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Prediction of Prognosis to Concurrent Chemo-Radiotherapy by Standardized Uptake Value of $2-[18^F]$ Fluovo-2-Deoxy-D-Glucose for Nasopharyngeal Carcinomas (비인강암 환자의 예후에서 $2-[18^F]$ Fluoro-2-Deoxy-D-Glucose PET 영상에서 계산되는 Standardized Uptake Value의 의의)

  • Lee Sang-wook;Im Ki Chun;Nam Soon Yuhl;Kim Jae Seung;Choi Eun Kyung;Ahn Seung Do;Shin Seong Soo;Ryu Jin Sook;Kim Sang Yoon;Lee Bong-Jae;Choi Seung-Ho;Kim Sung-Bae;Moon Dae Hyuk
    • Radiation Oncology Journal
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    • v.23 no.1
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    • pp.9-16
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    • 2005
  • Purpose : To prospectively evaluate the use of positron emission tomography with the glucose analog fluoro-deoxyglucose (FDG-PET) to deoxyglucose (FDG-PET) to predict disease-free survival (DFS) after concurrent chemo-radiotherapy (CCRT) in patients with non-disseminated nasopharyngeal carcinoma (NPC). Materials and Methods : We studied 41 patients with non-disseminated NPC scheduled to undergo platinum-based CCRT were eligible for this study. Patients were studied by FDG-PET prior to the CCRT. FDG uptake of tumors were measured with the maximal standardized uptake value (SUV). Results : Complete response rate was $100\%$. In ten patients who presented with any component of treatment failure, the median $SUV_{max}$ was 8.55 (range: $2.49\~14.81$) in any component of failure and the median $SUV_{max}$ was 5.48 (range: $2.31\~26.07$) In the remaining patients without any such failure. Patients having tumors with high FDG uptake had a significantly lower 3-year DFS ($51\%\;{\nu}91\%$, p=0.0070) compared with patients having low uptake tumors. Conclusion : FDG uptake, as measured by the SUV, has potential value in predicting DFS in NPC treated by CCRT, High FDG uptake may be a useful parameter for Identifying patients requiring more aggressive treatment approaches.

A Change Detection of Urban Vegetation of Seoul with Green Vegetation Index Extracted from Landsat Data (Landsat 녹색식생지수를 이용한 서울시 도시녹지 변화 조사)

  • 박종화
    • Korean Journal of Remote Sensing
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    • v.8 no.1
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    • pp.27-43
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    • 1992
  • The purpose of this study is to detect and evaluate the change of urban vegetation of Seoul during 1980s. Large areas covered with agricultural crops or forests were converted to residential and commercial areas, roads, schools, sports complexes, etc. There were also widespreas concerns on the deterioration of the quality of urban vegetation due to severe air pollution, overcrowding of nature parks, and idling of farm lands by land speculators. The image used for this study were MSS(Oct. 4, 1979) and TM(Apr. 26, 1990). The Green Vegetation Index of Kauth & Thomas(1976) was for the analysis. The GVI were resampled with 75$\times$75m grids and overlaid with the jurisdictional boundaries of 22 districts of Seoul. The results were reclassified to 6 classes, class 6 representing grids with the most vigorous vegetation or the best vegetation improvement in 1980s. The finding of this study can be summarized as follows : First, the most vigorous vigorous vegetation, in terms of GVI, of the 1979 image can be found at paddy fields located on alluvial near Han River. Broad-leaf forests located on hilly terrains have higher GVI than conifers located on the upper-parts of mountains. The average GVI of the northern part and southern part of Han River are 3.56 and 3.74, respectively. The main reason why the southern part has higher GVI is that there are more prime agricultural lands. Districts of Kangseo, Yangcheon, and Songpa have the highest percentage of grids of GVI class 6, and the percentages are 3.55 %, 3.47 %, and 2.69 %, respectively. Second, the most vigorous vegetation of the 1990 image can be found at the grass lands of the Yongsan golf club and the Sungsu horse racing track. The GVI of farm lands is lower than forest because most agricultural crops are at the early stage of growing season when the TM image was taken. The size of built-up area is much larger than of 1979. On the other hand, vegetation patches surrounded by developed area become smaller and have stronger contrast to surrounding area. The average GVI of the northern part and southern part of Han River are 3.57 and 3.51, respectively. The main reason why the southern part has lower GVI is the at more large-scale urban development projects were carried out in there during 1980s. Districts of Tobong, Nowon, and Seocho have the highest percentage of class 6, and the perecentages are 16.58 %, 10.14 %, and 8.50% respectively. Third, the change of urban vegetation in Seoul during 1980s are significant. Grids of GVI change classes 1 and 2, which represent severe vegetation loss, occupy 15.97% of Seoul. Three districts which lost the most vegetation are Yangcheon, Kangseo, and Songpa, where the percentages of GVI class 1 are 13.42%, 13.39% and 9.06%, respectively. The worst deterioration was mainly caused by residential developments. On the other hand, the vegetation of some part of Seoul improved in this period. Grids of GVI change classes 5 and 6 occupy 9.83 % of Seoul. Distircts of Jung, Yongsan, and Kangnam have the highest percentage of grids with GVI change classes 5 and 6, and their percentages are 22.31%, 19.17%, and 13.66%, respectively. The improvement of vegetation occurred in two areas. Forest vegetation is generally improving despite of concerns based on air pollution and heavy use by recreationists. Vegetation in open spaces established in riverside parks, large residential areas, and major public facilities are also improving.

