• Journal of Nutrition and Health
• /
• v.41 no.2
• /
• pp.147-155
• /
• 2008

Medical nutrition therapy (MNT) is considered a keystone of medical treatment of chronic diseases. However, only few studies have evaluated medical and economical outcome of MNT. The study was performed on the patient with type 2 diabetes mellitus to evaluate the effect of clinical and cost-effective outcomes of MNT. Subjects from two general hospitals were randomly assigned to two different groups; One receiving basic nutritional education (BE) (n = 35), and the other receiving intensive nutritional education (IE) (n = 32) for a 6-month clinical trial. The group which received BE had a single visit with a dietitian, while the other group which received IE had an initial visit with a dietitian addition to two visits during the first 4 weeks of the study periods. Anthropometric parameters, blood components, and dietary intake were measures at the beginning of study period and after 6 month. Cost-effective analysis included direct labor costs, educational materials and medication cost difference during 6 months. After 6 month, subjects from IE group showed significant reduction of body weight (p <0.05) and systolic blood pressure (p <0.05), whereas BE group did not show any significant changes. Result from biochemical indices showed glycated hemoglobin concentration was significantly reduced by 0.7% (p <0.05) only in the IE group. The ratio of energy intake to prescribed energy intake decreased significantly in both groups (p <0.05). Mean time taken for a dietitian to educate the subject was 67.9 ${\pm}$ 9.3 min/person for BE group, while 96.4 ${\pm}$ 12.2 min/person for IE group. Mean number of educational materials was 1.9 ${\pm}$ 0.7/person for BE group and 2.5 ${\pm}$ 0.7/person for IE group. Change in glycated hemoglobin level along the 6 month period of study can be achieved with an investment of \88,510/% by implementing BE and \53,691/% by implementing IE. Considering the net cost-effect of blood glucose control and HbA Ic, IE which provides MNT by dietitian had a cost efficiency advantage than that of BE. According to this study, MNT provided by dietitian had a significant improvements in medical and clinical outcomes compared to that of BE intervention. Therefore, MNT protocol should be performed by systemic intensive nutrition care by dietitian in clinical setting to achieve good therapeutic results of DM with lower cost.

• Radiation Oncology Journal
• /
• v.16 no.3
• /
• pp.303-310
• /
• 1998

Purpose : To evaluate the results of the treatment of locally advanced but resectable rectal cancers and to analyze prognostic factors. especially with the emphasis on the treatment time factor. Materials and Methods : There were 71 patients with rectal cancer who had been treated by curative surgical procedure and postoperative radiotherapy from August 1989 to December 1993. The minimum follow up period was 24 months and the median follow-up was 35 months Radiation therapy had been given by 6 MV linear accelerator by parallel opposing or four-box portals. Whole pelvis was treated up to 5040 cGy in most cases. Systemic chemotherapy had been given in 94$\%$ of the patients, mostly with 5-FU/ACNU regimen. Assessment for the overall and disease-free survival rates were done by life-table method and prognostic factors by Log-Rank tests. Results : Five-year overall survival, disease-free survival were 58.8$\%$ and 57$\%$, respectively. Two-year local control rate was 76.6$\%$. Stage according to Modified Astler-Coller (MAC) system, over 4 positive lymph nodes, over 6weeks interval between definitive surgery and adjuvant radiotherapy and over 7 days of interruption during radiotherapy period were statistically significant, or borderline significant prognostic factors. Conclusion : The treatment results of patients with rectal cancers are comparable to those of other large institutes. The treatment results for the patients with bowel wall penetration and/or positive regional lymph nodes were still discouraging for their high local recurrence rate for the patients with MAC 'c' stage diseases and high distant metastases rate even for the patients with node-negative diseases. Maybe more effective regimen of chemotherapy would be needed with proper route and schedule. To maximize postoperative adjuvant treatment. radiotherapy should be started at least within 6 weeks after surgery and preferably as soon as wound healing is completed. Interruption of treatment during radiotherapy course affects disease-free survival badly, especially if exceeds 7 days. So, the total treatment period trout definitive surgery to the completion of radiotherapy should be kept as minimal as possiable.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.31 no.2
• /
• pp.136-142
• /
• 2009

