In our study, osteoporosis was induced by ovariectomized in female rats, and the prevention and treatment efficacy of the climacteric disease the postmenopausal type I pattern was examined by using the experimental substance Cassia tora (CT) ethanol extracts. Female rats were either sham-operated (sham; n=5) or surgically ovariectomized (OVX; five animals per group) and then administered to OVX control, raloxifene hydrochloride (RLX) 1 mg/kg/day, or CT (20 and 200 mg/kg/day) for 12 weeks. Serum osteocalcin and creatinine concentration were significantly lower in the CT 200 mg/kg/day group compared with the OVX control group. Serum progesterone concentration was significantly higher in the CT 200 mg/kg/day group compared with the OVX control group. Reduction grade of the trabecular bone decreased in the RLX 1 and CT 200 mg/kg/day group compared with that of the OVX control group. In conclusion, CT 200 mg/kg/day may have inhibitory effects on osteoporosis in OVX rats.
Purpose: The need for the rapid evaluation and treatment of emergency department patients with major trauma is essential. A computerized physician order entry (CPOE) system can improve communication and provide immediate access to information with the goal of reducing ED time delays. The aim of this study was to report on the operation of a trauma CPOE program and demonstrate its usefulness by comparing time intervals from ED arrival to various evaluation steps before and after implementation of the program. Methods: This was a before-and-after observational study from a single emergency department at an academic center. The CPOE program was implemented for 6 months and compared with the data collected from the pre-CPOE implementation period. The efficacy of the program was assessed by comparing the time difference before and after CPOE implementation based on the following factors: total boarding time in ED, door-to-disposition decision time, door-to-blood-test report time, door-to-X-ray time, door-to-CT time, and door-to-transfusion time. Results: Over a period of 6 months, the CPOE was activated for a total of 17 patients. Total boarding time was reduced significantly after implementation [median, 641.5 minutes (IQR, 367.3-859.3) versus289.0 minutes (IQR, 140.0-508.0) for pre-CPOE vs. post-CPOE, respectively, p< 0.05). Time intervals for all evaluation steps were reduced after implementation of the program. The improvements in the door-to-blood-test and door-to-CT times were both statistically significant. Conclusion: This study demonstrated that a standard CPOE system can be successfully implemented and can reduce ED time delays in managing trauma patients.
Hong, Ji Hyun;Lee, Hyo Chun;Choi, Kyu Hye;Moon, Seok Whan;Kim, Kyung Soo;Hong, Suk Hee;Hong, Ju-Young;Kim, Yeon-Sil;Multidisciplinary Team of Lung Cancer in Seoul St. Mary's Hospital
Radiation Oncology Journal
/
v.37
no.2
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pp.101-109
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2019
Purpose: The purpose of this study is to evaluate the safety and efficacy of the multimodality treatment with neoadjuvant intensity-modulated radiotherapy (IMRT) for resectable clinical T1-3N0-1M0 malignant pleural mesothelioma (MPM). Materials and Methods: A total of eleven patients who received neoadjuvant chemotherapy and radiotherapy between March 2016 and June 2018 were reviewed. Patients received 25 Gy in 5 fractions to entire ipsilateral hemithorax with helical tomotherapy. Results: All of patients were men with a median age of 56 years. Epithelioid subtype was found in 10 patients. All patients received neoadjuvant chemotherapy with pemetrexed-cisplatin regimen. Ten patients (90.9%) completed 25 Gy/5 fractions and one (9.0%) completed 20 Gy/4 fractions of radiotherapy. IMRT was well tolerated with only one acute grade 3 radiation pneumonitis. Surgery was performed 1 week (median, 8 days; range, 1 to 15 days) after completing IMRT. Extrapleural pneumonectomy was performed in 4 patients (36.3%), extended pleurectomy/decortication in 2 (18.2%) and pleurectomy/decortications in 5 (63.6%). There was no grade 3+ surgical complication except two deaths after EPP in 1 month. Based on operative findings and pathologic staging, adjuvant chemotherapy was delivered in 7 patients (63.6%), and 2 (18.2%) were decided to add adjuvant radiotherapy. After a median follow-up of 14.6 months (range, 2.8 to 30 months), there were 3 local recurrence (33.3%) and 1 distant metastasis (11.1%). Conclusion: Neoadjuvant entire pleural IMRT can be delivered with a favorable radiation complication. An optimal strategy has to be made in resectable MPM patients who would benefit from neoadjuvant radiation and surgery. Further studies are needed to look at long-term outcomes.
