• Title/Summary/Keyword: Risk reduction

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Some Factors Affecting Bone Mineral Status of Postmenopausal Women (폐경 후 여성의 골격상태에 영향을 미치는 요인분석)

  • 오세인;이행신;이미숙;김초일;권인순;박상철
    • Korean Journal of Community Nutrition
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    • v.7 no.1
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    • pp.121-129
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    • 2002
  • Osteoporosis, the typical metabolic bone disease of the elderly, is characterized by a reduction in bone mineral density (BMD) and increased fracture risk. Genetic and environmental factors are known to play a key role in bone metabolism, and diet is also considered to be one of the important factors. The purpose of the present study was to investigate the relationship among the factors affecting BMD, including stature, body weight, age, time period since onset of menopause, and biochemical markers of bone turnover in postmenopausal women. Seventy-eight postmenopausal women who visited health promotion center for health examinations volunteered to participate in this study and they were divided into two groups according to the time period since onset of menopause : women with a time period since onset of menopause of less than 5 years (Group 1) and women with a time period since onset of menopause of 5 years or more (Group 2). The demographic characteristics and dietary intake were surveyed using a questionnaire. BMDs of the lumbar spine and femoral neck of subjects were measured by dual energy X-ray absorptiometry. Serum levels of 25-hydroxy-vitamin D and parathyroid hormone (PTH), known to be indicators of bone related hormone status, were anlyzed. Serum samples were measured for calcium, phosphorus, alkaline phosphatase, and osteocalcin as bone formation indicators, and urine was analysed for deoxypyridinoline, creatinine, calcium, and sodium as bone resorption indicators. The results are as follow : The mean BMDs of the lumbar spin and femoral neck were $1.02 \pm 0.02 g/cm^2 and 0.81 \pm 0.02 g/cm^2 respectively, and the BMD level of Group 2 was significantly lower than tat of Group 1 (p<0.01, p<0.05, respectively). The mean daily intake of energy was 1838 $\pm$ 55 kcal. When nutrient intake was compared with the recommended dietary allowances (RDA) of the subjects, only calcium, vitamin A and riboflavin intake showed means lower than the RDA. The nutrient intake did not show any significant differences between Group 1 and 2 Serum and urine levels of biochemical markers of bone turnover did not show any significant differences between Group 1 and 2, and all were within the normal range. However, the PTH and deoxypyridinoline levels showed a tendency to be higher, and the osteocalcin level to be lower in Group 2 than in Group 1. Although age and years after menopause (YAM) showed negative correlations with lumbar spine bone mineral density (LBMD) (r= -0.38, p<0.001, and r= -0.26, p< 0.05, respectively), no correlation was found with femoral neck bone mineral density (NBMD). While height, body weight and body mass index (BMI) showed a positive correlation with LBMD (r= 0.32, p<0.001, r= 0.38, p<0.001, r= 0.22, p= 0.05, respectively), only body weight and BMI showed a positive correlation with NBMD (r= 0.30, p<0.01, and r= 0.27, p<0.05, respectivley). There was no significant corealtion between BMDs and the nutrient intake of subjects, except in the case of carbohydrates (r= 0.22, p<0.05). Also, serum and urine levels of bone turnover markers showed no significant correlation with nutrient intake. On the other hand, serum osteocalcin had a positive correlation with vitamin C intake (r= 0.22, p= 0.05), and urine deoxypyridinolin showed a negative correlation with niacin intake (r= -0.22, p= 0.05). Urinary na was negatively correlated with protein intake(r= -0.23, p= 0.05). The results suggested that it is difficult to prevent the decrease in bone mass among postmenopausal women eating the usual Korean diet. However, the BMDs of the lumbar spine and femoral neck were positively related to body weight ad BMI in postmenopausal women. Therefore, this study confirmed that one of the most effective ways to minimize bone loss in postmenopausal women would be to maintain an adequate body weight with balanced nutrient intake and activity in the pre-and postmenopausal periods.

