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The Effect of Various Cleansing Methods for the Total Colonofiberscopy (대장청결법에 대한 고찰)

  • Yang, Hye-Zong;Woo, Myung-Hee
    • The Korean Nurse
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    • v.29 no.3
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    • pp.25-35
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    • 1990
  • It is a fact that there are recent increasing trends or incidence of the colorectal carcinoma among other colorectal diseases. In such trend, the early detection remain to be most important by the air contrast barium enema and total colonofiberscopy. There are several ways to prepare the colon for barium enema and colonofiberscopy which include several agents. The mechanical cleansing have been used most frequently since Brown's method was adapted to be most perfect for colon deansing. The ideal laxatives and enema solutions were limited to adequate dose, it's effectiveness, patient's diet and bowel habit, minimal side effect, low cost and simple to perform. In order to compare the effectiveness of various cleansing solutions, six experimental methods were formed as shown; 1. normal saline enema, 2. castor oil with normal saline enema, 3. castor oil with soap suds enema, 4. magnesium citrate with normal saline, 5. magnesium citrate with soap suds enema and 6. ingestion of Golyetly solution. The authors have compared and determined the degree of cleanness by an experienced endoscopist. The total number of patients was 247, age distribution was $43{\pm}15$ years old, and sex distribution was 133 males and 114 females. The grade I and II represented no difficulties at performing the colonofiberscopy, but grade ill and N had some difficulties, even unable to perform the colonofiberscopy. The effectiveness the cleansing agents, represented with grade I and II was 95.9% (47/49) in method 6, 93.2%(54/58) in method 2, 83.3%(30/33) in method 3, 70.0%(28/10) in method 5, 66.7%(16/24) in method i, and 45.7%(18/40) in method 4. Method 2 and 6 were the most effective in normal bowel habit patients. In constipated patients, method 6 was the most effective and all method except method 11 were effective in diarrhea patients. The degrees of less mucosal irritation by various bowel cleansing method were in the order of method 6(100%), 1(100%), 5(74%), 2(69%). In subjective symptoms and cleansing groups, abdominal distension, pain, nausea and vomiting were complained, and that's subject symptoms were in the order of method 3(88.9%), 6 (79.6%), 1(75%), 5(72.5%), 2(72.4%), 4(67.5%). In conclusion, we believe that the Golytely of the mechanical cleansing solution for colonofiberscopy was the most effective, but others depended on the patient's condition und bowel habit.

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Television Watering, Family Social Class, Parental Overweight, and Parental Physical Activity Levels in Relation to Childhood Overweight (아동기 과체중 위험 인자로서의 TV시청시간, 사회계층요인, 부모의 과체중 및 부모의 활동수준)

  • 윤군애
    • Korean Journal of Community Nutrition
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    • v.7 no.2
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    • pp.177-187
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    • 2002
  • This study was done to determine the factors associated with childhood overweight in 721 sixth grade elementary school students, in Busan. The students' heights, weights, waist circumferences and triceps-skinfold thicknesses were measured using standard techniques. Other data were collected using a questionnaire that included information about physical activity, television watching, and the amount of exorcise taken during leisure times, family history of diseases related to obesity: social data including family income, parents'education and occupations, eating behaviors; parental weights and heights; and parental activity levels. Childhood overweight was defined as a body mass index at or above the 85th percentile for age and sex. The prevalence of overweight revealed no significant difference between sexes, (24.2% in boys and 22.03% in girls). The risk of childhood overweight was significantly greater if either the mother or the father were overweight. The odds ratio for childhood overweight associated with maternal overweight was 5.045 (94% CI : 3.262-7.801), and 2.727 (95% CI : 1.764-4.218) was the case for parental overweight. Children having a history of hear diseases had higher odds ratios than those who did not. The odds ratios for overweight associated with income were not different. However, a higher odds ratio for overweight was observed in children whose fathers had only an elementary or middle school education than those whore fathers had a high school or college education. Children whose fathers' occupations were service workers or shopkeepers (OR : 3.314, 95% C = 1.851-5.934) or had no occupation (OR = 3.756, 95% CI : 1.898-7.430) had a treater risk of overweight than those whose fathers'were professionals or once workers. The risk of overweight increased in children having more irregular meal times and faster eating times, rather than those having an intake pattern of high energy and sugar containing floods. The amount of exercise taken during leisure times, and daily physical activity showed no difference between overweight and non-overweight children. However, television watching time, especially on weekends, was greater in overweight children than in non-overweight children. Television watching time was positively correlated with BMI, triceps-skin(31d thickness, waist circumference and waist/height ratio. Therefore, television watching was found to be a useful predictor of overweight in children. Television watching in children was negatively related to paternal activity levels, and positively related to parental television watching time. In fact, fathers whose children were overweight were physically less active than fathers whose children were non-overweight. Parents appeared to be a strong influence on their children's physical activity levels. In conclusion, a low family social class, defined on the basis of the father's occupation or education, parental overweight, increased television watching, and unhealthy physical activity levels in parents were all considered risk factors for childhood overweight. Among these, television watching time and lack of physical activity were considered to be the most important risk factors that could be easily modified for the prevention of and intervention in, overweight in children.