A study on the state of inservice education for dental hygienists and their relevant awareness (치과위생사의 보수교육 실태 및 인식에 관한 연구)

  • Jung, Jae-Yeon;Kim, Kyung-Mi;Cho, Myung-Sook;Ahn, Geum-Sun;Song, Kyoung-Hee;Choi, Hye-Jung;Choi, Youn-Seon;Hwang, Yoon-Sook
    • Journal of Korean society of Dental Hygiene
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    • v.7 no.1
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    • pp.73-89
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    • 2007
  • The purpose of this study was to examine the reality of inservice education provided to members of Korean Dental Hygienists Association, the state of relevant academic conferences, and the perception of the members about inservice education and academic conference. It's basically meant to help boost their participation in inservice education and their satisfaction with it, and to show some of the right directions for that. The subjects in this study were dental hygienists who attended a symposium on July 1, 2006. After a survey was conducted, the answer sheets from 489 participants were analyzed, and the findings of the study were as follows: 1. General hospitals and university hospitals made up the largest group(91.4%) that gave a monthly leave of absence, and the second largest group was dental hospitals(75.4%), followed by dental clinics(58.3%) and public dental clinics(48.0%). The most common closing time in dental clinics and dental hospitals was 5 p.m., and that was 12 p.m. in general hospitals and university hospitals. The dental hygienists in public dental clinics didn't work on Saturdays. By type of workplace, treatment was the most common duty for the dental hygienists in dental clinics and dental hospitals to perform, and those who worked at general hospitals, university hospitals and public health clinics were in charge of extensive range of jobs. 2. The rates of the dental hygienists who took that education stood at 94.9% in public dental clinics, 78.7% in dental hospitals and 75.3% in dental clinics, general hospitals and university hospitals. Regarding how many marks they got on an yearly basis, those who got eight marks or more made up the largest group(55.6%), followed by four marks or more(11.8%), six marks or more(3.4%), and two marks or more(1.5%). As for the usefulness of inservice education for their job performance, the largest number of the dental hygienists(40.8%) found it to be helpful, and the second greatest group(37.5%) considered its effectiveness to be so-so. The third largest group(8.4%) found it to be of great use, and the fourth biggest group(4.2%) considered it to be of no service. The fifth biggest group(l.3%) thought it was absolutely useless. By type of workplace, the workers in dental clinics, dental hospitals, general hospitals and university hospitals wanted the most to learn how to take care of clinical work(acquisition of up-to-date technology), and those in public health clinics hoped the most to learn about public dental health. By type of workplace, the workers in dental clinics had their sight set on self-development the most, and the dental hygienists in dental hospitals, general hospitals, university hospitals and public health clinics were most in pursuit of acquiring new knowledge. By type of workplace, the specific given conditions at work were most singled out by the dental clinic workers as the reason, and the dental hospital employees pointed out time constraints the most. The dental hygienists in general hospitals and university hospitals cited time constraints and financial burden the most, and the public health clinic personnels mentioned inaccessibility of a place for inservice education as the reason. 3. The public health clinic workers participated in academic conferences the most(90.8%), followed by the general and university hospital personnels(68.8%), dental hospital employees(65.6%) and dental clinic workers(65.5%). By type of workplace, the public health clinic workers(73.5%) expressed the most satisfaction, followed by the general and university hospital employees(67.7%), dental clinic workers(62.3%) and dental hospital personnels(54.1%). By type of workplace, the employees of dental clinics, dental hospitals, general hospitals and university hospitals preferred Saturdays, and the public health clinic workers had a liking for weekdays. As for a favored place, hotels were most preferred, followed by university hospitals, general hospitals, college lecture rooms, district halls and local public institutions. Hotels were most favored regardless of the type of workplace. 4. Regarding outlook on inservice education, they had the highest opinion on the facilities and given conditions of lecture rooms($3.41{\pm}0.83$), followed by the professionalism of lecturers($3.34{\pm}0.83$), procedures of receipt and attendance confirmation($3.34{\pm}0.83$) and class size($3.13{\pm}0.89$). On the contrary, they took the most dismal view of the inaccessibility of a place of inservice education($2.08{\pm}0.92$), followed by limited opportunity and limited date for that education($2.51{\pm}0.99$), extra financial burden($2.53{\pm}1.18$) and high tuition fee($2.57{\pm}0.96$).