The Relationship of the Severity of Sleep Apnea Syndrome to the Resting Energy Expenditure and Leptin (수면무호흡증의 중증도와 안정시 에너지 대사 및 혈중 Leptin과의 관계)

  • Lee, Kwan-Ho;Shin, Kyeong-Cheol;Ahn, Jae-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.6
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    • pp.836-845
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    • 1999
  • Background : Obesity is present in the majority of adult patients with obstructive sleep apnea(OSA) and is considered to be a major risk factor for its development. A reduction in body weight has been associated with substantial improvement in the severity of apnea. However, a variety of treatment strategies for obesity have yielded limited sucess. This study was done to determine resting energy expenditure(REE) in patients with obstructive sleep apnea and the correlation between the severity of sleep apnea and REE, and to investigate whether leptin influences REE and correlated with the severity of sleep apnea in 39 patients with OSA and 45 controls matched for obesity. Method : Overnight polysomnography was performed on all subjects using standard techniques. Measurements of REE were made using a Sensormedic Vmax 229 and a canopy system. Serum leptin concentration was measured by human leptin RIA kit of LINCO Research INC. Results : REE was greater in patients with OSA compared with controls, but there was no difference between the two groups on REE%. And also there was no significant correlation between anthropometric data, polysomnographic data and REE%. Serum leptin was linearly related to body mass index(BMI), apnea index, apnea hypopnea index and lowest arterial oxygen saturation($SaO_2$) but not related to REE%. Conclusion : This study suggests the followings. Firstly patients patients with sleep apnea have a pattern of obesity characterized by energy homeostasis at an elevated body weight set-point. In order to achieve a lower body weight in these patients, it may be necessary to increase energy expenditure by increasing physical activity. Secondly leptin level was not correlated with REE, suggesting that leptin may predominantly regulate body fat by altering eating behavior rather than calorigenesis. Lastly leptin level was significantly correlated with the severity of sleep apnea. These elevated level of leptin in patients of sleep apnea may be related to the obesity, however it needs further studies to determine the relationship between the severity of sleep apnea and serum leptin.

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Strategies of Large Park Development and Management through Governance - Case Studies of The Presidio and Sydney Harbour National Park - (거버넌스를 통한 대형 도시공원의 조성 및 운영관리 전략 - 프레시디오 공원과 시드니 하버 국립공원 사례를 중심으로 -)

  • Sim, Joo-Young;Zoh, Kyung-Jin
    • Journal of the Korean Institute of Landscape Architecture
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    • v.44 no.6
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    • pp.60-72
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    • 2016
  • This study aims to suggest strategies of development and management for large parks by examining experimental cases of park governance models related to a shift away from public administration. The shifts towards governance as well as public-private partnership in city parks have involved the need for new public management. This study has analyzed two exemplary cases of Presidio Park and Sydney Harbour National Park in the aspects of planning process and management strategies, as the results derived the meaning and effect of park governance management and is also an essential prerequisite for the achievement of the model. There are six dimensions of research frames--namely policy, governance, partnership, finances and funds, design and maintenance-management, and evaluation-monitoring-taken as the basis for this study. Through the analysis, several key characteristics of these cases were elicited. First, the park planning process must be consistent in carrying a policy from planning to implementation, and furthermore, an independent operation body which can properly authorize an execution and uphold its responsibility from the public could serve in adaptable park services. Second, it has been suggested to build various partnerships with PAs and NGOs, private corporations, community groups, and academic institutes that allow it to expand the diversity of the park activities. Third, there has been experimental exploration to achieve a financially self-sufficient model by establishing internal revenue models and hence allow the reduction of reliance on public finances. The result of this type of park management would allow for improving park quality and make the park space a vital part of the local economy. Fourth, the strategies for a local community's participation are needed to allow the community to become a producer as well as a consumer. This study shows that the direction and significance of the park governance model regarding the fact that the plans sought by the two parks are extending the layout of public-centered discussion to the private sector and the third non-governmental sector including to the local community group. This shows both implications and limitations, such as the risk of privatization through non-governmental activities at the park or the violation of essential functions as a public good due to a profit-generating management policy for securing financial self-sufficiency. At the current point in which plans are under way for the development and management of large parks, a park governance model requires continuous study and expansion of discussion in the future.