In the changing social and economic conditions, reorientation of the health care system is a process of rearranging health care resources keeping in mind the appropriativeness, relevancy, and efficacy of health care programs. Also it has been recognized recently that the CHP program is in need of review for the same reasons, that is to say, the ease in which health care facilities are available, the high rate of coverage with insurance and the development of an effective transportation system. Therefore there is a social inclination to think that there are no remote areas and to question the roles of public health facilities, health centers, health sub centers and CHP posts. This paper was done to review problems and to propose new directions for the CHP system. The findings of this study are as follows ; 1) It is necessary that primary health care should be simplified into three parts, medical treatment, preventive care services and the organization of administration and logistics. Also each department should be supplemented with the appropriate professional personnel in order to develop a task oriented system. The reorientation of the CHP system should be managed in keeping with that of other public health care systems. Therefore it is necessary to look at the CHP system problems as one aspect of the reorientation process of public health care systems, and to work to find new ways to address these problems. 2) The location of the CHP post should be decided by the needs of the community in both the medical and preventive areas. If the people have a minimum need, the location of the CHP post should be altered and the existing roles of the CHP should be modified to allow for flexibility according to the community needs. 3) Use of the problem solving method in regular team meetings will prove to be as efficient as continuing education programs in improving job competancy. 4) The supervision of CHP's activities should be made by the same type professional personnel, that is, senior CHPs or charge nurses in the public health center at the county level. 5) The operational expensies of CHP post should be supported by the administrative department of the public health center and should create working conditions that will allow the CHP to concentrate on community health service programs. 6) The organizations for community participation, working committees, community health workers and a number of the local assembly, should be activated to provide for participation in finding solutions to health related problems in the com-munity.
Translational research (TR) as high quality research can accelerate collaboration strongly between biotechnology-based researchers and clinical-research experts for overcoming diseases. TR facilitates basic science translated to clinical efficacy and effectiveness from bench (basic science) to bedside (clinical practice) for the enhancement of human health. Disease-oriented TR programs were defined as unilateral, bilateral and multilateral TR in this patent performance analysis. Patent performance was measured in a R&D project on Health and Medical Technology to enhance the productivity of R&D investment on disease-oriented TR in Health Technology (HT). Patent Map (PM) analysis and Bibliometrics were conducted to collect information for the assessment of research patents of TR programs. Futhermore, PIAS (Patent Information Analysis System) and Thinklear programs were applied for quantitative and qualitative analysis successfully. These indicate that multi-dimensional analysis of patent performance for disease-oriented TR could promote the connection of R&D-IP (Research and Development-Intellectural Property) and R&BD (Research and Business Development) supporting system significantly.
Journal of Korean Tunnelling and Underground Space Association
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v.18
no.1
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pp.1-12
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2016
When utilizing a Tunnel Boring Machine (TBM) for tunnelling work, unexpected ground conditions can be encountered that are not predicted in the design stage. These include fractured zones or mixed ground conditions that are likely to reduce the stability of TBM excavation, and result in considerable economic losses such as construction delays or increases in costs. Minimizing these potential risks during tunnel construction is therefore a crucial issue in any mechanized tunneling project. This paper proposed the potential risk events that may occur due to risky ground conditions. A resistivity survey is utilized to predict the risky ground conditions ahead of the tunnel face during construction. The potential risk events are then evaluated based on their occurrence probability and impact. A TBM risk management system that can suggest proper solution methods (measures) for potential risk events is also developed. Multi-Criterion Decision Making (MCDM) is utilized to determine the optimal solution method (optimal measure) to handle risk events. Lastly, an actual construction site, at which there was a risk event during Earth Pressure-Balance (EPB) Shield TBM construction, is analyzed to verify the efficacy of the proposed system.
Background: Nerve blocks, including epidural analgesia, can be risky for terminal cancer pain patients in generally poor conditions. We performed this study to evaluate the efficacy of intravenous patient-controlled analgesia(PCA) to treat severe pain of terminally ill cancer patients during the last days of life. Methods: We explained the patient's poor general condition to relatives and received a written consent to administer PCA. The starting dose of opioid for PCA in cancer pain management was based on previous 24-hour dose. Previous 24-hour opioid dose was converted to intramuscular morphine equivalent. The concentration of opioid mixed into Basal Bolus $Infusor^{(R)}$ was controlled to allow for one half of the previous 24-hour equianalgesic dose to infuse continuously. Patients controlled their pain by pushing the PCA module themselves. Patients were observed by pain service team. Some discharged patients were treated at home until death. Results: Forty eight patients received PCA for last two years. The most common reason receiving a PCA was the patient's poor general condition(52.0%). The mean starting dose of PCA was $20.6{\pm}16.2$ mg of morphine. Over eighty percents of the patients were in good or tolerable state of analgesia. Half of the patients expired within one week. The mean duration of PCA was $8.7{\pm}7.0$ days. The problems during PCA were: difficulty in maintaining intravenous routes, early loss of mentality after starting PCA, hypotension and nausea. Conclusion: We concluded that PCA, if correctly, is an effective, relatively safe and readily controllable method of pain management in terminally ill cancer patients during the last days of life. For future considerations, terminal patients may expire at the comfort of their own homes after the resolution of legal problems regarding using opioid in home care.
