• Title/Summary/Keyword: cooperative treatment

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Comparative Analysis of Patterns of Care Study of Radiotherapy for Esophageal Cancer among Three Countries: South Korea, Japan and the United States (한국, 미국, 일본의 식도암 방사선 치료에 대한 PCS($1998{\sim}1999$) 결과의 비교 분석)

  • Hur, Won-Joo;Choi, Young-Min;Kim, Jeung-Kee;Lee, Hyung-Sik;Choi, Seok-Reyol;Kim, Il-Han
    • Radiation Oncology Journal
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    • v.26 no.2
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    • pp.83-90
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    • 2008
  • Purpose: For the first time, a nationwide survey of the Patterns of Care Study(PCS) for the various radiotherapy treatments of esophageal cancer was carried out in South Korea. In order to observe the different parameters, as well as offer a solid cooperative system, we compared the Korean results with those observed in the United States(US) and Japan. Materials and Methods: Two hundreds forty-six esophageal cancer patients from 21 institutions were enrolled in the South Korean study. The patients received radiation theraphy(RT) from 1998 to 1999. In order to compare these results with those from the United States, a published study by Suntharalingam, which included 414 patients[treated by Radiotherapy(RT)] from 59 institutions between 1996 and 1999 was chosen. In order to compare the South Korean with the Japanese data, we choose two different studies. The results published by Gomi were selected as the surgery group, in which 220 esophageal cancer patients were analyzed from 76 facilities. The patients underwent surgery and received RT with or without chemotherapy between 1998 and 2001. The non-surgery group originated from a study by Murakami, in which 385 patients were treated either by RT alone or RT with chemotherapy, but no surgery, between 1999 and 2001. Results: The median age of enrolled patients was highest in the Japanese non-surgery group(71 years old). The gender ratio was approximately 9:1(male:female) in both the Korean and Japanese studies, whereas females made up 23.1% of the study population in the US study. Adenocarcinoma outnumbered squamous cell carcinoma in the US study, whereas squamous cell carcinoma was more prevalent both the Korean and Japanese studies(Korea 96.3%, Japan 98%). An esophagogram, endoscopy, and chest CT scan were the main modalities of diagnostic evaluation used in all three countries. The US and Japan used the abdominal CT scan more frequently than the abdominal ultrasonography. Radiotherapy alone treatment was most rarely used in the US study(9.5%), compared to the Korean(23.2%) and Japanese(39%) studies. The combination of the three modalities(Surgery+RT+Chemotherapy) was performed least often in Korea(11.8%) compared to the Japanese(49.5%) and US(32.8%) studies. Chemotherapy(89%) and chemotherapy with concurrent chemoradiotherapy(97%) was most frequently used in the US study. Fluorouracil(5-FU) and Cisplatin were the most preferred drug treatments used in all three countries. The median radiation dose was 50.4 Gy in the US study, as compared to 55.8 Gy in the Korean study regardless of whether an operation was performed. However, in Japan, different median doses were delivered for the surgery(48 Gy) and non-surgery groups(60 Gy). Conclusion: Although some aspects of the evaluation of esophageal cancer and its various treatment modalities were heterogeneous among the three countries surveyed, we found no remarkable differences in the RT dose or technique, which includes the number of portals and energy beams.

Effect of Feeding Lactobacillus reuteri to Laying Hens on Laying Performance, Availability and Intestinal Microflora (Lactobacillus reuteri의 급여가 산란계의 생산성, 영양소 이용율 및 장내 미생물 변화에 미치는 영향)