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Comparison of the Results in Gastric Carcinoma Patients undergoing Billroth I and Billroth II Gastrectomiesy (원위부 위암에서 위절제술 후 위재건술식에 따른 잔위기능 및 영양 증상학적 삶의 질 비교)

  • Kim, Sung Geun;Kim, Young Kyun;Heo, Youn Jung;Song, Kyo Young;Kim, Jin Jo;Jin, Hyung Min;Kim, Wook;Park, Cho Hyun;Park, Seung Man;Lim, Keun Woo;Kim, Seung Nam;Jeon, Hae Myung
    • Journal of Gastric Cancer
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    • v.7 no.1
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    • pp.16-22
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    • 2007
  • Purpose: The proper reconstruction technique to use after a distal subtotal gastrectomy for a gastric carcinoma, there has been a subject for debated what is the proper reconstruction technique. The aim of this study was to compare the gastricemptying time and the quality of life following both B-I and B-II reconstructions after a distal gastrectomy for a gastric adenocarcinoma. Materials and Methods: We studied 122 patients who had undergone a distal gastrectomy for a gastric adenocarcinoma between June 1999 and July 2002 at our hospital. 51 patients underwent B-I group, and 71 patients underwent B-II group. To evaluate the gastric-emptying time, we analyzed the T1/2 time by means of radionuclide scintigraphy using a gamma camera after ingestion of an $^{99m}Tc$-tin-colloid steamed egg. The nutritional status was measured by the weight change. Postgastrectomy syndrome was evaluated using an abdominal symptoms survey. Dumping syndrome was measured using the Sigstad dumping score. Results: The gastric-emptying time was somewhat delayed in the B-I group after a 6 month period, but there was no difference after 12 months between the two groups. There was less weight loss in the B-I group than in the B-II group (P=0.023). Fewer abdominal symptoms were occurred in the B-I group than in the B-II group. Dumping syndrome occurred less frequently in the B-I group than in the B-II group (P=0.013). Conclusion: In our study, the Billroth I reconstruction led to less weight loss, a better nutritional status, and a better quality of life than the Billroth II reconstruction. We concluded that after a distal subtotal gastrectomy, the Billroth I reconstruction would be considered when the procedure is oncologically suitable.