A study on job-satisfaction and Turn-over(Transferability) of Dental Technicians in Korea (한국 치과기공사의 직무만족과 직장이동에 관한 연구)

  • Lim, Byung-Chul
    • Journal of Technologic Dentistry
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    • v.11 no.1
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    • pp.71-81
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    • 1989
  • This study was aimed for bettering productivity and technical level of the dental 1 aboratory, and helping the dental technician's benefits and rights, and then endowing them some belonged atmospher and stability on their post by Improving job- satisfaction and maintaining the transferability of one's post at a proper limitation. Therefore, 320 dental technicians extracted randomly from all the technicians working at 494 dental laboratories were subjected for this study. The approach to the study was a way through some postal questionaires executed from March 29, 1988 until May 4, the same year, in which total 254 technicians answered, showing 79% resp"nserate. responserate. The data-analysis was done by a model of the dental technician's transferability from their post, as considering Mobley's(1978)-model of post-transferability, and results through the study are as follows : 1. Satisfaction at a given post showed that the married is better than the unmarried(<0.05), and the experienced is better than the inexperienced(P<0.01). 2. Age, sex, educational experience, and one's service-duration did not affect significantly to the respondent's satisfaction on their post, statistically. 3. Satisfaction at a given post differed in adccordance with given conditions of one's post, i. e.,it stowed high when the monthly payment was good(P<0.05), and when too much duty on their job was given, it was the worst as shown in an example of the next order, too much

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Locally Advanced Rectal Carcinoma : Curative Surgery Alone vs. Postoperative Radiotherapy and Chemotherapy (국소적으로 진행된 직장암에 대한 근치적 수술 단독 치료군과 수술후 보조적 방사선 및 항암화학요법 병행군의 치료결과 분석)

  • Ahn Seung Do;Choi Eun Kyung;Kim Jin Cheon;Kim Sang Hee
    • Radiation Oncology Journal
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    • v.13 no.3
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    • pp.253-258
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    • 1995
  • Purpose : To evaluate the effects of postoperative radiotherapy and chemotherapy on the pattern of failure and survival for locally advanced rectal carcinoma, we analyzed the two groups of patients who received curative resection only and who received postoperative radiochemotherapy retro-spectively. Materials and Methods : From June 1989 to December 1992, ninety nine patients with rectal cancer were treated by curative resection and staged as B2-3 or C. Group I(25) patients received curative resection only and group II(74) patients postoperative adjuvant therapy. Postoperative adiuvant group received radiation therapy (4500cGy/25fx to whole pelvis) with 5-FU (500mg/$m^2$, day 1-3 IV infusion) as radiosensitizer and maintenance chemotherapy with 5-FU(400mg/$m^2$ for 5 days) and leucovorin (20mg/m^2$ for 5 days) for 6 cycles. Results : The patients in group I and group II were comparable in terms of age sex, performance status, but in group II $74{\%}$ of patients showed stage C compared with $56{\%}$ of group I. All patients were followed from 6 to 60 months with a median follow up of 29 months. Three year overall survival rates and disease free survival rates were $68\%,\;64\%$ respectively in group I and $64\%,\;61\%$, respectively in group II. There was no statistical difference between the two treatment groups in overall survival rate and disease free survival rate. Local recurrences occurred in $28{\%}$ of group I, $21{\%}$ of group II (p>.05) and distant metastases occurred in $20{\%}$ of group I, $27{\%}$ of group II(p>.05). The prognostic value of several variables other than treatment modality was assessed. In multivariate analysis for prognostic factors stage and histologic grade showed statistically significant effect on local recurrences and lymphatic or vessel invasion on distant metastasis. Conclusion : This retrospective study showed no statistical difference between two groups on the pattern of failure and survival. But considering that group II had more advanced stage and poor prognostic factors than group I, postoperative adjuvant radiochemotherapy improves the results for locally advanced rectal carcinoma as compared with curative surgery alone.

