• Title/Summary/Keyword: Systemic analysis

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THE CHARACTERISTICS OF CHILD AND ADOLESCENT INPATIENTS WITH SEVERE OBSESSIVE-COMPULSIVE DISORDER (심각한 소아 ${\cdot}$ 청소년 강박장애로 입원한 환아들의 특징)

  • Hwang, Jun-Won;You, So-Young;Chang, Jun-Hwan;Shin, Min-Sup;Cho, Soo-Churl;Hong, Kang-E;Kim, Boong-Nyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.15 no.2
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    • pp.143-151
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    • 2004
  • Objectives : Child and adolescent onset obsessive compulsive disorder(C-OCD) is known to be associated with poor drug response, high comorbid rate and strong genetic tendencies. Till now studies for C-OCD have been very rare in Korea. We conducted this study to investigate the informations about clinical features, familial psychiatric loading, treatment profiles and course of server C-OCD from the retrospective analysis of inpatient data of Seoul National University Children's Hospital. Method : Retrospective chart review and data analysis was performed. Twenty(male 16 : female 4) patients with final C-OCD diagnosis by DSM-IV at discharge from 1994 to 2002 were found and their medical chart, psychological data, family interview data and nursing reports were collected and analyzed. Results : 1) The sex ratio of C-OCD was male dominant(4:1). 2) Phenomenological, most common obsession was pathologic doubt, contamination fear, followed by aggressive obsession, need for symmetry, sexual obsession, most common compulsion was checking and washing, followed by breathing, movement, symmetry, repetitive asking, hoarding, mental compulsion. 3) Most common comorbid diagnosis was depression. Other axis-I diagnosis associated OCD were anxiety disorder, tic disorder, conduct and oppositional defiant disorder and psychosis. 4) Regarding psychiatric familial loadings, 17 patients(85%) had relatives with psychiatric disorders, OC-spectrum disorders(OCD or OCPD) were found in 9 patients(45%). 5) The majority of patients(75%) have received SSRI and antipsychotics treatment. The response rate above 'moderate improved" by CGI was 75%. 6) During follow-up period in outpatient clinic, five patients(25%) showed continuous complete remission, 10 patients (50%) did residual symptoms with chronic course. Conclusion : This seems to be the first systemic investigation of severe pediatric OCD patients in Korea. The children & adolescents with severe OCD in inpatient-setting showed the high comorbid rate, familial psychiatric loading, and combined pharmacotherapy with antipsychotics, As for symptoms, high rate of aggressive-sexual obsession and atypical compulsions like breathing and moving was reported in this study. Severe pediatric OCD patients, however, responded well to the combined SSRI and antipsychotics regimen.

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The Outcome of Conventional External Beam Radiotherapy for Patients with Squamous Cell Carcinoma of the Esophagus (식도의 편평상피세포암 환자에서 외부방사선치료의 결과)

