• Title/Summary/Keyword: e-health

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An analysis of the current state of cross-curricular learning topics in mathematics textbooks for grades 5 and 6 (2015 개정 교육과정에 따른 5~6학년군 수학 검정 교과서의 범교과 학습 주제 반영 현황 분석)

  • Kim, Nam Gyun;Oh, Min Young;Kim, Su Ji;Kim, Young Jin;Lee, Yun Ki
    • Communications of Mathematical Education
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    • v.38 no.1
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    • pp.27-48
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    • 2024
  • In order to prepare for changes in future society, cross-curricular learning is emphasized, and the need to link cross-curricular learning topics and subjects is increasing. However, there are few studies on how to deal with cross-curricular learning in mathematics education. This study analyzed the contents and methods of cross-curricular learning topics in subject-specific curriculum and mathematics textbooks. As a result of the study, the curriculum can be categorized into four types according to the variety of cross-curricular learning topics applied and the presence or absence of a main cross-curricular learning topic, and the mathematics curriculum belongs to the type where some cross-curricular learning topics are dealt with passively and there is no main topic. On the other hand, the analysis of 10 math textbooks for grades 5 and 6 according to the 2015 revised curriculum showed that, unlike the curriculum, various cross-curricular learning topics were applied in the textbooks, mainly environment and sustainable development education, safety and health education, career education, character education, and economic and financial education. In addition, in mathematics textbooks, cross-curricular learning topics appeared in various types such as materials, questions, explanations, illustrations, and in many cases, they appeared mainly as materials or illustrations. Based on these findings, implications were explored and suggested on how to integrate and apply cross-curricular learning topics in mathematics.

Impact of an Instrumental Daily Living Activities Occupational Therapy Program for Adults With Developmental Disabilities on Their Daily Living Activities and Quality of Life (성인 발달장애인 대상 수단적 일상생활활동 작업치료 프로그램이 일상생활활동 및 삶의 질에 미치는 영향)

  • Jeong, Eun-Hwa
    • Therapeutic Science for Rehabilitation
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    • v.13 no.2
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    • pp.85-94
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    • 2024
  • Objective : This study aimed to determine the impact of an instrumental daily living activity program for adults with developmental disabilities on their daily living activities and quality of life (QOL). Methods : This study used a single-group pre-test-post-test experimental design. Participants comprised 17 adults with developmental disabilities from the Welfare Center for the Disabled. This program consisted of 10 sessions, including pre- and post-assessments, pertaining to training and education on grocery shopping, meal preparation and cleaning, home management, safety, and emergency management. The evaluation tools used in this study were the Quality of Life Questionnaire, Korean version of the Life Space Assessment (K-LSA), and Korean version of the Instrumental Activities of Daily Living (K-IADL). Results : There was a statistically significant difference in the QOL and K-IADL scores before and after the instrumental activities of daily living occupational therapy program, and there was no statistically significant difference in the K-LSA scores. Conclusion : This study confirmed that implementing an IADL program for adults with developmental disabilities had a positive impact on performance and QOL. For adults with developmental disabilities to participate in daily life and society, interventions for work participation, including training in activities of daily living, must be expanded.

Fermented Protaetia brevitarsis Larvae Ameliorates Chronic Ethanol-Induced Hepatotoxicity in Mice via AMPK and TLR-4/TGF-β1 Pathways

  • Hyo Lim Lee;Jong Min Kim;Min Ji Go;Seung Gyum Joo;Tae Yoon Kim;Han Su Lee;Ju Hui Kim;Jin-Sung Son;Ho Jin Heo
    • Journal of Microbiology and Biotechnology
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    • v.34 no.3
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    • pp.606-621
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    • 2024
  • This study evaluated the hepatoprotective effect of fermented Protaetia brevitarsis larvae (FPB) in ethanol-induced liver injury mice. As a result of amino acids in FPB, 18 types of amino acids including essential amino acids were identified. In the results of in vitro tests, FPB increased alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) activities. In addition, FPB treatment increased cell viability on ethanol- and H2O2-induced HepG2 cells. FPB ameliorated serum biomarkers related to hepatoxicity including glutamic oxaloacetic transaminase, glutamine pyruvic transaminase, total bilirubin, and lactate dehydrogenase and lipid metabolism including triglyceride, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol. Also, FPB controlled ethanol metabolism enzymes by regulating the protein expression levels of ADH, ALDH, and cytochrome P450 2E1 in liver tissue. FPB protected hepatic oxidative stress by improving malondialdehyde content, reduced glutathione, and superoxide dismutase levels. In addition, FPB reversed mitochondrial dysfunction by regulating reactive oxygen species production, mitochondrial membrane potential, and ATP levels. FPB protected ethanol-induced apoptosis, fatty liver, and hepatic inflammation through p-AMP-activated protein kinase and TLR-4/NF-κB signaling pathways. Furthermore, FPB prevented hepatic fibrosis by decreasing TGF-β1/Smad pathway. In summary, these results suggest that FPB might be a potential prophylactic agent for the treatment of alcoholic liver disease via preventing liver injury such as fatty liver, hepatic inflammation due to chronic ethanol-induced oxidative stress.