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Fertilizer Effect of Waste Nutrient Solution in Greenhouses for Young Radish Cultivation (열무 재배를 위한 시설하우스 폐양액의 비료 효과)

  • Hong, Youngsin;Moon, Jongpil;Park, Minjung;Son, Jinkwan;Yun, Sungwook
    • Journal of Bio-Environment Control
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    • v.31 no.4
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    • pp.460-467
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    • 2022
  • The purpose of this study is to enhance utilization of the waste nutrient solution (WNS) disposed at the hydroponic greenhouse. Several sets of testing were conducted to examine the effects of WNS: (a) a fertilizer effect, (b) soil column leaching, and (c) crop cultivation. The fertilizer effect test was applied in young radish cultivation by examining the growth characteristics of young radish and soil based on inorganic nitrogen according to the soil treatment of the nitrogen fertilizer (NF) and the WNS. The fertilizer effects and crop cultivation test were conducted with five treatments (A-E): A, non-treatment (water); B, 100% of NF; C, 70% of NF + 30% of WNS; D, 50% of NF + 50% of WNS; and E, 30% of NF + 70% of WNS. The soil column leaching test was conducted with three treatments: non-treatment (water), 100% of NF, 50% of WNS + 50% of NF. As a result, the chemical properties of the WNS were pH 6.0, EC 2.4dS·m-1, total phosphorus (T-P) 28mg·L-1, ammonium nitrogen (NH4-N) 5.0mg·L-1, and nitrate nitrogen (NO3-N) 301mg·L-1. The chemical properties of the soil were pH 5.51, EC 0.31dS/m, organic matter 2.08g·kg-1, NO3-N 9.64mg·kg-1, and NH4-N 3.20mg·kg-1. The results of fertilizer effects showed that the ratio of 50% or less of NF and 50% or more of WNS was high in young radish growth. There was no statistically significant difference between the soil chemistry in the C-E treatments where WNS was mixed with NF and the B treatment where only NF was applied. As a result of the soil column leaching test, there was no significant difference in the concentrations of NO3 and NH4 in the treatment of 100% of NF and 50% of NF + 50% of WNS. The study indicates, if the mixed fertilizer of WNS and NF is applied in the soil cultivation of young radish, it will reduce the use of NF and environmental pollution. This also helps reduce production costs on farmers and increase the yield of young radish.

A survey on sex life behavior and factors of low back pain (요통환자들의 성생활 행태와 영향 요인 조사)

