• Journal of Hospice and Palliative Care
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• v.8 no.2
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• pp.152-155
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• 2005

Purpose: The lower extremity edema (LEE) is a common distressful symptom in advanced cancer patients and is hard to manage. We analyze the characteristics of LEE in patients with advanced cancer to provide the basic information of causes and adequate management. Methods: Physical examination, assessment of the location and severity of edema, blood chemistry (albumin, creatinine), Doppler Sono for patients with suspecting deep vein thrombosis (DVT), and abdomen CT scan for patient with suspecting lymph edema were performed. Severity of edema was classified according to NCI lymph edema scaling and improvement was defined as lowering at least 1 grade of edema after management. Results: Among 154 patient who had been admitted to Hospice Ward from Mar 2003 to Jan 2004, 33 had LEE, and 6 had both upper extremity edema and LEE except generalized edema. Their underlying cancers were stomach (7), lung (6), biliary tract (5), liver (5), colorectal (5), pancreas (2), and others (9). There were 12 patient with grade I, 20 patients with grade II, and 7 patients with grade III edema. The causes were hypoalbuminemia (11), lymph edema (10), DVT (7), obstruction of inferior vena cava (IVC) or portal vein (6), and dependent edema (5). The common managements were including leg elevation and diuretics. Elastic stocking was applied for patients with DVT and leg massage and pneumatic compression was used for lymph edema. The 2/3 patients were improved after management. Conclusion: The incidence of LEE in terminal cancer pts was high (25.3%) and their causes were variable including lymph edema, DVT, hypoalbuminemia and dependent edema. Active noninvasive management according to causes could result in good palliation.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.6 no.2
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• pp.120-128
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• 2003

Purpose: Recently, while the authors were experiencing that the epidemic period of rotaviral infection happened more in the early spring, we tried to find out how the outbreaks of rotaviral infection are changing in detail depending on the weather condition since it has something to do with the climate factors and PM10. Methods: Fourteen hundreds seventy nine patients who were proved to be positive to rotavirus were chosen among children less than 5 years old from January 1995 to June 2003. Among various climate factors, monthly average temperature, humidity, rainfall and PM10 were selected. Results: Rotaviral infection was most active in 2002 as 309 (20.9%) patients. It has been the spring that is the most active period of rotaviral infection since 2000. The temperature (RR=0.9423, CI=0.933424~0.951163), rainfall (RR=1.0024, CI=1.001523~1.003228) and PM10 (RR=1.0123, CI=1.009385~1.015248) were significantly associated with the monthly distribution of rotaviral infection. Conclusion: Through this study we determined that the epidemic period of rotaviral infection is changed to spring, which is different from the usual seasonal periods such as late fall or winter as reported in previous articles. As increased PM10 which could give serious influence to the human body, and changing pattern of climate factors such as monthly average temperature and rainfall have something to do with the rotaviral infection, we suppose that further study concerning this result is required in the aspects of epidemiology, biology and atmospheric science.

• Journal of Preventive Medicine and Public Health
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• v.24 no.2 s.34
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• pp.181-194
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• 1991