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Medical Care Utilization Status and Associated Factors with Extended Hospitalization of Psychiatric Patients in Korea (우리나라 정신질환자의 의료이용 현황과 장기입원 관련 요인)

  • Suh, Soo-Kyung;Kim, Yoon;Park, Jong-Ik;Lee, Myung-Soo;Jang, Hong-Suk;Lee, Sun-Young;Lee, Jin-Seok
    • Journal of Preventive Medicine and Public Health
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    • v.42 no.6
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    • pp.416-423
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    • 2009
  • Objectives : This study was performed to examine medical care utilization of psychiatric patients and to explore patients' characteristics associated with extended hospitalization. Methods : Data were extracted from information of Korean Health Insurance Review and Assessment Service. All data associated with admission and outpatient clinic visit were analysed by patient characteristics. We selected first psychiatric admission patients who diagnosed mental and behavioral disorders due to use of alcohol (main disease code: F10), schizophrenia and related disorders (F20-29) and mood disorders (F30~33) from January to June 2005. We analysed status of admission, mean length of stay, regular access to outpatient clinic and rates of extended hospitalization during 3 years. Bivariate and multivariate analyses were conducted to identify factors associated with extended hospitalization. Results : The number of psychiatric patients during the first six month of 2005 was 30,678. The mean length of stay was longest for schizophrenia and related disorders but shortest for mood disorders. Patients who experienced an extended hospitalization were 18.8% of total subjects. An extended hospitalization was more common in schizophrenia and related disorders than other diagnostic groups. The factors associated with the extended hospitalization were age, sex, diagnostic group, type of insurance and medical care utilization groups. Conclusions : The study indicates the problem of an extended hospitalization for psychiatric patients in Korea. It is suggested that variations in rates of extended hospitalization among medical care utilization group may need an active early intervention system in psychiatric treatment service. Particular attention needs to be devoted to planning and funding for reducing extended hospitalization.

Assessment of the Severity of Coronavirus Disease: Quantitative Computed Tomography Parameters versus Semiquantitative Visual Score

  • Xi Yin;Xiangde Min;Yan Nan;Zhaoyan Feng;Basen Li;Wei Cai;Xiaoqing Xi;Liang Wang
    • Korean Journal of Radiology
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    • v.21 no.8
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    • pp.998-1006
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    • 2020
  • Objective: To compare the accuracies of quantitative computed tomography (CT) parameters and semiquantitative visual score in evaluating clinical classification of severity of coronavirus disease (COVID-19). Materials and Methods: We retrospectively enrolled 187 patients with COVID-19 treated at Tongji Hospital of Tongji Medical College from February 15, 2020, to February 29, 2020. Demographic data, imaging characteristics, and clinical data were collected, and based on the clinical classification of severity, patients were divided into groups 1 (mild) and 2 (severe/critical). A semiquantitative visual score was used to estimate the lesion extent. A three-dimensional slicer was used to precisely quantify the volume and CT value of the lung and lesions. Correlation coefficients of the quantitative CT parameters, semiquantitative visual score, and clinical classification were calculated using Spearman's correlation. A receiver operating characteristic curve was used to compare the accuracies of quantitative and semi-quantitative methods. Results: There were 59 patients in group 1 and 128 patients in group 2. The mean age and sex distribution of the two groups were not significantly different. The lesions were primarily located in the subpleural area. Compared to group 1, group 2 had larger values for all volume-dependent parameters (p < 0.001). The percentage of lesions had the strongest correlation with disease severity with a correlation coefficient of 0.495. In comparison, the correlation coefficient of semiquantitative score was 0.349. To classify the severity of COVID-19, area under the curve of the percentage of lesions was the highest (0.807; 95% confidence interval, 0.744-0.861: p < 0.001) and that of the quantitative CT parameters was significantly higher than that of the semiquantitative visual score (p = 0.001). Conclusion: The classification accuracy of quantitative CT parameters was significantly superior to that of semiquantitative visual score in terms of evaluating the severity of COVID-19.