  • Nam, Chul-Hyun;Woo, Kwang-Seog
    • Journal of Korean Physical Therapy Science
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    • v.9 no.3
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    • pp.31-49
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    • 2002
  • The purpose of this study was to investigate discomforts and sexual life and to identify the relation between the discomforts and sexual life with low back pain. The data were collected from March 2 through July 31, 2001. Four hundred forty-two questionnaires were returned (response rate=88.0%). Analysis of the data was done with SPSS PC+ and use descriptive statistics, $x^2$-test, t-test, ANOVA. regression. The statistics shows that over than 80% of the adults experienced lumbago at least one time in their life, and Back pain is known as one of the most common complaints made by the patients of all ages in the general hospital or local medical clinics throughout. However, in certain case it leads to a chronic condition which can cause a great deal of problems in management and in financial burden to individuals and society. The result of this study was summarized as follows: 1) It appeared that regarding the distribution of gender, male was the higher(63.6%) then that of female, the portion of forties was 28.5%. Sitting for long time was 23.1% in men and 21.7% in women. Unknown reason including sexual behaviour was 12.9% in men and 15.5% in women. Patients treated medicine and physical therapy were 36.4%. In level of educational background, the rate of high school was 31.0%, technical college was 28.5%. The highest proportion by occupation was 18.3% of office workers, occupation posture was 41.9% of sitting. 2) Men(26.0%) and most of women(34.8%) were not satisfied in the explanation satisfaction rate of sex life concerned disease. 23.8% in men and 23.6% in women considered flexibility of waist good. Man(33.3%) and most of woman(35.0%) considered that Health education is necessary. 32.7% in men and 27.3% in women did't mind educator is whoever. Preventing of lower back pain(LBP) and proper Health education of sex life are demanded in daily life. 3) 58.0% of man and 64.0% of woman mostly had a posture which is man over woman. 28.5% in men and 27.8% in women considered that proper information finding of LBP and sex life was very few and few. 37.7% in men and 42.7% in women have acquired information about sex life flung their friends. 4) The number of sex life was decreased from 2.96 0.98 to 2.61 1.63 and also the time of sex life was decreased from 3.65 1.89 to 226 1.64. The satisfaction rate of sex life changed from 3.60 0.86 to 2.77 1.10. In the number of sex life, The non correct group was 2.62 1.91 and the correct group was higher in 2.68 1.65. In the time of sex life, The non correct group was 2.02 1.47 and the correct group was higher in 229 1.65. The satisfaction rate of sex life was 2.76 0.86 in non correct group and 2.88 1.10 in correct group. So there was a difference. 5) In the satisfaction rate of sex life, Men who have a lower back pain were higher than women and no attack group was higher than attack group. As they had many sex life, the satisfaction rate was higher significantly in statistics. As the time of sex life was short, the satisfaction rate was lower significantly in statistics. As the age was low, the demand rate of Health education was high and as means of patient who had a lower back pain was high, the demand rate of Health education was high. As the patient who had a lower back pain had a long married life, the demand rate of Health education was high and as education level was high, the demand rate of Health education was high. It is necessary to provide patients with conservative treatment, educational teaching, and training to prevent further injuries in the future. In general, it is important to educate the public how to prevent back injuries and how to treat themselves in an onset period to prevent further injuries sliding into a chronic state. Sexuality is an integral part of normal and healthy relationships, but patients are unable to enjoy sex because they are riot able to get into a comfortable position due to back pain. Many conditions of the spine can make certain positions uncomfortable. Health educator should make the education program of the discomforts and the sexual pattern for low back pain in workplace and/or hospital. Further study Is needed on how to integrate the educational program on sexuality into the total rehabilitation program.

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A STUDY ON THE FIVE ELEMENT THEORY INTODUCED (<황제내경(黃帝內經)>에 유입(流入)된 오행학설(五行學說)에 관(關)한 연구(硏究))

