• Title/Summary/Keyword: care management

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Clinical experience of therapeutic effect of peritoneal drainage on intestinal perforation in preterm infants (미숙아의 장천공에서 복막 배액술의 치료효과에 관한 임상적 경험)

  • Lee, Jun Seok;Koo, Kyo Yeon;Lee, Soon Min;Park, Min Soo;Park, Kook In;Namgung, Ran;Lee, Chul;Choi, Seung Hoon
    • Clinical and Experimental Pediatrics
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    • v.52 no.11
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    • pp.1216-1220
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    • 2009
  • Purpose:To analyze and compare various cases in which peritoneal drainage was used as the primary treatment method in preterm infants with intestinal perforation. Methods:Among the preterm infants of less than 28 weeks of gestation who were admitted to the neonatal intensive care unit (NICU) at the Gangnam Severance Hospital from April 2006 to April 2009, 7 who had developed intestinal perforation were studied retrospectively. We investigated the clinical characteristics, secondary operation performances, morbidities, complications, and mortalities. Results:Among the 7 infants, 5 survived. Of the 5 cases, 3 received laparotomy, of which 2 were confirmed as having necrotizing enterocolitis. Of the 2 infants who died, 1 had received laparotomy before 48 h of peritoneal drainage, while the other had not received any subsequent treatment. Of the 7 children, 4 had patent ductus arteriosus (PDA), of which 3 had received indomethacin injection. Five infants had begun enteral feeding before they developed intestinal perforation. Of the 5 infants who survived, 4 were diagnosed with cholestasis. Of the 7 infants, 4 developed periventricular leukomalacia (PVL) and 3 developed rickets. Conclusion:Although the use of peritoneal drainage as the primary management of intestinal perforation in preterm infants is controversial, we suggest that it can be used for treating extreme premature neonates. Further randomized controlled study will be required to determine the feasibility of using this method.

Status of Mixed Grain Diet by People with Diabetes in Jeollabuk-do and Sensory Evaluation of Different Composition of Mixed Grains (전라북도 지역 당뇨환자의 잡곡밥 섭취 실태 및 혼합비를 달리한 잡곡밥의 관능검사)

  • Jung, Eun-Sun;Shin, Dong-Hwa;Doo, Jae-Kyun;Chae, Soo-Wan;Kim, Young-Soo;Park, Young-Min
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.39 no.7
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    • pp.1049-1055
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    • 2010
  • This study investigated the status of mixed grain diet by 68 people with diabetes living in Jeollabuk-do and performed sensory evaluation of different composition of mixed grains to improve the sensory characteristics based on the investigation. BMI of all subjects were measured and found that 61.7% were overweight. 94.1% of them ate mixed grains and females ate more mixed grains than males (p<0.05). Most males and females answered that they ate mixed grains for their health. Females added more mixed grains than males (p<0.01). More females (47.1%) than males said they would continue to eat mixed grains (p<0.05). 59% of them said they had eaten mixed grains for more than 3 years. 46.0% of them said they purchased mixed grains at a small mart near their houses. The mostly added grain to rice was black soybean (76.5%). RMGD-50 is composed of six mixed grains excluding nonglutinous rice and has the mixing rate of 50%. RMGD-40 has the mixing rate of 40%. Sensory evaluation was performed and RMGD-50 got lower score ($3.33{\pm}0.68$, $3.50{\pm}0.81$) than RMGD-40 in the appearances and color. RMGD-40 with Control 1 that includes more glutinous grains and Control 2 that is polished rice were compared. RMGD-40 got lower score than Control 1 in its appearances, smell and color, although there wasn't a meaningful difference. For the people with diabetes who are accustomed to mixed grains, the polished rice got the lowest score in moisture amount, gumminess and overall taste ($3.26{\pm}0.82$, $3.48{\pm}0.85$, $3.19{\pm}0.70$). It showed meaningful difference from RMGD-40 and Control 1 (p<0.01). Consequently people with diabetes preferred mixed grains that include more glutinous grains that have lower mixed ratio. So it is necessary to educate the people with diabetes about eating grains for better blood sugar management. Continual study and development of mixed grains that can help people with diabetes to control their blood sugar are necessary.