  • Kim S. H.;Park S. Y.;Lee S. J.;Ryu K. S.
    • Korean Journal of Poultry Science
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    • v.31 no.4
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    • pp.265-271
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    • 2004
  • A feeding trial was conducted to investigate the influence of feeding Lactobacillus reuteri culture (LR) on productive performance, intestinal microflora and availability in laying hens. Four hundred and eighty, Isa-Brown layers, 49 weeks of age, were fed diets supplemented with LR at the level of 0 (control), 0.1, 0.2, and $0.4\%$ of the diets for eight weeks. Egg production and egg weight were measured daily. Feed intake was weighed every two weeks. Egg quality was measured three times at the start, mid-term, and end of the experiment. Intestinal microflora were examined for Lactobacillus spp., E. coli and Salmonella at the end of the experiment. Overall egg production was the highest in $0.2\%$ LR (P<0.05), but that of $0.1\%$ or $0.4\%$ LR treatments did not significantly differ from that of control. Egg weight was significantly higher in LR feeding group than the control (P<0.05). Daily egg mass was significantly higher in $0.2\%$ and $0.4\%$ LR treatments compared to the control and $0.1\%$ LR (P<0.05). The number of jumbo and extra large eggs were increased in LR supplemented groups, especially in $0.1\%$ LR. Feed intake of layers fed LR supplemented diets tended to be lower than the control. However, feed conversion ratio significantly improved in LR supplemented groups (P<0.05). Availability of dry matter and crude protein improved significantly in $0.4\%$ LR treatment (P<0.05). But, those of ether extract and crude ash were not significantly different among treatments. Eggshell breaking strength and eggshell thickness were not significantly influenced by LR supplementation, and Haugh unit and yolk index were also similar to the control. Total number of Lactobacillus spp. in ileum and cecum fed LR supplemented diets were significantly higher than those of the control (P<0.05). There were no significant differences in intestinal E. coli and Salmonella in all treatments. Therefore, it is concluded that dietary supplementation of Lactobacillus reuteri culture can improve the laying performance, feed efficiency and intestinal Lactobacillus.

The Perception of Gifted Science Teachers Regarding a Individualized Instruction for Scientifically Gifted (영재 개별화 교육에 관한 과학영재 지도교사들의 인식)

  • Kim, Su-yeon;Han, Shin;Jeong, Jinwoo
    • Journal of the Korean Society of Earth Science Education
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    • v.9 no.2
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    • pp.199-216
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    • 2016
  • The purpose of this study is to figure out how much gifted science education teachers in charge of the class realize the necessity of individualized curriculum and program for scientifically gifted, to find out the problems of the gifted science educational institutions from exploring them in depth in the light of the reality in the gifted science educational institutions, and to draw implications about the applicable direction of more aggressive individualized curriculum and program for scientifically gifted. I chose 15 people with the incumbent teachers who have ever taught scientifically gifted and have a degree in the gifted education or science subject education as study participants and had a depth interview with them. According to result of the study, 14 of 15 study participants recognized the necessity of individualized education in science should understand the personal requirements according to the tendency of the gifted students and should be a study led by students themselves. Of the problems in gifted science education, teachers regarded the reduction in the financial support as the biggest problem and the vocation and professionalism of teachers were referred as a very important factor. With constraints of time and space, there were plenty of opinions that can't ignore the influence of educational environment associated with the university entrance examination. There were many opinions that there is excessive expansion of the agencies and the target for gifted students, no standardized measurement tools and programs and the lack of the system for the coherent observation as a teacher. Also, the unified curriculum of gifted science education institutions were pointed out as the problem and the individualized programs which were already under way have a lot of weakness and being offered marginally. Thus, from now on, to apply for individualized education of gifted science, teachers demanded optimized education conditions and consistent policy support, and expressed the opinion that there needs of a possible continuous observation system. Besides, the curriculum and programs matched the needs of the students should be taken priority the most, and there were another answers that fellow learning within the cooperative learning can be an alternative of the individualized. Along with that, there were lots of opinions that the treatment to overcome an inferiority complex according to the individualized should be followed.

Clinical Characteristics of Pulmonary Aspergilloma (폐국균종의 임상적 고찰)

