Objective: The visually impaired have limited access to health care services and related information, and thus, they can have serious hurdles against properly taking medications. Despite that it is important to improve self-care ability of the visually impaired for correct medication use, there have been few studies investigating their needs for health care services in Korea, particularly focusing on proper medication usage. This study is to explore safety-related issues regarding mediation usage among the visually impaired based on in-depth interview. We particularly focus on any obstacles for safe use of medicines including experience on medication-related adverse effects in order to provide preliminary evidence for policy measures to improve proper medication use among the visually impaired. Methods: Study sample was visually impaired individuals who resided in Seoul area and were registered in the National Association of Visually Impaired. The association helped the process of recruiting the study participants. In-depth interview for each study participants was conducted. Each interview was recorded and later converted into a written script to extract core contents for the analysis. Results: The study participants comprised of three women (42.9%) and four men (57.1%). One was in his 20's, and there were four participants in 30's and two in 40's. Fully impaired participants were majority (5 out of 7). Limitation to physical access to health care providers and health information were the key factors to hamper safe medication utilization among the study participants. Difficulty reading medication information and may take the wrong medication or incorrect doses of medication, resulting in serious consequences, including overdose or inadequate treatment of health problems. Visually impaired patients report increased anxiety related to medication management and must rely on others to obtain necessary drug information. Pharmacists have a unique opportunity to pursue accurate medication adherence in this special population. This article reviews literature illustrating how severe medication mismanagement can occur in the visually impaired elderly and presents resources and solutions for pharmacists to take a larger role in adherence management in this population. Conclusion: The visually impaired had difficulties reading medication information and identifying medicines, and took incorrect doses of medications. Public support for safe medication use and medication management among the visually impaired is necessary.
This study aims to research on the actual state of the ways that the aged people live in Seoul use intentionally or unintentionally to maintain in their health. The aged people selected randomly for the study are 541 men and 902 women who are all more than 65 years old. This survey carried out from April to May in 1980. The results of this study are summed up as follows: 1. The main means of making a living engage was agriculture with the per cent of 57. 3 and next was commerce (11.9%). 2. As for their staple foods, the majority of them eat mixed food of rice and barley, and the rest eat rice or minor-grain mixed rice. As subsidiary foods, vegetables are the most common side dishes (68.9%) and see-weeds (6.7%) are taken by the minority of them. 3. Most of them (74.6%) frequently or occasionally take special health foods to maintaing their health. The most common health food turned out to be tonic liquor to men, while honey to women. 4. The majority of them(23.2% of men and 45.5% women) refrain from drinking and smoking. 5. 39.5 per cent of men and 25.5 per cent of wome) take light exercise such as going up hill and walking. 6. The majority of them undergo routine health check with the per cent of 10.8 or occasioanal health check with the 42.9. As medical treatment, many of them(45.9%) take Chinese remedies, western remedies(39.1%) and folk remedies (15.0%). 7. Many of them (66.0%) feel subjective symptoms about some geriatric diseases such as neuralgia, hypertension and cough. 8. Many of them (63.2%) free from mental trouble, while 17.7 per cent of them appeal to no job to do, 10.0 per cent of alienation and 9.1 per cent of domestic troubles. 9. Their subjective judgements of their secrets of health and longevity attach more importance to leading a regular life. 10. Most of them want to be served appropriate medical care, rest place, health consultations, etc. All these results reveal that health and longevity of the aged people are maintained by necessary cares and efforts, not by accident nor by apathy. It is thus highly desired tha tmany studies, enlightments and nationwide support about this problem be carried out in future.
In partial edentulous patients, implant-assisted removable partial denture which provide additional retention and support by placing a small number of implants in strategic positions might be suitable treatment. This case of patient with loss of maxillary posterior teeth and moderate to severe wear of residual dentition, three implants were placed in the maxillary anterior edentulous area and then surveyed bridges were made including remaining anterior natural teeth. Posterior edentulous area was restored with distal extension removable partial denture (RPD). In addition, the worn mandibular natural teeth were restored with fixed prostheses. As a result, reduced vertical dimension and collapsed occlusal plane were rehabilitated, and improved functionally and aesthetically. The purpose of this case was to report the results of three-year follow-up of full mouth rehabilitation with anterior implant surveyed bridges and distal extension RPD.