The effective quality assurance for image guided device using the AMC G-Box (AMC G-Box를 이용한 영상유도장치의 효율적인 정도관리)

  • Kim, Chong Mi
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.2
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    • pp.199-206
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    • 2014
  • Purpose : According to the rapid increase recently in image-guided radiation therapy, It is necessary to control of the image guidance system completely. In particular for the main subject to the accuracy of image guided radiation therapy device to be done essentially the quality assurance. We made efficient phantom in AMC for the management of the accurate and efficient. Materials and Methods : By setting up of five very important as a quality assurance inventory of the Image guidance system, we made (AMC G-Box) phantom for quality assurance efficient and accurate. Quality assurance list were the Iso-center align, the real measurement, the center align of four direction, the accuracy of table movement and the reproducibility of Hounsfield Unit. The rectangular phantom; acrylic with a thickness of 1 cm to $10cm{\time}10cm{\time}10cm$ was inserted the three materials with different densities respectively for measure the CBCT HU. The phantom was to perform a check of consistency centered by creating a marker that indicates the position of the center fixed. By performing the quality assurance using the phantom of existing, comparing the resulting value to the different resulting value using the AMC G-Box, experiment was analyzed time and problems. Therapy equipment was used Varian device. It was measured twice at 1-week intervals. Results : When implemented quality assurance of an image guidance system using AMC G-Box and a phantom existing has been completed, the quality assurance result is similar in $0.2mm{\pm}0.1$. In the case of the conventional method, it was 45 minutes at 30 minutes. When using AMC G-Box, it takes 20 minutes 15 minutes, and declined to 50% of the time. Conclusion : The consistency and accurate of image guidance system tend to decline using device. Therefore, We need to perform thoroughly on the quality assurance related. It needs to be checked daily to consistency check especially. When using the AMC G-Box, It is possible to enhance the accuracy of the patient care and equipment efficiently performing accurate quality assurance.

A Study on Actual Conditions of Preschool Education for Activation of Public Education (공교육 활성화를 위한 유아교육 현황 분석)

  • Jeong, Kyoung Hwa;Kwon, Eun Joo
    • Korean Journal of Childcare and Education
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    • v.2 no.1
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    • pp.65-88
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    • 2006
  • This study intended to activate public education, researched and analyzed real conditions of preschool education to know desirable directions of public education and help parents recognize public education. The final purpose is to offer basic materials to reestablish preschool education in the public education system. First, parents' recognition concerning preschool education in the public education system was much different from that of teachers. As for definitions of preschool education as a public education, parents understood that it means 'the nation and self-governing bodies manage aid both the public and private kindergartens', and teachers recognized that it means that 'the nation and self-governing bodies not only found operate public kindergartens but also aid manage educational funds of private kindergartens. Second, the examination of educational environments of kindergartens told that teachers and parents thought that opportunity to enter the kindergarten is not equal for all children in our country, and quality of kindergarten teachers is satisfactory. Also, they thought that curriculums of preschool educational organs have been set well according to children's developmental stages, education quality is different according to preschool education organs' foundation-types. They recognized that facilities and apparatus of preschools are satisfactory, security and neatness of preschools are satisfactory, too. Third, the examination of developmental directions of preschool education as a public education proved following facts; as for foundation-types of kindergartens in the future when promoting preschool education as a public education, parents answered financial support and supervision by the government, teachers answered aid and management of operational fees as well as support for teacher personnel expenses.

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A Study on Dental Hygiene Students' Knowledge, Attitude and Behavior towards the Elderly in Busan (부산지역 일부 치위생과 학생의 노인에 대한 지식과 태도 및 행동에 관한 연구)