  • Kim, Boo-Hwan;Park, Hyun-Kook
    • The Journal of Dong Guk Oriental Medicine
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    • v.1
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    • pp.161-191
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    • 1992
  • The purpose of this study is how have the form and theory of the five element theory in the (黃帝內徑) by the investigation of the course of the course of the five element introduced the ancient oriental medicine from ancient oriental philosophy. The following results were obtained. 1. The five elements in (尙書) meaned the uses of water, fire, earth, wood, metal which were important in living. Because these had very important meaning in ancient political and economic society, emphasized to big law(洪範) 2. The five elements in (左傳) and (國語) mean the five uses too, and there are the phases of "five win metal"(火勝金) and "wather win fire"(水勝火), but these only meaned the physical interrelation. 3. In the five circulating factor theory made by Chu Yen(鄒衍) which have the attribute of the five elements, he more reasonably had argued human affairs like that a dynasty become different in step with the circulating five favors. There is the regular annual policy in the (呂氏春秋) which closely connected nature and human living, and attached the various colors, animals, visceras, flavors, sounds, the sexagenary cycle and so on to the five elements. 4. In the (春秋繁露) writed in fore-period of Han(漢) dynasty, the interactions of the five elements are concretely applicated to policy, Dong Jung Soe(童仲舒) had discrived the interactions of the five elements by Dong Lyu Sang Dong theory(同類相動說) and the misfortune theory(災異說), emphasized the sympathy of nature and human. Thought there is many content which are superstitious and contradictory, I concider which that affcted many effects in the formation of five element theory of oriental medicine. In the (淮南子) the order of matters were explained by the five element theory too, as the interrelations of the five elements were explained by the sexagenary ctcle, I assume that the bud of O-Un theory(五運理論). And there was not founded the fullscale intriduction of the five element theory in the Ma Wang Tye(馬王堆) excavated finds, the Mu Yyi medical writings formed the dynasty(武威漢代醫簡) and the documents about Pyun Jak(偏鵲) and Sun U Ie(淳于意). 5. The application of the five element theory in the (Whang Di Nei Qing) (黃帝內徑) is devided into the attachement to the five elements, the interelations of the five elments, and Un Gi theery(運氣論). In the attachment to the five elemeant theory, it made the attachment of the five viseras of (今文尙書) party a standard and attached the sections of a human body, the whole internal organs of sense, the five colors, the five flavors and the five sounds and so on to the five elements. It put to use by means of the apllivation of the interrelation of the five elements in the transferations of the diseases and the relative severeness of a disease in step with change of time and season. Un Gi theory(運氣論) which synthesized by the attachment to the five elements, the inter-relations of the five elements and the climate which observerd from ancient times systematically argued the effects of weather to human. 6. The application of the five elements theory in (黃帝內徑) have the significant what had get rid of irrational factors like that the emotion and action of human could to influense the weather, what had been formes more rational thingking by the obesrvation of human and nature. It is required more reserches about the possibility of the formation of the doctrinal faction bt the geographical effect of the Yon, Je(燕,薺) region, the application of the five element theory in other ancient medical books and the relationship of the five element theory and Yin Yang(陰陽)

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A Study on Effective Management & Administration System for Deluxe Hotel Kitchen in Seoul Area. (관공호텔 조리직무의 분업과 통합에 따른 문제점과 개선방안에 관한 연구)

  • 라영선
    • Culinary science and hospitality research
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    • v.1
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    • pp.57-89
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    • 1995
  • Despite prologed business stagnation of both international and domestic economy, hotel business as well as tourist industry has continuously been keeping growing, owing to increase of surplus income and world flowing population. During recent 4 years, growth rate of yearly mean in domestic hotels reached 9.9% and especially that of the superior class hotels 15.2%. In the composition of domestic tourist hotel's revenue, the earnings of guest rooms form 37.4%, on the other hand those of food & beverage 39.9%. This result is that our hotel business is concentrated on its interest in FOOD & BEVERAGE of which productivity per unit dimension can be increased to an unlimited extent and extent and superior class hotels strengthened in F&B are increasing in comparison with European or American hotels which are focused on guest rooms in their management. For value added rate of F&B is low as compared with increase of their earnings, they are interested in the management techniques which focus on rising the rate. As for the cost of Food & Beverage, personnel expenditure forms 36.5% and the direct materials 31.5%. Therefore how to manage personnel and materials costs which compose as much as 68% of total revenue will greatly affect net profit. We can say that an effective management technique in cost of Food & Beverage is one of the most important know-hows in hotel management. Especially management know-how for the Kitchen Department where the most of foods come out makes a great effects on various expenses, productivity and it is the achievement from hotel management. For the most of the hotel's top managers, they don't seriously take the fact that KITCHEN SYSTEM affects greatly total expenditure. This study starts from the point of recognizing the question of fundamental cause affecting tow largest cost elements incurred in Food & Beverage and trying to present an effective kitchen system. To settle the questions raised, I compared and analyzed productivity and cost of food & beverage and unit kitchen centered around superior class hotels in Seoul, which vary in Kitchen Systems. In order to attain the aforementioned study effectively purpose of this study, I compared Room-Service and Coffee-Shop Menu, flow of basic food in the kitchen, extent and result of division of labor and integration in the kitchen, scale of outlet kitchen, productivity, the turnover rate of food in store, food cost rate one another which all vary in Kitchen Systems. All these elements are compared and analyzed each other being divided into two main groups such as①. Main Production kitchen and Banquet Kitchen, and ②. coffee-shop kitchen and Room-service Kitchen. Therefore this study is to point out the problems in managing kitchens of superior class hotels which are different in systems. An effort was made to find out the better Kitchen System for superior deluxe hotels. I emphasize the followings on the proper scale of division of labor and integration of unit kitchen and a disposition plan for outlet kitchens of restaurant. First, KITCHEN SYSTEM as a sub-system of Hotel Management System is composed of sub-systems of outlet unit kitchen. Basic food materials are cooked and served for the guests while support kitchen and out restaurant kitchen interact organically each other. So Kitchen should be considered as a system composed of integrated sub-systems. Second, support and banquet kitchens should be integrated to be managed. And these unit kitchens have to be designed to be placed in the back of banquet rooms area. Third, coffee-shop kitchen and room-service kitchen should be integrated to be managed. Fourth, several unit business kitchens should be place on the same floor. Fifth, main production kitchens ought to be located near the loading duck, food store and large refrigerator. Sixth, considering the limits of supervision, duties should be adjusted as 12-20 cooks in two shifts a day for a sub-kitchen, and 18-30 cooks in three shifts a day so that labor division can be made. Last, I would like to two points for direction and task of future study. Firstly, I compare the effective income and increasing costs each other, which are incurred by increasing the use rate of the second processing materials for foods perched outside and through the results. I can find out the better points of the processing production and circulation system, and then I study this effects made on hotel kitchen system. Secondly, I can point out that more efficient kitchen system shall be established through comparing and analyzing the matter of amount of indirect costs and flow of food in different kitchen systems.

