• Journal of Yeungnam Medical Science
• /
• v.24 no.1
• /
• pp.41-54
• /
• 2007

Background : The causes of chest pain vary but the leading cause of chest pain is ischemic heart disease. Mortality from ischemic chest pain has increased more than two fold over the last ten years. The purpose of this study was to determine the data necessary for rapid treatment of patients with signs and symptoms of ischemic chest pain in the emergency department (ED). Materials and Methods : We interviewed 170 patients who had ischemic chest pain in the emergency department of Yeungnam University Hospital over 6 months with a protocol developed for the evaluation. The protocol used included gender, age, arriving time, prior hospital visits, methods of transportation to the hospital, past medical history, final diagnosis, and outcome information from follow up. Results : Among 170 patients, there were 118 men (69.4%) and the mean age was 63 years. The patients diagnosed with acute myocardial infarction (AMI) were 106 (62.4%) and with angina pectoris (AP) were 64 (37.6%). The patients who had visited another hospital were 68.8%, twice the number that came directly to this hospital (p<0.05). The ratio of patients who visited another hospital were higher for the AMI (75.5%) than the AP (59.4%) patients (p<0.05). The median time spent deciding whether to go to hospital was 521 minutes and for transportation was 40 minutes. With regard to patients that visited another hospital first, the median time spent at the other hospital was 40 minutes. The total median time spent before arriving at our hospital was 600 minutes (p>0.05). The patients who had a total time delay of over 6 hours was similar 54.8% in the AMI group and 57.9% in the AP group (p>0.05). As a result, only 12.2% of the patients with an AMI received thrombolytics, and 48.8% of them had a simultaneous percutaneous coronary intervention (PCI). In the emergency department 8.5% of the patients with an AMI died. Conclusion : Timing is an extremely important factor for the treatment of ischemic heart disease. Most patients arrive at the hospital after a long time lapse from the onset of chest pain. In addition, most patients present to a different hospital before they arrive at the final hospital for treatment. Therefore, important time is lost and opportunities for treatment with thrombolytics and/or PCI are diminished leading to poor outcomes for many patients in the ED. The emergency room treatment must improve for the identification and treatment of ischemic heart disease so that patients can present earlier and treatment can be started as soon as they present to an emergency room.

• Journal of Nutrition and Health
• /
• v.48 no.6
• /
• pp.558-570
• /
• 2015

Purpose: The objective of this study is to investigate the work performances and the factors contributing to the work performance of nutrition teachers and school dieticians according to employment status in Daejeon and Chungcheongnamdo. Methods: A survey was conducted among 415 school dieticians from selected elementary, middle, and high schools in the area. This survey was used for analysis of the general characteristics and the status of working and foodservice environments. The frequency of occurrence was measured using the ${\chi}^2$-test while analysis of differences in work performance of 57 variables grouped according to 12 categories by mean ${\pm}$ SD was performed using student t-test. In addition, a regression analysis was performed to assess the influence of occupational (working and foodservice) environment on work performances. Results: All 14 environmental factors including general characteristics were different between nutrition teachers and school dieticians. In 12 of 57 variables there were significant differences in work performance between the two groups. When compared using average work performance, 5 domains showed significant difference in work performance between the two groups. These 5 domains were other works (T = 6.050), dietary habit guide (T = 4.789), menu (nutrition) management (T = 3.524), foodservice administration and evaluation (T = 2.757), and production and service management (T = 2.588). Overall, the work performances of nutrition teachers were comparably higher than those of school dietitians. A correlation analysis between occupational (working or foodservice) environments and work performances of the two groups showed that the work performances of nutrition teachers were influenced by the number of employees, number of students, meal frequency a day, annual salary, age, foodservice years of school, and school type. Conclusion: Meanwhile, the work performances of school dieticians were influenced by the number of students, number of employees, meal frequency a day, work hour, education level, age, school type, and service years as a dietitian.