PRESENT SITUATION AND PROSPECT OF PEDIATRIC DENTISTRY IN KOREA - FOCUSED ON MANAGEMENT OF DENTAL CARIES - (한국 소아치과의 현재와 전망 - 치아우식증관리 분야를 중심으로 -)

  • Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.39 no.2
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    • pp.206-225
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    • 2012
  • General status of pediatric dentistry in Korea is to conduct vigorous academic activities and specialized medical care centering the Korean Association of Pediatric Dentistry (KAPD) that has about 1,000 pediatric dentists as members, pediatric dentistry departments of 11 Colleges of Dentistry, numbers of pediatric dentistry training institutions and private clinics specialized in children. From 1996, the accredited pediatric dentists were produced by the KAPD and from 2008, the state began to produce the accredited pediatric dentists. Since then, doctors with expertise in pediatric care had opened private clinics in addition to the university hospitals, it became the basis of a momentum to deepen the specialty of pediatric dentistry. The Dentistry community of Korea is going through rapid and profound changes recently, and the underlying reasons for such changes can be classified largely into a few categories: (1) Decreasing population and structural changes in population (2) Increase in numbers of dentists, (3) Changes in the pattern of dental diseases and (4) Changes in medical environment. In Korea, the children population in the age range of 0 ~ 14 years old had been decreased by 2 million in 2010 compared to that of 2000 due to reduction of birth rate. The current population of children in the age range of 0 ~ 4 years old in 2010 takes up 16.2% of the total population, but it is estimated that such percentage would decrease to 8.0% by 2050. Such percentage is largely behind the estimated mean global population of 19.6% by 2050. On the other hand, the number of dentists had been largely increased from 18,000 in 2000 to 25,000 in 2010. And it is estimated that the number will be increased to 41,000 by 2030. In addition, the specialized personnel of Pediatric dentistry had been shown as increased by 2.5 times during past 10 years. For the changes in the pattern of dental diseases, including dental caries, each df rate of 5 years old children and 12 years old children had been decreased by 21.9% and 16.7% respectively in 2010 compared to 2000. Each df Index also had been decreased by 2.5 teeth and 1.2 teeth respectively. The medical expenditure of Korea is less than that of OECD and more specifically, the expenditure from the National Health Plan is less than OECD but the expenditure covered by households is larger than OECD. These facts indicate that it is considered as requiring the coverage of the national health plan to be reinforced more in the future and as such reinforcement needs continuous promotion. In medical examination pattern of Pediatric dentistry, the preventive and corrective treatment were increased whereas the restorative treatment was decreased. It is considered that such change is caused from decrease of dental caries from activation of the prevention project at national level. For the restorative treatment, the restorations in use of dental amalgam, pre-existing gold crowning and endodontic treatment had been decreased in their proportion while the restorative treatment in use of composite resin had been increased. It is considered that such changes is caused by the change of demands from patients and family or guardians as they desired more aesthetic improvement along with socio-economic growth of Korean society. Due to such changes in dentistry, the pediatric dentistry in Korea also attempts to have changes in the patterns of medical examination as follows; It tends to implement early stage treatment through early diagnosis utilizing various diagnostic tools such as FOTI or QLF. The early stage dental caries so called white spot had been included in the subjects for dental care or management and in order to do so, the medical care guidelines essentially accompanied with remineralization treatment as well as minimally invasive treatment is being generalized gradually. Also, centering the Pediatric dentists, the importance of caries risk assessment is being recognized, in addition that the management of dental caries is being changed from surgical approach to internal medicinal approach. Recently, efforts began to emerge in order to increase the target patients to be managed by dentists and to expand the application scope of Pediatric dentistry along with through such changes. The interest and activities of Pediatric dentists which had been limited to the medical examination room so far, is now being expanded externally, as they put efforts for participating in the preventive policy making process of the community or the state, and to support the political theories. And also opinions are being collected into the direction that the future- oriented strategic political tasks shall be selected and researches as well as presentations on the theoretical rationale of such tasks at the association level.