Is antibiotic prophylaxis necessary after endoscopic ultrasound-guided fine-needle aspiration of pancreatic cysts?

  • Seifeldin Hakim;Mihajlo Gjeorgjievski;Zubair Khan;Michael E. Cannon;Kevin Yu;Prithvi Patil;Roy Tomas DaVee;Sushovan Guha;Ricardo Badillo;Laith Jamil;Nirav Thosani;Srinivas Ramireddy
    • Clinical Endoscopy
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    • v.55 no.6
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    • pp.801-809
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    • 2022
  • Background/Aims: Current society guidelines recommend antibiotic prophylaxis for 3 to 5 days after endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of pancreatic cystic lesions (PCLs). The overall quality of the evidence supporting this recommendation is low. In this study, we aimed to assess cyst infection and adverse event rates after EUS-FNA of PCLs among patients treated with or without postprocedural prophylactic antibiotics. Methods: We retrospectively reviewed all patients who underwent EUS-FNA of PCLs between 2015 and 2019 at two large-volume academic medical centers with different practice patterns of postprocedural antibiotic prophylaxis. Data on patient demographics, cyst characteristics, fine-needle aspiration technique, periprocedural and postprocedural antibiotic prophylaxis, and adverse events were retrospectively extracted. Results: A total of 470 EUS-FNA procedures were performed by experienced endosonographers for the evaluation of PCLs in 448 patients, 58.7% of whom were women. The mean age was 66.3±12.8 years. The mean cyst size was 25.7±16.9 mm. Postprocedural antibiotics were administered in 274 cases (POSTAB+ group, 58.3%) but not in 196 cases (POSTAB- group, 41.7%). None of the patients in either group developed systemic or localized infection within the 30-day follow-up period. Procedure-related adverse events included mild abdominal pain (8 patients), intra-abdominal hematoma (1 patient), mild pancreatitis (1 patient), and perforation (1 patient). One additional case of pancreatitis was recorded; however, the patient also underwent endoscopic retrograde cholangiopancreatography. Conclusions: The incidence of infection after EUS-FNA of PCLs is negligible. Routine use of postprocedural antibiotics does not add a significant benefit.

Workplace influenza vaccination in private hospital setting: a cost-benefit analysis

  • Mohd. Ab. Hadi Tohiar;Safurah Jaafar;Azimatun Noor Aizuddin;Tan Kok Leong;Azrin Syahida Abdul Rahim
    • Annals of Occupational and Environmental Medicine
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    • v.34
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    • pp.3.1-3.12
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    • 2022
  • Background: Influenza illness causes several disruptions to the workforce. The absenteeism that often ensues has economic implications for employers. This study aimed to estimate the cost-benefit of influenza vaccination in a healthcare setting from the employer's perspective. Methods: A cross-sectional questionnaire survey was conducted in a private hospital in 2018-2019 comparing voluntary vaccinated with non-vaccinated employees with influenza vaccine. The analyses were made based on self-reporting on absenteeism and presenteeism from Influenza-like illnesses (ILIs). The costs incurred, both direct and indirect costs, were included in the study. A cost-benefit analysis was performed by measuring the cost of the vaccination program. The costs of absenteeism and reduced productivity were calculated using 3 hypothesised levels of effectiveness in the following percentage of productivity of 30%, 50%, and 70%. The costs were also calculated based on four scenarios: with and without operating income and with and without replacement. The benefits of the influenza vaccination from the employer's perspective were analysed. The benefit to cost ratio was determined. Results: A total of four hundred and twenty-one respondents participated. The influenza vaccination rate was 63.0%. The rate of ILI of 38.1% was significantly lower among vaccinated. The ILI-related absenteeism reported was also significantly lower amongst vaccinated employees at 30% compared to 70% non-vaccinated. Employers could save up to USD 18.95 per vaccinated employee when only labour cost was included or 54.0% of cost savings. The cost-saving rose to USD 155.56 when the operating income per employee was also included. The benefit to cost ratio confirmed that the net cost-benefit gained from the vaccination was more than the net cost of vaccination. Conclusions: Influenza vaccination for working adults was cost-saving and cost-beneficial when translated into financial investments for the employer. A workplace vaccination demonstrates a significant cost-benefit strategy to be applied in any institutional setting.