• Tuberculosis and Respiratory Diseases
• /
• v.42 no.6
• /
• pp.923-933
• /
• 1995

Background: Pleural abnormality is the the most common respiratory change caused by asbestos dust inhalation and also develop other asbestos related disease after cessation of asbestos exposure. So we conducted epidemiologic study to investigate if the pleural abnormality is associated with pulmonary function change and what factors are influenced on pulmonary function impairment. Methods: Two hundred and twenty two asbestos workers from 9 industries using asbestos in Korea were selected to measure the concentration of sectional asbestos fiber. Ouestionnaire, chest X-ray, PFT were also performed. All the data were analyzed by student t-test and chi-square test using SAS. Regressional analysis was performed to evaluate important factors, for example smoking, exposure concentration, period and the existence of pleural thickening, affecting to the change of pulmonary function. Results: 1) All nine industries except two, airborn asbestos fiber concentration was less than an average permissible concentration. PFT was performed on 222 workers and the percentage of male was 88.3%, their mean age was $41{\pm}9$ years old, and the duration of asbestos exposure was $10.6{\pm}7.8$ yrs. 2) The chest X-ray showed normal(89.19%), pulmonary Tb(inactive)(2.7%), pleral thickening (7.66%), suspected reticulonodular shadow(0.9%). 3) The mean values of height, smoking status, concentration of asbestos fiberwere not different between the subjects with pleural thickening and others, but age, cumulative pack-years, the duration of asbestos exposure were higher in subjects with pleural thickening. 4) All the PFT indices were lower in the subjects with pleural thickening than in the subjects without pleural thickening. 5) Simple regression analysis showed there was a significant correlation between $FEF_{75}$ which is sensitive in small airway obstruction and cumulative smoking pack-years, the duration of asbestos exposure and the concentration of asbestos fiber. 6) Multiple regression analysis showed all the pulmonary function indices were decreased as the increase of cumulative smoking pack-years and especially in the indices those are sensitive in small airway obstruction. Pleural thickening was associated with reduction in FVC, $FEV_1$, PEFR and $FEF_{25}$. Conclusion: The more concentration of asbestos fiber and the more duration of asbestos exposure, the greater reduction in $FEF_{50}$, $FEF_{75}$. Therefore PFT was important in the evaluation of early detection for small airway obstruction. Furthermore pleural thickening without asbesto-related parenchymal lung disease is associated with reduction in pulmonary function.

• Journal of Nutrition and Health
• /
• v.48 no.2
• /
• pp.180-191
• /
• 2015

Purpose: There is a lack of data on the energy cost of children's everyday activities, adult values are often used as surrogates. In addition, the influence of body weight on the energy cost of activity when expressed as metabolic equivalents (METs) has not been vigorously explored. Methods: In this study 20 elementary school students 9~12 years of age completed 18 various physical activities while energy expenditure was measured continuously using a portable telemetry gas exchange system ($K_4b^2$, Cosmed, Rome, Italy). Results: The average age was 10.4 years and the average height and weight was 145.1 cm and 43.6 kg, respectively. Oxygen consumption ($VO_2$), energy expenditure and METs at the time of resting of the subjects were 5.41 mL/kg/min, 1.44 kcal/kg/h, and 1.5 METs, respectively. METs values by 18 physical activities were as follows: Homework and reading books (1.6 METs), playing game with a mobile phone or video while sitting (1.6 METs), watching TV while sitting on a comfortable chair (1.7 METs), playing video game or mobile phone game while standing (1.9 METs), sweeping a room with a broom (2.7 METs) and playing a board game (2.8 METs) belong to light intensity physical activities. By contrary, speedy walking and running were 6.6 and 6.7 METs, respectively, which belong to high intensity physical activities over 6.0 METs. When the effect of body weight on physical activity energy expenditure was determined, $R^2$ values increased with 0.116 (playing a game at sitting), 0.176 (climbing up and down stairs), 0.246 (slow walking), and 0.455 (running), which showed that higher activity intensity increased explanation power of body weight on METs value. Conclusion: This study is important for direct evaluation of energy expenditure by physical activities of children, and it could be used directly for revising and complementing the existing activity classification table to fit for children.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.25 no.2
• /
• pp.35-40
• /
• 2021