Relationship of Level of Stress, Life Style, Subjective Symptoms and Clinical Diagnosis in Clients taken Multiphasic Screening Program (종합검진 수검자의 스트레스 수준과 생활습관, 자각증상 및 임상적 진단의 관련성)

  • Park, Jun-Han;Chun, Jin-Ho;Kang, Jang-Mi;Son, Byung-Chul;Kim, Dae-Hwan;Lee, Chang-Hee;Jeong, Kui-Won;Urm, Sang-Hwa
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.4 s.63
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    • pp.728-739
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    • 1998
  • To improve wellness and quality of life by recognizing the health efforts of stress, the author estimated the relationships between stress, subjective symptoms and clinical diagnosis through a questionnaire and a battery of specified laboratory tests; electrocardiography, blood pressure, cholesterol, aspartate aminotransferase(AST), alanine aminotransferase(ALT), gamma glutamyl transferase$(\gamma-GTP)$, fasting blood sugar, gastro-endoscopy or UGI, abdominal sonography, etc. The data was gathered from 337 clients who were undergoing multiphasic screening program at a University Hospital from January to March 1998. The mean age of subjects was $46.5{\pm}11.2$ years and the mean of body mass index was $24.0{\pm}3.7kg/m^2$. The mean vol of stress was $18.5{\pm}6.0$ expressed as the score out of 40. By general characteristics and lift style among male, mean level of stress was significantly higher in case of lower socioeconomic status, habitual drug use, longer daily working time(>10 hours), no regular exercise, drinkers, irregular meal, skip-ping breakfast(p<0.05). In case of female, that was significantly higher in case of lower education, lowe. socioeconomic status, longer daily working time(>10 hours), no regular exercise, drinkers, smokers, irregular meal, skipping breakfast(p<0.05). Significant correlations were observed between stress and subjective symptoms in all kinds of organ system (p<0.01). Correlation coefficients of stress among male were relatively high with neuro-psychiatric symptom$(\gamma=0.476)$ and cardio-vascular symptom$(\gamma=0.361)$ in order, and correlation coefficients of stress among female was highest with neuro-psychiatric symptom$(\gamma=0.371)$. The prevalence of the diagnosis through the battery of laboratory tests was high in upper gastrointestinal disorders and hypercholesterolemia in order in both sex group. Among male the mean score of stress was significantly high in ulcerative peptic disorder of upper gastrointestine and hepatopathy in order (p<0.05) . Among female that was significantly high in diabetes mellitus. In summary, it is likely that there are associations between stress, subjective symptoms and clinical diagnosis. To promote wellness and quality of life it would be of value that periodic stress evaluation program and stress management including apropriate control of smoking and drinking, regular exercise and meal.

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An Analysis of Research Productivity by Fields in Science and Engineering (이공계 분야별 연구생산성 분석)

  • Kim, Ki-Hyoung;Seol, Sung-Soo
    • Journal of Korea Technology Innovation Society
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    • v.18 no.1
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    • pp.98-125
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    • 2015
  • This study will show the determinants of research productivity by fields in science and engineering. However, we present the differences between fields by personal attributes, research resources, and research productivities. The data includes 1,383 researchers who participated in the BK21 PLUS program during 2010-2012. The fields are physics, chemistry, biology, mechanics, electricity and electronics and chemical engineering. As for research productivity, 3 indices are used such as the number of papers publicized, patents and combination of papers and patents. As for explanation factors, two kinds of variables are used. The personal factors include sex, age, academic rank, location of affiliation, and country of PhD acquisition, and the resource factors are the number of graduate students, 3 types of research funds such as government fund, industrial fund and overseas fund. This study is unique in several aspects; Dealing with 3 productivity indices, and using massive official data, 6 different fields, and determinants of research productivity. The results are as follows; 1) there is a big difference in determinants by fields. 2) No variables affect the research productivity of all the fields at the same time. 3) In science, the number of determinants are quite low than engineering. 4) The ratio between papers and patents are different by fields. 5) The correlations between paper and patent by fields are different; no relationship in the field of physics and chemistry and positive relationship in the other 4 fields.