Oxidized LDL Accelerates Cartilage Destruction and Inflammatory Chondrocyte Death in Osteoarthritis by Disrupting the TFEB-Regulated Autophagy-Lysosome Pathway

  • Jeong Su Lee;Yun Hwan Kim;JooYeon Jhun;Hyun Sik Na;In Gyu Um;Jeong Won Choi;Jin Seok Woo;Seung Hyo Kim;Asode Ananthram Shetty;Seok Jung Kim;Mi-La Cho
    • IMMUNE NETWORK
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    • v.24 no.3
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    • pp.15.1-15.18
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    • 2024
  • Osteoarthritis (OA) involves cartilage degeneration, thereby causing inflammation and pain. Cardiovascular diseases, such as dyslipidemia, are risk factors for OA; however, the mechanism is unclear. We investigated the effect of dyslipidemia on the development of OA. Treatment of cartilage cells with low-density lipoprotein (LDL) enhanced abnormal autophagy but suppressed normal autophagy and reduced the activity of transcription factor EB (TFEB), which is important for the function of lysosomes. Treatment of LDL-exposed chondrocytes with rapamycin, which activates TFEB, restored normal autophagy. Also, LDL enhanced the inflammatory death of chondrocytes, an effect reversed by rapamycin. In an animal model of hyperlipidemia-associated OA, dyslipidemia accelerated the development of OA, an effect reversed by treatment with a statin, an anti-dyslipidemia drug, or rapamycin, which activates TFEB. Dyslipidemia reduced the autophagic flux and induced necroptosis in the cartilage tissue of patients with OA. The levels of triglycerides, LDL, and total cholesterol were increased in patients with OA compared to those without OA. The C-reactive protein level of patients with dyslipidemia was higher than that of those without dyslipidemia after total knee replacement arthroplasty. In conclusion, oxidized LDL, an important risk factor of dyslipidemia, inhibited the activity of TFEB and reduced the autophagic flux, thereby inducing necroptosis in chondrocytes.

Integrative Analysis of Probiotic-Mediated Remodeling in Canine Gut Microbiota and Metabolites Using a Fermenter for an Intestinal Microbiota Model

  • Anna Kang;Min-Jin Kwak;Hye Jin Choi;Seon-hui Son;Sei-hyun Lim;Ju Young Eor;Minho Song;Min Kyu Kim;Jong Nam Kim;Jungwoo Yang;Minjee Lee;Minkyoung Kang;Sangnam Oh;Younghoon Kim
    • Food Science of Animal Resources
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    • v.44 no.5
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    • pp.1080-1095
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    • 2024
  • In contemporary society, the increasing number of pet-owning households has significantly heightened interest in companion animal health, expanding the probiotics market aimed at enhancing pet well-being. Consequently, research into the gut microbiota of companion animals has gained momentum, however, ethical and societal challenges associated with experiments on intelligent and pain-sensitive animals necessitate alternative research methodologies to reduce reliance on live animal testing. To address this need, the Fermenter for Intestinal Microbiota Model (FIMM) is being investigated as an in vitro tool designed to replicate gastrointestinal conditions of living animals, offering a means to study gut microbiota while minimizing animal experimentation. The FIMM system explored interactions between intestinal microbiota and probiotics within a simulated gut environment. Two strains of commercial probiotic bacteria, Enterococcus faecium IDCC 2102 and Bifidobacterium lactis IDCC 4301, along with a newly isolated strain from domestic dogs, Lactobacillus acidophilus SLAM AK001, were introduced into the FIMM system with gut microbiota from a beagle model. Findings highlight the system's capacity to mirror and modulate the gut environment, evidenced by an increase in beneficial bacteria like Lactobacillus and Faecalibacterium and a decrease in the pathogen Clostridium. The study also verified the system's ability to facilitate accurate interactions between probiotics and commensal bacteria, demonstrated by the production of short-chain fatty acids and bacterial metabolites, including amino acids and gamma-aminobutyric acid precursors. Thus, the results advocate for FIMM as an in vitro system that authentically simulates the intestinal environment, presenting a viable alternative for examining gut microbiota and metabolites in companion animals.