Fusarium head blight (FHB) caused by infection with Fusarium graminearum leads to enormous losses to crop growers, and may contaminate grains with a number of Fusarium mycotoxins that pose serious risks to human and animal health. Antagonistic bacteria that are used to prevent FHB offer attractive alternatives or supplements to synthetic fungicides for controlling FHB without the negative effects of chemical management. Out of 500 bacterial strains isolated from soil, Bacillus amyloliquefaciens JCK-12 showed strong antifungal activity and was considered a potential source for control strategies to reduce FHB. B. amyloliquefaciens JCK-12 produces several cyclic lipopeptides (CLPs) including iturin A, fengycin, and surfactin. Iturin A inhibits spore germination of F. graminearum. Fengycin or surfactin alone did not display any inhibitory activity against spore germination at concentrations less than 30 ug/ml, but a mixture of iturin A, fengycin, and surfactin showed a remarkable synergistic inhibitory effect on F. graminearum spore germination. The fermentation broth and formulation of B. amyloliquefaciens JCK-12 strain reduced the disease incidence of FHB in wheat. Furthermore, co-application of B. amyloliquefaciens JCK-12 and chemical fungicides resulted in synergistic in vitro antifungal effects and significant disease control efficacy against FHB under greenhouse and field conditions, suggesting that B. amyloliquefaciens JCK-12 has a strong chemosensitizing effect. The synergistic antifungal effect of B. amyloliquefaciens JCK-12 and chemical fungicides in combination may result from the cell wall damage and altered cell membrane permeability in the phytopathogenic fungi caused by the CLP mixtures and subsequent increased sensitivity of F. graminearum to fungicides. In addition, B. amyloliquefaciens JCK-12 showed the potential to reduce trichothecenes mycotoxin production. The results of this study indicate that B. amyloliquefaciens JCK-12 could be used as an available biocontrol agent or as a chemosensitizer to chemical fungicides for controlling FHB disease and as a strategy for preventing the contamination of harvested crops with mycotoxins.
Journal of the Korea Society of Computer and Information
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v.28
no.9
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pp.177-188
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2023
The purpose of this study is to develop and validate a scale for measuring digital literacy by identifying the factors consisting of digital literacy and extracting items for each factor. Preliminary items for the Delphi study were developed through the analysis of previous literature and the deliberation of the research team. As a result of two rounds of the expert Delphi study, 65 items were selected for the main survey. The validation of the items was carried out in the process of exploratory and confirmatory factor analyses, reliability test, and criterion validity test using the data collected in the main survey. As a result, a 4-factor structure composed of 31 questions(factor 1: digital technology & data literacy- 9 questions, factor 2: digital content & media literacy- 8 questions, factor 3: digital communication & community literacy- 9 questions, factor 4: digital wellness literacy - 5 questions) was confirmed. Also, the goodness of fit indices of the model were found to be good and the result of reliability test revealed the scale had a very appropriate level of Cronbach's alpha(α=.956). In addition, a statistically significantly positive correlations(p<.001) were found between digital literacy and internet self-efficacy and between digital literacy and self-directed learning ability, which were predicted in the existing evidence, therefore the criterion validity of the developed scale was secured. Finally, practical and academic implications of the study are provided and future study and limitations of the study are discussed.
Ji-In Seo;Yun-Jae Lee;Seo-Lim Ko;Nu-Ree Kim;Jeong-Hun Kim;Mi-Ju Son;Young-Eun Kim;An-Na Kim;Eun-Hee Lee
The Journal of Korean Obstetrics and Gynecology
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v.36
no.4
/
pp.96-120
/
2023
Objectives: This study reports the findings that support the efficacy of herbal medicine (HM) for premenstrual syndrome (PMS). Methods: We conducted meta-analysis of findings from randomized controlled trials (RCTs) for PMS treated with HM. The articles were published before July 2022, located using 9 databases (Pubmed, EMBASE, Cochrane Library, CINAHL, CNKI, CiNii, SCIENCE ON, KoreaMed, OASIS). Results: We observed 2,034 studies, of which 23 RCTs met our inclusion criteria. The risk of bias in the included studies was relatively unclear or high. Meta-analysis of 3 RCTs showed that HM group had a significantly higher total effective rate than the western medicine group (RR 1.20 [95% CI 1.06, 1.36, p=0.004]). Meta-analysis of 1 RCT showed that HM group had a significantly lower symptom score (MD -3.04 [95% CI -5.36, -0.72, p=0.01]), while there was no significant difference in daily record of severity of problems scale (MD -20.52 [95% CI -49.33, 8.29, p=0.16]). Conclusions: HM significantly improved PMS symptoms than general treatment and no serious adverse events were reported. However, the evidence on the effectiveness and safety of HM for PMS was not enough to provide reliable results due to the small number and low quality of included studies. We believe that rigorous RCTs will lead to more reliable evidence of the intervention.
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