  • Kang, Hyun-Kyung
    • Journal of dental hygiene science
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    • v.6 no.3
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    • pp.219-225
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    • 2006
  • As the number of old people grows in today's modern society, dental hygienist's role is more emphasized than ever before for oral hygiene management of the aged. It is also important to find out college students' knowledge, attitude and behavior towards the elderly. Therefore, this study is conducted through interview with college students who are majoring in dental hygiene of health care in Busan and will be in charge of oral hygiene. According to the interview, this study obtains the following results: 1. The level of undergraduate students' knowledge of old people shows a total score of $14.53{\pm}2.35$ (correct response rate is 69.9%). 2. The average score of undergraduate students' attitude towards old people is in a neutral range(50~70), recording 63.12(${\pm}7.22$) on a scale of 100. 3. The average score of undergraduate students' behavior towards old people is lower than a neutral range(43~60), recording 39.09(${\pm}13.43$) on a scale of 85 and showing negative behavior. 4. Experience of living together with the elderly and participating in volunteer jobs lead to significant differences in undergraduate students' attitude towards old people. 5. Experience of living together with the elderly causes significant differences in undergraduate students' behavior towards old people. That is, undergraduate students living together with the elderly show a positive behavior towards old people. 6. Undergraduate students' knowledge shows a strong positive relationship with their attitude, but it has a bit positive correlation with behavior even though there are no statistically significant differences between knowledge and behavior. No relationship is found between behavior and attitude. That is, undergraduate students have more positive attitude as their knowledge of the elderly is higher, but their behavior is not positive.

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Economic Value of the Sirolimus Eluting Stent($CYPHER^{TM}$) in Treating Acute Coronary Heart Disease (관상동맥질환 치료를 위한 시롤리무스 방출 스텐트 ($CYPHER^{TM}$)의 경제성 분석)

  • Lee, Hoo-Yeon;Park, Eun-Cheol;Park, Ki-Dong;Park, Ji-Eun;Kim, Young;Lee, Sang-Soo;Kang, Hye-Young
    • Journal of Preventive Medicine and Public Health
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    • v.36 no.4
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    • pp.339-348
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    • 2003
  • Objective : To quantify the economic value of the Sirolimus fluting Stent ($CYPHER^{TM}$) in treating acute coronary heart disease (CMD), and to assist in determining an adequate level of reimbursement for $CYPHER^{TM}$ in Korea. Methods : A decision-analytical model, developed by the Belgium Health Economics Disease Management group, was used to investigate the incremental cost-effectiveness of $CYPHER^{TM}$ versus conventional stenting. The time horizon was five years. The probabilities for clinical events at each node of the decision model were obtained from the results of large, randomized, controlled clinical trials. The initial care and follow-up direct medical costs were analyzed. The initial costs consisted of those for the initial procedure and hospitalization, The follow-vp costs included those for routine follow-up treatments, adverse reactions, revascularization and death. Defending on the perspective of the analysis, the costs were defined as insurance covered or total medical costs (=sum of insurance covered and uncovered medical costs). The cost data were obtained from the administrative data of 449 patients that received conventional stenting from five participating Korean hospitals during June 2002. Sensitivity analyses were peformed for discount rates of 3, 5 and 7%. Since the major clinical advantage of $CYPHER^{TM}$ over conventional stenting was the reduction in the revascularization rates, the economic value of $CYPHER^{TM}$, in relation to the direct medical costs of revascularization, were evaluated. If the incremental cost of $CYPHER^{TM}$ per revascularization avoided, compared to conventional stenting, was no higher than that of a revascularization itself, $CYPHER^{TM}$ would be considered as being cost-effective. Therefore, the maximum acceptable level for the reimbursement price of $CYPHER^{TM}$ making the incremental cost-effectiveness ratio equal to the cost of a revascularization was identified. Results : The average weighted initial insurance covered and total medical costs of conventional stenting were about 6,275,000 and 8,058,000 Won, respectively. The average weighted sum of the initial and 5-year follow-up insurance covered and total medical costs of conventional stenting were about 13,659,000 and 17,353,000 Won, respectively. The estimated maximum level of reimbursement price of $CYPHER^{TM}$ from the perspectives of the insurer and society were $4,126,897{\sim}4,325,161$ and $4,939,939{\sim}5,078,181$ Won, respectively. Conclusion : By evaluating the economic value of $CYPHER^{TM}$, as an alternative to conventional stenting, the results of this study are expected to provide a scientific basis for determining the acceptable level of reimbursement for $CYPHER^{TM}$.