Current Status and Transition of the Prevalence of Intestinal Parasitic Infections in Korea (한국(韓國)에 있어서의 장내기생충감염(腸內寄生虫感染)의 현황(現況)과 추이(推移))

  • Kim, Dong-Chan
    • Journal of agricultural medicine and community health
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    • v.9 no.1
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    • pp.83-108
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    • 1984
  • Out of a total of 58 species of helminthic and protozoan parasitic infections in Korea, so far 38 species were reported as intestinal parasites of man. Quite a few species of the intestinal parasitic infections have long been prevalent throughout the country and this has been a significant public health problem. In this paper, current status and transition of the intestinal parasitic infections in the past years were presented. Chronological reviewing of data show background and prospects of change in the prevalence of infections. In the national prevalence survey on parasitic infections conducted once every five years since 1971, stool examinations were done by both cellophane thick smear and brine flotation techniques. Every egg positive case of Ascaris lumbricoides and Clonorchis sinensis was further examined by Stoll's dilution egg counting technique. In 1981, perianal swab using adhesive cellulose tape was added for Enterobius infection. For protozoan cyst examination conducted by province and city in '81, fecal specimens were fixed in SAF solution and examined by the formalin-ether concentration technique. High prevalence of parasitic infection in ana before the 1960s can be easily understood from the data given by the Ministry of Health and Social Affairs in 1967. From a parasite control point of view, the 1960s was the preparatory period particularly for control of soil-transmitted helminthiasis. Several organizations which have contributed to parasite control were founded in this period and the prevention law of parasitic infections was passed in '66. In the '70s, overall prevalence rates of the common intestinal parasitic infections, which were highly prevalent in the past were turned into reduction phase for the first time. The '80s can be said to be an active control period of parasitic infections. Intestinal helminths According to the reports of the national prevalence survey on parasitic infections, the prevalence of helminthic infections was 84.3%(number of person examined:24,887) in '71, 63.2%(27,178) in '76, and 41.1%(35,018) in '81. By area, the prevalence rate in '81 was 35.1%(20,569) in urban areas and 49.6%(14,447) in rural areas. Intestinal nematodes Ascaris lumbricoides The prevalence of Ascaris infection has decreased significantly in recent years. Among students, the prevalence was 55.4%, in '69 and decreased to 4.7% in '83. In the national prevalence surveys, the prevalence decreased to 13.0% in '81 from 54.9% in '71. By area, the prevalence decreased to 8.5% in '81 from 46.4% in '71 in urban area and 19.4% in '81 from 59.6% in '71 in rural area. By age, the prevalence has become in recent years relatively even in all age groups, although higher prevalence used to be seen in young age groups of around 10 years old, particulary in the highly prevalent rural areas. By sex, the prevalence was higher in the female than in the male. Unfertilized egg positive rates among the ascariasis cases increased gradually up to 55.4% on the average in '81. The intensity of the infection was also significantly decreased. Trichuris trichiura Trichuris infection had also decreased to 23.4% in '81 from 65.4% in '71. By area, the decreasing tendency of the prevalence became faster in urban areas than in the rural areas. The prevalence in urban and rural areas in '71 was 69.7%, and 63.1% respectively and decreased to 19.5% and 29.0% respectively in '81. By age, the prevalence reached a peak at the 10-14 age group and showed relatively even distribution throughout all age groups. By sex, the prevalence was close in young age groups, but in the 30s or over age group, especially in rural area, the prevalence was significantly higher in the female than in the male. The prevalence has much fluctuated depending in the area. The prevalence in rural areas surveyed in the '80s shows a range between 20.9% and 73.7% by locality. It is anticipated that the prevalence of Trichuris infection will drop more rapidly, when mass treatment is conducted. Hookworms Hookworm infection by mostly Ancylostoma duodenale and a few by Necator americanus has decreased to a negligible levels in recent years. In the national prevalence surveys, the prevalence was 10.7% in '71, 2.2% in '76, and 0.5% in '81. The prevalence was higher in rural areas than in urban areas. Wide application of multi-specific anthelminthics in the ascariasis control programmes conducted in the past decade appear to have been effective against hookworm infection. Trichostrongylus orientalis As in the case with hookworm infection, the prevalence of Trichostrongylus infection has reached a negligible levels. In the national prevalence surveys, the