Journal of the korean academy of Pediatric Dentistry
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v.27
no.2
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pp.344-350
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2000
Incidence of crown-root fracture due to traumatic injury, have been reported 3% in the permanent dentiton, 2% in the deciduous dentition. There are two treatment methods for crown-root fractured teeth with pulp exposure, when the fracture line was located under the alveolar crest. One way is the extrusion by orthodontic force the other way is intra-alveolar transplantation which occlusally repositioning of apical fragment in the alveolar socket. Since intra-alveolar transplantation has introduced in 1970s, it was practiced as alternative to orthodontic extrusion. As the result, this method may thoughted that had a good prognosis. As a result of trauma, completely crown-root fracture was occured in the maxillary right central incisor in this case. We couldn't reposition the deepest fracture line above the alveolar crest by the conventional surgical extrusion, because apical fragment was too short. Thus, after extraction of apical fragment, we repositioned it to the socket following demineralized freezed dried bone graft, which possible to support the apical fragment. At the 15-month recall examination, the root still showed normal mobility and there was not observed any in flammatory or replacement root resorption in the periapical radiograph.
Kim, Min-Ju;Kwak, Jung-Hyun;Baek, Seung-Han;Yeo, Hyun-Yang;Song, Ju-Hyun;Cho, Bong-Jun;Kim, Oh-Yoen
Preventive Nutrition and Food Science
/
v.15
no.2
/
pp.137-142
/
2010
Previous studies report that organo-sulfur compounds derived from garlic inhibited smooth muscle cell (SMC) proliferation and induced apoptosis of cancer cells. Recently, lipid-soluble compounds such as diallyl sulfides (DAS) and diallyl disulfides (DADS) have been reported to more effectively suppress tumor cell proliferation. However, there were few studies on the suppressive effects of lipid-soluble garlic sulfur compounds on the proliferation and migration of vascular smooth muscle cells (VSMC). Therefore, this study investigated the effect of DAS and DADS on VSMC proliferation/migration induced by oleic acid (OA), a principal fatty acid in circulating triglyceride of blood stream. Assays performed include a tetrazole (MTT) assay, a wound healing assay and a Western blots. VSMC proliferations were enhanced by OA in a dose-dependent manner at concentrations of $10{\sim}50\;{\mu}M$ and inhibited by DAS and DADS compared to non-treated control. OA-induced proliferations were also attenuated by DAS and DADS. OA-induced cell migrations were 2.5 times higher than non-treated control, and they were significantly attenuated by DAS (32% at $150\;{\mu}M$ and 50% at $200\;{\mu}M$) and DADS (40% at $150\;{\mu}M$ and 46% at $200\;{\mu}M$). OA-induced cell migration was also attenuated by PD98059 (ERK inhibitor), SB203580 (P38 inhibitor) and particularly by LY204002 (PI3K inhibitor) and SP600125 (JNK2 inhibitor). Additionally, Western blot assays showed that OA-induced JNK1/2-phosphorylation was down-regulated after treatment with DAS and DADS. In conclusion, the findings of our study support the idea that DAS and DADS may have a suppressive effect on the proliferation and migration of OA-induced VSMC and that this effect may be partly associated with PI3K and JNK2 pathways.