The Prevalence of Cancer in Kangwha County (강화지역 암의 유병률)

  • Yi, Sang-Wook;Lee, Kang-Hee;Kim, Suk-Il;Kang, Hyung-Gon;Jee, Sun-Ha;Ohrr, Hee-Choul
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.3
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    • pp.333-342
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    • 1999
  • Objectives: Most descriptive studies of cancer have focused either or cancer incidence or mortality. Cancer prevalence has rarely been estimated. Cancer prevalence data can be used as a measure of the economic and social burden of cancer and are also useful for health care planning. This study attempts to estimate cancer prevalence in Kangwha county. Methods: This investigation is based on data of Kangwha cancer registry. The data include all cases of cancer diagnosed from 1983 through 1992. We define 'prevalent cases' as cancer patients who is alive as of January 1, 1993. For each five-year age group, the number of 'known prevalent cases' is added to the number of 'estimated prevalent cases'. Prevalence is calculated by dividing these sums by the populations of Kangwha County on December 31, 1992(derived from Kangwha Statistics Annual). Results: Crude prevalence of cancel among males and females are 536.7 and 601.1 per 100,000 respectively. Gastric cancer is the most common malignant neoplasm(213.2 per 100,000, crude prevalence) among males. It is followed by lung cancer(45.1 per 100,000), liver cancer(32.8 per 100,000), rectal cancer(25.4 per 100,000) and colon cancer(25.4 per 100,000). Cervical cancer is the most common cancer(201.9 per 100,000, crude prevalence) and is fellowed by gastric cancer(91.5 per 100,000), thyroid cancer(64.8 per 100,000), breast cancer(57.2 per 100,000) and rectal cancer(32.7 per 100,000) among females. Conclusions: We tried to estimate cancer prevalence based on the Kangwha cancer registry for the first time in Korea. The estimation of cancer prevalence based on a population-based cancer registry will be more correct and useful as the data accumulate. We will make another estimation in the near future.

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DOUBLE TEETH IN MAXILLARY PERMANENT INCISORS : CASE REPORTS (상악 전치부에 발생한 이중치: 증례보고)

  • Kim, Mi-Ni;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taek;Kim, Chong-Chul;Hahn, Se-Hyun;Lee, Sang-Hoon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.1
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    • pp.119-125
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    • 2009
  • Fusion and gemination are irregularities in tooth development. It is often difficult to differentiate between gemination and fusion and it is common to refer to these anomalies as 'double teeth'. The deciduous teeth are most commonly involved, but in 0.1% of cases permanent teeth are affected, in which case aesthetic, funtional and periodontal problems can result. Double teeth present great difficulties in management and required a multidisciplinary approach. The central groove on the labial and palatal surfaces of a double tooth is extremely prone to caries, therefore early 'fissure sealing' is essential. In permanent dentition, surgical separation of fused teeth may be possible with subsequent orthodontic alignment and restorative treatment as needed to reshape the crown. Reshaping or reduction of a double tooth with a single canal may be attempted by modifying the appearance of the labial groove and the use of composite tints but is often impossible and extraction may be the only alternative. Orthodontic treatment and prosthetic replacement is then required. Implants may be an option for adolescents. The present study describes three clinical cases of double teeth in the position of the maxillary permanent incisors. The first case demonstrates an example of multidisciplinary care including surgical intraoral hemisection, root canal therapy, restorative and orthodontic treatment. The second and third cases describe the external and internal morphology of the two fused teeth by means of three dimensional dental computer tomography.

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Development of Simple and Rapid Radioactivity Analysis for Thorium Series in the Products Containing Naturally Occurring Radioactive Materials (NORM) (천연방사성물질(NORM)을 함유한 가공제품 내 토륨계열 방사능 평가를 위한 간단/신속 분석법 개발)