Bone density in the recipient implant site seems to be an important factor for long term success of endosseous implants. Preoperative evaluation of bone density is very helpful to assist the clinician with the treatment planning of implant therapy. Accurate information on bone density will help the surgeon identify suitable implant sites, thereby improving the success rate of the procedure. Purpose; The aim of this study was to evaluate a correlation between bone density measured preoperatively with computerized tomography and histologically measured bone density by bone biopsy. Patients and methods; Twenty seven patients were selected. All the patients were in good health, with no systemic disorder and additional bone graft. Preoperatively the patients underwent CT scanning to evaluate Houmsfield Unit(HU). Each patients wore a surgical template for implant placement. During surgery 2mm in diameter and 6mm in length specimens were taken. Histomorphometric analysis was performed using digitalized image analysis software Axiovision 4.3. Also, the Resonance frequency analysis(RFA) and insertion torque values were recorded. Results; The highest histomorphometric values was found in the posterior mandible $32.3{\pm}3.8$, followed by $29.9{\pm}2.6$ for the posterior maxilla, $29.4{\pm}2.6$ for the anterior maxilla, $28.6{\pm}2.3$ for the anterior mandible(p=0.214). The hounsfield unit was $989.2{\pm}258.1$ in the posterior mandible, $845.0{\pm}241.5$ in the anterior maxilla, $744.5{\pm}92.6$ in the anterior mandible, $697.3{\pm}136.9$ in the posterior maxilla(p=0.045). This results may suggest that there are strong correlation between the histomorphometric values and hounsfield unit(r=0.760, p<0.05). The RF measurements were $81.9{\pm}2.4$ ISQ in the posterior mandible, $79.0{\pm}1.4$ ISQ in the anterior mandible, $78.3{\pm}4.6$ ISQ in the posterior maxilla, $76.5{\pm}5.0$ ISQ in the anterior maxilla(p=0.048). The insertion torque values was $43.2{\pm}4.2\;Ncm$ in the posterior mandible, $42.0{\pm}0.0\;Ncm$ in the anterior mandible, $41.3{\pm}4.1\;Ncm$ in the posterior maxilla, $40.8{\pm}3.8\;Ncm$ in the anterior maxilla(p=0.612). This results may suggest that there are statistical significance between the hounsfield unit and the insertion torque values(r=0.494, p<0.05), the histomorphometric values and the insertion torque values(r=0.689, p<0.05). But there was no correlation between histomorphometric values and ISQ. There was no statistical significance in age and gender effect on parameters. Conclusions; There was significant correlations between bone density and implant stability parameters. The bone density measurements using preoperative CT may help clinicians to predict primary stability before implant insertion, which is associated with implant survival rates.

• Tuberculosis and Respiratory Diseases
• /
• v.61 no.6
• /
• pp.554-561
• /
• 2006

Background: In AIDS patients, the respiratory tract is one of the most frequently involved site of by an opportunistic infection, and an even common, casual pulmonary infection manifests in a peculiar ways in AIDS patients. In Korea, because of the low prevalence of AIDS, there is insufficient data compared with other Southeast Asian counties. However, considering the sexual behavior of the younger generation, it is expected that it will not be long before AIDS becomes a major public health issue in Korea. This study examined the clinical manifestation of HIV positive people and AIDS patients. The pulmonary manifestion of HIV-positive was evaluated. This study focused on the differences in the clinical manifestation between AIDS patients with pulmonary disease and simple HIV positive people. The characteristics of common pulmonary infections in AIDS patients were also analyzed. Method: The medical records of 28 HIV positive patients who visited the hospital of ChungAng University Hospital from January, 2001 to February, 2006 were analyzed retrospectively. Result: Twenty-seven patients out of 28 HIV positive patients were male and the average age was 40.6(23-65). Patients in their thirties were most commonly affected. Elven patients had pulmonary diseases. Pulmonary tuberculosis (4 cases) and pneumocystis pneumonia (4 cases) were the most common respiratory infection. One patient showed a peculiar type of systemic cryptococcus. which was accompanied by lung and pleural dissemination. The CD4+lymphocyte count of patients with a pulmonary infection was significantly lower in patients with a pulmonary manifestation than those with only a HIV infection ($79.5/mm^3$ vs $400/mm^3$, respectively)(p<.05). Patients with pulmonary disease were in a more severe immunosuppressive state. There were 4 patients with pulmonary tuberculosis, 4 with pneumocystis pneumonia, 4 with secondary syphilis, 2 with primary syphilis, and 2 with HZV infection. The average CD4 lymphocyte counts was $56/mm^3$ in those with pulmonary tuberculosis, $42/mm^3$ in those with pneumocystis pneumonia, and $455/mm^3$ in those with secondary syphilis. Conclusion: This study examined the clinical manifestation of HIV positive patients, particularly AIDS patients with pulmonary disease, A more severe immunosuppressive status was observed in HIV-related pulmonary compared with those with HIV-related extrapulmonary disease, and the frequency of pulmonary tuberculosis in pulmonary disease was higher than expected. Respiratory infection in AIDS manifest in uncommon ways e.g. disseminated cryptococcosis involving the lung and pleura. Evidently, AIDS patients with a respiratory infection have a more severe form of immunosuppression than those with a simple HIV infection. As expected, patients with a pulmonary infection were in a more severe immunosuppressed state than those with a simple HIV infection. Opportunistic infections can show peculiar clinical presentations in AIDS patients.