A study involving nutrient balances and radioisotope labeling techniques was undertaken to study energy and protein metabolism, and glucose kinetics of female crossbred Etawah goats, using 12 weaned (BW $14.0{\pm}2.0kg$), 12 late pregnant (BW $27.8{\pm}1.8kg$) and 12 first lactation does (BW $25.0{\pm}5.0kg$). Each class of animal was randomly allotted into 3 dietary treatment groups R1, R2 and R3, that received 100%, 85%, and 70% of ad libitum feed. The rations offered were pellets containing 21.8% CP and 19.3 MJ GE/kg, except for the lactating does who received pellets (17.2% CP and 18.9 MJ GE/kg) and fresh Penisetum purpureum grass. Energy and nitrogen balance studies were conducted during a two-week trial. Daily heat production (HP, estimated by the carbon dioxide entry rate technique), glucose pool and flux were measured. Equations were found for metabolizable energy (ME) and protein intake (IP) requirements for growing goats: ME (MJ/d)=1.87+0.55 RE-0.001 ADG+0.044 RP $(R^2=0.89)$ and IP (g/d)=48.47+2.99 RE+0.029 ADG+0.79 RP $(R^2=0.90)$; for pregnant does: ME (MJ/d)=5.92+0.96 RE-0.002 ADG+0.003 RP $(R^2=0.99)$ and IP (g/d)=58.34+5.41 RE+0.625 ADG-0.30 RP $(R^2=0.98)$; and for lactating does: ME (MJ/d)=4.23+0.713 RE+0.003 ADG+0.006 RP+0.002 MY $(R^2=0.86)$; IP (g/d)=84.05-5.36 RE+0.055 ADG-0.16 RP+0.068 MY $(R^2=0.45)$, where RE is retained energy (MJ/d), ADG is average daily gain in weight (g/d), RP is retained protein (g/d) and MY is milk yield (ml/d). ME and IP requirements for maintenance for growing goats were 0.46 MJ/d.kg $BW^{0.75}$ and 7.43 g/d.kg $BW^{0.75}$, respectively. Values for the pregnant and lactating does were in the same order, 0.55 MJ/d.kg $BW^{0.75}$ and 11.7 g/d.kg $BW^{0.75}$, and 0.50 MJ/d.kg $BW^{0.75}$ and 10.8 g/d.kg $BW^{0.75}$, respectively. Milk protein ranged from 3.06 to 3.5% and milk fat averaged 5.2%. Glucose metabolism in Etawah crossbred female goat is active, but glucose flux is low compared to temperate ruminant breeds which may implicate its role to support production.
Inhibitory effects of Maclura amboinenesis Bl, one plant used traditionally for the treatment of cancers, on metastatic potential of highly metastatic B16F10 melanoma cells were investigated in vitro. Cell proliferation was assessed using the MTT colorimetric assay. Details of metastatic capabilities including invasion, migration and adhesion of B16F10 melanoma cells were examined by Boyden Chamber invasion and migration, scratch motility and cell attachment assays, respectively. The results demonstrated that n-hexane and chloroform extracts exhibited potent anti-proliferative effects (p<0.01), whereas the methanol and aqueous extracts had less pronounced effects after 24 h exposure. Bioactivity-guided chromatographic fractionation of both active n-hexane and chloroform extracts led to the isolation of two main prenylated xanthones and characterization as macluraxanthone and gerontoxanthone-I, respectively, their structures being identified by comparison with the spectral data. Interestingly, both exhibited potent effective effects. At non-toxic effective doses, n-hexane and chloroform extracts (10 and $30{\mu}g/ml$) as well as macluraxanthone and gerontoxanthone-I (3 and $10{\mu}M$) significantly inhibited B16F10 cell invasion, to a greater extent than $10{\mu}m$ doxorubicin, while reducing migration of cancer cells without cellular cytotoxicity. Moreover, exposure of B16F10 melanoma cells to high concentrations of chloroform ($30{\mu}g/ml$) and geratoxanthone-I ($20{\mu}M$) for 24 h resulted in delayed adhesion and retarded colonization. As insights into mechanisms of action, typical morphological changes of apoptotic cells e.g. membrane blebbing, chromatin condensation, nuclear fragmentation, apoptotic bodies and loss of adhesion as well as cell cycle arrest in the G1 phase with increase of sub-G1 cell proportions, detected by Hoechst 33342 staining and flow cytometry were observed, suggesting DNA damage and subsequent apoptotic cell death. Taken together, our findings indicate for the first time that active n-hexane and chloroform extracts as well as macluraxanthone and gerontoxanthone-I isolated from Maclura amboinensis Bl. roots affect multistep of cancer metastasis processes including proliferation, adhesion, invasion and migration, possibly through induction of apoptosis of highly metastatic B16F10 melanoma cells. Based on these data, M. amboinensis Bl. represents a potential candidate novel chemopreventive and/or chemotherapeutic agent. Additionally, they also support its ethno-medicinal usage for cancer prevention and/or chemotherapy.