Effect Assessment and Derivation of Ecological Effect Guideline on CO2-Induced Acidification for Marine Organisms (이산화탄소 증가로 인한 해수 산성화가 해양생물에 미치는 영향평가 및 생태영향기준 도출)

  • Gim, Byeong-Mo;Choi, Tae Seob;Lee, Jung-Suk;Park, Young-Gyu;Kang, Seong-Gil;Jeon, Ei-Chan
    • Journal of the Korean Society for Marine Environment & Energy
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    • v.17 no.2
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    • pp.153-165
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    • 2014
  • Carbon dioxide capture and storage (CCS) technology is recognizing one of method responding the climate change with reduction of carbon dioxide in atmosphere. In Korea, due to its geological characteristics, sub-seabed geological $CO_2$ storage is regarded as more practical approach than on-land storage under the goal of its deployment. However, concerns on potential $CO_2$ leakage and relevant acidification issue in the marine environment can be an important subject in recently increasing sub-seabed geological $CO_2$ storage sites. In the present study effect data from literatures were collected in order to conduct an effect assessment of elevated $CO_2$ levels in marine environments using a species sensitivity distribution (SSD) various marine organisms such as microbe, crustacean, echinoderm, mollusc and fish. Results from literatures using domestic species were compared to those from foreign literatures to evaluate the reliability of the effect levels of each biological group and end-point. Ecological effect guidelines through estimating level of pH variation (${\delta}pH$) to adversely affect 5 and 50% of tested organisms, HC5 and HC50, were determined using SSD of marine organisms exposed to the $CO_2$-induced acidification. Estimated HC5 as ${\delta}pH$ of 0.137 can be used as only interim quality guideline possibly with adequate assessment factor. In the future, the current interim guideline as HC5 of ${\delta}pH$ in this study will look forward to compensate with supplement of ecotoxicological data reflecting various trophic levels and indigenous species.

Debris flow characteristics and sabo dam function in urban steep slopes (도심지 급경사지에서 토석류 범람 특성 및 사방댐 기능)

  • Kim, Yeonjoong;Kim, Taewoo;Kim, Dongkyum;Yoon, Jongsung
    • Journal of Korea Water Resources Association
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    • v.53 no.8
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    • pp.627-636
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    • 2020
  • Debris flow disasters primarily occur in mountainous terrains far from cities. As such, they have been underestimated to cause relatively less damage compared with other natural disasters. However, owing to urbanization, several residential areas and major facilities have been built in mountainous regions, and the frequency of debris flow disasters is steadily increasing owing to the increase in rainfall with environmental and climate changes. Thus, the risk of debris flow is on the rise. However, only a few studies have explored the characteristics of flooding and reduction measures for debris flow in areas designated as steep slopes. In this regard, it is necessary to conduct research on securing independent disaster prevention technology, suitable for the environment in South Korea and reflective of the topographical characteristics thereof, and update and improve disaster prevention information. Accordingly, this study aimed to calculate the amount of debris flow, depending on disaster prevention performance targets for regions designated as steep slopes in South Korea, and develop an independent model to not only evaluate the impact of debris flow but also identify debris barriers that are optimal for mitigating damage. To validate the reliability of the two-dimensional debris flow model developed for the evaluation of debris barriers, the model's performance was compared with that of the hydraulic model. Furthermore, a 2-D debris model was constructed in consideration of the regional characteristics around the steep slopes to analyze the flow characteristics of the debris that directly reaches the damaged area. The flow characteristics of the debris delivered downstream were further analyzed, depending on the specifications (height) and installation locations of the debris barriers employed to reduce the damage. The experimental results showed that the reliability of the developed model is satisfactory; further, this study confirmed significant performance degradation of debris barriers in areas where the barriers were installed at a slope of 20° or more, which is the slope at which debris flows occur.

Effects of Medicinal Enzyme Powder on Intestinal Mobility, Lipid Level, and Blood Parameters of Loperamide-Induced Constipation in Rats (약선효소 분말식이가 Loperamide의 투여로 유발된 변비 쥐의 장 운동과 지질 함량 및 혈액학적 성분 변화에 미치는 영향)