Purpose Glomerular filtration rate(GFR) is an important indicator for the diagnosis, treatment, and follow-up of kidney disease and is also used by healthy individuals for drug use and evaluating kidney function in donors. The gold standard method of the GFR test is to measure by continuously injecting the inulin which is extrinsic marker, but it takes a long time and the test method is complicated. so, the method of measuring the serum concentration of creatinine is used. Estimated glomerular filtration rate (eGFR) is used instead. However, creatinine is known to be affected by age, gender, muscle mass, etc. eGFR formulas that are currently used include the Cockroft-Gault formula, the modification of diet in renal disease (MDRD) formula, and the chronic kidney disease epidemilogy collaboration (CKD-EPI) formula for adults. For children, the Schwartz formula is used. Measurement of GFR using ⁵¹Cr-EDTA (diethylenetriamine tetraacetic acid), ^99mTc-DTPA (diethylenetriamine pentaacetic acid) can replace inulin and is currently in use. Therefore, We compared the GFR measured using ^99mTc-DTPA with the eGFR using CKD-EPI formula. Materials and Methods For 200 kidney transplant donors who visited Asan medical center.(96 males, 104 females, 47.3 years ± 12.7 years old) GFR was measured using plasma(Two-plasma-sample-method, TPSM) obtained by intravenous administration of ^99mTc-DTPA(0.5mCi, 18.5 MBq). eGFR was derived using CKD-EPI formula based on serum creatinine concentration. Results GFR average measured using ^99mTc-DTPA for 200 kidney transplant donors is 97.27±19.46(ml/min/1.73m²), and the eGFR average value using the CKD-EPI formula is 96.84±17.74(ml/min/1.73m²), The concentration of serum creatinine is 0.84±0.39(mg/dL). Regression formula of ^99mTc-DTPA GFR for serum creatinine-based eGFR was Y = 0.5073X + 48.186, and the correlation coefficient was 0.698 (P<0.01). Difference (%) was 1.52±18.28. Conclusion The correlation coefficient between the ^99mTc-DTPA and the eGFR derived on serum creatinine concentration was confirmed to be moderate. This is estimated that eGFR is affected by external factors such as age, gender, and muscle mass and use of formulas made for kidney disease patients. By using ^99mTc-DTPA, we can provide reliable GFR results, which is used for diagnosis, treatment and observation of kidney disease, and kidney evaluation of kidney transplant patients.

• Journal of the Korean Society of School Health
• /
• v.4 no.2
• /
• pp.176-192
• /
• 1991

