy grouppatients and 71% in BCS patients. Grade 2 toxicity was 6% in mast group and 23% in BCS group. Grade 3 was 6% in BCS group, no grade 3 toxicity in mastectomy patients and there was no grade 4 skin toxicity in any case. Post RT at 1 month; 39% of BCS patients had persisting Grade I skin reaction which was only 2% in mastectomy patients. At 3 months post RT, 18% patients had persisting hyperpigmentation. At 6 months 8% patients had persisting erythema in the BCS group only. Some 3% BCS and 8% mastectomy patients had lymph edema till the date of evaluation. Cosmetic outcome in BCS patients remained good to excellent 6 months post surgery and radiotherapy. 1 patient of BCS and 3 patients of mast had developed metastatic disease at the time of evaluation. Conclusions: Hypofractionated RT is well tolerated in Indian population with reduced acute skin toxicity and good cosmetic outcome. Regimens such as these should be encouraged in other centers to increase machine output time. The study is on-going to assess long term results.

Physical Activity and Cancer Prevention: Awareness and Meeting the Recommendations among Adult Saudis

  • Amin, Tarek Tawfik;Al-Hammam, Abudllah Mohammed;AlMulhim, Nasser Abdullah;Al-Hayan, Mohammed Ibrahim;Al-Mulhim, Mona Mohammed;Al-Mosabeh, Modhahir Jawad;Al-Subaie, Mohammed Ali;Al-Hmmad, Qassem Ahmed;Al-Omran, Ahmed Adi
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권6호
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    • pp.2597-2606
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    • 2014
  • Background: There is a scarcity of information about the proportion of the adult Saudi population that meet the recommended guidelines of physical activity (PA) to reduce cancer risk. Moreover, their awareness about the role of PA in cancer prevention is unclear. Objectives: This cross-sectional study aimed at estimating the proportion of adult Saudis meeting the PA guidelines, specifically those recommended by American Cancer Society (ACS) for cancer prevention, and to assess the public awareness about the role of PA in cancer prevention. Materials and Methods: Using a multistage sampling method, 2,127 adult Saudis of both genders were recruited from 6 urban and 4 rural primary health care centers in Al Hassa, Saudi Arabia. Participants were personally interviewed to gather information about their sociodemographic characteristics, searching activity about PA and cancer, and the time spent in leisure time PA (moderate and vigorous)/week using the Global Physical Activity Questionnaire with show cards. Finally, items about the role of PA in cancer risk reduction were inquired. Results: Of the included participants, 11.6% met the recommendations for cancer prevention (${\geq}45$ minutes of moderate-vigorous PA activity/${\geq}5$ days/week or 225 minutes/week). Multivariate regression showed that being male (AOR=1.49, CI=1.09-2.06), <20 years of age (AOR=3.11, CI=2.03-4.76), and unemployed (AOR=2.22, CI=1.57-3.18) were significant predictors for meeting PA recommendations for cancer prevention. Only 11.4% of the sample indicated correctly the frequency and duration of PA required for an average adult to be physically active and while >70% of them indicated the role of PA in prevention of hypertension, coronary heart disease and lowering elevated blood cholesterol, only 18.6% and 21.7% correctly mentioned the role of PA in reducing colon and breast cancer risk, respectively. Poor knowledge was found among those with less than college education and aged ${\geq}50$ years. The level of knowledge was significantly positively correlated with total leisure time PA of the participants. Conclusions: A minority of adult Saudis in Al Hassa was aware about the role of PA in cancer prevention and engaged in sufficient LTPA for cancer risk reduction benefits, highlighting the need for public health actions to include policies and programs that address factors deterring their participation in LTPA and increasing their awareness with remedies to manage the prevalent misconceptions.