prevalence was 7.7% in '71, 1.0% in '76 and 0.2% in '81. Enterobius vermicularis In the national prevalence survey in '81, the egg positive rate was 12.0%. Higher prevalence is expected when examined repeatedly. The prevalence rate was 10.3% in urban area and 14.6% in rural area. In recent surveys conducted in rural areas among schoolchildren, the prevalence was 32.4% in Gimhae Gun in '82 and 64.1% in Yeongyang Gun in '83. By age, the egg positive rate was higher in young age groups of around 10 and sharply decreased in age groups of around 20 and then somewhat increased again in middle age groups. By sex, the prevalence was higher in the female than in the male. Strongyloides stercoralis Strongyloides stercoralis infection has rarely been found in Korea. Three cases were reported in 1914. And 0.1-0.5% were found infected out of 2,642 persons examined at the prisoner-of-war camp on Geojedo in 1956. One case was reported in '54 and '82, respectively. Anisakis spp. No systematic survey has been conducted for anisakiasis In Korea. So far, only several cases have been found 1 case in Seoul in '71, 5 cases in Busan in '81 and 1 case in Busan in '84. Intestinal trematodes Metagonimus yokogawai In the national prevalence survey conducted in 1981, the egg positive rate was 1.24% on the average. High endemic areas are located in the southwestern part of Korea. The prevalence in Hadong Gun was 29.1% on the average in '79. In a survey conducted in 76, the prevalence was 44.0% in Gwangyang, 55.0% in Gogseung and 29.0% in Gurye. The infection is closely correlated with raw sweetfish consumption in these areas. Other intestinal trematodes A human case of Heterophyes heterophyes was reported in 1914. Several species were reported in the '80s : 17 cases of Fibricola seoulensis, 9 cases of Pygidiopsis summa, 8 cases of Heterophyes heterophyes nocens, 1case of Heterophyopsis continua, 2 cases of Stellantchasmus falcatus, 1 case of Stictodora sp., 1 case of Echinostoma hortense, and 4 cases of Echinochasmus japonicus. As the intermediate hosts, snakes and frogs play a role for F.seoulensis and fish for the rest of the species. Intestinal cestodes Taenia saginata and T. solium Egg positive rates in the national prevalence survey were 0.7% in '76 and 1.1% in '81. The prevalence in '81 was 0.6% in urban area and 1.8% in rural area. The proglottid positive rate in Jeju Do was 19.2% on the average. On Udo, Jeju Do in 1983, the egg positive rate among the inhabitants was 2.9%. Hymenolepis nana In the national prevalence survey, egg positive rates were 0.6% in '76 and 0.4% in '81. No difference was seen in the prevalence by area and sex. Hymenolepis diminuta Infected cases were reported : 3 in '64 and I in '66. Egg positive rate in '81 was 0.01% in the national prevalence survey. Diphylobothrium latum So far, about 30 cases have been reported. The cases have been reported more frequently in recent surveys. Mesocestoides sp. A case was reported from a hospitalized patient in Seoul in '67. Spirometra erinacei Two cases were reported in '84 following reidentification of the adult worms collected in '74. Intestinal protozoa Out of a total of 23 species of human protozoan infections in Korea, 13 species were reported as intestinal protozoa : Entamoeba histolytica, E coli, Endolimax nana, Iodamoeba b$\ddot{u}$tschlii, Dientamoeba fragilis, Giardia lamblia, Chilomastix mesnilii, Embadomonas sp., Enteromonas hominis, Trichomonas hominis, Isospora belli, I. Hominis(Sarcocystis hominis), and Balantidium coli. Since the first report on intestinal protozoan infections in 1925, there have been quite a few survey data on the prevalence of the infection. It was found reviewing the data chronologically that up to the early '70s the infection was prevalent around a 30-50%. After that, the protozoan cyst positive rate has shown the tendency of gradual decrease throughout the country. Protozoan cyst survey conducted in Seoul and several provinces in 1981 revealed infection rates of 8.9%(1,310) in Gangweondo, 10.7%(1,703) in Gyenggi Do, 11.7%(1,032) in Jeonra Buk Do, 9.1%(4,116) in Jeonra Nam Do, and 1.4%(5,275) in Seoul. Entamoeba histolytica In the survey conducted by province in '81, the cyst positive rate was 0.8% in Gangweon-do, 0.3% in Gyeonggi Do, 1.4% in both Jeonra Buk Do and Jeonra Nam Do, and 0.2% in Seoul. Giardia lamblia In the survey by province in '81, cyst positive rates were 2.2% in both Gyeonggi Do and Jeonra Buk Do, 1.9% in Jeonra Nam Do, 0.5% in Gangweon Do, and 0.9% in Seoul. Balantidium coli Two cases were reported. One in 1930 and the other in '74. Isospora belli and I. Hominis(Sarcocystis hominis) Isospora belli was reported : 1 case in '56 and 3 cases in '66. I. Hominis, recently identified to be synonymous with Sarcocystis hominis, was reported : 3 cases in '66. Other intestinal protozoa The protozoan parasites other than the above mentioned are generally treated as commensal, although some of them are considered to be pathogenic. The data of '81 show that about 10% of the inhabitants are still infected with protozoa.