This study intended to obtain an useful information on the prevalence of subjective symptoms, and to clarify the interrelationships between blood lead and lead related symptoms in low level lead exposure. The 93 male workers exposed to lead and 56 male nonexposed workers were examined for their blood lead(PBB), Zinc-protoporphy(ZPP), hemoglobin(HB) and personnal history, and completed 15 questionnaires related to symptoms of lead absorption : also measured lead concentration in air (PBA) in the workplace. The results obtained were as follows ; 1. The means of blood lead (PBB), blood ZPP and hemoglobin (HB) among workers exposed to lead were $26.1{\pm}8.8{\mu}g/dl,\;28.3{\pm}26.0{\mu}g/dl$ and $16.2{\pm}1.2g/dl$ : whereas those of nonexposed workers were $18.7{\pm}5.1{\mu}g/dl,\;20.6{\pm}8.7{\mu}g/dl$ and $17.3{\pm}1.1g/dl$. The means of above three indicies between two groups showed significant difference statistically (p<0.05). 2. The means of blood lead (PBB), blood ZPP and hemoglobin of workers exposed .to different lead concentration in air were as follows : When it was below $25{\mu}g/m^3$, the indices were $24.7{\pm}79,\;26.1{\pm}26.8{\mu}g/dl\;and\;16.4{\pm}1.1g/dl$ respectively : These indices were $27.1{\pm}8.5,\;23.9{\pm}10.92{\mu}g/dl\;and\;16.2{\pm}1.3g/dl$ when the lead concentration in air was $25{\sim}50{\mu}g/m^3$ : and they were $3.4{\pm}9.3,\;42.3{\pm}31.3{\mu}g/dl\;and\;15.5{\pm}1.2g/dl$ when the concentration of lead was above $50{\mu}g/m^3$. Although there were statistical difference in blood lead and hemoglobin among three different lead concentration in air, there was no statistical difference of blood ZPP among the three groups with different exposure levels (p>0.05). 3. The most frequent by complained symptom was 'Generalized weakness and fatigue', and fewest symptom was 'Intermittent pains in abdomen' 4. Only two symptoms out of fifteen symptoms checked by themselves revealed significant difference between exposed and nonexposed groups. These were 'Intermittent pains of abdomen' and 'Joint pain or arthralgia' (p<0.05), No positive correlation was found between the levels of blood lead and symptom groups categorized as gastrointestinal, neuromuscular and constitutional symptoms, 5. Blood lead (r=0.3995) and ZPP (r=0.2837) showed statistically significant correlation with mean lead concentration in air, whereas correlations were not demonstrated between blood lead and lead related symptoms or blood ZPP and lead related symptoms. 6. Blood lead (PBB) and ZPP showed association (r=0.2466) and the equation PBB=23.75+0.0842 ZPP was derived. 7. On stepwise multiple regression, using blood lead level as a dependent variable and ZPP, hemoglobin (HB), age, work duration (WD) and symptom prevalence as a independent variables, only ZPP significantly contributed a lot to blood lead level. 8. While the ZPP measurement was found to be a good indicator in evaluating health effect of lead absorption in low level lead exposure, lead related symptoms were not sensitive enough to evaluate of lead absorption in low level exposure.

• Journal of Korean Public Health Nursing
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• v.7 no.2
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• pp.53-66
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• 1993