피로와 우울.불안증 환자에서 Fatigue Severity Scale의 임상적 유용성 (Clinical Usefulness of Fatigue Severity Scale for Patients with Fatigue, and Anxiety or Depression)

  • 정규인;송찬희
    • 정신신체의학
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    • 제9권2호
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    • pp.164-173
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    • 2001
  • 연구목적: 피로는 일차 진료에서 흔한 증상이지만 비특이적 주관적 특성상 명확한 정의와 객관적 평가가 어렵고, 특히 기질적 질환이 없는 피로의 평가는 더욱 힘들다. 이에 저자들은 기질적 질환이 없는 피로 환자에게 Fatigue severity scale (FSS) 을 적용하여 그 유용성을 알아보고자 하였다. 방법: 피로환자 44명, 우울 또는 불안증의 정신과 환자 43명과 대조군 45명에게 피로도, 스트레스, 우울 불안 척도를 이용하여 FSS의 신뢰도와 타당도를 조사하였다. 결과: FSS의 신뢰도 계수는 0.935이었고 재검사의 상관관계 계수는 0.916이었다 (p<0.01). FSS 점수는 피로 군에서 유의하게 가장 높았고 대조군에서 가장 낮았다 (p<0.01). FSS와 Chalder fatigue scale의 상관관계 계수는 0.782로 높았다 (p<0.01). 피로군과 대조군에 대한 FSS index의 최적의 절단점은 민감도 84.1%. 특이도 85.7%인 3.22로 조사되었다. 결론: FSS는 일차진료에서 기질적 질환이 없는 피로환자와 우울 또는 불안증 환자에서 피로도를 평가할 수 있는 유용한 도구이며, 향후 보다 많은 환자를 대상으로 한 연구가 필요하리라 생각된다.

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간편한 선별검사법에 의한 농촌 노인인구의 백내장에 대한 역학조사 (The Epidemiological Study on the Cataract of the Rural Aged Population Using a Simplified Screening System)

  • 박은규
    • 한국안광학회지
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    • 제5권1호
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    • pp.165-171
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    • 2000
  • 본 조사는 경북 농촌지역의 백내장 분포를 알아보기 위하여 실시하였다. 백내장은 전 세계적으로 설명과 시력장애의 주원인일 뿐 아니라 노인인구의 증가로 인해 백내장 환자의 수는 현저하게 증가하였다. 이러한 추세에도 불구하고 백내장으로 인해 심하게 시기능이 저하된 상태에 있으면서도 안과적 진단 기회를 얻지 못하고 있는 환자들이 아직도 많이 있다. 이런 환자들의 선별과 분포조사를 위해 경북 칠곡과 문경 지역에서 일반 건강검진을 희망한 50세 이상 주민 636명(1272안)을 대상으로 최근 일본 Kanazawa 의과대학의 Sasaki 등이 제안한 간편한 백내장 일차선별검사를 적용하여 다음과 같은 결과를 얻었다. 전체 조사대상자 중 시력장애를 호소한 사람은 모두 493명(77.5%)이었다. 제1단계 선별검사로 448명(90.9%), 제2단계 선별검사로 308명(48.4%)의 백내장이 의심되는 시력불량군을 분류하였고, 제1, 2단계일차 선별검사에 의해 최종적으로 백내장으로 분류된 사람의 수는 421명(66.2%)이었다. 연령에 따른 유병율은 50대 27.5%, 60대 62.5%, 70대 86.1%, 80세 이상 94.3%이었다. 따라서 백내장이 실명과 시력장애의 주원인 일 뿐 아니라 국내에서도 공중보건분야의 중요한 문제인 만큼 적절한 관리와 안보건 대책이 요구되며 특히 안보건을 위한 의료활동이 농촌지역에까지 확대되어야 할 것으로 사료되었다.