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The Location of Medical Facilities and Its Inhabitants' Efficient Utilization in Kwangju City (광주시(光州市) 의료시설(醫療施設)의 입지(立地)와 주민(住民)의 효율적(效率的) 이용(利用))

  • Jeon, Kyung-Sook
    • Journal of the Korean association of regional geographers
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    • v.3 no.2
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    • pp.163-193
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    • 1997
  • Medical services are a fundamental and essential service in all urban areas. The location and accessibility of medical service facilities and institutions are critical to the diagnosis, control and prevention of illness and disease. The purpose of this paper is to present the results of a study on the location of medical facilities in Kwangju and the utilization of these facilities by the inhabitants. The following information is a summary of the findings: (1) Korea, like many countries, is now witnessing an increase in the age of its population as a result of higher living standards and better medical services. Korea is also experiencing a rapid increase in health care costs. To ensure easy access to medical consultation, diagnosis and treatment by individuals, the hierarchical efficient location of medical facilities, low medical costs, equalized medical services, preventive medical care is important. (2) In Korea, the quality of medical services has improved significantly as evident by the increased number of medical facilities and medical personnel. However, there is still a need for not only quantitative improvements but also for a more equitable distribution of and location of medical services. (3) There are 503 medical facilities in Kwangju each with a need to service 2,556 people. This is below the national average of 1,498 inhabitants per facility. The higher locational quotient and satisfactory population per medical facility showed at the civic center. On the other hand, problem regions such as the traditional residential area in Buk-Gu, Moo-deung mountain area and the outer areas of west Kwangju still maintain rural characteristics. (4) In the study area there are 86 general medicine clinics which provide basic medical services. i. e. one clinic per every 14,949 residents. As a basic service, its higher locational quotient showed in the residential area. The lower population concentration per clinic was found in the civic center and in the former town center, Songjeong-dong. In recently build residential areas and in the civic center, the lack of general medicine clinics is not a serious medical services issue because of the surplus of medical specialists in Korea. People are inclined to seek a consultation with a specialist in specific fields rather than consult a general practitioner. As a result of this phenomenon, there are 81 internal medicine facilities. Of these, 32.1% provide services to people who are not referred by a primary care physician but who self-diagnose then choose a medical facility specializing in what they believe to be their health problem. Areas in the city, called dongs, without any internal facilities make up 50% of the total 101 dongs. (5) There are 78 surgical facilities within the area, and there is little difference at the locational appearance from internal medicine facilities. There are also 71 pediatric health clinics for people under 15 years of age in this area, represents one clinic per 5,063 people. On the quantitative aspect, this is a positive situation. Accessibility is the most important facility choice factor, so it should be evenly located in proportion to demander distribution. However, 61% of 102 dongs have no pediatric clinics because of the uneven location. (6) There are 43 obstetrical and gynecological clinics in Kwangju, and the number of residents being served per clinic is 15,063. These services need to be given regularly so it should increase the numbers. There are 37 ENT clinics in the study area with the lower concentration in Dong-gu (32.4%) making no locational differences by dong. There are 23 dermatology clinics with the largest concentration in Dong-Gu. There are 17 ophthalmic clinics concentrated in the residential area because of the primary function of this type of specialization. (7) The use of general medicine clinics, internal medicine clinics, pediatric clinics, ENT clinics by the inhabitants indicate a trend toward primary or routine medical services. Obstetrics and gynecology clinics are used on a regular basis. In choosing a general medicine clinic, internal medicine clinic, pediatric clinic, and a ENT clinic, accessibility is the key factor while choice of a general hospital, surgery clinic, or an obstetrics and gynecology clinic, thes faith and trust in the medical practitioner is the priority consideration. (8) I considered the efficient use of medical facilities in the aspect of locational and management and suggest the following: First, primary care facilities should be evenly distributed in every area. In Kwangju, the number of medical facilities is the lowest among the six largest cities in Korea. Moreover, they are concentrated in Dong-gu and in newly developed areas. The desired number of medical facilities should be within 30 minutes of each person's home. For regional development there is a need to develop a plan to balance, for example, taxes and funds supporting personnel, equipment and facilities. Secondly, medical services should be co-ordinated to ensure consistent, appropriate, quality services. Primary medical facilities should take charge of out-patient activities, and every effort should be made to standardize and equalize equipment and facility resources and to ensure ongoing development and training in the primary services field. A few specialty medical facilities and general hospitals should establish a priority service for incurable and terminally ill patients. (9) The management scheme for the inhabitants' efficient use of medical service is as follows: The first task is to efficiently manage medical facilities and related services. Higher quality of medical services can be accomplished within the rapidly changing medical environment. A network of social, administrative and medical organizations within an area should be established to promote information gathering and sharing strategies to better assist the community. Statistics and trends on the rate or occurrence of diseases, births, deaths, medical and environment conditions of the poor or estranged people should be maintained and monitored. The second task is to increase resources in the area of disease prevention and health promotion. Currently the focus is on the treatment and care of individuals with illness or disease. A strong emphasis should also be placed on promoting prevention of illness and injury within the community through not only public health offices but also via medical service facilities. Home medical care should be established and medical testing centers should be located as an ordinary service level. Also, reduced medical costs for the physically handicapped, cardiac patients, and mentally ill or handicapped patients should be considered.