By this time, a few of previous studies of factors related to separation from their jobs and job satisfaction only have dealt with the separation rate. the cause of separation and related factors that induce job satisfaction and incentive factors, the actualities of morale some suggestions for reduction of the separation rate. This study is attempted to determine factors that have effect on job satisfaction of national hospital nurses. and to proide information and materials for the development of the administration of nursing through the appreciation of factors influencing on job satisfaction between isolated ward nurses and general ward nurses working at national hospitals. 185 nurses of national hospitals responsed th this study, and were divided into two groups. Group 1: 57 nurses working at isolated wards for tuberculosis patients and Group 2 : 128 nurses at general wards. Relevant data were collected from August, 5, 1992 through August 20, 1992. The questionnaire consisted of 8 genalized items and 4 items concerning job satisfaction. The collected data were processed with SPSS, and the relationship among vaviables was analyzed by means of $X^2-test$, Pearson Correlation, Multiple Regression. The results of this study are as follows: 1. There is no significant difference between two groups in terms of generalized items. Age distributions show $44.3\%$ under the category of less than 34. and $55.7\%$ under the category more than 35, $19.3%$ was single and $74.6\%$ was married respectively. 2. $79.4\%$ of the nurses have the desire to have in-service education under the satisfactory physical environments such as welfare system, accommodating structures and facilities, instruments or management systems of the hospital, but under the category of unsatisfactory circumstances, $60.3\%$ have the intention of having in- service education. The concern in terms of in-service education shows statistically significant difference between two groups $(X^2=8.85,\;p<0. 05)$. This result accepts the hypothesis that good physical environments could intensify interests in service education. 3. The extent of satisfaction related to psychological environments is heightend according to good physical environments. In result, the hypothesis that the extent of satisfaction in terms of physical environments could raise satisfaction about psychological environment is accepted. 4. In the light of the extent of satisfaction about physical environments, $33.3\%$ of isolated ward nurses are satisfied with physical environments, but only $11.7\%$ of general ward nurses are satisfied. $(X^2=10.88,\; p<0.01)$. This result shows that the satisfaction degree about phusicalenvironments of isolated war nurses was higher than that of general ward nurses in spite of high physical and psychological risks due to exposure to infection. Consequently. the hypothesis was rejected that the satisfaction degree about physical environments would be lower in isolated ward nurses than in general ward nurses. 5. The fact that $87.7%$ of isolated ward nurses took interest in service education and $53.19\%$ of general ward nurses took interest in service education demonstrats that isolated ward nurse have more interest in service education than gerneral ward nurses. The result shows that the hypothesis is accepted that isolated ward nurses would have mor interests in service education than general ward nurses. 6. In the extent of satisfaction about physical environments such as morale human relationship promotion, there is no significant difference between two groups in terms of statistics. The hypothesis is rejected that satisfaction about psychologic environments would be high in isolated ward nurses than in general ward nurses. In conclusion. factors influencing on job satisfaction are considered to have effect on. another, and also interdisciplinary amelioration of factors accompanied with systematic inter cooperative investigation is necessary.

• Journal of Korean Society of Forest Science
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• v.101 no.3
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• pp.333-343
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• 2012

In-stream large wood (LW) has a critical impact on the geomorphic characteristics relevant to ecosystem management and disaster prevention, yet relatively little is known about variations in its dynamics and subsequent export on the watershed-scale perspective in Korea. Here we review variations in the dynamics and subsequent export of LW as a function of stream size, which is appropriate for Korean mountain streams. In upstream channels with narrow bankfull widths and low stream discharges, a massive amount of LW, resulting from forest dynamics and hillslope processes, may persist for several decades on valley floor. These pieces, however, are eventually transported during infrequent debris flows from small tributaries, as well as peak hydrology in main-stem channels. During the transport, these pieces suffer fragmentation caused by frictions with boulders, and stream bank and bed. Although infrequent, these events can be dominant processes in the export of significant amounts of LW from upstream channel networks. In downstream channels with wide bankfull widths and high stream discharges, LW is dominantly recruited by forest dynamics and bank erosion only at locations where the channel is adjacent to mature riparian forests. With the LW pieces that are supplied from the upstream, these pieces are continuously transported downstream during rainfall events. This leads to further fragmentation of the LW pieces, which increases their transportability. With decreasing stream-bed slope, these floated LW pieces, however, can be stored and form logjams at various depositional sites, which were developed by interaction between channel forms and floodplains. These pieces may decay for decades and be subsequently transported as particulate or dissolved organic materials, resulting in the limitation of LW fluvial export from the systems. However, in Korea, such depositional sites were developed in the extremely limited streams with a large dimension and no flood history for decades, and thus it does not be expected that the reduction of LW export amount, which can be caused by the long-term storage. Our review presents a generalized view of LW processing and is relevant to ecosystem management and disaster prevention for Korean mountain streams.