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A Study to Determine the Effectsiveness of Severance Hospice Home Care Program (호스피스케어에 대한 평가 연구 - 세브란스호스피스 중심으로)

  • Kingsley, Marian R.N.;Cho, Won-Jung;Kim, Cho-Ja;Lee, Won-Hee;Yoo, Ji-Soo
    • The Korean Nurse
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    • v.29 no.4
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    • pp.51-72
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    • 1990
  • The purpose of this study was to determine whether Severance Hospice Home Care Pro gram was able to meet its objectives. This was done in order to show in detail the effects of hospice home care on the quality of life of terminally ill patients and to provide rationale for setting up more hospice home care programs in korea. The results of the study were as follows: The subjects of the study were 100 terminally ill patients who hnd died 'while in the hospice program and 64 family members who were registered with Severance Hospice Home Care Program between march 1988 and Feb. 1990. The nursing needs of these terminally ill patients were assessed by the nursing records of these patients. The need for pain control(82%) was the highest nursing need so far as the physical aspects were concerned. This was followed by poor appetite(37%), 8 dyspnea(34%), nausea and vomiting(30%) in that order of frequency. In reqard to spiritual needs, the need for religious' support was also high at 72%. Their main psychological symptoms were anxiety and fear(34% ). Burn-out was a major problem for 44% of the family members. The psychological process experiencel by the terminal ill patients was compared to the dying process, described by Kiibler Ross. In comparison of the five stages outlined by kubler Ross with the dying process of the subjects it was found that the subjects not only experienced the five stages but also experienced denial and doubt-fulness or denial with acceptance or acceptance with the expectation of a miracle. But rather than acceptance of the dying process, giving up was a frequent end point of the psychological process, of the subjects. However, when the combination of states was observed, most of the patients reached the state of acceptance in the dying process. It was difficult to identify a definite pattern of change in the psychological process of the subjects. Also it was difficult to identify the factors that influenced the psychological process. The symptoms of the terminally j]] subjects just before dying, that is, 3-4 days before dying included apparent signs of dying. These were a reduction of intake(77%), reduction of the amount of urination(63%), increase in sleeping time (64%) and acceptance of dying by patients and their families who had been unaccepting be before that time(66%). The primary care givers(family member's) degree of satisfaction with the care given to the patient by the hospice was 88.7%. The results of this study show that Severance Hospice Home Care Program had a positie effeet on the quality of life of the terminally ill patients and their family members as they faced the death of the patient. It can be seen from this study that there is an urgent need to extend hospice programs - in order to provide quality of care for terminally ill patient and their families. Based upon the reesults of this study several suggestions are presente as follows: 1) A follow up study should be carried out to identify the dying process as it is unique to Korea. 2) A comparison should be made of other hospice care programs. 3) A comparison study should- be made with subjects who do not receive any hospice care as compared to those who do by use of an experimental and control group methodology. 4) There is a need to determine a scientific method to adequeto measure the interventions carried out to meet the hospice patients nursing care needs. 5) A study should be made using quality research methodology to evaluate effects of hospiec care from the patients, their family members and the nurrse's perspective.