• Journal of Preventive Medicine and Public Health
• /
• v.16 no.1
• /
• pp.59-65
• /
• 1983

Screening data from preplacement and periodic examination in Gu Mi Industrial Estate from May, 1983 to June, 1983 provide an opportunity to evaluate the accuracy of self-reported height and weight. The data for men and women were analyzed separated for effects of age, marrital status, educational level, employment status, measured height, measured weight and relative weight (percent of ideal body weight). The mean percent discrepancy from self-reported and measured height was analysed by cross-tubulation, P. value for analysis of variance and multiple correlation analysis in men and women. It is clear from the data that self-reported height and weigt differ from the quantities in systemic ways. But the magnitude of misreporting is very small on average except for weight in women. Whereas height tend to be over-reported, weight is under-reported in women but over-reported in men. Weight was accuracte for age group 20-29 years in men and age group over 40 year in women and over-reporting of weight increased with age in men and under-reporting of weight decreased with age in women. Weight was accurate in 60-64kg group in men and under 50kg group in women and under-stating of weight increased with weight in men and women. Weight was the most accurate in 100-109 percent relative weight group in men and in 90-99 percent relative weight group in women and under-stating of weight increased with relative weight and over-stating decreased with relative weight and over-stating decreased with relative weight in men and women. Height was the most accurate for group of primary school and except group of primary school, accuracy of height increased with educational level in men and women. In height, the highest measured height groups (over than 175cm measured height in men and over than 165cm measured height in women) were the most accurate and of over-reporting of height decreased with measured height. Single variable regression analysis and ANOVAs showed age(P<0.003), measured weight(P<0.0001) relative weight(P<0.0001), educational level(P<0.0005) and employment status(P<0.0007) to be significantly related to ${\Delta}WT$ in women and measured height(P<0.0001), educational level(P<0.03) and marrital status (P<0.03) to be significantly related to ${\Delta}WT$ in men. The women were more sensitive about her body weight than height.

• Journal of the Society of Disaster Information
• /
• v.17 no.3
• /
• pp.487-499
• /
• 2021

Purpose:The purpose of the paper is to review the problems of performance enhancement of safety certification standards and to suggest directions for improvement in order to rationalize safety certification standards for future industrial development and environmental changes. Method: The problems and limitations of the safety certification system are summarized through literature review and interview with manager, and the status of safety certification standards is classified into design standards, performance standards, and detailed standards, and the status analysis is performed. In addition, by synthesizing the results of the investigation and analysis, improvements are suggested to improve the performance of the safety certification standards. Result: Through the survey, the problems and limitations of safety certification could be grouped into six categories: government-led certification system operation, standardized certification standards, long time required to improve certification, poor certification standards preparation system, and lack of reflection of industry opinions. And, as a result of analyzing the certification standards by dividing them into performance and design standards, in the case of machinery, equipment, and protection devices, the design standards were high at 69.7% and 64.9%, whereas in the case of protective equipment, the performance standards were high at 61.1%. In order to improve the performance of safety certification standards centered on design standards, it is necessary to determine the possibility of performance enhancement of the certification standards and determine the feasibility of the inspection test method. In order to improve performance, it was reviewed that it was necessary to establish a systemic foundation and infrastructure, such as strengthening the Product Liability Act, systematizing market monitoring, etc., distributing certification test tasks, and participating in the preparation of certification standards by the private sector. Conclusion: Through this study, the problems and limitations of Korea's safety certification system were summarized and the necessity for performance improvement was reviewed. Performance improvement of safety certification standards is a matter that requires preparatory work, such as legislative revision and infrastructure construction, and requires mid-to-long-term promotion. In addition, rather than improving the overall safety certification standards, the performance requirements for each item subject to certification should be reviewed and promoted, and details should be specified through additional research.