• Journal of Music and Human Behavior
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• v.4 no.1
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• pp.1-20
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• 2007

Mothers of Children with Disabilities have many difficulties in parenting because of their children's disabilities. The purpose of this study was to examine the effects of a Group music psychotherapy programs on parenting stress and self efficacy, and to explore the experiences of the mothers who participated in the program. Twenty mothers of children with disabilities participated in this study. These twenty mothers were divided into 10 mothers of each group. The Experimental group participated in the Group music psychotherapy programs, while the control group did not. The Group music psychotherapy program was implemented for 8 weeks. To prove the effects of the program, pretest-posttest control group design was applied. The differences between pre-test and post-test of two groups were analyzed using independent t-test. The quantitative results of the study were as follows: First, a significant differences was found between the experimental group and control group in parenting stress level. Second, a significant differences was found between the experimental group and control group in self-efficacy level. From the qualitative analyses, four themes emerged from the decrement of parenting stress; Positive change of recognition about their children, Getting rid of stress, Keeping their composure, and Sharing of their emotions. And three themes emerged from the increment of self-efficacy; Discovery of oneself, New stimulus, and Mental support. All the result described above shows that group music psychotherapy program gives positive effect to decrease in parenting stress and also to increase in self-efficacy. And new possibility and effectiveness can be proposed in the music therapeutic approach to the parents of children with disabilities.

• Clinical and Experimental Pediatrics
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• v.51 no.8
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• pp.861-867
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• 2008

Purpose : We carried out this study to determine if there is any difference in the occurrence rate of the epileptiform discharge between awake EEG and sleep EEG and if there are any factors influencing on the occurrence rate of EEG. Methods : This study included 178 epileptic children who had visited neurology clinic of the department of pediatrics, Pusan National University Hospital from July 2005 to July 2006. The medical and EEG records of these children who had had both awake EEG and sleep EEG were reviewed. We analysed the occurrence rate of the epileptiform discharge between awake EEG and sleep EEG. We investigated the related clinical factors which included sex, seizure types, underlying causes, age at first seizure, antiepileptic drug (AED) medication, age at recording, and background activity. Results : Among 178 epileptic children, 91 patients (51.1%) showed epileptiform discharge in awake or sleep states, 10 patients (11.0%) abnormal only in awake, 40 patients (44.0%) abnormal only in sleep, 41 patients (45.0%) abnormal in both awake EEG and sleep EEG. The occurrence rate of sleep EEG was 81 of 178 patients (45.5%) which was more than that of the awake EEG (28.7%) (P<0.001). The occurrence rate of sleep EEG is more than that of the awake EEG regardless of sex and underlying causes. But there is no significant difference from awake EEG and sleep EEG in finding the epileptiform discharge in the patient with generalized seizure, younger than 5 years old at first seizure, younger than 10 years old at recording, no antiepileptic medication, and abnormal background activity. Conclusion : The sleep EEG is thought to be more helpful in the diagnosis of childhood epilepsy.

• Investigative Magnetic Resonance Imaging
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• v.14 no.1
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• pp.47-55
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• 2010

Purpose : To evaluate the geometry of carotid artery by assessing the images of contrast-enhanced MR angiography (CE-MRA) and interrelationships between the geometry of carotid artery and clinical factors. Materials and Methods : 216 consecutive patients who performed supraaortic CE-MRA with fast spoiled gradient-echo imaging were included. Their medical records were reviewed for variable information including risk factors predictive of generalized atherosclerotic disease (age, hypertension (HTN), diabetes mellitus, hyperlipidema, and smoking), sex, body weight, height, and body mass index (BMI). We reviewed the CE-MRA with carotid origin (3 types), carotid artery tortuosity, angle of internal carotid artery bifurcation, the type of aortic arch branching, and the presence of the coiling of carotid artery. Results : Multinomial logistic regression analysis showed that significantly contributed clinical backgrounds for carotid origin were the age and the BMI. With an increase of age at 1, the probability that the type of carotid origin become from type 1 to type 2 was 0.9 times (p=0.004) in right carotid artery (RCA), 0.9 times (p = 0.031) in left carotid artery (LCA), 0.9 times that are likely to be type3 from type 2 (p<0.001) in RCA and 0.9 times in LCA (p=0.009). Increase in BMI at 1 increased odds of becoming type 2 as 1.1 times (p = 0.067) in RCA, 1.1 times (p=0.009) in LCA and increased chance of becoming type 3 as 1.2 times (p = 0.001) in RCA, 1.2 times (p=0.003) in LCA. Mean value of right and left carotid tortuosity were $240.9{\pm}69.0^{\circ}$and $154.4{\pm}55.0^{\circ}$, respectively. Conclusion : The BMI, age, sex and presence of HTN affects the geometry of carotid arteries, the site of origin and tortuosity of carotid artery specifically.