  • Jang, Ji-Young
    • Radiation Oncology Journal
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    • v.26 no.1
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    • pp.17-23
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    • 2008
  • Purpose: The best treatment for advanced esophageal cancer is chemoradiotherapy followed by surgery. In spite of the advance of multimodality therapy, most patients with esophageal cancer are treated with radiation therapy alone. This study reports the outcome of the use of conventional external beam radiotherapy alone for the treatment of esophageal cancer. Materials and Methods: Between January 1998 and December 2005, 30 patients with squamous cell carcinoma of the esophagus were treated with external beam radiotherapy using a total dose exceeding 40 Gy. Radiotherapy was delivered with a total dose of 44-60 Gy(median dose, 57.2 Gy) over $36{\sim}115$ days(median time, 45 days). Thirteen patients(43.3%) had a history of disorders such as diabetes, hypertension, tuberculosis, lye stricture, asthma, cerebral infarct, and cancers. Four patients metachronously had double primary cancers. The most common location of a tumor was the mid-thoracic portion of the esophagus(56.7%). Tumor lengths ranged from 2 cm to 11 cm, with a median length of 6 cm. For AJCC staging, stage III was the most common (63.3%). Five patients had metastases at diagnosis. Results: The median overall survival was 8.3 months. The survival rates at 1-year and 2-years were 33.3% and 18.7%, respectively. The complete response rate $1{\sim}3$ months after radiotherapy was 20%(6/30) and the partial response rate was 70%(21/30). Sixteen patients(53.3%) had an improved symptom of dysphagia. Significant prognostic factors were age, tumor length, stage, degree of dysphagia at the time of diagnosis and tumor response. Cox regression analysis revealed the aim of treatment, clinical tumor response and tumor length as independent prognostic factors for overall survival. Twenty-eight patients had local failure and another four patients had metastases. Three patients were detected with double primary cancers in this analysis. A complication of esophageal stricture was observed in three patients(10%), and radiation pneumonitis occurred in two patients(6.7%). Conclusion: The prognosis of esophageal cancer remains poor, in spite of advances in radiotherapy techniques. Radiotherapy is one of the main treatment modalities for the relief of dysphagia and treatment related complications are minimal. It is expected that the addition of chemotherapy or another systemic modality to radiotherapy will improve tumor control and increase the survival rate in advanced esophageal cancer.

A Study for the Shoes Micro-sized Manufacturing Industry and the Development of the Government Policy: Surveyed on Beomcheon-Dong in Busan (신발소공인 산업의 실태분석 및 정책지원 방향: 부산진구 범천동을 중심으로)

  • Kim, Chul Min;Kim, Nog Hyeon
    • Journal of Korea Society of Industrial Information Systems
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    • v.22 no.6
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    • pp.47-59
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    • 2017
  • Korean Economy has been developed by the Korean Government's Support for the Large-sized Firms. This Government Policy causes the Polarization between Large-sized and Micro-sized Firms Aggravated. Micro-sized Firms are distributed over the Whole Industry Area, and can also cause the Economic Crisis If They are crashed down. Therefore Government Policy for the Micro-sized Manufacturing Industry is very Important Issue. This Paper Focused on the Analysis of Current Status for the Shoes Micro Manufacturing Industry. For the Effective Analysis, This Paper uses the Statistical Data Open to the Public and also conducts the Survey for the Micro-sized Firms in Busan. Statistical Program is used for Analyzing the Collected Data and the Major Findings are as Follows. First, Shoes Industry is led by the Micro and Small & Medium sized Firms rather than the Large-sized. And the Micro-sized Firms are getting the High Rate among the Whole Shoes Industry. Busan is heavily populated Area as the Origin of Shoes Industry. Second, even though Most of the Owner of the Micro-sized Firms have the High Technology Skill Level, Worker's Aging Phenomenon gets Worse and causes the Technology Handing down to the Next Generation Difficult. Third, Because the Factory Facility of the Micro-sized Firms is Dirt and Unstable, the Modernized Manufacturing Infrastructure such as the Apartment Factory Facility is Necessary. Forth, as the Micro-sized Firms which have the Intangible Asset such as Patent is Few, the Government Policy for Encouraging the Patent Application is strongly Needed. Fifth, Entrepreneurship and Collaboration Mind between Micro-sized Firms are Lacked, so Establishment of the Cooperative Union is required. Finally, the Effort for the Systemic Planning for the Management is lacked, and the Introduction of the Management Innovation is strongly needed. The Limitation and Future Research Direction is also discussed.