  • Yoo, Jaeryong;Park, Seyoung;Yoon, Seokwon;Ha, Wi-Ho;Lee, Jaekook;Kim, Kwang Pyo
    • Journal of Radiation Protection and Research
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    • v.41 no.1
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    • pp.71-79
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    • 2016
  • Background: It is necessary to analyze radioactivity of naturally occurring radioactive materials (NORM) in products to ensure radiological safety required by Natural Radiation Safety Management Act. The pretreatments for the existing analysis methods require high technology and time. Such destructive pretreatments including grinding and dissolution of samples make impossible to reuse products. We developed a rapid and simple procedure of radioactivity analysis for thorium series in the products containing NORM. Materials and Methods: The developed method requires non-destructive or minimized pretreatment. Radioactivity of the product without pretreatment is initially measured using gamma spectroscopy and then the measured radioactivity is adjusted by considering material composition, mass density, and geometrical shape of the product. The radioactivity adjustment can be made using scaling factors, which is derived by radiation transport Monte Carlo simulation. Necklace, bracelet, male health care product, and tile for health mat were selected as representative products for this study. The products are commonly used by the public and directly contacted with human body and thus resulting in high radiation exposure to the user. Results and Discussion: The scaling factors were derived using MCNPX code and the values ranged from 0.31 to 0.47. If radioactivity of the products is measured without pretreatment, the thorium series may be overestimated by up to 2.8 times. If scaling factors are applied, the difference in radioactivity estimates are reduced to 3-24%. Conclusion : The developed procedure in this study can be used for other products with various materials and shapes and thus ensuring radiological safety.

The Determinants of Health Promoting Behavior of Industrial Workers (산업장 근로자의 건강증진행위와 자아개념 및 건강의 중요성 인식에 관한 연구)

  • Kim, Chung Nam
    • Korean Journal of Occupational Health Nursing
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    • v.7 no.1
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    • pp.5-19
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    • 1998
  • This descriptive-correlational study was conducted to identify the major factors affecting health promoting behaviors. 344 workers who employed in four different manutacturing plants in Taegu and Kyungbuk area were selected by convenience sampling method. Data were collected from April let to April 18th, 1998 by ready structured questionaires. The purpose of this study was to offer the basic data for health promotion theory development and health promotion strategy planning. This study was based on Pender's Health Promotion Model and examined three variables health promoting behavior, self-concept and perceived importance of health. The Life Style and Health Habit Assessment scale(LHHA) developed by Pender(1982).The Self-concept scale developed by Choi(1972) and the Health Value scale developed by Wallston, Maides and Wallston(1980) were used for this study. Data was analyzed by percentage, mean. t-test. ANOVA, Pearson Correlation Coefficient, and Stepwise Multiple Regression. The major findings of this study are as follows ; 1. The average level of health promoting behavior practice was 63.2% and possible range was from 62 to 248 point. The mean score of respondent's positive self-concept was 75.8. 81.4% of respondents put a high priority on the importance of health. 2. There was a significant difference between the practice level in the category of general self care and less amount of working hours per day(P=0.000), less amount of working hours per week(P=0.000). There was a significant difference between the practice level in the category of nutrition and age(0.002), marital status(0.000), working hour per day(0.008), working hours per week(0.001), There was a significant difference between the practice level in the category of nutriton and sex(0.000), age(0.000), marital status(0.025), education level(0.000), working hours per day(0.002), working hours per week(0.006). There was a significant difference between the practice level in the category of sleep and rest and age(0.003), marital status(0.002), working hours per day(0.001), working hours per week(0.001). There was a significant difference between the practice level in the category of stress management and working hours per day(0.001), working hours per week(0.002). There was a significant difference between the practice level in the category of self-actualization and working hours per day(0.050). 3. General characteristics influencing the respodent's self-concept were level(P=0.009) and worksite(P=0.001). 4. The results of the hypothesis tests are as follows The first hypothesis, that "The respondent who have more positive self-concept will have higher scores in the practice of health promoting behavior." was supported(r=0.2973, P=0.0001). The second hypothesis that "The respondent who have higher perception level on importance of health will have higher scores in the practice health promoting behavior." was rejected(r=- 0665, P=0.2225). 5. The most important factor that affects health promoting behavior practice was working hours per week(6.0%). The combination of working hours per week, age, education level accounted for 10.0% of the variance in health promoting behavior. In conclusion, the results of this study on industrial workers supported Pender's health promotion model in partial and showed the relatedness between self concept and the practice of health promoting behavior. Further research is required to find factors influencing health promoting behaviors of industrial workers.

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