• Clinical and Experimental Pediatrics
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• v.50 no.7
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• pp.672-677
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• 2007

Purpose : To assess the prevalence and characteristics of headache comorbidity with epilepsy in children and adolescents in a specialty epilepsy clinic. Methods : Two hundred twenty nine consecutive patients attending the Chosun University Hospital Pediatric Epilepsy Clinic (mean age $10.0{\pm}4.1\;years$, range 4-17, M:F ratio 1.1:1.0) were interviewed with a standardized headache questionnaire. Headache was classified according to the International Classification of Headache Disorders, 2nd Edition and epilepsy was classified according to the International League Against Epilepsy. Disability was assessed using pediatric migraine disability assessment (PedMIDAS). Results : Of the 229 epilepsy patients, 86 (37.6%) had co-morbid headache. Of the headache patients, 64 (74.4%) had migraine (65.6%- migraine without aura, 20.3% - migraine with aura, 14.1% - probable migraine). The mean headache frequency was $7.2{\pm}8.4$ per month, mean duration was $2.2{\pm}4.0$ hours, mean severity was $5.2{\pm}2.2$ out of 10, and mean PedMIDAS score was $13.0{\pm}35.4$. The proportion of females was not higher in epilepsy with headache patients (48.8%) compared to epilepsy patients alone (48.0%). In the patients with migraine, 48.4% had complex partial seizures, 17.2% had simple partial seizures, and 34.4% had generalized seizures (P=0.368). A postictal association of migraine was reported in 18.8% with 17.2% reporting a preictal headache, and 7.8% reporting an ictal headache. Conclusion : The prevalence of headache in pediatric epilepsy is higher than that in general pediatric population, suggesting a co-morbidity of headache in epilepsy patients with migraine being the most frequent headache disorder. Altered cerebral excitability resulting in an increased occurrence of spreading depression may explain the headache comorbidity with epilepsy. Further studies are needed to assess the etiology of this co-morbidity as well as assess the frequency, duration, severity and disability response to antiepileptic drugs.

• KSCE Journal of Civil and Environmental Engineering Research
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• v.5 no.3
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• pp.49-59
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• 1985

Formulation of the geometric optimization for truss structures based on the elasticity theory turn out to be the nonlinear programming problem which has to deal with the Cross sectional area of the member and the coordinates of its nodes simultaneously. A few techniques have been proposed and adopted for the analysis of this nonlinear programming problem for the time being. These techniques, however, bear some limitations on truss shapes loading conditions and design criteria for the practical application to real structures. A generalized algorithm for the geometric optimization of the truss structures which can eliminate the above mentioned limitations, is developed in this study. The algorithm developed utilizes the two-phases technique. In the first phase, the cross sectional area of the truss member is optimized by transforming the nonlinear problem into SUMT, and solving SUMT utilizing the modified Newton-Raphson method. In the second phase, the geometric shape is optimized utilizing the unidirctional search technique of the Rosenbrock method which make it possible to minimize only the objective function. The algorithm developed in this study is numerically tested for several truss structures with various shapes, loading conditions and design criteria, and compared with the results of the other algorithms to examme its applicability and stability. The numerical comparisons show that the two-phases algorithm developed in this study is safely applicable to any design criteria, and the convergency rate is very fast and stable compared with other iteration methods for the geometric optimization of truss structures.