  • Kang, Tae-Kyung;Kim, Chang-Ho;Park, Jae-Yong;Jung, Tae-Hoon;Sohn, Jeong-Ho;Lee, Jun-Ho;Han, Seong-Beom;Jeon, Young-Jun;Kim, Ki-Beom;Chung, Jin-Hong;Lee, Kwan-Ho;Lee, Hyun-Woo;Shin, Hyeon-Soo;Lee, Sang-Chae;Kweon, Sam
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1308-1317
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    • 1997
  • Background : Pulmonary aspergillomas usually arise from colonization and proliferation of Aspergillus in preexisting cavitary lung disease of any cause. About 15% of patients with tuberculous pulmonary cavities were found to have aspergilloma. We analyzed the clinical features and course of 91 patients with pulmonary aspergilloma. Method : During the ten-year period from June 1986 to May 1996, 91 patients whose condition was diagnosed as pulmonary aspergilloma at 4 university hospitals in Taegu city were reviewed. All patients fulfilled one of the following criteria : 1) histologic evidence of aspergilloma within abnormal air space in tissue sections, or 2) a positive Aspergillus serum precipitin test with the radiologic finding of a fungus ball. The histological diagno-sis was established in 81 patients(89.0%) and clinical diagnosis in 10 patients(11.0%). Results : 1) The age range was 22 to 65 years, with an average of 45 years. A male and female ratio was 1.7 : 1 (57 men and 34 women). 2) Hemoptysis was far the most frequent symptom(89%), followed by cough, dyspnea, weakness, weight loss, fever, chest pain. 3) In all but 14 cases(15.4%) there had been associated conditions. Pulmonary tuberculosis was far the most frequent underlying condition found(74.7%), followed by bronchiectasis (6.6%), cavitary neoplasm(2.2%), pulmonary sequestration(1.1%). 4) The involved area was usually in the upper lobes; the right upper lobe was involved in 39(42.9%), the left upper lobe in 31(34.1%), the left lower lobe in 13(14.3%), the right lower lobe in 7(7.7%), and the right middle lobe in 1(1.1%). 5) On standard chest roent geno gram the classic "bell-like" image of a fungus ball was found in 62.6% of the subjects. On CT scan, 88.1% of the subjects in which they were done. 6) The surgical therapy was undertaken in 76 patients, and medical therapy in 15 patients, including 4 patients with intracavitary instillation of amphotericin B. 7) The surgical modality was lobectomy in 55 patients(72.4%), segmentectomy in 16 patients(21.1%), pneumonectomy in 4 patients(5.3%), wedge resection in 1 patient(1.3%). The mortality rate was 3.9% (3 patients) ; 2 patients died of sepsis and 1 died of hemoptysis. The postoperative complications were encountered in 6 patients (7.9%), including each one patient with respiratory failure, bleeding, bronchopleural fistula, empyema, and vocal cord paralysis. 8) In the follow-up cases, each 2 patients of 71 patients with surgical treatment and 10 patients with medical treatment had recurrent hemoptysis. Conclusion : During follow-up of the chronic pulmonary disease with abnormal air space, if the standard chest roentgenograms are insufficient to detect a fungus ball, computed tomographic scan and serum precipitin test are likely to aid the diagnosis of patients with suspected pulmonary aspergilloma. A reasonable recommendation for management of a patient with aspergilloma would be to reserve surgical resection for those patients who have had severe, recurrent hemoptysis. And a well controlled cooperative study to the medical treatment such as intracavitary antifungal therapy is further needed.

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Performance State and Improvement Countermeasure of Primary Health Care Posts (보건진료소(保健診療所)와 업무실태(業務實態)와 개선방안(改善方案))