School nurses, in service of 102 special schools in Korea, were urveyed by mail questionnaires from February to March, 1991 and 77 of hem responded. Collected data were analyzed to establish the direction of health management in special school and to provide basic reference data for improving the quality of the management of school-nurses' services. The major findings are as follows: Out of special schools surveyed, 67.5% is private school and 83.2% is located in city. The average number of classes, students, and educational personnels per special school is 17.2, 194, and 28 respectively. The average age of school-nurses surveyed is 32.7. The proportion of graduates from the junior college and upward was 97.4%, the proportion of the married was 71.4%. Out of respondents, 71.4% has religion : 79.2% has past career in the fields of clinics or public health: 62.3% accompanishes independent services: 77.9% belongs to primary school. About 69% of nursing room in special schools surveyed is located at the first floor. Out of special school surveyed, 90.9% has no organization for school health programms: Only 18.2% entrusted everyone of school doctor, school dentist, and school pharmacists with school health. 46.8% of respondents didn't know about the annual budget for school health programmes. The average annual expenditure for school health programme per special school was 317,000F26. won and the purchase cost for medical supplies accounted for the larger part of them. The monthly average number of students utilizing school nursing room was 71 per school, annual utilization times of school nursing room was 4.4 per student and utilization due to injury was prevalent by 26.6% and there is some differences in using the school nursing room according to disabled area. Rate of referral to medical facilities was 1.4%. The leading reason of referral to medical facilities was high fever among those who have visual handicaps, fracture among those who have emotional disturbance, injury by trauma among others. Nine hundred fifty six students of students in special school surveyed have sufferd from epilepsy and prevalence rate of epilepsy was 6.4%. Only 22.6% of respondents replied that they had physical examination more than 2 times per year. Out of respnodents, 98.7% answered that they had health education and 67.1% of them ansered that they educated in a classroom, 98.7% of respondents emphasized need of sex education. Respondents put the most emphasis on the personal hygiene when they performed health education and they used broadcasting education in the area of visual handicaps, OHP or VTR in hearing handicaps, home correspondence or OHP VTR in other area importantly. About 47% of repondents answered that health education was the most difficult and they emphasized that definite guide on health management was requested. Respondents had self-confidence and high perfomance rate in most of school-nurses' services completely, but so they was not in area of evaluation of school health programmes, an examination of physical strength, evaluation of health education, management of school purification area, suture of wounds. In consideration of above findings, we may conclude that special education for school-nurse in special schools as well as improvement of definite guiding principles are requested to establish direction for health management in special schools and to improve the degree of quality for school-nurses' sevices in special schools.

• Clinical and Experimental Pediatrics
• /
• v.48 no.7
• /
• pp.737-744
• /
• 2005

Purpose : Infants and children with cardiovascular diseases often present with respiratory symptoms. However, missed or delayed evaluation for potential airway problem may complicate overall prognosis. The aim of this study is to determine the clinical characteristics of these patients and explore the cause of airway problem. Methods : We reviewed the medical records of 64 patients(M : F=33:31, mean age : $6.3{\pm}7.5$ months) whose airway problems were proven by computed tomography or bronchoscopy in perioperative periods at the Asan Medical Center from January 1997 to June 2004. Patients were divided into two groups based on the duration of ventilator care : ${\leq}7$ days(group 1 : 23 cases, M : F=10 : 13) and >7 days(group 2 : 41 cases, M : F=23 : 18). Results : The patients in group 2 significantly developed more post-operative respiratory symptoms than group 1(P<0.001) and had more airway problems including extrinsic obstruction, intrinsic anomaly, and combined problem than group 1 although not significantly different(P=0.082). Among underlying diseases, the most common diseases were vascular anomaly(26.2 percent) and aortic arch anomaly(26.2 percent) in group 1 and pulmonary atresia with ventricular septal defect(22.4 percent) in group 2. The most frequent respiratory symptoms were recurrent wheezing pre-operatively and failure of ventilator weaning post-operatively. The major types of airway anomaly were tracheomalacia and tracheal stenosis(in each case 18.2 percent). Nineteen patients with persistent airway problems underwent aortopexy or other vascular correction. Of the 19 patients, 13(68.4 percent) were improved, but 2 failed in weaning ventilator and 4 died of non-airway problems. Conclusion : Early evaluation and treatment for potential airway problems may affect natural or surgical prognosis in patients with cardiovascular diseases presenting with respiratory symptoms.

• The Korean Journal of Food And Nutrition
• /
• v.29 no.6
• /
• pp.835-848
• /
• 2016