• Tuberculosis and Respiratory Diseases
• /
• v.85 no.1
• /
• pp.37-46
• /
• 2022

Background: Although respiratory tract infection is one of the most important factors triggering acute exacerbation of chronic obstructive pulmonary disease (AE-COPD), limited data are available to suggest an epidemiologic pattern of microbiology in South Korea. Methods: A multicenter observational study was conducted between January 2015 and December 2018 across 28 hospitals in South Korea. Adult patients with moderate-to-severe acute exacerbations of COPD were eligible to participate in the present study. The participants underwent all conventional tests to identify etiology of microbial pathogenesis. The primary outcome was the percentage of different microbiological pathogens causing AE-COPD. A comparative microbiological analysis of the patients with overlapping asthma-COPD (ACO) and pure COPD was performed. Results: We included 1,186 patients with AE-COPD. Patients with pure COPD constituted 87.9% and those with ACO accounted for 12.1%. Nearly half of the patients used an inhaled corticosteroid-containing regimen and one-fifth used systemic corticosteroids. Respiratory pathogens were found in 55.3% of all such patients. Bacteria and viruses were detected in 33% and 33.2%, respectively. Bacterial and viral coinfections were found in 10.9%. The most frequently detected bacteria were Pseudomonas aeruginosa (9.8%), and the most frequently detected virus was influenza A (10.4%). Multiple bacterial infections were more likely to appear in ACO than in pure COPD (8.3% vs. 3.6%, p=0.016). Conclusion: Distinct microbiological patterns were identified in patients with moderate-to-severe AE-COPD in South Korea. These findings may improve evidence-based management of patients with AE-COPD and represent the basis for further studies investigating infectious pathogens in patients with COPD.

• 한국노년학
• /
• v.27 no.2
• /
• pp.473-486
• /
• 2007

This study focused on the diversification of the elderly living cost estimate through statistical analysis method and Engel method(market basket method). The results of this study were as follows. First of all, due to Engel method, it has shown that the minimum living cost of aged couples was 566,478won on average of 2006, single aged men 306,210 won and single aged women 260,276 won. Secondly, according to the first way of statistical analysis, the minimum living cost of elderly couples was 860,043won, the standard was 1,018,669won and abundant 1,287,555won. The second way of that, the minimum(of elderly couples) was 694.916won, the standard 1,037,779won and abundant 1,556,551won. Those numbers included imputed rent. These results were changed to that the minimum is 435,416won, the standard 548,250won and the abundant 699,844won when imputed rent were excluded Moreover, it was also represented that the minimum of Engel method was between that of quasi-relative standard line and that of not imputed rent. Lastly, in the deprivation indicators method studied by Korea Institute for Health and Social Affair, it was concerned that an underestimation of elderly deprivation might have been got if some inappropriate data include. Given this study, it could not be judged that various estimating ways had been tried were consistency, but market-basket method was keenly needed. Market-basket method is being an absolute estimating way including only elderly data. Therefore, what is asking for first is - because other analysis can be limited by absolute estimating ways, particularly market-basket method - to be required systemic and all-arounded elderly living cost with more various ways.