  • Park, Chan Sung;Park, Kyung Soo;Kim, Mi Lim;Kong, Hyun Joo;Yang, Kyung Mi
    • Journal of Life Science
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    • v.23 no.2
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    • pp.228-236
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    • 2013
  • This study was aimed at investigating whether dietary therapy using medicinal enzyme powder is effective in reducing constipation caused by loperamide in rats. Nine-week-old male Sprague Dawley were subdivided into 4 groups: normal diet group (C), loperamide treatment and normal diet (CL), medicinal enzyme powder diet (E), and loperamide treatment and medicinal enzyme powder diet (EL). Constipation was induced by subcutaneous injection of loperamide (1.5 mg/kg) 3 days prior to sacrifice. The treatment with loperamide led to an increase in weight gain, a decrease in the number and wet weight of fecal pellets, and a decrease in intestinal motility. The administration of the medicinal enzyme powder significantly reduced weight gain but increased intestinal mobility compared with the loperamide-treated group. The treatment with loperamide in the normal diet group reduced the activities of both suggesting that constipation may be involved in the low level of glutamic oxaloacetic transaminase (GOT) and glutamic pyruvic transaminase (GPT). Additionally, the loperamide treatment in the medicinal enzyme powder diet group increased the level of GOT, but reduced the level of GPT. Loperamide treatment also reduced cholesterol and increased the atherogenic index (AI) and cardiac risk factors (CRFs). Interestingly, the treatment with the medicinal enzyme powder effectively attenuated both the increase in AI and the reduction in high density lipopretein (HDL)-cholesterol, caused by the treatment with loperamide. Although there were no significant differences in the blood protein level, including hemoglobin and hematocrit, between the normal diet group and the loperamide-treated group, the administration of the medicinal enzyme powder to the loperamide-treated group effectively increased the levels of both hemoglobin and hematocrit. Collectively, the results demonstrate that the medicinal enzyme powder can help to combat the negative events caused by constipation.

Evaluation of the Jaw-Tracking Technique for Volume-Modulated Radiation Therapy in Brain Cancer and Head and Neck Cancer (뇌암 및 두경부암 체적변조방사선치료시 Jaw-Tracking 기법의 선량학적 유용성 평가)

  • Kim, Hee Sung;Moon, Jae Hee;Kim, Koon Joo;Seo, Jung Min;Lee, Joung Jin;Choi, Jae Hoon;Kim, Sung Ki;Jang, In-Gi
    • The Journal of Korean Society for Radiation Therapy
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    • v.30 no.1_2
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    • pp.177-183
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    • 2018
  • Purpose : Volumetric Modulated Arc Therapy(VMAT) has the advantage of uniformly and precisely irradiating the tumor to the shape of the tumor while reducing the risk of radiation damage to normal tissues. such as brain cancer, head and neck cancer and prostate cancer, It is being used for treatment. The purpose of this study is to evaluate the usefulness of the Jaw-Tracking technique(JTT) in VMAT for brain and head and neck cancer. Materials and Methods : We selected eight patients with brain and head and neck cancer(4 Brain, 4 head and neck) who were treated with the VMAT treatment technique. Contouring information of the patient's tumor and normal organ was fused to the Rando phantom using the deformable registration of Velocity(Varian, USA). A treatment plan was developed using the Varian Eclipse(ver 15.5, Varian, USA) with the same patient actual beam parameters except for the use of jaw-tracking. As the evaluation index, the maximum dose and mean dose of target and OAR were compared and a portal dosimetry was performed for the treatment plan verification. Results : When using JTT, the relative dose of OAR decreased by 5.24 % and the maximum dose by 7.05 %, respectively, compared with the Static-Jaw technique(SJT). In the various OARs, the mean dose and maximum dose reduction ranges ranged from 0.01 to 3.16 Gy and from 0.12 to 6.27 Gy, respectively. In the case of the target, the maximum dose of GTV, CTV, PTV decreased by 0.17 %, 0.43 %, and 0.37 % in JTT, and the mean dose decreased by 0.24 %, 0.47 % and 0.47 %, respectively. Gamma analysis The JTT and SJT passing rates were $98{\pm}1.73%$ and $97{\pm}1.83%$ on the basis of 3 % / 3 mm, respectively. Comparing the doses of all OARs applied to the experiment, it was found that the use of JTT resulted in a significant decrease in dose due to additional jaw shielding besides MLC than SJT. Conclusion : In radiation therapy using VMAT treatment plan, we can apply JTT in the case of adjacent tumor and normal organs such as brain cancer and head and neck cancer, and in radiotherapy required large field and high energy caused increase leakage dose through MLC. It is considered that the target dose of PTV can be increased by lowering the dose of normal tissue surrounding the tumor.