Factors Related to the Diagnostic Yield of Flexible Bronchoscopy without Guidance in Bronchoscopically Invisible Peripheral Lung Lesions

  • Kang, Hye Seon;Ha, Jick Hwan;Kang, Hyeon Hui;Yeo, Chang Dong;Rhee, Chin Kook;Kim, Sung Kyoung;Moon, Hwa Sik;Lee, Sang Haak
    • Tuberculosis and Respiratory Diseases
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    • v.80 no.3
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    • pp.284-290
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    • 2017
  • Background: We aimed to analyze the factors predicting the diagnostic performance of flexible bronchoscopy without guidance in peripheral lung lesions that are endoscopically invisible. Methods: This was a retrospective study conducted in St. Paul's Hospital, The Catholic University of Korea, between January 2007 and March 2013. We included all patients who received bronchoscopy during this period. The analyzed variables were age, sex, the etiology of the lesion, lesion size, distance from the pleura, and presence of the bronchus sign. We used multiple logistic regression analysis to identify the significant independent factors associated with diagnostic yield. Results: We included 151 patients in this study. The overall diagnostic yield was 58.3%. The sensitivity was 43.2% for malignant disease and 78.1% for benign disease. The benign lung lesions (p<0.001), lesion size (p=0.015), presence of the exposed type of bronchus sign (p<0.001), and presence of cavitary lung lesions (p=0.005) were factors influencing the yield of flexible bronchoscopy by univariate analysis. In a multivariate logistic regression analysis, the exposed type of bronchus sign and benign lung lesions were independent predicting factors (odds ratio [OR]: 27.95; 95% confidence interval [CI], 7.56-103.32; p<0.001 and OR, 4.91; 95% CI, 1.76-13.72; p=0.002). Conclusion: The presence of the exposed type of bronchus sign and benign lung lesions are determining factors of the diagnostic yield in flexible bronchoscopy in evaluating peripheral lesions that are not endoscopically visible.

10% Pentastarch Versus 5% Albumin Solution for Volume Expansion Following Cariopulmonary Bypass in Patients Undergoing Open Heart Surgery (개심수술후 혈량 증가를 위한 10% Pentastarch와 5% Albumin 용액의 비교연구)

  • 장병철
    • Journal of Chest Surgery
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    • v.27 no.3
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    • pp.177-186
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    • 1994
  • Pentastarch is a hydroxyethyl starch similar to hetastarch, but lower average molecular weight and fewer hydroxyethyl groups which result in enhanced enzymatic hydrolysis and faster renal elimination.This report was performed to compare the clinical efficacy and safety of 10 % pentastarch[Pentaspan , group I] for plasma volume expansion after open heart surgery with that of 5% albumin[Plasmanate, group II]. There were no statistically significant differences between the group I [n=18] and group II [n:19] in the preoperative parameters [age, sex, body weight] and operative parameters[bypass time, aorta cross clamping time]. During the first 24 hours after arrival of the patient in the surgical intensive care unit, colloid solution [500--1000 ml] was infused to maintain left atrial pressure of more than 8 mmHg, or cardiac index of 2.0 L/min/M2 of more. In results, there were 3 complications of hypotension immediately after infusion of 5 % albumin solution and 2 among the 3 patients were excluded for the study. However there was no complication after infusion of 10 % pentastarch solution. Hemodynamic responses to infusion was similar for both groups, although in group I a greater increase in both left atrial pressure[mean 1.8 versus 0.7 mmHg, p< 0.05] and right atrial pressure [mean 2.2 versus 1.7 mmHg, p < 0.05] was observed during infusion of the first 500 ml. There were no significant differences in any of the measured respiratory parameters[PaO2, intrapulmonary shunt, and effective lung compliance]. Homodilution with colloid significantly reduced hemoglobin [mean 1.2 versus 0.8 gm/dl], and serum protein and albumin level[total protein;4.8$\pm$ 0.5 versus 5.2 $\pm$0.5 gm/dl, p < 0.05: albumin: 3.2 $\pm$0.4 versus 3.6 $\pm$0.6 gm/dl, p < 0.05] by 6:00 AM on 1 day postoperatively, however there were no significant differences on 7 day postoperatively. The mean serum colloid osmotic pressure and osmolarity was similar in both group.There were no abnormal findings of liver function and kidney function in all the patients. There were no significant between-group differences in bleeding time, platelets, prothrombin time, activated partial thromboplastin time and amount of chest tube output measured on 1st and 7th postoperative day. These findings demonstrated that 10% pentastarch is more effective and safe for plasma volume expension than 5 % albumin solution with no adverse effects on coagulation. Also 10 % pentastarch is less expensive than 5 % albumin and it would appeare to be a reasonable first choice for plasma volume expansion.

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