• Journal of the Korean Association of African Studies
• /
• v.29
• /
• pp.27-53
• /
• 2009

At the start of the new century, South Africa probably had the largest number of HIV-infected people of any country in the world. The only nation that comes close is India with a population of one billion people compared to South Africa's figure of 57 million. The tragedy is that this did not have to happen. South Africa was aware of the dangers posed by AIDS as early as 1985. In 1991, the national survey of women attending antenatal clinics found that only 0.8percent were infected. In 1994, when the new government took power, the figure was still comparatively low at 7.6 %. The 2004 figure which has been published is 26.5%. This article tracks the epidemic globally, in the region and in South Africa. I explain some of the basic concepts around the disease and look at what may happen with respect to numbers. The situation is bad, and the number of people falling ill, dying and leaving families will rise over next few years. This will impact on South Africa in a number of important ways. This article assesses the demographic, economic and social consequences of the epidemic. It disposes of a number of myths and present the real facts. The AIDS in South Africa is not related to individuals only. It warns that AIDS in Africa is becoming a community and systemic problem. The acuteness of the problem does not stem merely from the fact that communities are affected, or could even be wipe out by the end of this decade, but from the fact that AIDS will place incredible burdens and obligations upon medical services, health care and religious communities such as churches. The facts confront churches' mission with the important question: who is going to take care of all the patients and where? The reality is that people dying of AIDS will have to be cared for at home by relatives and friends. A further question that arises is whether our people are prepared for this. AIDS was considered to be a homo-plague and the hunt was on for a scapegoat in the light of the fatal implication of the disease. At present we are in the strategic phase where we all realize that it will be of no avail to scare people with the ominous threat of AIDS AIDS destroys the optimism of our achievement ethics. This exposure of the culture of optimism is also an exposure of the so-called 'human basic fear which accuses Christianity that their concept of sin is a damper on man's search for liberation and basic need to be freed from all Imitation. AIDS is also a test for our ecclesiastical genuineness and the sincerity of our mission sensibility. It poses the question: How unconditional is Christian love? Is there room for the AIDS sufferer in the community of believers, despite the fact he is an acknowledged homosexual? The question to put to the church is whether the community of believers is an exclusive to put to the koinonia which excludes homosexuals. They may be welcome on principle, but in actual fact are not acceptable to the church community. As South Africa enters the new century, it is clear that the epidemic is not having a measurable impact. However, the impact of AIDS is gradual, subtle and incremental. The author's proposal of what is currently most needed in South Africa is that the little things will make a difference. It's about doing lots of little things better at grassroots level, with the emphasis on doing. There are so many community, churches and NGOs initiatives worth building on and intensifying. One must not underestimate the therapeutic value of working together in small groups to overcome a problem

• Journal of Nutrition and Health
• /
• v.47 no.3
• /
• pp.214-220
• /
• 2014

Purpose: The purpose of this study was to assess hygiene status of meals for poorly-fed children through microbiological quality. Methods: Meals were provided by two social enterprises, one franchise, and one convenience store. There were a total of six meal samples; two samples (social enterprise meal 1; SEM 1, social enterprise meal 2; SEM 2) from two social enterprises, respectively, two samples (franchise meal 1; FM 1, franchise meal 2; FM 2) from one franchise, and two samples (convenience store meal 1; CSM 1, convenience store meal 2; CSM 2) from one convenience store. Microbiological analysis and assessment were performed by Korean food standards codex (KFSC). Results: General bacteria and E. coli in SEM 1 were detected, but the levels were not over KFSC, and Coliform less than $9.2{\times}10$ CFU/g was also detected in seasoned bean sprouts of SEM 1. General bacteria was detected at $1.6{\times}10^6$ CFU/g in cabbage kimchi of SEM 2. Coliform was detected in cabbage kimchi, squid cutlet, stir-fried pork, and fried chicken of FM1 and 2, but the levels were not over KFSC. In addition, S. aureus was detected in cabbage kimchi and seasoned dried white radish of FM 1 and 2 ($9.8{\times}10^2$ CFU/g, $9.4{\times}10^3$ CFU/g respectively), thus was over KFSC. B. cereus was detected in stir-fried pork and fried chicken ($1.2{\times}10^3$ CFU/g, $1.5{\times}10^3$ CFU/g respectively) of FM 1 and 2, thus was over KFSC. Finally, S. aureus was detected in stir-fried dried squid, seasoned spicy chicken, and stir-fried kimchi of CSM 1 and 2, and was over KFSC too ($9.5{\times}10^4$ CFU/g, $2.4{\times}10^2$ CFU/g, $1.3{\times}10^3$ CFU/g respectively). Conclusion: Results of this study suggest that systemic management of hygiene is necessary to safely providing meals to poorly-fed children.