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일개 농촌 면단위지역 주민의 보건지소 의료 이용 추이 (Utilization Trends of Health Subcenter for Primary Medical Care in a Korean Rural Area)

  • 조희숙;위자형
    • 농촌의학ㆍ지역보건
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    • 제21권2호
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    • pp.151-157
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    • 1996
  • This study was analyze through the reports which published on the subject matter of Su Dong-Myun from year of 1972-1993, and analysis of data in 1994 was performed with medical records on the health subcenter by PC-SAS program. The result are as follows: The number of population in Su-Dong Myun(study area) was 5,707 in 1995, 4,641 in 1985 and 5,424 in 1975. In the composition rate of population "0-14" of age group only showed markedly decreasing tendancy from 42.8% in 1975 to 19.1% in 1995. However, "65 and over" showed markedly increasing tendancy from 5.7% in 1975 to 9.8% in 1995. Annual utilization rate showed rapidly increasing tendency from year of 1972 to 1978, such as 314 per showed rapidly decreasing tendency, such as 708 in 1981, 485 in 1984, 272 in 1987, 309 in 190 and in 1993. In the annual age-specific utilization rate, the age group of "0-14" showed the highest rate of 621 per thousand population in 1975, 1159 in 1980, 1021 in 1985 and 538 in 1990. However the age group of "65 and over" showed the highest rate of 481 in 1994. Age specific annual utilization rate showed markedly decreasing tendency in the age group of "0-14" and "15-44", however showed slightly decreasing tendency or same level in the group of "45-64" and "65 and over" from year of 1980 to 1994. In the age specific utilization rate, the lower down the age was, the higher tendency the rate showed, such as 621 per 1,000 population in "0-14" of the age group, 543 in "15-44", 406 in "45-64" and 294 in "65 and over" in 1975. However, the higher up the age was, the higher tendency the rate showed in 1980, 1985 and 1994, except "0-14" of age group. The 5 major diseases were disease of Respiratory system, Gastrointestinal system, Skin and Subcutaneous tissue, Accidents, Poisoning and Violence and Nervous system and Sense organ, in 1975, 1980 and 1985. However, in 1990 and 1994, the 5 major disease were disease of Respiratory system, Gastrointestinal system. Skin and Subcutaneous tissue, Musculoskeletal system and, Connective tissue and Circulatory system. In Composition rate of patient in Su Dong-Myun Health Subcenter by Charged Medical Fee, medical insurance showed almost all the highest rate of 93.9% in year of 1994 and C.H.D.A. of 100% in 1975. Proportion of insurance showed increasing tendency such as 6.6% in 1980, 21.3% in 1985, 69.0% in 1990 and relatively C.H.D.A. showed decreasing tendency.

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유아교육과 신입생 멘토링 프로그램에 참여한 멘티의 경험의 의미 (The meaning of the mentee's experiences who participated in the mentoring program for freshmen of department of early childhood education)

  • 서혜정;원계선;임진형
    • 한국보육지원학회지
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    • 제7권1호
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    • pp.67-92
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    • 2011
  • 본 연구는 유아교육과 신입생을 대상으로 한 멘토링 프로그램의 멘티인 신입생의 경험과 그 의미를 드러내는 데 목적이 있다. 연구 참여자는 3년제 대학 유아교육과 1학년 13명이었다. 연구 자료의 수집은 2010년 3월 21일에서 2010년 9월 9일에 걸쳐 이루어졌다. 수집한 자료는 멘토링 프로그램에 참여한 후 멘티들이 기록한 저널, 서술식 질문지, 면담자료이다. 이러한 자료들은 세그멘팅, 초기 코딩, 심층 코딩의 과정으로 분석하였다. 분석 결과 멘티들은 첫 만남에서 독특한 경험과 감정, 관계형성에 대한 기대감, 멘토로부터 얻는 다양한 정보들을 경험하였고, 전체 프로그램에서 시간관리, 발표 방법, 자료 찾는 방법, 시험 잘 보는 요령, 진로설계 등을 배우고 실천하였다. 그러나 멘토들과의 사적인 만남이 없어 아쉬웠다는 경험도 이야기 하였다. 멘티들은 이러한 멘토링 경험을 인생에서 좀처럼 만나기 힘든 행운이라 생각하게 되어서, 이후 자신이 받은 것을 멘토, 예비 후배와 나누고 싶은 마음이 생겼다. 한편으로 멘티들은 멘토와의 관계 교류 보강을 포함하는 더 진보된 멘토링 프로그램을 제안하기도 하였다.