Background: The incidence rate and the treatment costs of hepatocellular carcinoma (HCC) are high, especially in Thailand. Previous studies indicated that early detection by a surveillance program could help by down-staging. This study aimed to compare the costs and health outcomes associated with the introduction of a HCC surveillance program with no program and to estimate the budget impact if the HCC surveillance program were implemented. Materials and Methods: A cost utility analysis using a decision tree and Markov models was used to compare costs and outcomes during the lifetime period based on a societal perspective between alternative HCC surveillance strategies with no program. Costs included direct medical, direct non-medical, and indirect costs. Health outcomes were measured as life years (LYs), and quality adjusted life years (QALYs). The results were presented in terms of the incremental cost-effectiveness ratio (ICER) in Thai THB per QALY gained. One-way and probabilistic sensitivity analyses were applied to investigate parameter uncertainties. Budget impact analysis (BIA) was performed based on the governmental perspective. Results: Semi-annual ultrasonography (US) and semi-annual ultrasonography plus alpha-fetoprotein (US plus AFP) as the first screening for HCC surveillance would be cost-effective options at the willingness to pay (WTP) threshold of 160,000 THB per QALY gained compared with no surveillance program (ICER=118,796 and ICER=123,451 THB/QALY), respectively. The semi-annual US plus AFP yielded more net monetary benefit, but caused a substantially higher budget (237 to 502 million THB) than semi-annual US (81 to 201 million THB) during the next ten fiscal years. Conclusions: Our results suggested that a semi-annual US program should be used as the first screening for HCC surveillance and included in the benefit package of Thai health insurance schemes for both chronic hepatitis B males and females aged between 40-50 years. In addition, policy makers considered the program could be feasible, but additional evidence is needed to support the whole prevention system before the implementation of a strategic plan.
Purpose. Medical tourism is recently becoming a new industry with great growth potential. The South Korean government is shifting medical tourism from simple cultural tourism to a high value-added industry with a new paradigm. Methods. The government has been providing positive support and marketing policies since the introduction of the article concerning foreign patient attraction to the medical law in 2009, and various types of medical institutions around the country has participated actively in medical tourism by themselves or in cooperation of government bodies and made increasingly greater performance. Results. This study obtained the following results. The medical institutions in Korea have been making efforts to see more development and profitability in diverse ways, including medical tourism for foreign patients and the advance of the Korean medical institutions into foreign markets. However, many local governing bodies and medical institutions participating in medical tourism around the country have primarily focused on examination and treatment on the basis of foreign patients' visit to South Korea and rarely built a medical network with other countries directly for medical tourism. This study presents a case of building a local medical network and a network for international medical tourism successfully on the basis of the local medical association, CMP, which has been formed naturally in Busan. The success factors for CMP included 1) enthusiasm of the official in charge; 2) the medical level, the service level, and open-mindedness of participant medical institutions; 3) cost efficiency due to executive office management with no costs, no conflicts, and constant partnership; 4) security of non-competitive expertise for participants; 5) local factors of CMP; 6) participation of good agencies; 7) reinforcement of participation networks; and 8) post facto management and local doctor management. Conclusions. Its positive effects included patient introduction and greater profitability on an internal basis as well as construction of the collaboration system with the institutions related to medical tourism and confidence. However, there are some limitations: it is still difficult to predict performance due to the short period of their activities, and it is necessary to continue to observe their constant activities since a single medical association was involved.
Yeo, Kyu Dong;Jo, Eun Hui;Jung, Young Hun;Yi, Choong Sung
KSCE Journal of Civil and Environmental Engineering Research
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v.32
no.5B
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pp.273-285
/
2012
Current TMDL based on the 'Polluter Pays Principle' in Republic of Korea is individually operated by each local government for the designed allocated pollution load of unit watershed and unit district. However, unlike the motion of the air contaminants, the polluted contaminants in a river move from upstream to downstream, and a river can affect to districts more than two. In addition, a decision making on the construction of a sewage treatment facilities follows the concept of 'economy of scale'. These reasons support the collaboration among local governments in order to reduce the costs in improving water quality. This study suggested a method to reduce water quality management cost by redistributing reduction load considering cost-effectiveness for an entire watershed. The assessment on the suggested method is conducted in Youngsan river watershed. Without variation in total load, reduction load assigned for unit watershed and unit district is retributed in the region where pollutant source is concentrated, and then water quality and cost reduction improved from the redistribution of reduction load is analyzed. The results show that the cost saved by the suggested method is KRW 124 billion for scenario-1 and 172 billion for scenario-2 considering total cost of KRW 788 billion for the existing plan. We expect that the suggested method is a good example to reduce water quality management cost in local governments for TMDL.
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