The purpose of this study was to find efficient and customized tools for delivering the benefit of health functional foods (HFFs). Delivery tools which could influence the impact of advertising were images, explanations of ingredients, diagrams of health benefit, patents, and comments from authority. Six advertisements were developed using these tools: "A": relevant image + explanation of ingredients + scientific diagram of efficacy; "B": relevant image + explanation of ingredients; "C": relevant image; "D": irrelevant image; "E": irrelevant image + explanation of ingredient + patent; "F": irrelevant image + explanation of ingredient + comments from authority. To analyze the consumer perceptions on HFFs and advertisement effects, 300 respondents were requested to answer a questionnaire comprising of the following questions: 5 questions of attitudes (necessity of HFFs, trust in HFFs, gathering information, watching advertisements and trust in advertisement claims) and 6 questions on the 6 developed advertisements (attention, understanding, sufficiency of information, sympathy, trust, and purchase). Scoring was done as per the 5 Likert scale. There was a higher proportion of females and the elderly, as compared to males and youngsters. The overall consumer attitudes were positive. Explanation of ingredients, scientific diagram of health benefit, patents and expert comments were helpful factors in increasing the advertisement evaluation by consumer, but the images were not. Advertisement evaluation of consumer did not differ with gender and age. However, differences were observed between some of the consumer attitudes (necessity of HFFs, trust in HFFs, gathering information and trust in advertisements claim) and advertisement evaluations (attention, understanding, sympathy and purchase). Our results indicate that for consumers utilizing the HFFs, advertisements with concrete tools such as diagrams, patent, and expert comments are more helpful. However, for consumers who do not have interest in HFFs, the scientific information was irrelevant. We believe that to maximize the effect of health information in advertisements, consumers should be segmented, and customized tools for each segment needs to be developed.

• Radiation Oncology Journal
• /
• v.26 no.2
• /
• pp.83-90
• /
• 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.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.14 no.2
• /
• pp.77-82
• /
• 2010

Purpose: As PET/CT come into wide use, it caused increasing of expose in clinical use. Therefore, Korea Food and Drug Administration issued Patient DRL (Diagnostic Reference Level) in CT scan. In this study, to build the basis of patient dose reduction, we analyzed effective dose in transmission scan with CT scan. Materials and Methods: From February, 2010 to March 180 patients (age: $55{\pm}16$, weight: $61.0{\pm}10.4$ kg) who examined $^{18}F$-FDG PET/CT in Asan Medical Center. Biograph Truepoint 40 (SIEMENS, GERMANY), Biograph Sensation 16 (SIEMENS, GERMANY) and Discovery STe8 (GE healthcare, USA) were used in this study. Per each male and female average of 30 patients doses were analyzed by one. Automatic exposure control system for controlling the dose can affect the largest by a patient's body weight less than 50 kg, 50-60 kg less, 60 kg more than the average of the three groups were divided doses. We compared that measured value of CT-expo v1.7 and ImPACT v1.0. The relationship between body weight and the effective dose were analyzed. Results: When using CT-Expo V1.7, effective dose with BIO40, BIO16 and DSTe8 respectably were $6.46{\pm}1.18$ mSv, $9.36{\pm}1.96 $mSv and $9.36{\pm}1.96$ mSv for 30 male patients respectably $6.29{\pm}0.97$ mSv, $10.02{\pm}2.42$ mSv and $9.05{\pm}2.27$ mSv for 30 female patients respectably. When using ImPACT v1.0, effective dose with BIO40, BIO16 and DSTe8 respectably were $6.54{\pm}1.21$ mSv, $8.36{\pm}1.69$ mSv and $9.74{\pm}2.55$Sv for 30 male patients respectably $5.87{\pm}1.09$ mSv, $8.43{\pm}1.89$ mSv and $9.19{\pm}2.29$ mSv for female patients respectably. When divided three groups which were under 50 kg, 50~60 kg and over 60 kg respectably were 6.27 mSv, 7.67 mSv and 9.33 mSv respectably using CT-Expo V1.7, 5.62 mSv, 7.22 mSv and 8.91 mSv respectably using ImPACT v1.0. Weight and the effective dose coefficient analysis showed a very strong positive correlation(r=743, r=0.693). Conclusion: Using such a dose evaluation programs, easier to predict and evaluate the effective dose possible without performing phantom study and such dose evaluation programs could be used to collect basic data for CT dose management.