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Prognostic Analysis of Drug-Eluting Balloon Catheter and Drug-Eluting Stent for In-Stent Restenosis of Drug-Eluting Stent (스텐트 재협착 병변에서 약물코팅 풍선카테터과 약물용출 스텐트의 예후 분석)

  • Lee, Doo Hwan;Song, Jong Nam;Park, Sin eui;Choi, Nam Gil;Han, Jae Bok;Kim, In Soo
    • Journal of the Korean Society of Radiology
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    • v.13 no.3
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    • pp.381-389
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    • 2019
  • Although the development of Drug-eluting stent (DES) improved the ISR significantly more than the Bare metal stent (BMS), the coronary stent restenosis (ISR) treatment still has a high recurrence rate. This study is compared the efficacy of DEB with that of DES implantation in patients with ISR. Among 4,316 patients who underwent coronary stent implantation at the Chonnam National University Hospital between November 2012 and December 2016, 187 patients developed ISR on follow-up coronary angiography ($66.3{\pm}11.0years$, 123 males) were enrolled and divided into two groups according to revascularization method as group I (DEB group; n=127) and group II (DES group; n=60). Primary end point was defined as major adverse cardiac events (MACEs), composite of cardiac death (CD), myocardial infaction (MI), target lesion revascularization (TLR) and stent thrombosis (ST) during two-year follow-up between the two groups. There were no differences in the baseline characteristics and angiographic findings except that prevalence of device length was shorter ($21.1{\pm}5.3$ vs. $25.3{\pm}9.6 mm$, p<0.002) in group I.Two-year MACE were not different in the two groups (8.7%vs.10.0%, p=0.789). The incidences of cardiac death (0%vs.0%, p=1.000), MI (1.6%vs.6.7%, p=0.085), TLR(8.7% vs. 10.0%, p=0.789) and ST (0% vs. 0%, p=1000). DEB demonstrated comparable risk reduction for MACEs compared with DES in patients with ISR during two-year follow-up. DEB might be good alternative for the treatment of ISR in patients with ISR.

Distributional Characteristics and Evaluation of the Population Sustainability, Factors Related to Vulnerability for a Polygonatum stenophyllum Maxim. (층층둥굴레(Polygonatum stenophyllum Maxim.)의 분포특성과 개체군의 위협요인 및 지속가능성 평가)

  • Kim, Young-Chul;Chae, Hyun-Hee;Ahn, Won-Gyeong;Lee, Kyu-Song;Nam, Gi-Heum;Kwak, Myoung-Hai
    • Korean Journal of Environment and Ecology
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    • v.33 no.3
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    • pp.303-320
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    • 2019
  • Plants interact with various biotic and abiotic environmental factors. It requires much information to understand the traits of a plant species. A shortage of information would restrict the assessment, especially in the evaluation of what kind of factors influence a plant species to face extinction. Polygonatum stenophyllum Maxim. is one of the northern plants of which Korea is the southern distribution edge. The Korean Ministry of Environment had designated it to be the endangered species until December 2015. Although it is comparatively widespread, and a large population has recently been reported, it is assessed to be vulnerable due to the low population genetic diversity. This study evaluated the current distribution of Polygonatum stenophyllum Maxim. We investigated the vegetational environment, population structures, phenology, soil environment, and self-incompatibility based on the results. Lastly, we evaluated the current threats observed in the habitats. The habitats tended to be located in the areas where the masses at the edge of the stream accumulated except for those that were located on slopes of some mountainous areas. Most of them showed a stable population structure and had re-established or recruited seedlings. Polygonatum stenophyllum Maxim. had the difference in time when the shoots appeared above the ground depending on the depth of the rhizome located in the underground. In particular, the seedlings and juveniles had their rhizome located shallow in the soil. Visits by pollinator insects and success in pollination were crucial factors for bearing of fruits by Polygonatum stenophyllum Maxim. The threats observed in the habitat of Polygonatum stenophyllum Maxim. included the expansion of cultivated land, construction of new buildings, and construction of river banks and roads. Despite such observed risk factors, it is not likely that there would be rapid population reduction or extinction because of its widespread distribution with the total population of more than 2.7 million individuals and the new populations established by the re-colonization.