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Effect of water storage on the fracture toughness of dental resin cement used for zirconia restoration (수분이 지르코니아 수복물 전용 레진시멘트의 파괴인성에 미치는 영향에 관한 연구)

  • Goo, Bon-Wook;Kim, Sung-Hun;Lee, Jai-Bong;Han, Jung-Suk;Yeo, In-Sung;Ha, Seung-Ryong;Kim, Hee-Kyung
    • The Journal of Korean Academy of Prosthodontics
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    • v.52 no.4
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    • pp.312-316
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    • 2014
  • Purpose: The aim of this study was to compare the fracture toughness of currently available resin cements for zirconia restorations and evaluate the effect of water storage on fracture toughness of those resin cements. Materials and methods: Single-edge notched specimens ($3mm{\times}6mm{\times}25mm$) were prepared from three currently available dual cure resin cements for zirconia restorations (Panavia F 2.0, Clearfil SA luting and Zirconite). Each resin cement was divided into four groups: immersed in distilled water at $37^{\circ}C$ for 1 (Control group), 30, 90, or 180 days (n=5). Specimens were loaded in three point bending at a cross-head speed of 0.1 mm/s. The maximum load at specimen failure was recorded and the fracture toughness ($K_{IC}$) was calculated. Data were analyzed using one-way ANOVA and multiple comparison $Scheff{\acute{e}}$ test (${\alpha}$=.05). Results: In control group, the mean $K_{IC}$ was $3.41{\pm}0.64MN{\cdot}m^{-1.5}$ for Panavia F, 2.0, $3.07{\pm}0.41MN{\cdot}m^{-1.5}$ for Zirconite, $2.58{\pm}0.30MN{\cdot}m^{-1.5}$ for Clearfil SA luting respectively, but statistical analysis revealed no significant difference between them. Although a gradual decrease of $K_{IC}$ in Panavia F 2.0 and gradual increases of KIC in Clearfil SA luting and Zirconite were observed with storage time, there were no significant differences between immersion time for each cement. Conclusion: The resin cements for zirconia restorations exhibit much higher $K_{IC}$ values than conventional resin cements. The fracture toughness of resin cement for zirconia restoration would not be affected by water storage.