Comparison of Single vs Combined Modality Treatment in Locally Advanced Non-Small Cell Lung Cancer (국소 진행된 비소세포 폐암에서 복합요법과 단일요법의 비교)

  • Kim, Ae-Kyoung;Jeong, Seong-Su;Shin, Kyoung-Sang;Park, Sang-Gee;Jo, Hai-Jeong;Lee, Jong-Jin;Seo, Jee-Won;Kim, Ju-Ock;Kim, Sun-Young
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.4
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    • pp.502-512
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    • 1995
  • Background: One quarter to one third of patients with NSCLC present with primary tumors that although confined to the thorax are too extensive for surgical resection. Until resently standard treatment for these patients had been thoracic radiation, which produces tumor regression in most patients but few cures and dismal 5-year survival rate. The fact that death for most patients with stage III tumors is caused by distant metastases has promped a reevaluation of combined modality treatment approaches that include systemic chemotherapy. Therefore, we report the results observed in a study to evaluate the effect of multimodality treatment in locally advanced non-small cell lung cancer from 1/91 to 8/93 in CNUH. Method: We grouped the patients according to the treatment modalities and evaluated response rate, median survival and the effect of prognostic variables. Among 67 patients evaluated, twenty seven patients classified with group A, received cisplatin and etoposide containing combination chemotherapy alone, eighteen patients, classified with group B, received chemotherapy and radiotherapy, fifteen patients, group C, received neoadjuvant or adjuvant chemotherapy and surgery with/without radiation therapy, seven patients, group D, received only supportive care. Result: The major response rate for group A and B was 37% and 61% respectively. There was no statistically significant difference in response rate between A and B groups(p=0.97). The analysis of prognostic factors showed that differences of age, sex, pathology, blood type, smoking year, stage and ECOG performance did not related to improvement in survival. Median survival time was 8.6 months for group A, 13.4 months for group B, 19.2 months for group C, and 5.4 months for group D, respectively and there was statistically significant difference(p=0.003), suggesting that multimodality therapy was associated with signigicant improvement in survival. Subset survival analysis showed a significant therapeutic effect for earlier stage and good performance state(p=0.007, 0.009, respectively). A possible survival advantages were observed for major response groups. Conclusion: It was suggested that multimodality therapy for the management of patients who had stage III disease, has yielded good median survival and long survival for seleted patients. But, it is necessory to validate above result with further investigation in large scale and in prospective randomized trials.

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Etiology and Analysis of Severity in Childhood Pancreatitis (소아 췌장염의 원인과 중증도 분석)

  • Park, Jun-Eun;Kim, Kyong-Mo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.2 no.2
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    • pp.194-203
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    • 1999
  • Purpose: Childhood pancreatitis has more various and somewhat different etiology than adult. Until now the analysis of severity in childhood pancreatitis were not well-known, although several studies have been made. Therefore, we studied the etiology and complications in childhood pancreatitis and analyzed whether Ranson and CT criteria could be applicated to evaluate the severity of childhood pancreatitis patients. Methods: The records of 30 patients with pancreatitis under 15 years of ages who were diagnosed in Asan medical center were reviewed. Age, sex, history, etiology, clinical features and treatment was reviewed in all patients but complications, Ranson and CT criteria were available in only 12 patients. Correlation between the number of complications and both Ranson and CT criteria were calculated with Spearman correlation coefficient. Results: 1. Median age at diagnosis was 7.3 years of age. 28 cases were acute pancreatitis and 2 cases were chronic pancreatitis. 2. Etiology: choledochal cyst(8 cases), drug (7 cases), trauma (4 cases), infection (3 cases), biliary stone or bile sludge (3 cases), idiopathic (2 cases) Hemolytic uremic syndrome, pancreatic duct obstruction, iatrogenic (1 case). 3. Local complications were ascites (5 cases), pseudocyts (4 cases) and systemic complications were hyperglycemia (4 cases), hypocalcemia (3 cases), pleural effusion (3 cases), etc. 4. Positive correlation was found between the number of complication and Ranson creteria (r=0.78, P=0.0016) and between the number of complication and CT criteria (r=0.65, P=0.015) in 13 cases. Conclusion: A trial to search the biliary duct anomaly may help to find the causes of childhood idiopathic pancreatitis, and both Ranson and CT criteria can be applicated to pediatric patients to evaluate the severity of childhood pancreatitis.