  • Park, Young-Hee;Kam, Sin;Han, Chang-Hyun;Cha, Byung-Jun;Kim, Tae-Woong;Gie, Jung-Aie;Kim, Byong-Guk
    • Journal of agricultural medicine and community health
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    • v.25 no.2
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    • pp.353-377
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    • 2000
  • This study was performed to investigate the performance state and improvement countermeasure of Primary Health care Posts(PHPs). The operation reports of PHPs(1996 330 PHPs, 1999 313 PHPs) located in Kyongsangbuk-Do and data collected by self-administered questionnaire survey of 280 community health practitioners(CHPs) were analyzed. The major results were as follows: Population per PHP in 1999 decreased in number compared with 1996. But population of the aged increased in number. The performance status of PHP in 1999 increased compared with 1996. A hundred forty one community health practitioners(50.4%) replied that the fiscal standing of PHP was good. Only 1.4% replied that the fiscal standing of PHP was difficult. For the degree of satisfaction in affairs, overall of community health practitioners felt proud. The degree of cooperation between PHP and public health institutions was high and the degree of cooperation of between PHP and private medical institutions was high. The degree of cooperation between PHP and Health Center was significantly different by age of CHP, the service period of CHP, and CHP's service period at present PHP. Over seventy percent of CHPs replied that they had cooperative relationship with operation council, village health workers, community organization. CHPs who drew up the paper on PHP's health activity plan were 96.4 % and only 11.4% of CHPs participated drawing up the report on the second community health plan. CHPs who grasped the blood pressure and smoking status of residents over 70% were 88.2%, 63.9% respectively and the grasp rate of blood pressure fur residents were significantly different according to age and educational level of CHP. CHPs received job education in addition continuous job education arid participated on research program in last 3 years were 27.5%, respectively. CHPs performed the return health program for residents in last 3years were 65.4%. Over 95% of CHPs replied that PHPs might be necessary and 53.9% of CHPs replied that the role of PHPs should be increased. CHPS indicated that major reasons of FHPs lockout were lack of understanding for PHP and administrative convenience, CHPs were officials in special government service governors intention of self-governing body. CHPs suggested number of population in health need such as the aged and patients with chronic disease, opinion of residents, population size, traffic situation and network in order as evaluation criteria for PHP and suggested results of health performance, degree of relationship with residents, results of medical examination anti treatment, ability for administration and affairs in order as evaluation criteria for CHP. CHPs replied that the important countermeasures for PHPs under standard were affairs improvement of PHPs and shifting of location to health weakness area in city. Over 50% of CHPs indicated that the most important thing for improvement of PHPs was affairs adjustment of CLIP. And CHPs suggested that health programs carried out in priority at PHP were management of diabetes mellitus and hypertention. home visiting health care, health care for the aged. The Affairs of BLIP should be adjusted to satisfy community health need and health programs such as management of diabetes mellitus and hypertention, home visiting health care, health care for the aged should be activated in order that PHPs become organization reflecting value system of primary health care.

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A Comparative Study on Awareness of Middle School Students, School Parents, and Human Resources Directors in Industrial Institutions about Admission into Specialized High Schools and Career after Graduating from Specialized High Schools (특성화고 진학 및 졸업 후 진로에 대한 중학생, 학부모, 산업체 인사 담당자의 인식 비교 연구)

  • Lee, Byung-Wook;Ahn, Jae-Yeong;Lee, Chan-Joo;Lee, Sang-Hyun
    • 대한공업교육학회지
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    • v.38 no.2
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    • pp.48-67
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    • 2013
  • This study tried to suggest implications about operation direction of specialized high schools (SHS) by researching awareness of middle school students (MSS), school parents (SP), human resources directors in industrial institutions (HRDII) who will be the main users of SHS education, about entering SHS and career after graduating from SHS. Seniors of middle school, SP and HRDII in Asan, Chungnam were the subject of this survey research. The summary of the result of this study is as follow: First, MSS and SP usually hoped to enter general high schools rather than vocational education schools such as SHS, meister high schools, and MSS considered school records and SP considered aptitude and talent for the factors to choose high school. Second, MSS, SP, and HRDII recognized purposes of SHS as improvement of talent and aptitude, and getting a job. As for positive images of SHS, they recognized it as applying talent and aptitude to life early, getting good jobs easily, fast independence after graduation, and learning excellent technologies, and as for negative images of SHS, they recognized it as social prejudices and discrimination, students with bad school records enter them, disadvantages about promotion and wages, and being unfavorable for entering universities. They also recognized education of SHS as being effective for improvement of basic and executive ability and key competency, development of creative human resources, and improvement of right personality and courteous manners. Third, many MSS and SP showed intention to enter SHS if it is established in Asan. They wished to enter SHS because they would like to apply their aptitude and talent to life early, learn excellent skill, and hope for early employment, on the other hand, they did not wish to enter SHS because it was not suited for their aptitude and talent, awareness about SHS is low, it is unfavorable to enter universities, and there were social prejudices and discrimination. They also similarly hoped for getting jobs and entering universities after graduating from SHS. And the reason they wanted to get a job was usually because they want to be successful by advancing into society early, or because it is still hard to get a job even after graduate from the university, on the other hand, the reason they want to enter university is because is usually in-depth education about major and social discrimination about level of education. The ability to perform duties forms the greatest part of the employment standard that MSS, SP, and HRDII aware. MSS and SP usually hoped for industrial, home economics and housework and commercial majors in SHS, and considered aptitude and talent, the promising future, and being favorable for employment for choosing major. The reason HRDII hire SHS student was to develop student into talent of industrial institution, ability of student, and need for manpower with high school graduation level, and there were also partial answer that they can hire SHS student if they have ability to perform duties. The proposals about operation direction of SHS according to the results above are as follow: SHS should diversify major and curriculum to meet various requirements of student and parents, establish SHS admission system based on career guidance, and improve student's ability to perform duties by establishing work-based learning. The Government should organize work-to-school policy to enable practical career development of students from SHS, and promote relevant policy to reinforcing SHS education rather than quantitative evaluation such as employment rate, and cooperative support from each government departments is required to make manpower with skill related to SHS to get proper evaluation and treatment.