성별에 따라 아동이 지각한 부모의 방임학대와 지역사회 인식이 학교생활적응에 미치는 영향 (The Effects of Parental Abuse/Neglect Perceived by Child and Community Awareness of Child on School Life Adjustment according to Child Gender)

  • 김혜금;양숙경
    • 한국보육지원학회지
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    • 제10권5호
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    • pp.117-131
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    • 2014
  • 본 연구는 성별에 따라 초등학교 6학년 아동이 지각하는 부모의 방임학대와 지역사회 인식이 학교생활적응에 미치는 영향을 살펴보았다. 본 연구의 대상은 한국아동 청소년패널조사 3차년도(2012년) 데이터로서 초등학교 6학년 학생 총 2,219명(남아 1,167명, 여아 1,052명)이었다. 연구결과는 다음과 같다. 첫째, 남아가 여아에 비해 부모의 학대를 더 지각하는 것으로 나타났고 남아가 여아보다 지역사회를 긍정적으로 인식하는 것으로 나타났으며 남아가 여아보다 교우관계 적응에 어려움을 갖는 것으로 나타났다. 둘째, 남아가 지각한 부모의 방임과 학대는 학교생활적응의 모든 하위요인과 부적 상관을 보였고 남아가 지각한 지역사회 인식은 학교생활적응의 모든 하위요인과 정적 상관이 있는 것으로 나타났다. 한편 여아가 지각한 부모의 방임과 학대는 학교생활적응의 모든 하위요인과 부적 상관을 보였고 여아가 지각한 지역사회 인식은 학교생활적응의 모든 하위요인과 정적 상관이 있는 것으로 나타났다. 셋째, 남아와 여아 모두 부모의 학대와 방임을 덜 지각할수록, 지역사회가 안전하고 믿을만하다고 지각할수록 학교생활적응을 더 잘 하는 것으로 나타났다. 본 연구결과는 초등학교에서 중학교로 이행해가는 전이과정에 있는 6학년 아동의 학교생활적응을 향상시킬 수 있는 부모의 방임학대와 지역사회 인식의 기초자료를 제공하였다는 점에서 의의를 찾을 수 있다.

소아에서의 shell teeth의 치험례 (TREATMENT OF SHELL TEETH IN CHILD : A CASE REPORT)

  • 박인호;윤정훈;이창섭;이상호;이난영
    • 대한소아치과학회지
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    • 제32권1호
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    • pp.49-54
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    • 2005
  • Shell teeth는 매우 드문 상아질 이상으로 상아질 이형성증의 한 형태로서 특징적으로 정상적인 법랑질, 매우 얇은 상아질, 비정상적으로 큰 치수강, 짧아진 치근 등을 보인다. Shell teeth는 1954년 Rushton이 21세 남자 환자에서 나타난 증상을 설명하여 처음 명명하였으며, 1984년 Kinirons이 8세 남아의 shell teeth에 대해 보고하였다. 1992년 Harrison과 Kennedy는 7세 6개월 된 남아에서 보인 shell teeth를 14년간 관찰하여 보고하였는데 이 환아는 유치열과 영구치열 모두 shell teeth가 관찰되었고, 일반적인 shell teeth와 달리 치관에서는 shell teeth의 특징이 나타나지 않았으며, 치근에서만 나타났다. 매우 얇은 상아질과 큰 치수강은 국소적 이형성증에도 관찰되는 특징인데, shell teeth는 전치열에서 보이는데 반해 국소적 이형성증은 한정된 몇 개의 치아에서만 관찰되어 감별진단 할 수 있다. 본 증례는 3세 남아에 관한 것으로 구강내 소견은 모든 유치 치관이 파괴되어 상아질이 노출되어 있었고, 방사선 소견은 얇은 상아질로 둘러싸인 매우 큰 치수강과 확장된 치근관을 보였으며 다수의 소구치가 결손되어 있었다. 환아는 행동조절의 문제 때문에 전신마취하에 치료를 받았다. 현재 환아는 공간유지장치를 장착하고 있으며, 정기적인 관찰이 필요하리라 사료된다.

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