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An Analysis of Epidemiological Investigation Reports Regarding to Pathogenic E. coli Outbreaks in Korea from 2009 to 2010 (최근 2년간(2009-2010) 우리나라 병원성 대장균 식중독 역학조사 보고서 분석)

  • Lee, Jong-Kyung;Park, In-Hee;Yoon, Kisun;Kim, Hyun Jung;Cho, Joon-Il;Lee, Soon-Ho;Hwang, In-Gyun
    • Journal of Food Hygiene and Safety
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    • v.27 no.4
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    • pp.366-374
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    • 2012
  • Recently pathogenic E. coli is one of the main foodborne pathogens resulting in many patients in Korea. To understand the characteristics of pathogenic E. coli outbreaks in Korea, the epidemiological investigation reports of pathogenic E. coli outbreak in 2009 (41 reports) and in 2010 (27 reports) were collected in the web site of the Korea Centers for Disease Control and Prevention, reviewed and analysed in this study. The main places of the pathogenic E. coli outbreaks were food catering service area (64.8%) and restaurants (25.0%). The main type of the pathogens were EPEC (44.7%) and ETEC (34.2%). EAEC and EHEC was responsible for 10.5 and 9.2%, respectively. Eight of 68 outbreak cases were caused by more than 2 types of pathogenic E. coli which implicates the complicated contamination pathways of pathogenic E. coli. The incidence rate of pathogenic E. coli was $33.6{\pm}30.5%$ and the main symptoms were diarrhea, stomach ache, nausea, vomiting, and fever etc. The two identified food sources were identified as frozen hamburger pattie and squid-vegetable mixture. To improve the food source identification by epidemiological investigation, food poisoning notification to the agency should not be delayed, whole food items attributed the outbreak should be collected and detection method of the various pathogenic E. coli in food has to be improved. In conclusion, the characteristics between the EHEC outbreaks in the western countries and the EPEC or ETEC outbreaks in Korea needs to be distinguished to prepare food safety management plan. In addition, the development of the trace back system to find the contamination pathway with the improved detection method in food and systemic and cooperative support by the related agencies are necessary.

A Basic Study on the Performance Improvement of Safety Certification Standards (안전인증기준 성능화에 대한 기반 연구)

  • Byeon, Jung-Hwan;Kim, Jung-Gon
    • Journal of the Society of Disaster Information
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    • v.17 no.3
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    • pp.487-499
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    • 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.

The social representation and trust of Korean society and people: Indigenous psychological analysis of the perception of Korean adolescents and adults (한국 사회와 사람에 대한 사회적 표상과 신뢰: 청소년과 성인의 지각을 통해 본 토착심리 분석)

  • Uichol Kim ;Young-Shin Park
    • Korean Journal of Culture and Social Issue
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    • v.10 no.3
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    • pp.103-129
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    • 2004
  • This article examines the Korean adolescents and adults' social representation and trust of Korean society and people using indigenous psychological analysis. Respondents were asked to write in an open-ended questionnaire their perception of the following five aspects: Korean politics, economy, society, culture and people. They were then asked to report why they trust or distrust Korean society. A total of 1,064 respondents (218 middle school students, 200 university students, 218 fathers of the middle school students, 218 mothers of the middle school students, and 210 teachers) completed a questionnaire developed by the present researchers. The data were collected during April to June, 2003. The results indicate that 94.5% of Koreans view the existing political system and politicians as being corrupt, inept, factional, and lacking in integrity. A vast majority (84.9%) recognize the existence of systemic problems in the Korean economy. A total of 78.2% see problems in Korean society being dominated by selfishness, factionalism, conservatism, and social uncertainty. For Korean culture, a majority of respondents report being proud of its cultural tradition, accomplishment, and creativity. At the same time, 45.7% report loss of cultural identity and pride due to external influences. More than half of the respondents report negative aspects of Korean people (i.e., selfish, lack of morality, rushed, and overly focused on their social image), while nearly half of the respondents report positive aspects of Korean people as being compassionate, cooperative, good-natured and hard-working. As for reason for trusting Korean society, around a third report "because it is our country," followed by its future potential, and the good-nature and willingness of Korean people to work hard. The reasons for distrusting Korean society is the dishonesty politicians, corruption, institutional ineptness, and economic uncertainty. These results indicate a low level of collective efficacy in influencing and affecting change in Korean society.