A Study on the Sasang Constitutional Distribution Among the People in the United States of America (북미지역주민(北美地域住民)의 사상체질(四象體質) 분포(分布)에 관(關)한 연구(硏究))

  • Koh, Byung-hee;Kim, Seon-ho;Park, Byung-gwan;Lavelle, Jonathan D;Tecun, Marianne;Anthony Jr., Ross;Hobbs, Ron;Zolli, Frank;Chin, Kyung-hee
    • Journal of Sasang Constitutional Medicine
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    • v.11 no.2
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    • pp.119-150
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    • 1999
  • In spite of recent remarkable recent development in both western and oriental medical sciences, there is still only a shallow understanding of individual differences for various prognoses of incurable diseases and immunopathy diseases. Nevertheless, the care, cure and prevention methods of Sasang Constitutional Medicine are broadly used as an effective treatment of incurable diseases like immunopathy diseases and stress-related diseases and diseases due to aging. In this sense, the establishment of classification norms is urgent and essential for the worldwide application of Sasang Constitutional Medicine(SCM). This study began with the confirmation process of whether Sasang Constitutional types exist in Americans. To accomodate for cultural differences, the distinguishing tool was readjusted so that Sasang Constitutional Types in Americans could be determined. Hence, the selected tool is the new QSCCII+, which is a newly revised English version of the QSCCII. QSCCII was made and standardized by Dept. of SCM in Kyung Hee Medical Center and Dr. Kim7). The evaluation methods of the old version were improved in the new QSCCII+ through necessary statistical manipulation. The original QSCCII was officially authorized by the Korean Society of Sasang Constitutional Medicine as the only computerized version of Sasang diagnostics. This study is the first attempt to design a new diagnostic tool for the classification of Sasang Constitutional types in North Americans with the revision of QSCCII. The subjects of this study were selected from the cooperative people among the students and staffs of the University of Bridgeport and the patients who visited the Clinic in the Health Science Center. This study takes for about 1 year from 1998. 8 to 1999. 8 The conclusions of the study can be summarized as follows: 1. Sasang constitutional types also exist in Americans. It can also naturally be inferred that Sasang Constitutional types exist in all human beings, for there are many different human races in America. 2. There are more So-Yang In's than any other types in American white people. This result confirms the hypothesis that there also exist Sasang Constitutional types in westerners. 3. The result of repetitive tests suggests that the new QSCCII+ is an effective diagnostic tool for westerners when we consider the constant diagnostic results of the QSCCII+. 4. Sasang Constitutional types exit in the sample group regardless of racial difference. 5. The question items that were not often checked by Americans need to be modified into more understandable expressions. 6. The standardization of diagnosis for Americans should be established by use of the QSCCII+ 7. It can be guessed that there are many Tae-yang In's among the 71 persons who could not be clearly classified by the QSCCII+. Due to the scarcity of Tae-yang-In in general, it is important to improve upon the discernability of the QSCC II+. 8. The results of the Sasang Constitutional distribution in North Americans are as follows: The percentage of So-yang In distribution in the sample group is 36.25%(87persons), that of Tae-eum In is 13.75%(33persons), and that of So-eum In is 20.41%(49persons).

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