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MECHANISM IN ANTIBACTERIAL ACTIVITY OF POLYPHOSPHATES AGAINST PORPHYROMONAS ENDODONTALIS (Porphyromonas endodontalis에 대한 Polyphosphate의 항균기전에 관한 연구)

  • Choi, Sung-Baik;Park, Sang-Jin;Choi, Gi-Woon;Choi, Ho-Young
    • Restorative Dentistry and Endodontics
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    • v.25 no.4
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    • pp.561-574
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    • 2000
  • Poly-P has been used to prevent decomposition of foods and has been shown to have inhibitory effect on the growth of gram positive bacteria. The purpose of this study was to evaluate the effect of poly-P on the growth of Porphyromonas endodontalis, a gram negative obligate anaerobic rod, endodontopathic bacterium. P. endodontalis ATCC 35406 was in BHI broth containing hemin and vitamin K with or without poly-P. Inhibitory effect of each poly-P which was added at the beginning(lag phase) or during(exponential phase) the culture, MIC(minimum inhibitory concentration) was determined by measuring the optical density of the bacterial cell at 540nm. Viable cell counts were measured to determined whether poly-P has a bactericidal effect. Leakage of intracellular nucleotides from P. endodontalis was determined at 260nm and morphological change of P. endodontalis was observed under the TEM(transmission electron microscope). Binding of 32P-labeled poly-P to P. endodontalis was examined. SDS-polyacrylamide gel electrophoresis and zymography were performed to observe the changes in protein and enzyme profiles of P. endodontalis, respectively. The results from this study were as follows : 1. The minimal inhibitory concentration(MIC) of poly-P to P. endodontalis appeared to be 0.04~0.05%. 2. Poly-P added to the P. endodontalis culture during the exponential phase of P. endodontalis was as much effective as poly-P added at the begining of the culture, suggesting that the antibacterial effect of poly-P is not much dependent on the initial inoculum size of P. endodontalis. 3. Poly-P are bactericidal to P. endodontalis, demonstrating the decrease of the viable cell counts. 4. Intracellular nucleotide release from the P. endodontalis, was not increased in the presence of poly-P and was not reversed by the addition of divalent cations like $Ca^{2+}$ and $Mg^{2-}$. 5. Under the TEM, it was observed that fine electro-dense materials were prominent in the poly-P grown P. endodontalis, appearing locally in the cell, and the materials were more abundant and more dispersed in the cell as the incubation time with poly-P increased. In addition, highly electron dense granules accumulated in many poly-P grown cells, most of which were atypical in their shape. 6. Binding of 32P-labeled poly-P to P. endodontalis appeared to be 32.8 and 45.5 and 53.4% at 30 minutes, 1 hours and 2 hours, respectively. 7. In the presence of poly-P. the synthesis of proteins with apparent molecular masses of 25, 27, 35, 45 was lost or drastically decreased whereas expression of a protein with an apparent molecular mass of 75 was elevated. 8. Proteolytic activity of P. endodontalis was decreased by poly-P. The overall results suggest that use of poly-P may affect the growth of P. endodontalis, and the anti-bacterial activity of poly-P seems largely bactericidal. Changes in shape, protein expression, and proteolytic activity of P. endodontalis by poly-P may be directly and indirectly attributed to the antibacterial effect of poly-P. Further studies will be needed to confirm the effect of poly-P.

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