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Immunohistochemical Detection of Lymph Nodes Micrometastases in Patients of Pathologic Stage I Non-small-cell Lung Cancer (병리적 병기 1기의 비소세포폐암 환자에서 면역조직화학염색에 의한 림프절 미세전이 관찰)

  • Ryu, Jeong-Seon;Han, Hye-Seung;Kim, Min-Ji;Kwak, Seung-Min;Cho, Jae-Hwa;Yoon, Yong-Han;Lee, Hong-Lyeol;Chu, Young-Chae;Kim, Kwang-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.4
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    • pp.345-350
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    • 2004
  • Background : To evaluate the frequency and clinical significance of lymph node micrometastasis in patients of non-small-cell lung cancer pathologically staged to be T1-2,N0. Method : From consecutive 29 patients of non-small-cell lung cancer who received curative operation and routine systemic nodal dissection, we immunohistochemically examined 806 lymph nodes from mediastinal, hilar and peribronchial lesion. All slides were stained with hematoxylin and eosin staining for one section and with cytokeratin AE1/AE3 antibody for another consecutive section of same lymph node to find out micrometastasis. Results : In 806 lymph nodes examined, no tumor cell was seen on hematoxylin and eosin staining and micrometastic foci were shown to be on 0.37%(3) of 806 lymph nodes, in which were upper paratracheal, interlobar and peribronchial lymph node. These three positive stains constitute 10.3%(3) of the 29 patients with non-small-cell lung cancer. Nine patients died from disease progression(4), postoperative complication(3) and concomitant diseases(2). The four patients with disease progression did not show evidence of micrometastasis on their lymph node examination. Conclusion : The frequency of lymph node micrometastasis was in 0.37% of 806 lymph nodes examined. The study results might suggested that routine analysis of micrometastasis on the lymph node didn't give any clinical implication on patients with non-small-cell lung cancer.

The Relationship between Dementia and Oral Health in Some Elderly in Daejeon (대전 일부 노인의 치매와 구강건강의 관계)

  • Go, Hye-Bin;Kim, Min-Gyeong;Kim, Jin-Young;Kim, Hyun-Soo;Park, Young-Seo;Seo, Seung-Hyeon;Hwang, Soo-Jeong
    • Journal of dental hygiene science
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    • v.16 no.6
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    • pp.481-487
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    • 2016
  • The elderly population with dementia is rapidly growing in South Korea. The aim of this study was to investigate the relationship between dementia and oral health in 197 subjects aged ${\geq}65$ years. The questionnaire included questions on subjective health status, subjective health concern, subjective oral health status and behavior, mastication ability, Oral Health Impact Profile-14 (OHIP-14), and Korean Dementia Screening Questionnaires (KDSQ). Oral examination was conducted by a single dentist to evaluate upper or lower denture use, and determine the numbers of remaining and functioning teeth, including implant and fixed prosthesis. The subjects who required a dementia test (KDSQ-C [cognition] of ${\geq}6$) had significant differences in systemic disease prevalence rate, subjective health status, subjective health concern, KDSQ-V (vascular disease) score, KDSQ-D (depression) score, subjective oral treatment need, key food mastication ability and OHIP-14 score compared to the healthy subjects. The proportion of denture wearers, total remaining teeth, total functioning teeth, toothbrushing frequency, oral pain severity, symptoms of periodontal disease, subjective oral health status, and subjective oral health concern showed no significant differences between the two groups. KDSQ-C and OHIP-14 scores showed a strong positive relationship, while KDSQ-C score and total remaining teeth or key food mastication ability showed a weak negative relationship. In the multiple regression analysis, the KDSQ-D, KDSQ-V, and OHIP-14 scores influenced the KDSQ-C scores. We suggest a relationship between oral health and cognitive impairment.